How often do you walk into a room and completely forget why you went into the room? Or do you struggle with remembering someone’s name a few seconds after they introduce themselves to you? It seems that these “senior moments” occur more frequently as we all get older. As a clinical neuropsychologist, I am often asked if this is normal aging or if it is a sign of a bigger problem such as Alzheimer’s disease. The field of neuropsychology is uniquely skilled to answer this very question. Clinical neuropsychology is a sub-field of psychology which examines the relationship between the brain and behavior. It uses neuroscience, neuroanatomy, cognitive psychology, cognitive science and clinical psychology to understand the structure and function of the brain in relation to behavior and the information processing aspects of the mind. Neuropsychologists help to assess, diagnosis and treat individuals with neurological, medical, developmental or psychiatric conditions across the lifespan. Neuropsychological testing can aid in understanding how different areas of the brain are working. Neuropsychologists use various standardized tests to objectively examine a person’s strengths and weaknesses in all areas of thinking or cognition. Tests may be paper-and-pencil, answering questions, computer-based or task oriented. Areas of cognitive impairment or deficit can be identified and placed within the context of the individual’s medical and psychological history in order to determine what condition may be impacting a person’s functioning and thinking.
Studies have shown that almost 9 out of 10 adults have difficulty using the health information they receive. This difficulty reflects a gap in patients’ capacity to obtain, process, and understand basic health information and the services needed to make appropriate health decisions. In other words, the studies reflect a gap in health literacy.
It’s been more than twenty years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviate the burdens, and focus attention on alternatives that better reflect the current practice of medicine. The implementation of electronic medical records has allowed providers to document more information, yet repetitive templates, cloning, and other workflows have pushed the envelope on compliance in documenting the traditional elements of the visit.
As the summer months are a time when many people take vacations, it is a good time to get veins treated. So, today, we are decoding the facts about one of the latest minimally invasive technology offerings at the Alabama Vein Center: VenaSeal™ closure system.
One of the most frustrating things PC users can experience is slow performance or freezing while using their normal programs. It can make even the simplest tasks take several times longer and greatly slow down your work day, which impacts patient care as well. While it will sometimes mean there could be hardware issues and your PC needs an upgrade, there are several steps that you and your IT support can take to speed up the performance of your PC through cleanup tools, anti-virus and anti-malware scans, or optimizing settings.
Benign Prostatic Hyperplasia, or BPH, is a common condition that a lot of men will experience as they age. The prostate, which is involved in male sexual function, sits at the neck of the bladder. I tell my patients that, as it enlarges, it’s like putting your thumb on the end of a water hose. It requires more force to push the urine out effectively. Symptoms can arise as early as our 30’s and perhaps 50% of us will have issues by our 60’s. It causes all sorts of symptoms including slowing of the urinary stream, incomplete bladder emptying, frequent or urgent urination, urinary retention and nocturia. Unfortunately, a large percentage of men will simply ignore these symptoms and just chalk it up to “old age.” Not only can these symptoms be bothersome but, in some cases, it can lead to significant bladder dysfunction, kidney issues, infections, etc
Venous ulcers of the lower extremities can be a frustrating disease process for clinicians. Do I send them to wound care center (WCC), do I need to order specific studies, are they venous or arterial?
Atrial Fibrillation (AF) is the most common abnormal heart rhythm which can cause adverse clinical outcomes such as stroke and heart failure. An estimated 2.7 to 6.1 million people have AF in the United States. As the prevalence of AF increases with increasing age, with an aging population, prevalence of AF is expected to double in the next 2-3 decades. People above the age of 40 years have a 1 in 4 chance of developing AF in their lifetime. Patients with AF are 6-7 times more likely than general population to suffer from a stroke.
What is the importance of occupational and physical therapy rehabilitation? Each discipline has its own unique benefits for clients of all age ranges with varying diagnoses and various settings. A common misconception regarding therapy in general is that treatment will elicit pain and discomfort. However, one of the primary goals of both occupational and physical therapy is to control pain in order to increase daily function and skill.
Many Alabama providers participated in the Quality Payment Program in 2017, under MIPS (Merit Based Incentive Program). A handful participated in a MIPS APM (Alternative Payment Model), which is a baby step towards alternative payments, but still left the participants free from downside risks. As we pass the half-way point for the 2018 performance period, exploring risk bearing programs is on the rise.
Is your EHR application in the cloud or are you considering moving to a cloud based provider? If so ensuring that you know the providers processes for data backup, disaster recovery and overall security are extremely important.
