This new feature is of interest to Cardiologists, Vascular Surgeons, Cardiothoracic Surgeons, Electrophysiologists

Do you use Horizon Cardiology - Cardiovascular Information System (CVIS)?

You asked for faster online access to patient reports with fewer downloads and access
via PC, Mac or your Tablet. Because we value your time, our Information Services department has developed a NEW SATX Clinical Imaging Desktop. Learn more below, and contact us via email to have this new feature added to your login.

Benefits of the NEW SATX Clinical Imaging Desktop
* Allow users to access the CVIS application on Window PCs and Macs through Citrix
https://remote.baptisthealthsystem.com
* Allow users to access the CVIS application on Tablets through Citrix Receiver
https://mobile.baptisthealthsystem.com
* Images display faster for physicians to use
* Complete your Echo report and Cath reports
* Access to MUSE without additional downloads
* Access to ODYSSEY CINEMA CLIENT without additional downloads
* View the PHYSICIAN PORTAL on the same desktop

IMPROVING REMOTE READING ACCESS FOR PHYSICIANS
If you would like the new SATX Clinical Imaging Desktop added to your
login please email us at bhspacs@baptisthealthsystem.com with your
name and physician ID number.

Dear colleagues,

As per our recent Joint Commission survey, the Baptist Health System overall did very well and received valuable recommendations as to how we can do better. One particular area that we, the medical staff, struggle with is authentication of our telephone/verbal orders with a signature along with time and date.

An excellent strategy to reduce the number of these problem orders, is when you are on call for your group and you find previously unsigned telephone/verbal orders by other members of your group, please sign them. In addition, when you are rounding and find telephone/verbal orders from another member of the patient's care team that they missed signing, it is okay to sign that order, in fact it is good care. If there is a disagreement, then please reach out to the other physician as you would for any other discussion regarding patient care plan modification. And then please sign the order with time and date. Both CMS regulations and Texas law not only support this practice, it is actually good medicine. This is an excellent opportunity to review the care plan by the doctor you are covering for, and also the best time to make the likely necessary revisions in that plan of care.

So write new orders as you feel appropriate, but also be alert and on the lookout for that pink post-it reminder flag identifying other orders that need your attention as well as those unsigned telephone and verbal orders. In the short and long term such action by you is good for everyone: the patient and the doctor you are covering for as well as the Baptist Health System

Thanks so much for your assistance with this very important initiative.

Please join me in welcoming Douglas Warden, M.D., of Clinical Pathology Associates to his new role of medical director of the Hematopathology Section of the Baptist Health System Department of Pathology and Laboratory Medicine. Dr. Warden, a native Texan, is board certified in Anatomic and Clinical Pathology and in Hematopathology.  He received his undergraduate education at Baylor University where he earned a BA in Biology.  He graduated from Medical School from Texas A&M University Health Science Center College of Medicine in 2006.  He completed his residency in anatomic and clinical pathology from University of Oklahoma Health Science Center College of Medicine and his fellowship in hematopathology at the Cleveland Clinic Foundation.  He has been with Clinical Pathology Associates and  a member of the BHS medical staff since 2012. He is the primary author on abstracts presented at national pathology meetings as well as a contributing author to several peer-review publications. We believe the hematopathology laboratories at our five hospitals will benefit from his expertise.  He will continue to serve as medical director of laboratory information services. 


 
I wish to thank Dr. Jennifer Rushton for her contributions to the hematopathology service for the past two years.  Dr. Rushton will continue to serve in her capacity of chief of pathology services at NCBH, medical director of Molecular Pathology and Medical Director of Microbiology for BHS. 

Both Dr. Warden and Dr. Rushton will work with me and our Clinical Pathology Associates team as I continue to serve as the chief of service at Mission Trail Baptist Hospital and the medical director of the Department of Pathology and Laboratory Services of BHS.

Sincerely,
Emily E. Volk, MD
Clinical Pathology Associates
Medical Director of Pathology and Laboratory Medicine
Baptist Health System

Our recommendation is:

DO – add https://portal.baptisthealthsystem.com to your Internet Explorer trusted sites to disable the ‘Update Java’ prompt.

DO NOT – select Update

See further details below.  For help with Physician Portal, please call the help desk at 297-8721.

Please share with your office manager.

What you need to know about the re-classification of
Hydrocodone Combination Products as Schedule II controlled substances

Situation
Effective October 6th, 2014, Hydrocodone combination products (HCPs) will become Schedule II controlled substances (CII). This includes cough preparations containing Hydrocodone, e.g. Tussionex and Hycodan, in addition to those products used for pain.

