BMN Blog

It has been a difficult 2020 with the ongoing presence of COVID 19 exhausting frontline healthcare entities and stalling the outpatient services. The pandemic has been a devastating historical event, but it has brought sweeping changes for 2021.

State Health Officer is a difficult role to fill, especially this year. While partisanship and conspiracies continue to divide us, it is the job of the State Health Officer to make decisions for the good of all people throughout Alabama. This is exactly what Dr. Scott Harris has done for Alabamians during (and before) the COVID-19 pandemic.

Gastroesophageal Reflux Disease (GERD) Awareness Week occurs annually around the week of Thanksgiving and is intended to increase awareness about GERD and its potential health risks when left undiagnosed or untreated, potential adverse effects of long-term proton pump inhibitor (PPI) medication use, and the links between chronic heartburn and adenocarcinoma, the most common type of esophageal cancer in the U.S.

October brings many welcome changes, including cooler temperatures, colorful leaves and the return of fall sports. As a breast-specialized radiologist, I look forward to October events designed to promote breast cancer screening awareness. Public campaigns, corporate promotions and community awareness events all contribute to this effort. I’m always happy to see those annual mammography patients who have established themselves as “October regulars” as a result of these efforts.

Annual mammography has been shown to decrease breast cancer death by at least 40 percent.

As we enter into the last few months of this challenging year, many practices will be looking to perform a HIPAA IT Security Risk Analysis. When considering the approach to this year's analysis, it's important to consider any changes that may have been made to critical IT systems as part of the practice's response to COVID-19.

Throughout training, physicians are taught how to prescribe medications. How does the medication work within the body? Which patients will benefit? What is the appropriate dose? What are the side effects? The cost? We spend years honing our expertise on how to prescribe medications safely and correctly. Great care is taken to prescribe the best medication for each situation in each patient. We become comfortable prescribing medications early in training. Over the course of a patient’s lifetime, the number of these medications can build, leading to polypharmacy.

The COVID 19 pandemic has thrown a wrench into all of our day to day routines, including going to work, taking our children to school, running household errands, exercising, and even going to see our doctors or dentists.

Oral Immunotherapy (OIT) for food allergies is a life changing medical treatment that re-trains the immune system to become desensitized to food allergens through regular ingestion of food proteins at increasing doses. Alabama Allergy's Food Allergy Treatment Center provides OIT to patients who are at risk for anaphylactic reactions to peanut, tree nuts, milk, egg, soy, sesame seed, and wheat. This treatment is guided by Sunena Argo, MD Board Certified Allergist and Erin Cuzzort, CRNP.

Over the past few years, you may have heard about companies, app makers, and service providers launching two-factor verification or two-factor authentication.

The importance of a having well-designed website and creating an online presence is crucial to your medical practice now more than ever, regardless of how the pandemic affects your marketing outcomes. You don’t want to risk deterring new and current patients from using your practice.

Pediatric office visits have declined by half during the COVID-19 pandemic, according to the American Academy of Pediatrics (AAP). Not only are children missing well-child checks, but also the vaccines that are given during these visits. Manufacturers are reporting a decline in vaccine orders and vaccine doses distributed through the Vaccines for Children program.

In this day and age of advanced technology, physicians have access to abundant clinical information at their fingertips. Electronic medical record (EMR) systems can provide physicians with the data they need to care for their patients at virtually any time or place (whether or not these systems are user-friendly is another story).

Potential complications of both surgery (carotid endarterectomy or CEA) and conventional stenting (accessed from the groin) for stroke prevention in patients with carotid artery disease occur during or after the procedures. Studies have shown a higher risk of stroke during conventional stenting as compared to surgery and a higher risk of heart attack and wound complication with surgery as compared to conventional stenting.

Obesity is a growing disease both in the US and around the world. It is a major cause of many diseases including diabetes, hypertension, heart disease, cancer, cerebrovascular disease and stroke, gastroesophageal reflux disease, bone and joint damage and respiratory disorders. It also places individuals at increased risk of developing serious complications from COVID-19.