Children’s of Alabama in collaboration with the Anne B. LaRussa Foundation of Hope launched a new service in March 2018 targeting patients, families and providers who seek better access to mental health care resources. The Psychiatric Intake Response Center, or PIRC, located in Children’s Emergency Department, is staffed by licensed mental health clinicians who, via telephone or in person, assess a child or adolescent’s mental, emotional and behavioral needs, and recommend the best treatment options.
Dr Beth Malizia and Alabama Fertility Specialists are thrilled to announce the first pregnancy in the state of Alabama from a new technology that allows for the intra-vaginal culture of embryos. This new technique using a device (INVOcell) cultures embryos within a patient’s vagina rather than utilizing the complex incubators of an IVF laboratory.
I find it intriguing that physicians are one of the only professionals who pledge an oath before practicing their craft. Other notable “oath” moments in our country focus mainly on Nationalism and Service (Military, Law Enforcement, Public Servants and Naturalization among others). How different might some professionals behave, if included in their daily duties, was the acknowledgement that they are working under an assumed set of values and principles that help guide their tasks? For CERTIFIED FINANCIAL PLANNER™ professionals this exists, not in an oath form however; but within principles expressing ethical and professional ideals.
“We’re all wearing our team colors, but colors don’t matter when it comes to concussion,” says Dr. Jimmy Robinson, University of Alabama lead team physician. This year, at the Children’s of Alabama Annual Concussion Summit, a special science, vision, and engineering breakout session featured the insight of Dr. Robinson and others in the trenches of Division I sidelines. Led by UAB’s director of medical athletics, Dr. Heath Hale, and UAB Team Eye Doctor, Dr. Kathy Weise, lead team physicians and scientists from Alabama, Auburn, Florida and Clemson joined forces to weigh in on UAB’s advancements in concussion expertise. What if a contact lens could determine how much the eye sloshes around in the orbit to predict how much the brain moves in the skull when exposed to impact? What if retinal blood flow could predict cerebral blood flow following concussion? What if an objective pupil test could help predict prolonged concussion recovery?
Fraud. It’s an ugly thing and it’s everywhere, the medical industry is no exception. When most people think about fraud, they think about white collar criminals stealing millions of dollars from big name companies, or the “dark web” where most of our social security numbers and credit card numbers are floating around just waiting for a buyer. The truth is most businesses will experience some type of fraud during their operation. It is so important for owners and business managers to be constantly vigilant to protect their practices.
One of the greatest challenges facing the healthcare industry isn’t a political issue, it’s a geographic issue. What if I told you that approximately 50 million Americans (17 percent of the total population of the US) have limited access to high quality healthcare because they live in rural communities? Rural healthcare has a unique set of challenges including not only geographic but also economic and lifestyle factors.
Unfortunately, yes! Diabetes is the leading cause of new cases of blindness in adults ages 20-74 in the U.S. African Americans are two times more likely to have diabetic eye disease than Caucasian patients. Despite the risk of vision loss, only about half of people with diabetes follow the recommendation to receive a dilated eye exam every year.
Those of us who live in the South are pretty familiar with hot weather, but as we get into the dog days of summer, the heat can become excessive and oppressive. All the normal rules for heat and sun safety apply, but as temperatures soar, you may need to take more extreme measures to stay cool and safe.
Over 10 million people in the Unites States and over 200 million worldwide have peripheral arterial disease (PAD).1 Critical limb ischemia (CLI), defined as ischemic rest pain or tissue loss resulting from arterial insufficiency, affects approximately 1% of the adult population, or 10% of patients with PAD.2 Further increasing the impact of CLI is the poor prognosis it carries. Major amputation occurs in 33-67% of patients with ischemic tissue loss at 4 years.3,4 Mortality at 2 years in CLI patients is as high as 40%, and appears to be even higher in those with tissue loss. The vast majority of these deaths are due to cardiac events, cardiovascular disease, and cancer, rather than PAD.4,5
Where are the old (and not so good) days when a patient with myocardial infarction was staying in hospital bed for a week?
Other than skin cancer, prostate cancer is the most common cancer in American men. Although it is common, it is still one of the least well-known cancers and a diagnosis can cause confusion about treatment, symptoms, and potential side effects. In search of a minimally-invasive treatment for your prostate cancer? Through our partnership with Vituro Health, Urology Centers of Alabama is the first and only in the state to offer High Intensity Focused Ultrasound, or HIFU treatment.