Background
The DEA published this rule on Friday, August 22, 2014. For more information on the DEA's Final Rule, please visit http://go.usa.gov/mc8d

Assessment
Prescriptions for HCPs issued ON or AFTER October 6, 2014 shall NOT authorize any refills. If issued BEFORE October 6, 2014, and authorized for refilling, may be dispensed as CIII (if such dispensing occurs before April 8, 2015). Please note that the original triplicate prescription form for Schedule II controlled substances (which began in 1982) is now required for these products. Modifications to the official prescription form do not invalidate previously issued prescription forms.

Recommendation
If you need to order additional prescription pads for Schedule II Controlled Substances, these may ONLY be obtained from the Texas Prescription Program. Reordering cards are mailed with each prescription set. Order cards may also be requested from the Texas Prescription Program at (512) 424-7293. In lieu of an order card, you may send a request on official letterhead which includes the practitioner's registration information and the quantity of forms requested. Orders must include a check or money order. The cost is $9 per pad of 100.

Orders and payment must be sent to:
Texas Department of Public Safety
Texas Prescription Program
PO Box 15999
Austin, Texas 78761-5999

Cardiologists, Cardiac Interventionalists,  EP specialists,

Reminder: All physicians utilizing fluoro guided interventional procedures are required to complete one hour of hands-on training and 8 hours of online CME by May 2015. Below is the schedule of Fall hands-on training and links to your online CME opportunity.

Hands-on classes for the month of October

• Northeast Baptist Hospital Cath Lab, 7-8 a.m., October 24.
• Baptist Medical Center Cath Lab, 7-8 a.m, October 29th.

Signup sheets will be posted in the Cath Labs. If you have questions don't hesitate to contact myself or Keith McIntosh at BMC, at ekmcinto@baptisthealthsystem.com or Danny White at NBH, at hxwhite@baptisthealthsystem.com.

Online CME options

For your convenience, below are links provided by Dr. Carl Keener to the online radiation safety courses to meet the requirement of 8 hours of online training.

You have two options from which to choose; you do not have to do both.

The first has one course for all physicians:

http://www.fluoroscopicsafety.com/texas_fluoroscopy.html

The second site (AHEC) offers a mobile c-arm version and a cath lab version. A physician may use either course:

https://store.aheconline.com/index.php?route=product/product&path=60_168&product_id=1280

https://store.aheconline.com/index.php?route=product/product&path=60_168&product_id=1283

Margie Petty, MSN, BSN, RN
Regional Director of Cardiovascular Services
mxpetty@baptisthealthsystem.com

M E M O R A N D U M

TO:                 Baptist Health System Medical Staff
FROM:           David M. Siegel, MD, JD, FACEP, FACP, Interim Regional Chief
                       Medical Officer, Texas Facilities, Tenet Healthcare Corporation, 
                       CMO,  Baptist Health System
SUBJECT:      Ebola update and Decision Algorithm Tool
DATE:            Oct. 1, 2014
  
I am sure you have heard about the recent confirmed case of Ebola Virus Disease (EVD) in Dallas.

Baptist and Tenet are in the process of reviewing all of our infection control plans and processes to insure we would be able to appropriately care for any such potential patient at our facilities.

We want our medical staff to have current and accurate information about Ebola Virus Disease as well. Please see this example of an algorithm for the testing and monitoring of a potential EVD patient. This protocol comes from the Dallas County Health and Human Services Department and provides some guidance as to the evaluation of these patients. In addition, it lists many CDC references and links on EVD.

We will continue to circulate appropriate information on this topic to our medical staff. If you have input, questions and/or comments, please direct them to me or to one of our CMOs, Dr. Lee Rodgers or Dr. Richard Marple.

Thank you for supporting Baptist Health System.

Pacira, maufacturer of Exparel® (liposomal bupivacaine) has received an offical warning notification from the Food and Drug Administration (FDA) that the FDA considers EXPAREL® to be a "misbranded" product. The major points in the warning letter issued to Pacira by the FDA cite that the only indications for which it has proven to be safe and effective and for which its labeling provides adequate directions for use is in hemorrhoidectomy and bunionectomy.

Furthermore, the FDA noted claims that Exparel® is able to provide pain relief up to 72 hours, while, in fact, the drug is only approved for pain relief up to 24 hours. Pacira has been asked to provide a comprehensive plan of action to "disseminate truthful, non-misleading amd complete corrective messages" about the issues. The FDA considers these violations to be extremely concerning from a public health perspective because they provide evidence of the intended use of Exparel® in surgical procedures other than those for which the drug has shown to be safe and effective and suggest that EXPAREL® is more effective than has been demonstrated.