Never before in history have we been so limited in our ability to be freely active, to compete, or simply to spectate the sports we love. The devastating effects of Covid-19 are at the front of our collective consciousness, and we have nothing to distract us. Though fall football may be a fan favorite, spring, it can be argued, is one of the best stretches in sports with March Madness, The Masters, Major League Baseball’s opening day, and the ramp up to NBA and NHL playoffs. While we struggle with the frustration as fans without a team to watch or games to attend, my greater sympathies reside with all of the senior athletes, both college and high school, whose final steps on the field, court, green, or rink were never realized. 

The COVID-19 pandemic has challenged virtually every aspect of life, and for many of us, sleep has been severely affected.

The Brookwood Baptist system recently incorporated state-of-the art Cardiac Magnetic Resonance (CMR) imaging for diagnosis patients with complex cardiovascular conditions. The technique allows for the acquisition of three-dimensional multi-planar moving images of the heart, blood vessels and associated organs without the need for ionizing radiation in about one 15-minute session.

We are in the midst of a historic and unprecedented event. The COVID-19 pandemic of 2020 will be one for the history books.  How will history judge our response to this crisis? Certainly we as a nation and as a health system were unprepared for a pandemic of this magnitude. It has exposed the flaws and weaknesses in our health system and pointed out the real need for expanded primary care in our country.

The National Institute of Standards and Technology has published a bulletin that provides several key reminders for people who have had to shift to working remotely as a response to COVID-19. The guidance, which can be found in full at the link below, summarizes previous NIST guidelines for working safely when out of the office.

We live in a three-dimensional world, where many physicians and surgeons diagnose, treat and operate on patients using flat images, but that is not the case at Children’s of Alabama. Seven years ago, I helped open Children’s first 3-D laboratory, which provides cutting-edge technology through advanced visualization. We help our medical staff provide a clearer, less invasive and more realistic view of joints and organs. With this type of information, doctors can also give patient families a clearer vision and understanding of their child’s condition.

I have a meniscus tear, now what?

Many patients who come to my clinic with an MRI that shows a meniscus tear are looking for advice on what to do next. Another physician may have told them that they need surgery because the MRI is abnormal. Some people just want another opinion. Not all meniscus tears need surgery.

I first want to understand the patient’s symptoms, and I look to see if the knee is locking, catching, or if it feels unstable. Meniscus tears that are unstable create these problems, which may indicate that more damage is being done to the articular cartilage in the rest of the knee. An additional concern here is that the knee could give way at a bad time, causing a fall or buckle leading to another injury. Be careful.

As 2020 approaches and people begin to contemplate their New Year’s resolutions, weight loss is often at the top of the list. There are two excellent options available for dramatic weight loss: the gastric bypass procedure and gastric sleeve procedure.

Breaking a bone is often the first sign of osteoporosis. Approximately one in two women, and up to one in four men age 50 and older will break a bone due to osteoporosis. Osteoporosis causes bone to become brittle and weak, which allows them to fracture with relatively low impact. We typically refer to an osteoporotic fracture as a fragility fracture.

With more healthcare organizations moving to VoIP (Voice-over-Internet Protocol) for their phone and communication needs, it’s important to understand the technology and how to make it work for your business needs. So let’s start with the basics.

The holidays are a season of joy, gratitude, and family. However, for people with allergies it can be a difficult time. Class parties and homemade treats make it hard to check food labels and ingredients. Christmas trees and decorations can cause their own problems with those who are environmental or dust mite allergic. Having to say “no” to a thoughtful treat given by a neighbor due to your child’s nut allergy, but still remaining grateful for the gesture can be awkward.

Are you struggling to keep your employees engaged? Are you aware of the factors that impact engagement in the workplace? Often, we assume that if employees like their jobs, they will be fully engaged at work, but in reality, healthy workplace engagement extends beyond job satisfaction. Engaged employees not only enjoy their jobs, but are also motivated to work toward a common goal aligned with their company’s vision. It’s a big-picture formula that involves both the organization and management.

During your first visit as a new patient to our fertility clinic, the American Institute for Reproductive Medicine, you will undergo a series of lab tests. These tests are critical in determining the right treatment plan. We focus on eight common lab tests.

Managing medical waste is not for the faint of heart - and neither is managing a medical office. Your facility’s staff must adhere to strict, sometimes time-consuming medical waste guidelines and regulations while providing the highest level of patient care. You must protect the health of your patients, your employees, and the environment. Following best practices in health care delivery, medical waste management, and medical office management can streamline processes and help ensure the best delivery of service in each area.

