Paul Grundy, MD, MPH, global director of Healthcare Transformation at IBM, was one of the plenary speakers at "Building the Patient-Centered Medical Home: Inspiration and Tools to Help Transform your Practice."

College hosts conference about Patient-Centered Medical Home

College of Community Health Sciences faculty and staff, along with healthcare providers from Tuscaloosa and across the state, gathered for a two-day study and discussion on the Patient-Centered Medical Home.

The Patient-Centered Medical Home (PCMH) is a model of primary care delivery that is patient-centered, comprehensive, coordinated, accessible and focuses on quality and safety, according to the Agency for Healthcare Research and Quality.

The College hosted the conference “Building the Patient-Centered Medical Home: Inspiration and Tools to Help Transform Your Practice” on July 25 and 26 at Hotel Capstone on The University of Alabama campus. The conference was held to educate physicians and other health-care providers on how to incorporate this model into their medical practices.

“It’s about moving forward,” said Richard Streiffer, MD, Dean of the College, in his welcoming address. “That’s really what this conference is all about. It’s about moving forward as a College and a community with this concept of the Patient-Centered Medical Home.“

The conference featured experts in the concept of the Patient-Centered Medical Home (PCMH), implementers of pilot programs, leaders in family- and patient-centered health care and experts in the business side of the PCMH.

One of those speakers was Paul Grundy, MD, MPH, global director of Healthcare Transformation at IBM, where he develops strategies to shift health care delivery toward consumer-focused, primary-care based systems through the adoption of new philosophies, primary care pilot programs, new incentive systems and the information technology required to implement such changes. As a founding father of the PCMH, Grundy said that the medical home it isn’t a literal home for patients, but rather for data.

“Data is now made available, and it has to go somewhere and be acted on. And there has to be accountability that it is being acted on.”

Acting on that data means that every patient has a health-care plan that is managed by a team of providers, which overall, leads to promoting a healthy population, Grundy said. Another part of the PCMH is the idea of a medical neighborhood, Grundy said, or a model where primary care physicians work with specialists to provide comprehensive care for patients.

“This is not just about health care,” Grundy said. “This is about value for your state and for your community.”

The second plenary speaker at the conference was Beverley Johnson, president and CEO of the Institute for Patient- and Family-Centered Care in Bethseda, Md. Johnson served as a project director for a multi-year initiative to develop resource materials for senior leaders in hospital, ambulatory and long-term care settings on how to partner with patients and families to enhance the quality, safety and experience of care. In her talk, she focused on both patient-centered and family-centered health care and how the PCMH is a culture shift in health care.

“This is about culture change—it’s about the work you’re going to do together to profoundly change the culture of health-care organizations.”

Melly Goodell, MD, chair of Family Medicine at MedStar Franklin Square in Baltimore, MD, oversaw the 2011 achievement by MedStar’s Family Health Center of Level III NCQA Patient-Centered Medical Home status and the center’s acceptance as one of the 50 statewide practices into Maryland’s three-year PCMH Pilot Program, so she spoke about the process of changing into a PCMH as the morning plenary speech for the second day of the conference.

“[Change] is hard,” she said. “But you really do need to have an approach and some guiding principles around change.

Michael Canfield, MD, associate chief of staff of Ambulatory Care for the Central Alabama Veterans Health Care System in Montgomery, Ala., gave the lunchtime plenary speech later that day. Canfield worked as a family physician and was a partner with Palmetto Primary Care Physicians in Summerville, S.C. Palmetto is an organization of more than 90 physicians and 650 clinical and support staff who practice primary and specialty care at 32 offices in South Carolina.

Canfield talked about the business side of the PCMH model. He outlined the keys to success for Palmetto.

“The quality of the care of patients is the cornerstone of the group.” Canfield said. “And corporate decisions must have the consensus of the group and be for the good for the group.”

Other speakers included Mary Coleman, MD, PhD, professor of family medicine and director of community health clinics at Louisiana State University School of Medicine, who spoke about population and patient-care management; Melanie Tucker, PhD, assistant professor of Community and Rural Medicine and director of clinical investigations at the College, who spoke on leading patients to better health through health coaching; Sylvia Brown, executive director of Gulf Coast Patient Care Network, and Chelley Alexander, associate professor and chair of Family Medicine at the College, both of whom spoke about innovative care delivery.

At the end of the conference, Candice Biby, program coordinator for Family Medicine at the College, hosted a question-and-answer session about NCQA certification.