With this warning now in place, it is advised that caution be exercised before utilizing Exparel® (liposomal bupivacine) for procedures other than hemorrhoidectomy and bunionectomy, and that appropriate plans for pain management other than Exaprel® be considered after the first 24 hours post-op.

Elliott R. Mandell, PhD. MBA, RPh.
Vice President
Baptist Health System
Dept of Pharmacotherapy and Pharmacy Services

Physician Colleagues:

Each Spring and Fall, Tenet conducts a survey of its entire medical staff to determine our satisfaction with its hospitals, and to seek suggestions for improvement.

The Fall survey will be Oct. 27 - Nov 14, 2014. Each member of the Baptist Health System medical staff will receive an email invitation to participate in the survey, as well as a unique passcode. The survey will take 10 - 15 minutes to complete, and is easily accessible via web link.

You may remember we took a similar survey last May, and hospital administrators have taken a number of steps toward improvement based on our responses.

I encourage each member of the Baptist Health System medical staff to participate. This is our chance to offer confidential assessments and suggestions regarding the practice environment within Baptist.

Watch for your PULSE Survey invitation email on Oct. 27. It will come from physiciansurvey@coniferhealth.com and will include the survey link as well as your unique passcode, which is required to take the survey. If you lose your passcode, your hospital President or Market Development Manager will be happy to provide it.

Thank you for participating. Your input is valuable as we work together to make Baptist Health System a great place for patients to receive treatment and a great place for physicians to practice.

Regards,
William H. Bradshaw, M.D., F.A.C.S.
President, Medical Staff 2013-2015
Baptist Health System

M E M O R A N D U M

TO:                     Baptist Health System Medical Staff
FROM:                David M. Siegel, MD, JD, FACEP, FACP, Interim Regional Chief
                           Medical Officer, Texas Facilities, Tenet Healthcare Corporation,
                            CMO, Baptist Health System
SUBJECT:          Update on Baptist Health System plan for the care of potential Ebola
                            patients
DATE:                 Oct. 17, 2014
 
I realize you are aware of the continuing Ebola Virus Disease (EVD) situation. I do want to provide you with this update on plans Baptist Health System has put in place to care for these potential patients.

Much planning and training has been undertaken during the past weeks to prepare for any possible case of EVD that might present to our Baptist hospitals.

The safety of our patients, staff, and physicians is paramount. Effective and optimal care of the patient is a top concern.

Some initiatives we've already implemented include the following:

• Ordered new Personal Protective Equipment (PPE) that is WHO approved, with Level 4 classification and that provides the highest liquid barrier protections defined by the AAMI Standard
• Developed a PPE Donning and Doffing toolkit (video, printed guide, etc.) that is being shared with other Tenet hospitals
• Educated staff, ED physicians and ICU physicians on proper donning, doffing and use of PPE
• Scheduled education of L&D staff and physicians, as L&D also is an access point to the hospital
• Educated staff on our new buddy system to assure proper donning and doffing of PPE
• Assembled and dispensed Communicable Disease carts to all five facility EDs and ICUs
• Rounded with hospital staff and physicians to assure confidence in processes and equipment
• Participated in city, regional and Tenet planning sessions to ensure effective coordination

As part of the coordinated regional preparation effort, I represented Baptist Health System at a citywide Ebola news conference this week.

In addition to the above, we plan to expand these protocols to all sites of care and access in our System.

On Oct. 20, we will begin assembling Ebola Care Teams at each hospital, to include an ED Physician, RRT, ICU Charge Nurse, ED RN, and Observer.

We will be supplying you with more detailed information in days to come. As always, refer to the Centers for Disease Control (CDC) for the most current information on EVD. If you have input, questions and/or comments, please direct them to me, your hospital CMO, or your hospital Infection Control Practitioner (ICP).

Thank you for your continued care of our patients at Baptist Health System and for your support.

 
Stroke and thromboembolism are frequent devastating complications of atrial fibrillation and atrial flutter (AF). Patients with AF should be fully anticoagulated unless they are low risk for stroke or there are contraindications to blood thinners. 