Most people associate allergy season with the Spring, but just because the pollen isn’t present doesn’t mean the sniffles aren’t.

Hay fever, despite its name, actually has nothing to do with hay. Ragweed is a common cause of hay fever/allergic rhinitis. Ragweed begins to pollinate in mid-August and will continue provoking allergy symptoms through the fall until a hard freeze. Allergy shots, sublingual allergy drops or dissolvable ragweed tablet are beneficial for patients who struggle with ragweed, helping to build immunologic tolerance to pollen.

According to the Medical Group Management Association (MGMA), the fourth most challenging issue in practice management is collecting from self-pay and high deductible patients. With patient payments representing a growing portion of practice revenue, re-engineering how patient collections are approached is crucial to practice success.

Real estate is the second highest expense behind payroll for most healthcare practices. The benefits of capitalizing during lease negotiations can include a healthy raise through increased profitability, reduced debt, a nicer office and more. On the contrary, if negotiations are not handled properly, the results can be decreased profitability, resulting in the need to produce tens to hundreds of thousands of additional dollars just to pay the same bills that should have cost less.

Information Technology now dominates almost every part of our daily lives and in most cases, we do not have to think or worry the outcomes. We trust that what we input on our phones, keyboards and tablets will result in the right answer. With these repetitive motions it has allowed our business to grow and flourish. But what happens when those items break?

Influenza, commonly known as flu, is a virus that can be spread by droplets. It can occur anytime of the year, but the majority of cases occur in December through March. Flu vaccines are the single best way to protect yourself from getting the flu. It is best to be vaccinated in early fall, as it takes two to four weeks to build up immunity. You can still develop the flu after being vaccinated, but cases are generally milder than for those that have not been vaccinated.

You are likely aware of the outbreak of measles that has received a lot of attention in 2019. The CDC reports that over 1,000 cases of measles have been reported this year, which is the greatest number of cases reported in the U.S. since 1992.

Cataracts are the number one cause of reversible vision loss in the world. While cataracts can cloud your vision, they don’t have to cloud your life. I was drawn to this Ophthalmology medical specialty because of the profound life change I could make with his patients. Surgical treatment of cataracts can completely restore a patient’s vision. There are very few other types of conditions where complete recovery can be achieved by a very simple outpatient surgery.

VoIP is a game-changer for the healthcare industry’s communication landscape, allowing for quicker, more reliable communication. However, it also brings with it a multitude of HIPAA concerns that can be confusing to navigate.

Yesterday, I received a text from my eye doctor informing me that I have not scheduled my yearly exam and need to make an appointment. The notification was an electronic version of the Annual Patient Postcard reminders. But unlike the old postcards, the text included links to automatically call the office or direct me to visit self-scheduling. Booking that appointment has been on my to-do list for weeks, but I seem to only remember to do it after the office has closed. Yet, with one click and about two minutes of my time, the mission was accomplished. That’s when it dawned on me – healthcare is going “Amazon.”

While it’s easy to shop around for the best price on a car or the cheapest gallon of milk, it can be nearly impossible to predict what your medical bill will be following a procedure or hospital visit, regardless of your health insurance coverage.

It is that time of year again - pool parties, camping, hiking, yard work, and picnics. Along with increased time outdoors comes the risk of an insect sting. While insect stings occur regularly, only about two to three percent of patients will experience an anaphylactic reaction. These anaphylactic reactions occur more commonly in adults than in children. A majority of these patients do not seek medical care. 

There is no one simple solution that will eliminate all business security risks. However, organizations can build a robust internal culture of security that can profoundly decrease those risks. This approach starts from the top down.

The “just right” theme repeated in the classic fairy tale of Goldilocks and the Three Bears hits close to home at Children’s of Alabama’s Pediatric Imaging Center (PIC), where services are tailored especially for kids. Every inch of the PIC, located at Children’s South Pediatric Outpatient Center in Birmingham, is designed with children in mind to ensure their experience is “just right.”

One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.

Many of the patients I see at the American Institute for Reproductive Medicine have endometriosis.

Sound processes are essential to the success of any business. This is even more important in healthcare, where the ever-changing environment makes process improvement vital in order for a practice to prosper.