The College also hosted an evening event on Friday night at Hotel Capstone that was open to the public. “Better Care, Better Value: The Business Case for the Patient-Centered Medical Home,” started with remarks by Grundy and featured a discussion panel about the business side of the PCMH and included Grundy, Goodell, Kathleen Bowen, MD, medical director of BlueCross BlueShield of Alabama, and Robert Moon, MD, chief medical officer for Alabama Medicaid.

Medical students inducted into Gold Humanism Honor Society

Medical students of the College of Community Health Sciences were inducted this month into the Gold Humanism Honor Society, a signature program of the Arnold P. Gold Foundation established to recognize medical students, residents and faculty who practice patient-centered medical care by modeling the qualities of integrity, excellence, compassion, altruism, respect and empathy.

Stevie Nichole Bennett, Anna Eunjoo Choe, Jacquelynn Kristina Parks, Shweta Naran Patel and James Anthony Raley, were the Class of 2015 inductees at the College, which serves as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, headquartered in Birmingham.

Amber Michelle Beg, John Thomas Killian, Jr., and Paul Frederick Sauer, Jr., were the inductees from the campus’ Class of 2016.

“Being inducted into the Gold Humanism Honor Society is really a special honor for these students,” says Heather Taylor, MD, assistant professor of Pediatrics and director of Medical Student Affairs. “They have been recognized by their peers for representing the ideals of compassionate, empathetic patient care. We could not be prouder of these students.”

The students’ nominations for the honor society originated from their student peers’ observations of their characteristics related to humanism. A selection committee then evaluates the nominees’ academic eligibility, along with program director evaluations and essays indicating the students’ willingness and qualifications of to serve if selected. About 10 to 15 percent of each class is selected to membership, says Brook Hubner, program director of Medical Education for the College.

There are more than 19,000 members nationally in training and practice.

 

Daniel Avery, MD, (right) professor and chair of the Department of Family Medicine, was the recipient of the Louis W. Sullivan, MD, Health Policy Leadership Award. Sullivan (left) presented the award to Avery on behalf of the American Board of Physician Specialists.

Faculty receives Louis W. Sullivan, MD, Health Policy Leadership Award

Daniel Avery, MD, professor and chair of the College of Community Health Sciences’s Department of Obstetrics and Gynecology, was the 2014 recipient of the Louis W. Sullivan, MD, Health Policy Leadership Award, presented by the American Board of Physicians Specialists (ABPS).

The award, named for Louis W. Sullivan, MD, the former Secretary of the U.S Department of Health and Human Services during the George H. W. Bush administration (1989-1993) and the founding dean of Morehouse School of Medicine in Atlanta, Ga., is presented to a physician who has served as a champion of major health policy changes and an advocate for health policy improvements. According to the ABPS, the award goes to someone who has made an outstanding contribution to improve the health status of an individual, a group of people, or a population.

The award was established in 2012 and was first presented to Omofolasade Kosoko-Lasaki, MD, associate vice president of Health Sciences and professor of surgery (opthamology), preventative medicine and public health at Creighton University School of Medicine in Omaha, Neb. She, in turn, nominated Avery for this year’s award.

Avery worked with Kosoko-Lasaki at the American Academy of Surgery, and she nominated Avery for his work as a family medicine physician who also provides obstetrical care in rural areas, including Winfield, Ala., where he has practiced since he completed his residency and currently provides obstetrical care for about 4,000 patients. Avery also provides obstetrical care to the Demopolis community after its Bryan Whitfield Memorial Hospital closed its labor and delivery unit earlier this year.

Kosoko-Lasaki also recognized Avery’s work with medical students who choose to practice family medicine in rural areas, Avery says. The College serves as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, which is headquartered in Birmingham. Avery says that Kosoko-Lasaki also cited his work with the Alabama Family Practice Rural Health Board.

“I am honored to have received this award,” Avery says. “The best part about it was that Dr. Sullivan came to the ABPS meeting and presented me with the award.”

Sullivan, who is now retired, remains, according to Avery, “a champion for the rural, underserved and minority populations.” He is a public member of the AAPS Board of Directors and chairman of the board of the National Health Museum in Atlanta.

According to the Alabama Department of Public Health, the lack of OB/GYN services in rural counties makes it challenging for rural residents to receive adequate prenatal care. In Alabama, 25.9 percent of the live births in 2012 occurred with less than adequate prenatal care, according to the ADPH and the Adequacy of Prenatal Care Utilization (Kotelchuck) Index. The lack of adequate prenatal care can lead to problems and complications, according to the U.S. Department of Health and Human Services. Babies of mothers who do not receive prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care, the department says.