The CHA2DS2-VASc score is the recommended tool for assessing patients' stroke risk in AF. It should be calculated, documented, and used to guide choice of antiplatelet or anticoagulant therapy in all patients with AF. The CHA2DS2-VASc score is more accurate than the CHADS score, especially at identifying patients that are truly at low risk (CHA2DS2-VASc score of 0), in whom it is reasonable to omit antithrombotic therapy. For patients with a CHA2DS2-VASc score of 1, no antithrombotic therapy, or treatment with an oral anticoagulant or aspirin may be considered. For patients with a CHA2DS2-VASc score of 2 or more, oral anticoagulation is recommended if there are no contraindications.

For patients admitted with a primary diagnosis of AF, please see the AF Admission order set which includes the CHA2DS2-VASc scoring chart.

Your opinion matters, so don't lose your chance to express it.

The Tenet Physician Survey begins Monday, Oct. 27. Please take the 10-15 minutes to complete it. It is a two-step process.

STEP ONE
Watch for your email invitation sometime Monday, Oct. 27, from PhysicianSurvey@coniferhealth.com. It includes the survey link and your unique passcode. You need that passcode to complete your survey.

STEP TWO
Follow the link and answer the simple questions. If a question does not apply to you, there will be a "Not Applicable" option.

JUST IN CASE
If you lose your passcode, contact your hospital leader. A contact list is below. You can get to the survey directly via this link.

Thank you in advance for participating.

If you have misplaced your unique passcode, please contact you hospital representative

Baptist Medical Center
President -- Jon Turton, 979-777-6041, jrturton@baptisthealthsystem.com
Market Development Manager -- Tammy Windsor Bochat 210-393-3396, tjwindso@baptisthealthsystem.com

Mission Trail Baptist Hospital
President -- Andy Harris, 210-297-3600,amharris@baptisthealthsystem.com
Market Development Manager -- Raul Zertuche, 210-326-1307, rjzertuch@baptisthealthsystem.com

North Central Baptist Hospital
President -- Bill Waechter, 210-289-6730, bwaecht@baptisthealthsystem.com
Market Development Manager -- Wendee Murphy, 210-288-5607, wwmurphy@baptisthealthsystem.com

Northeast Baptist Hospital
President – Michael Poore, 210-297-2600, jmpoore@baptisthealthsystem.com
Market Development Manager -- Ryan Denman, 210-262-4467, rndenman@baptisthealthsystem.com

St. Luke’s Baptist Hospital
President -- John Knox, 563-581-0285, john.knox@baptisthealthsystem.com
Market Development Manager -- Liza Gonzales, 210-412-7906, lmgonza5@baptisthealthsystem.com

Physician Colleagues:

Who speaks for you regarding your practice within the Baptist Health System?

Our annual Tenet Physician Survey comes to an end this Friday, Nov. 14. Many of you have completed the survey, and I thank you for that. You have expressed your opinion on what is positive and what needs attention in the Baptist System.

Our goal is that at least half of our medical staff participate, and as a system, we have not yet achieved that goal.

If you have not yet completed the confidential survey, please do so today. It will take 10 to 15 minutes, and is time well-spent. This is an excellent way to speak up for your practice and to offer your appreciation and suggestions for improvement. The hospital presidents made a number of changes and improvements as a result of the short Pulse survey last spring. This current survey is another way you can contribute to meaningful improvements.

You should have received your survey invitation, link and your unique passcode via email from physiciansurvey@coniferhealth.com Oct. 27, and then again Nov. 10 or as late as today.

You can access the survey at this link.

If you have lost your passcode, any of our hospital Presidents or Market Development Managers can provide it

Baptist Medical Center 
Jon Turton, President, jrturton@baptisthealthsystem.com
Tammy Windsor Bochat, MDM, tjwindso@baptisthealthsystem.com

Mission Trail Baptist Hospital
Andy Harris, President amharris@baptisthealthsystem.com
Raul Zertuche, MDM, rjzertuch@baptisthealthsystem.com

North Central Baptist Hospital
Bill Waechter, President, bwaecht@baptisthealthsystem.com
Wendee Murphy, MDM, wwmurphy@baptisthealthsystem.com

Northeast Baptist Hospital
Michael Poore, President, jmpoore@baptisthealthsystem.com
Ryan Denman, MDM, rndenman@baptisthealthsystem.com

St. Luke's Baptist Hospital
John Knox, President, john.knox@baptisthealthsystem.com
Liza Gonzales, MDM, lmgonza5@baptisthealthsystem.com

Thank you for participating. Your input is valuable as we work together to make Baptist Health System a great place for patients to receive treatment and a great place for physicians to practice.

Regards,
William H. Bradshaw, M.D., F.A.C.S.
President, Medical Staff 2013-2015
Baptist Health System