Over the last few years, cell phones have become computers, capable of much of the functionality that your office computer has. This is also true for small portable devices such as iPads, Windows and Android tablets. Are these devices and applications as secure as those you use from your clinic? In most cases, the answer is no.

Arrhythmias are abnormal heart rhythms that are often under recognized cardiac problems and can lead to dangerous consequences if ignored or not treated appropriately. Typical symptoms can mimic those of other cardiac conditions like a heart attack, and often include palpitations (abnormal sensation in the chest, feeling like your heart is racing or beating abnormal). Sometimes symptoms may be associated with chest discomfort, shortness of breath at rest or with exertion, dizziness, near passing out or passing out, and/or fatigue.

As the temperatures spike this summer, the risk of heat-related injury such as heat stroke and heat exhaustion also rise. While the temperatures are hard to avoid, there are ways to recognize symptoms and prevent heat-injury. People who tend to be more at risk are young children and infants, people over the age of 65 and those who are overweight or have a preexisting illness. It is important to note that some medications can also make you more sensitive to sun exposure and heat.

Millions of patients around the world wear contact lenses to correct their vision.¹In fact, research suggests that contact lenses provide patients with benefits such as better perceived cosmetic appearance, better social acceptance, and a better ability to play sports compared to glasses.^2-4While most contact lens wearers use soft contact lenses for cosmetic reasons, some patients wear specialty hard contact lenses because they are the only way that they can achieve functional vision without undergoing surgery to correct a visually debilitating eye disease like keratoconus (a degenerative disease that results in an irregularly shaped cornea).⁵In other cases, patients who suffer from moderate to severe dry eyes wear specialty contact lenses because they have the ability to make their eyes comfortable enough to effectively function.⁶While there is more than one type of specialty contact lens that can help patients with these conditions, scleral lenses have emerged over the past few years as the contact lens treatment of choice for these difficult-to-treat patients.⁷

Trying to comply with HIPAA can be a challenge for healthcare providers, especially when there is so much confusion about specific aspects of the rules. Policyholders contact SVMIC almost every day for assistance with HIPAA-related issues. In fielding those calls and emails, we have identified some commonalities.

As our society transitioned to mobile phones, a frequently overheard question and related advertising theme was “Can you hear me now?”

What if a microscopic amount of food protein you accidentally ingested quickly resulted in life threatening symptoms such as hives, swelling, vomiting, diarrhea, coughing, wheezing, or difficulty breathing? This is a serious reality for patients with food allergies and results in a constant anxiety and fear of accidental ingestion. Many are never able to eat out at restaurants, go to baseball games, fly on planes, attend movies, or simply have the option to eat at any table in a cafeteria without fear. This not only affects the patients, but their families as well.

Over the past several years the healthcare industry has become the number one target of cyberattacks. These attacks have exposed tens of millions of customers’ identities worldwide, costing an estimated $1 billion USD in losses.

The Apple Watch and other wearables are now able to monitor your heart rhythm. The Apple watch can detect irregular heart rhythms, and if it does so five times, it will prompt you to record your rhythm. In that way, it can also be used to diagnose atrial fibrillation.

The United States Environmental Protection Agency (“EPA”) regulates pharmaceutical hazardous waste. Under the EPA, unused and disposed of pharmaceuticals are evaluated, managed and disposed of as potential “hazardous waste” under the Resource Conservation and Recovery Act (RCRA) Regulations. The RCRA establishes procedures and standards for hazardous and solid waste material management and disposal. Under the RCRA, solid waste includes “solids, liquids and gases and must be discarded to be considered waste.”[i]

We have heard a lot from the media on active shooter events throughout the U.S., but how many of these include healthcare facilities? The Homeland Security and the FBI define “active shooter” as “an event where one or more persons actively engage in killing or attempting to kill people in a populated area.” Statistics show active shooter incidents involving healthcare facilities are less common than other events, but they can occur, so planning may save lives.

Like customers in most other industries, patients are turning to the internet to learn about physicians before seeking treatment. The following tips will help your practice manage your physician’s online identity in order to maximize the benefit and reduce the risks associated with online information.

The numbers tell the story.