Chelley Alexander, MD, (left) former Chair of the Department of Family Medicine, and Ricky Friend, MD, Residency Director and new Interim Chair of the Department of Family Medicine

Residency Director named Interim Chair of Family Medicine

Richard Friend, MD, director of The University of Alabama Family Medicine Residency • Tuscaloosa and vice chair of the College’s Department of Family Medicine has been named interim chair of the department.

Friend will continue to serve as director of the residency, one of the oldest and largest in the country and part of the College. He replaces Chelley Alexander, MD, an associate professor who has served as chair of the department since 2006. Alexander recently accepted the position of chair of the Department of Family Medicine at East Carolina University’s Brody School of Medicine in Greenville, N.C., and begins work there next month.

“I am looking forward to stretching my skills and talents to lead a bigger department, and continuing their legacy as a great place to train primary care physicians,” Alexander says. She added: “I have spent 20 wonderful years at CCHS, first as a medical student and then as a resident, affiliate faculty member, assistant residency director, residency director, assistant dean and chair. To my department, it has been an honor to serve as your chair over the last nine years. To all my colleagues, I think the College is well poised to continue its exceptional training of students and residents for the state of Alabama.”

Richard Streiffer, MD, dean of the College, thanked Alexander for her years of service. “Thank you for your dedication and hard work these many past years and we wish you all the best.”

Photo Credit: Associated Press

HIV/AIDS has migrated to Deep South, where stigma endures, Al-Jazeera America reports

When Pamela Payne Foster, Associate Professor in the College of Community Health Sciences’s Department of Community and Rural Medicine and Deputy Director of the College’s Institute for Rural Health Research, came to Alabama in 2004, she started an HIV/AIDS tour through the Black Belt to raise awareness and increase testing.

“We did town hall meetings and we wanted people to come out and get tested,” she said. “No one showed up.”

Foster studies the spread of HIV in the South. She said that when she interviews people living with HIV in rural Alabama, they regularly list church as the place they feel most stigmatized.

Lea Yerby, PhD, assistant professor in Community and Rural Medicine and the Institute for Rural Health Research, presents at the annual Alabama Academy of Family Physicians meeting.

College faculty present at annual Alabama family physicians meeting

Presentations were made at the annual Alabama Academy of Family Physicians meeting by College of Community Health Sciences faculty. The meeting, held June 26 – 29, 2014, in  Sandestin, Fla., provides networking opportunities and Continuing Medical Education to family physicians, physicians assistants, residents and medical students from across Alabama.

An entire day of lectures was presented by the College on Saturday, June 27, the third day of the conference. Faculty presented new information respective to their specialties.

Presenting on autism screenings and the role played by family medicine physicians in early detection and intervention were Lea Yerby, PhD, assistant professor in Community and Rural Medicine and the Institute for Rural Health Research; and Angela Barber, PhD, assistant professor in communicative disorders at The University of Alabama.

The prevalence of autism in Alabama per thousand is 5.7, while the national prevalence per thousand is 14.7, they said. The reason for the discrepancy is a screening issue, Yerby said. And the key to more screenings and early intervention is for family medicine physicians and autism specialists to work together.

Ninety two percent of parents of a child with autism first expressed concern to their primary care provider, Yerby said.

“It takes two—screeners and family physicians. Neither of them can do it alone. But those two combined are really where we move forward, where more children are less likely to fall through the cracks.”

Scott Arnold, MD, associate professor and chair of the Department of Internal Medicine, presented new findings in adult medicine literature from 2013 to 2014. Some areas Arnold covered included diabetes prevention and care, treatment of heart disease, blood clotting, intracranial stenting, sepsis, hepatitis C screening and treatment, low testosterone treatment, and lung, colon and cancer screenings.

Jerry McKnight, MD, a professor of Family Medicine, presented a clinical case study of 10 patients with one common etiology: hereditary hemochromatosis. The case study was presented in a typical grand rounds fashion, presenting the symptoms to the attendees of the patients and leading into the diagnosis.

Following McKnight was Richard Friend, MD, director of the The University of Alabama Family Medicine Residency • Tuscaloosa (operated by the College), who wrapped up the day with a presentation on critical care and emergency room medicine for family physicians. Many physicians present during his presentation indicated they work in some sort of emergency medicine capacity.

Friend discussed the role of family physicians in the ICU, common trends and diagnoses in an emergency setting and various procedures such as intubating, performing a lumbar puncture and atrial fibrillation.