Malware are created with the intent to damage or disable our mobile devices, computers or servers. These attempts can include disrupting computing or communication operations, trying to steal sensitive data, accessing our private networks, or hijacking our systems to exploit their resources. With the tremendous growth in email and internet use over the last couple of decades, we have seen a corresponding explosion of growth in malware
I recently visited a specialty practice at a major health system. As I approached the registration desk a posted sign directed me to a standing kiosk to sign in. The family member I accompanied to the visit was unable to stand at the kiosk, so I provided the needed information and signed her in. Although it was a quick and seamless process, I was concerned because if I needed assistance, there were no employees to ask. Many practices have implemented kiosk sign-ins and have someone to assist a patient with the process if needed. Practice administrators have made the decision to implement kiosk to assure verification of the current insurance policy and prompt the patient to pay any out of pocket expense before they see the doctor. Many of the kiosk solutions allow a pre-registration via email to allow the patient to populate data and upload information from their own device at their convenience. Benefits of Kiosk Sign-ins include: reduction in the staffing at the front desk, decrease in patient wait time, and most impressively is the increase of time of service collections.
One of the greatest challenges healthcare organizations face today is clinical application interoperability – the communication between computer systems, applications, or software to allow them to work in conjunction with one another.
Medical advancements through specialized programs and essential personnel are vital to the continued growth of the University of Alabama at Birmingham (UAB) Division of Pediatric Neurology at Children’s of Alabama. Expansion is underway while the unremitting needs of patients are met.
The CDC estimates that 1.2 million people in the United States have chronic Hepatitis B (HBV) but two-thirds do not know they are infected. These unaware patients can have clinically silent infections for decades until developing cirrhosis, end-stage liver disease, or hepatocellular carcinoma (HCC). HBV is transmitted by percutaneous or mucosal exposure to blood or body fluids of an infected person, such as from an infected mother to her newborn during childbirth, through close personal contact within households, through unscreened blood transfusion or unsafe injections in health- care settings, through injection drug use, and from sexual contact with an infected person.
"I believe it was divine intervention that I was sent to Aspire Physical Recovery Center at Cahaba River. The therapy team brought me back to myself."
The question is often asked, at what point should a patient and his or her physician begin to consider a total joint replacement?
It is especially important for smaller practices to be mindful of Electronic Protected Health Information (ePHI) security regulations – a breach of ePHI can lead to costly notification requirements and potential monetary penalties under the HITECH Act. Managing physicians of small independent practices hold many responsibilities, including the duty to comply with the Security Rule within HIPAA regulations. This article provides a brief overview of federal ePHI compliance safeguards required in a practice. While not meant to be a comprehensive discussion of all requirements, it highlights legal considerations and safeguards a practice must implement to comply with HIPAA ePHI regulations. The federal Security Rule under HIPAA requires a health care provider (typically known as a Covered Entity) to have the minimum ePHI safeguards, listed below.
Mitral valve regurgitation has been described as a very common cardiac valvular abnormality which is under recognized and under treated even in industrialized countries
As today’s healthcare drive pushes practices even further down the path of pay for performance versus the older models of pay for volume, administrators and executives throughout healthcare are researching and implementing ideas to provide an overall better experience for patients.
Pelvic organ prolapse (POP) is the descent of one or more parts of the vagina and/or uterus. Woman may experience displacement of the anterior, posterior or apex of the vagina, and often there is a combination. This is referred to as a cystocele, rectocele and enterocele.
According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.
More than 10 million people in the United States are affected by Peripheral Artery Disease (PAD). About one in every twenty Americans over the age of 50 has PAD. Smokers are four times more likely to develop the condition. Peripheral Artery Disease is a strong indicator for potential heart attack and stroke. Most people are aware of coronary artery disease but few know the symptoms of vascular disease. The most common symptom of PAD in the lower extremities is a painful muscle cramping in the hips, thighs and calves when walking or exercising. Other symptoms to be aware of are leg numbness, skin discoloration of the legs or toes & loss of hair on the lower legs.
Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners! Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.
In 2012, I read this article that made me question much of what I thought I knew about my profession of serving clients as a guide for their financial decisions. The designation following my name for which I had worked so hard at obtaining? Good, but not enough. The incredible technology –from complex financial forecasting to automated investment management? Lacking.
On Friday, January 19, 2018, the Department of Health and Human Services (HHS) issued a proposed rule that will complicate the issues healthcare providers face in providing treatment to LGBTQ patients.