• 176 pediatric heart transplants since 1981
• 59 pediatric heart transplants since 2012
• Zero deaths since 2014
• A 97 percent one-year survival rate over the last decade; considerably higher than the national rate of 90.2 percent

Atrial fibrillation (AFIB), a condition in which the heart fires so rapidly that the upper chambers quiver instead of beating in a normal rhythmic pattern, is the now most common arrhythmia condition worldwide and is recognized as a global health problem with its burden of morbidity and mortality resulting from embolic stroke. AFIB is expected to double by 2030.

Vince Lombardi once said football is not a contact sport. Dancing is a contact sport. Football is a collision sport. He was right. And when you or your family members are involved in collision sports like football (or soccer, wrestling, basketball, mountain biking, etc.) your shoulders may pay the price. Contact injuries to the shoulder are a common cause of down-time and occasionally result in surgery. What is the best management for these injuries?

Peripheral arterial disease, or PAD, is a disease process in which plaque buildup causes the arteries to narrow, resulting in reduced blood flow to the limbs. This can lead to a variety of medical emergencies: Claudication, stroke, uncontrolled hypertension, and possibly amputation.

In 2012, Transcatheter Aortic Valve Replacement (TAVR) became commercially available in the US to treat high-risk patients with severe aortic stenosis. It offered effective, minimally invasive, and often lifesaving treatment to tens of thousands of patients who previously had no option for aortic valve replacement surgery.

A recent global study by the Ponemon Institute finds that the financial damage caused by a data breach has risen by 6.4 percent in the last year and now costs companies an average of $3.86 million each.

In 2016 Forrester Research analysts focused their attention on emerging social phenomenon in consumer behavior. They identified several key social trends that are impacting our industry’s ability to adapt to changing policy, market trends and patient needs. One trend they observed was the rapid adoption of new solutions and the abandonment of solutions that didn’t immediately provide value. This trend was seen across all industries.

When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored. 

Regulation Background

The False Claims Act (“FCA” or “Act”) is a federal anti-fraud statute that protects against persons and companies defrauding the government. The Act has been dubbed the government’s “primary litigation tool for recovering losses resulting from fraud.”[1] The FCA imposes civil liability on any one who “knowingly presents…a false or fraudulent claim for payment or approval” to the federal government.[2] It is used extensively to protect against fraud in healthcare.[3]

January 14, 2020 is a special day for Microsoft Corporation (you know that little company that controls 82.88 percent of the computer software market share). On that date, Microsoft will end the life of some of the major software that businesses use. End of life means that the manufacturer will no longer support the product. This list includes:

At this point, nearly every American has heard about the opioid crisis. With increasing scrutiny from governing bodies regarding opioids, pain physicians are tested in treating patients in the challenging chronic pain population. While non-opioid medications, therapy and procedures have their place in treating chronic pain, what are physicians to do when patients fail all of these options? One treatment to consider is spinal cord and peripheral nerve stimulation.

The Department of Justice designated 12 federal prosecutors across the country as part of the Opioid Fraud and Abuse Detection Units. These Units are assigned to areas where the most opioid drug-related deaths have occurred: California, Nevada, Alabama, Central Florida, East Tennessee, West Virginia, North Carolina, Kentucky, Ohio, Pennsylvania, Michigan, and Maryland. Members of these Units also includes numerous federal, state, and local law enforcement and governing entities including the DEA, FBI, HHS, and other federal and state agencies (Medicaid Fraud Control Units, FDA, IRS, State Pharmacy Boards, etc.). These Units have a specific mandate to target physicians, pharmacists, and ancillary services (addiction treatment centers, etc.).  

During my 30 years in healthcare consulting, I have seen several reform initiatives come and go.

In many cases, the initiatives have enhanced the ability of consumers to access insurance coverage and ultimately healthcare. In 1993, President Clinton proposed legislation that led to growth in Health Maintenance Organizations (HMOs) and also the HIPAA privacy standards which are still in place today. In the 2000s, President George Bush proposed changes to the Medicare program that led to the implementation of Medicare Part D coverage.

2017 was the first year for participation in the Merit-based Incentive Payment System (MIPS), a Quality Payment Program (QPP) implemented by CMS, to award or penalize participating clinicians with regard to future Medicare reimbursements based upon reporting under four categories:

On Sept. 6, representatives of Children’s of Alabama, the University of Alabama at Birmingham (UAB) Division of Pediatric Rehabilitation Medicine and the Lakeshore Foundation gathered to cut the ceremonial red ribbon for the grand opening of Children’s at Lakeshore – the latest chapter in a partnership among the institutions.