“You have to have a heightened sense of awareness to [practice emergency medicine] and do it well,” he said. “The key is to really be aware of common procedures and to always practice evidence-based medicine.”

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

College to host Patient-Centered Medical Home conference

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

The College will host a conference in July that focuses on the Patient-Centered Medical Home (PCMH) and ways that physicians and other health care providers can incorporate this model of care into their medical practices.

The conference, “Building the Patient-Centered Medical Home: Inspiration and Tools to Help Transform Your Practice,” will be held July 25-26 at Hotel Capstone on The University of Alabama campus.

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

In his role at IBM, Grundy (known as the “Godfather of the PCMH) develops strategies to shift health-care delivery toward consumer-focused, primary-care based systems through the adoption of new philosophies, primary-care pilot programs, new incentive systems and the information technology required to implement such changes.

The Patient Centered Primary Care Collaborative works to advance an effective and efficient health-care system built on a foundation of primary care and the PCMH.

“As a College, we are interested in not only transforming our own practice into this PCMH approach, but also helping to move the bar and further the transformation of medical care in our area,” says Richard Streiffer, MD, dean of the College. “That is part of our mission and that is really the motivation for the conference. It is a tool for us internally as well as at the community level to increase awareness, create dialogue and learn from experts with experience in this transformative process.”

According to the Agency for Healthcare Research and Quality, the PCMH is best described as a model of primary care delivery that is patient-centered, comprehensive, coordinated, accessible, and that focuses on quality and safety.

The name PCMH can be confusing because in this case a medical home is not a place but rather a philosophy of providing care. All the attention to patients is not an extravagance. Heading off problems in the doctor’s office often keeps patients out of the emergency room or from being readmitted to the hospital, both costly forms of health care. The PCMH has also been shown to help patients manage chronic health conditions, which account for an estimated 75 percent of all U.S. health care spending.

In addition to Grundy, other keynote speakers at the conference will include: Beverley Johnson, president and CEO of the Institute for Patient- and Family-Centered Care in Bethesda, Maryland; Melly Goodell, MD, chair of the Department of Family Medicine at MedStar Franklin Square in Baltimore, Maryland, a state that is three years into a PCMH pilot project; and Michael Canfield, MD, associate chief of staff of Ambulatory Care for the Central Alabama Veterans Health Care System.

CME, as well as CEUs for nursing and social work, will be provided at the conference. For more information, visit the conference website at http://cchs.ua.edu/pcmh.

New family medicine physicians, fellows recognized at graduation

Twelve physicians graduated from The University of Alabama Family Medicine Residency on June 22 and will soon start practices in Alabama, Georgia and Tennessee.

The residency, which is operated by the College, provides physicians with three years of specialty training in family medicine. Founded in 1974, the residency is one of the oldest and largest in the United States. With the current class, the residency has graduated a total of 435 physicians who are practicing in 29 states.

Fellows were also recognized at the graduation ceremony, which was held at the South Zone in Bryant-Denny Stadium. The College offers one-year fellowships in sports medicine, hospitalist medicine, obstetrics, behavioral health and rural public psychiatry. The fellowships provides additional training for family medicine physicians in other specialty areas.

“This will be an exciting time for you, and there will be some anxiety as you enter the new world of practice,” Richard Streiffer, MD, dean of the College and a family physician, told the graduates. “In five or 10 years our discipline is going to be very different than it’s been during your residency, and I think it will be better. We’re seeing how we are being asked to be players in the healthcare system. At last the country is waking up to the fact that what we do as family medicine physicians is essential.”

Robert Ireland, MD, who recently retired from the College’s Department of Family Medicine after 22 years, was the graduation keynote speaker. He said connecting and building trust with patients is key.

“Over the last three years, we’ve given these young doctors an opportunity to develop their medical skills, but after the science, it’s all about how we treat people,” Ireland said. “Even with all the advances in medicine, it’s still pretty much observational in primary care and connecting with patients as only we in primary care can do.”

He told the graduates: “You are unequivocally ready for practice. Be confident that you are prepared for that responsibility.”

2014 residency graduates and where they will practice

Megan Bullard, MD – Muscle Shoals, Ala.

Mark Christensen, MD – Marshall County, Ala.

William Clifford, MDNATO peace-keeping mission in Kosovo

Jeffrey Colburn, MD – Dalton, Ga.

Alisha Congress, DO – Hueytown, Ala.

Tamer Elsayed, MD – Tuscaloosa, Ala.