According to the Ponemon Institute – www.ponemon.org - the average cost of a data breach was $3.62 million dollars. This breaks down to $141 dollars per stolen record. International Data Corporation – www.idc.com – estimates that globally data storage will grow ten-fold by 2025 total of 163 zettabytes (a trillion gigabytes) by 2025. Data is stored in a vast range of devices including your smart phone, laptops, notebooks, workstations, tablets and even on your smart TV. Most businesses focus on the technical aspects of how to avoid data breaches (firewalls, anti-virus, security patches, etc.) and often how physical technical assets are destroyed at the end of their life are often overlooked or do not have a set process in place.
Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women1. While the disorder was originally described in 19402, lipedema remains under-recognized and underdiagnosed in the United States3. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.
Almost everyone has seen the ads for the new anticoagulants at this point. However, many Americans still remain in the dark regarding what atrial fibrillation (Afib) is and it’s potentially devastating consequences. Despite increasing efforts to improve the awareness for atrial fibrillation, many still do not know it’s signs and symptoms or that it is a progressive disease. Afib is the most common arrhythmia in the world affecting 3-6 million Americans with projections of up to 16 million by the year 2050.
2018 marks 23 years since Children’s of Alabama entered the primary care market, expanding our footprint and brand awareness outside of our main campus on Birmingham’s Southside and strengthening our relationship with doctors who care for kids.
They were surprised, and you likely be will, too. Of the hundreds of healthcare organizations I’ve helped document HIPAA and meet compliance requirements, most are unaware that their Patient Health Information (PHI) is exposed in some way. If a cyber attacker took advantage of this situation, it could cause damage to your patients, bring giant HIPAA fines, and a loss of reputation.
A rare cancer of the eye known as uveal melanoma has affected a specific demographic, mainly women, who attended Auburn University in the late 1980’s and early 1990’s. Uveal melanoma is the most common cancer in the eye, but overall its incidence is extremely low, known to affect only 4.3 per 1 million people in the US. While these cancers are uncommon, they can lead to unfortunate outcomes including total removal of the eye, and even aggressive cancers spreading throughout the body, making it crucial to catch them early.
The new tax reform law — commonly referred to as the "Tax Cuts and Jobs Act" (TCJA) — is the most significant tax legislation in decades. Although the law was passed only a few weeks ago, the impact on the economy and business outlook cannot be overlooked as the stock market rally continues and both individuals and businesses appear the most optimistic in quite some time.
Birmingham, AL – Behavioral Health Systems, Inc. (BHS), a Birmingham-based corporation administering national behavioral health programs since 1989, will be hosting a national economic and legislative forum on Wednesday, April 18, 2018 at The Club in Birmingham, from 8:00 am to 5:00 pm.
At the core of the Affordable Care Act (ACA) is the three-legged stool: (1) insurance reforms; (2) the individual mandate; and (3) premium and cost-sharing subsidies. Removal of any one of these legs could destabilize the ACA. The ACA established insurance marketplaces in every state to provide access to ACA compliant private health insurance coverage (Qualified Health Plans) in the individual and small group markets. The ACA provides premium subsidies on a sliding scale for persons with incomes up to 400% FPL for the purchase of an individual policy on the marketplace exchange. It also provides cost-sharing subsidies for persons with incomes below 250% FPL. Prior to the implementation of the ACA, manual rating was typically used by insurers for rate-making in the individual and small group markets and exclusions from coverage for pre-existing conditions were common. Age-based rates were typically 5:1. The insurance reforms in the ACA are largely directed at the small group and individual markets (e.g., guaranteed issue/renewal, no preexisting condition limitations, adjusted community rating capped at a 3:1 ratio for age). Standardization of benefits is achieved by requiring coverage for ten essential health benefits (EHBs) and certain preventive services which in the latter case services must be provided without cost-sharing.
In the past few years, when we discussed patient satisfaction it pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as, plastic surgery who primarily practice on a cash basis. Consumerism is here to stay! Cost and quality will create a level playing field in healthcare. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website; I may also see online reviews.
When most people think of Spring they think of flowers blooming, birds chirping and sunny day ahead, but for millions… their thoughts turn to congestion, runny noses, itchy eyes or endless sneezes. They have what are known as seasonal allergies. Allergy symptoms are caused by a hypersensitive response to an otherwise harmless substance and not all allergies are the same.
If you surveyed managing physicians and office managers from the Birmingham area about their business continuity plans, how confident do you think they would be with their Disaster Recovery solution? Do they feel prepared? Have they even thought about it?
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