Studies have shown that almost 9 out of 10 adults have difficulty using the health information they receive.[1]  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.

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.

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.

“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.

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

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.

"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.[1]  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[2]) to have the minimum ePHI safeguards, listed below.

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.

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.

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.

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.

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.

Treatment for a pinched nerve in the neck (cervical radiculopathy) that has failed to improve with non-operative care has traditionally been treated with an anterior cervical discectomy and fusion (ACDF). Originally explained in 1958, this procedure achieves success by eliminating nerve root compression by removing the disc, replacing with bone graft via a fusion to prevent recurrent or pinched nerves and maintain stability. However, not only does this increase restricted motion to the spine (which is increased with multilevel fusions), but it also transfers force stresses to other levels or levels above and below the fusion which has been shown to increase symptoms/degeneration at other levels.

1. Control all of your “other” medical conditions.  Many chronic diseases negatively influence your intestinal tract: think poorly controlled diabetes, undertreated cardiovascular diseases, thyroid disorders, obesity, and so on.  There is a synergistic relationship between intestinal health and your other organ systems. 

If “Varithena” sounds like the latest Marvel or DC superhero, there’s good reason. When it comes to treating varicose veins, such an idea isn’t so far fetched!

Physicians serve on the frontlines of our healthcare system, and by extension the many social programs guaranteed by the Social Security Administration. It’s a large responsibility and we owe them a debt of gratitude. These dedicated care providers, across many areas of practice and at varied levels within our medical system, help more than 57 million children and adults who live with disabilities across the United States.

We hate to break it to you, but there's a HIPAA requirement you’re more than likely doing wrong. The Department of Health & Human Services’ Office for Civil Rights (OCR) is cracking down on requiring a true Healthcare Security Risk Analysis.

Most companies assume their cyber security is pretty good… until a breach happens and then you find out where the holes were. We often find that apathy and a lack of being proactive may cost you lots of money. An annual security audit is a necessity for all medical practices and companies in todays ever changing world of technology. It is a vital part of protecting your digital assets and cyber security plan for your organization. It’s not just about discovering any vulnerabilities or shortcomings, rather it’s about opportunities to strengthen your network security.

Q: Could you tell us about Norwood Clinic Ophthalmology?

A: We’re a part of Norwood Clinic, which is the oldest and largest multi-specialty medical group in the Birmingham area. At the ophthalmology location, we offer comprehensive ophthalmology services. This includes routine adult and pediatric eye exams; medical and surgical treatment for diseases of the eye and eyelids; and screening for ocular manifestations of systemic diseases such as diabetes.

We also have certified ophthalmic technicians and an optician to assist with the dispensing of glasses and contact lenses.

 A couple should consider seeking help from a fertility specialist after attempting to conceive for three months, six months, a year—there really is no right answer. Infertility could be due to a single factor, or multiple factors, and fertility treatments vary in complexity. One factor in particular has become more prominent nowadays in couples who are trying to conceive: age, which effects both the husband and wife, has become a threat to fecundity as society pressures couples to start a family later in life.

The Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama actively works toward the goal of a total cure through research and development of innovative therapies. More than a dozen prominent pediatric hematology, oncology and blood and bone marrow physician-scientists provide exceptional programs in patient care, education and research. Currently, the Center provides care or treatment for 90 percent of the pediatric hematology-oncology patients in the state.

Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.

Healthcare professionals are all well aware of what a clinical trial is, how they work, and the possibilities   that are provided to those who participate. However, the majority of Americans have not participated or heard about opportunities to participate in clinical research. According to a survey conducted by Research!America in partnership with Zogby Analytics (2017), fewer than 10% of Americans actually participate in clinical trials. Digging further into the reasons why, 55% of those surveyed stated that they were not aware or lacked information regarding clinical trials (Research!America, 2017).  

As we finalize 2017 participation in the Merit Based Incentive Program, most of us focused on improved performance in quality since the category carried the highest weight of 60%. Those who had previous success in Meaningful Use found the Advancing Care category easy to address.  The Practice Improvement category is new and somewhat vague, but many practices were already performing tasks that qualified as an improvement activity.  It is important to document the approach to improvement and track success because this category is subject to audit in the future.

Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk.  A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.