J.D. Engelbrecht, MD – Buchanan, Ga.

Danielle Henson, DO – Columbia, Tenn.

Maury Minton, MDGadsen, Ala.

Cynthia Mouton, MD – Demopolis, Ala.

Jonathan Parker, DO – Muscle Shoals, Ala.

Saman Razzak, MD – N/A

Fellowship graduates recognized

Scott Boyken, MD – Sports Medicine

Friederike Fischer, MD – Hospitalist Medicine

Bruce Lovins, MD – Hospitalist Medicine

Bhavik Patel, MD – Hospitalist Medicine

Shelley Waits, MD Obstetrics

College welcomes new fellows

In July, the College of Community Health Sciences welcomes five new fellows to three of the College’s fellowship programs: Lauren Linken, MD, will join the Obstetrics Fellowship; Shazia Malik, MD, and David Aymond, MD, will join the Hospitalist Fellowship; and Blake Perry, MD, and Jeremy Coleman, MD, will join the Sports Medicine Fellowship.

These fellowships, along with a Behavioral Health Fellowship in Family Medicine and a Rural Public Psychiatry Fellowship, make up the College’s post-residency training programs and provide family medicine residency graduates with training and expertise in a selected sub-specialty.

“While a fellowship is not for everyone, a significant number of family physicians today are seeking additional training in order to gain specialized expertise in a subset of the broad field of family medicine,” says Richard Streiffer, MD, dean of the College.

The Obstetric Fellowship, a 12-month training program, is aimed at addressing the overwhelming need for obstetric care in rural and remote areas. As the attrition of OB/GYNs in the United States exceeds the number of physicians completing OB/GYN residency programs and entering general OB/GYN practice, programs training family physicians to provide quality obstetrical care will continue to grow in importance.

“Family medicine physicians trained in obstetrical and newborn care is the answer to reducing perinatal morbidity and mortality, not only in Alabama, but throughout the United States,” says Daniel Avery, MD, professor and chair of Obstetrics and Gynecology at the College.

Linken is a graduate of the University of Alabama School of Medicine and recently completed a residency in Family Medicine and Community Health at the University of Massachusetts Medical School.

A program of both the Department of Internal Medicine and the Department of Family Medicine at the College, the Hospitalist Fellowship is designed to assist family physicians in obtaining the skills necessary to provide inpatient care appropriate to the existing and future needs of urban, rural and underserved areas.

This 12-month training program will be joined by Malik, a graduate of the Medical School of the Americas in Nevis, West Indies, who completed a family medicine residency at Western Michigan School of Medicine in Kalamazoo, and Aymond who received his medical degree from Ross University School of Medicine and completed a family medicine residency at Rapides Regional Medical Center in Alexandria, La., where he was appointed chief resident in 2013.

Perry, a graduate of the University of Alabama School of Medicine who gained his clinical training at the College, recently completed the Wake Forest Baptist Family Medicine Residency.

Coleman completed his medical degree at Duke University School of Medicine in Durham, N.C., and his residency in family medicine at Louisiana State University in New Orleans.

Both Perry and Coleman come to the Sports Medicine Fellowship with significant experience in sports medicine that will benefit them as they work through the 12-month training program under the supervision of James Robinson, MD, professor and endowed chair of Sports Medicine at the College.

Robinson also serves as the team physician for The University of Alabama football team.

“Fellowships are an important component of our graduate medical education offerings, and something we hope to expand in future years, for example in geriatrics, and perhaps women’s health,” says Streiffer. “These fellowships will prepare family physicians to better serve a need in their community or practice, to provide leadership in that area or to prepare them for a future academic role.”

Scarbrough selected to prestigious fellowship

Cathie Scarbrough, MD, an assistant professor in the College’s Department of Family Medicine and assistant director of The University of Alabama Family Medicine Residency, was selected to the University of North Carolina Faculty Development Fellowship in Chapel Hill.

This mid-career program for medical educators has a history of developing graduates for careers as leaders in family medicine education. The program is a one-year commitment, including six weeks in the Family Medicine Residency at Chapel Hill, and includes training and experiential projects in medical education, teaching, management and scholarship.

Scarbrough started the program in June, joining the 36th fellowship class, which consists of a diverse group of educators coming from a variety of community, university and military family medicine programs.

Jared Ellis, MD, an assistant professor in the College’s Department of Family Medicine and associate director of The University of Alabama Family Medicine Residency, recently completed the fellowship.

“The opportunity to interact with and learn with leading peers from around the nation has been an incredible opportunity,” Ellis says.