An estimated 3.5 million people in the United States are infected with Chronic Hepatitis C Virus (HCV). Many of these people do not know they are infected and are not receiving care or treatment.  The CDC estimates that while Baby Boomers (born 1945-1965) comprise only 27% of the US population, they account for approximately three fourths of all HCV infections.  Therefore, they are at greatest risk for hepatocellular carcinoma and other HCV-related liver disease.  HCV is now the leading cause of liver transplantation and liver cancer in the US. 

Robotic assisted surgery has seen an explosion since it was first introduced about 20 years ago with over 4 million procedures performed. Although minimally invasive laparoscopic surgery has been around longer, certain limitations existed within this field. Laparoscopic surgical instruments lack wristed movement, essentially forcing surgeons to operate with chop sticks. The effect was difficulty performing certain procedures and working at difficult angles. Robotic surgery allows wristed action of the instruments, better optics (depth perception), surgeon control of the camera, and better ergonomics. While there is not any significant change in long term outcomes, there are studies suggesting decreased pain and shorter hospital stays.

Your business' data could be compromised by the most unlikely of sources -- your own IT manager.

Over the past couple months, I’ve encountered multiple chilling examples of IT staff gone rogue. Of course, this isn't happening every day. But when it does, it's especially damaging to organizations with a one-person IT department. These lone IT managers often hold the keys to the kingdom. No one person - IT expert or not - should ever have complete control over passwords, access, processes, etc. Why? Consider these two recent incidents:

Venous reflux in the lower extremity is when blood from the foot which should travel towards the heart reverses downwards due to gravity.

Sleep is a very important activity, that we often take for granted. It is especially important in children as it allows for proper neurological development. One disorder that is more and more common is sleep apnea, or interrupted sleep from breathing issues. We generally associate sleep apnea and distressed breathing while sleeping with adults, but it does occur with children - actually in 3-5% of children.

There is a lot of confusion about SSDI and SSI, the two types of disability benefits that can be received from Social Security. The definition of disability is the same under both programs, but that is where the similarity ends. The following is a very basic description of the disability programs provided under the Social Security Act, titles II and XVI.

What is myopia?

Myopia is a condition that results in distant objects appearing blurry to a patient when not being corrected with glasses or contact lenses.¹ Myopic blur typically results from the eye being too long for its optical focusing components (cornea and crystalline lens), which causes distant objects to be in focus in front of the retina (back of the eye) instead on the retina, a requirement for the eye to be able to see clearly.¹ About one third of Americans have myopia, and its prevalence is likely increasing because of factors associated with living in a developed country (e.g., decreased time outdoors).^2-5 With that said, the scientific community only has a vague understanding of how genetics and the environment influence the development and progression of myopia.¹ While myopia’s visual affects can be a costly nuisance and strain on the health care system,⁶ myopia also places the affected individuals at a greater risk for developing vision-threatening conditions like cataracts, retinal detachments, and glaucoma.¹ Once present, myopia cannot be cured; therefore, preventing it or even reducing the amount of myopia that a patient develops is an upmost priority for the scientific community.⁷

For 2017, The American Cancer Society has estimated that around 252,710 new cases of invasive breast cancer will be diagnosed in women and 2,470 diagnosed in men, around 63,410 new cases of Carcinoma in situ(non-invasive and the earliest form of breast cancer) will be diagnosed, and approximately 40,610 cases will be fatal.

Over 36 million American adults have some degree of hearing loss.

That is over 4 times the amount of people who live in New York City.

An Oklahoma physician agreed on August 28, 2017 to pay the government $580,000 to resolve allegations that he violated the False Claims Act by submitting claims to the Medicare program for services he did not provide or supervise. According to the government, the physician allowed a company that employed him and in which he had an ownership interest to use his NPI numbers to bill Medicare for physical therapy evaluation and management services that he did not provide or supervise. The government further alleged that after he separated from the company and deactivated his NPIs associated with the company, he reactivated those NPIs so that the company could use them to bill Medicare for services he neither performed nor supervised.

Did you know a single patient health record can earn cybercriminals 10 times the price of a stolen credit card number on the black market?

The Office of Civil Rights is auditing small and large healthcare providers alike, imposing multi-million dollar fines in some cases. Meanwhile, the same electronic storage, mobile devices, and cloud-based applications that patients, doctors, and healthcare staff want to use often compromise a practice’s ability to keep that patient data safe.

It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved.  Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.

As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.

Albert Einstein once said, “Life is like riding a bicycle. To keep your balance, you must keep moving.” Moving is one thing the City of Opelika is determined to do…even on two wheels.

Bang, bang, bang! If you experience your heart banging against your chest or skipping beats you may be experiencing an arrhythmia. An arrhythmia is an irregular rate or rhythm of the heartbeat, where your heart can beat too fast or slow. Most commonly, this is caused by atrial fibrillation (AFib), when disorganized electrical signals cause the heart’s chambers not to beat in sync or fibrillate. Millions of Americans are affected by this disease and the number increases each year. AFib is the most common abnormal heart rhythm in America.

"Aspire Physical Recovery Center at Cahaba River is proud to offer its guest use of the OMNIVR system. The OMNI is a virtual reality augmented rehabilitation system that allows trained clinicians the opportunity to work with guests in novel, yet functional ways.

Tumor Treating Fields or TTF as it is more commonly known is a recently developed method by which malignant brain tumor cells are prevented from reproducing. Shelby Baptist Medical Center and Generations Radiotherapy & Oncology PC has begun therapy on its first patient using this entirely new approach in the treatment of malignant brain tumors with the Optune TTF system.

Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.

Most all medical practices are preparing a MACRA project this summer. Our healthcare team has had the opportunity to speak to many physicians and managers regarding preparation for the transition from volume to value based medicine and reimbursement.  A large project can be overwhelming for any practice but this is more than a project, it is a culture change!

The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.

Between 2000-2015 the number of Americans with hearing loss has doubled, bringing it close to 48 million. With the aging baby boomer population, that number will continue to climb in the coming years.  

The internet is a necessary part of the healthcare world today. This forces us to deal with the issue of managing employee Internet usage which can be a drain on your organizations productivity. This holds true in the healthcare industry whether you run a small clinic, large practice or hospital.

TUSCUMBIA – When you walk into Dr. Suzanne Blaylock’s office at the Helen Keller Pavilion, there’s a medical journal on her desk, paused and waiting for her to return to continue reading the most recent article. On the wall behind her chair are framed reminders of why she choose anesthesiology as her specialty – awards recognizing her from the Peer Reviewed Professionals, the Consumers’ Research Council of America as one of America’s Top Anesthesiologists, and the Consumers’ Research Council of America’s Top Physicians. Dr. Blaylock always knew she’d have a career in medicine, but what she got was so much more.

For years now, I have seen patient after patient frustrated with stubborn fat in areas that do not respond well (or quickly) to diet and exercise. Their concerns are very common, and certainly not something of which to be ashamed. Patients also frequently ask me for my recommendations on non-invasive cosmetic treatments designed to address these issues, like CoolSculpting®, Sculpsure®, Vanquish™ or Zerona™.

The Mobile area has many sites for tourists to visit during a stay. From the Gulf Coast Exploreum Science Center & IMAX Theater, the USS Alabama Battleship, the beautiful flowers of Bellingrath Gardens, dipping your toes in the warm Gulf waters of Dauphin Island, to celebrating Mardi Gras at the Mobile Carnival Museum, there’s one attraction in Mobile that may not immediately catch your attention, but you surely should not miss…the Mobile Medical Museum.

MONTGOMERY – Boyde Jerome “Jerry” Harrison, a family practitioner from Haleyville, was formally installed as president of the Medical Association of the State of Alabama during the 2017 Inauguration, Awards Presentation and 50-Year Physician Recognition Dinner on Friday, April 14.

Physicians Giving Back with Lee Irvin, M.D.

You probably don’t know Lee Irvin, M.D., of Mobile, and he’s fine with that. He’s the kind of gentleman you’d love to hang out with and have a drink or dinner with…swap stories with. But it’s easy to see that his medical mission over the last couple of years wears heavy on his heart.

MONTGOMERY – On March 29, officials from the Medical Association of the State of Alabama participated in a proclamation signing ceremony declaring March 30, 2017, the Second Annual Doctors’ Day in Alabama formally recognizing Alabama’s nearly 17,000 licensed physicians serving millions of residents through private practice, in hospitals, in research, and in other health care facilities.