Dr. Kelly Gray-Eurom, MD, MMM, FACEP President, Florida College of Emergency Physicians March 15, 2013

Dr. Kelly Gray-Eurom, MD, MMM, FACEP

President, Florida College of Emergency Physicians

March 15, 2013

The Florida College of Emergency Physicians exists to promote high quality emergency medical care.

FCEP supports and promotes the health and safety of the public by ensuring patient access to quality emergency care.

1,400 members statewide.

Treat/See Over 7,000,000 Patients Each Year in Florida

Working in Academic Setting, Community Hospitals, Urban-Tertiary Care

Diverse ED Environment

Diverse Specialty

FCEP values a working relationship with AHCA as well as with hospitals to ensure patients have access to quality care

FCEP supports the AHCA initiative to create transparency and further defining the Hospital Emergency Services Inventory

Access to Emergency Services and Care

LEGISLATIVE INTENT◦ The Legislature finds and declares it to be of vital

importance that emergency services and care be provided by hospitals and physicians to every person in need of such care.

It is further the intent of the Legislature that hospitals, emergency medical services providers, and other health care providers work together in their local communities to enter into agreements or arrangements to ensure access to emergency services and care.

The agency shall establish and maintain an inventory of hospitals with emergency services - ◦ All services within the service capability of the

hospital◦ Each hospital having emergency services shall

notify the agency of its service capability ◦ Assist emergency medical services providers and

others in locating appropriate emergency medical care.

◦ Available to the general public.

If the hospital provides the service (i.e. neurosurgery),then the hospital must provide that service to its Emergency Department patients

If the hospital is unable to provide that

service◦ Have a transfer arrangement relating to service◦ Obtain a waiver/exemption from AHCA

enforce the ability of persons to receive all necessary and appropriate emergency services and care;

and that the agency act in a thorough and timely manner against hospitals and physicians which deny persons emergency services and care

Where are the gaps? What needs to change to make this access

more available to our patients? What needs to change to make the system

more transparent to our providers? How can this information be more readily

available to the public? What resources does AHCA need?

Inventory of hospitals with emergency services ◦ All services within the service capability of the



others in locating appropriate emergency medical care

◦ Available to the general public

Trauma

Anesthesia Burn Cardiology Cardiovascular Surgery Colon/Rectal Surgery Emergency Medicine Endocrinology Gastroenterology General Surgery Hematology Hyperbaric Medicine Internal Medicine Nephrology Neurology

Neurosurgery Obstetrics Ophthalmology Oral/ Max Facial Surgery Orthopedics Otolaryngology Plastic Surgery Podiatry Psychiatry Pulmonary Medicine Radiology Thoracic Surgery Urology Vascular Surgery

Trauma



General Cardiology

Interventional Cardiology

Internal Medicine is becoming an out patient specialty

Hospitalist or Primary Care Admissions

General Neurology

Stroke (thrombolytic agents)

Cranial Spine

Hand◦ General ◦ Micro-vascular

Trauma PEDIATRICS



Emergency Medicine evaluates and treats all age groups

Most adult providers will only see patients >17 years old◦ Consultations◦ Admissions◦ Procedures

Pediatrics must be required on the emergency services inventory

Pediatric surgical subspecialties should be added◦ General surgery◦ Gastroenterology◦ Neurosurgery

Critical Care / Pulmonary Medicine






ACHA needs to do an assessment of the statewide inventory of emergency services.

Provide medical oversight to assist with approval of exemptions – formerly State EMS Medical Director/DOH provided.

Currently the AHCA website has 16 hospitals listed that are approved for exemptions◦ PDF◦ Static◦ Hospital Licensure

Create a non-punative reporting structure if possible to promote honesty and transparency

Do not provide Provide on a limited basis by exemption Provide through a transfer agreement with

another hospital Provide through a combination of in-house

and transfer agreement Provide in-house 24 hours, 7 days a week

Interactive list of services denoting changes◦ Updated regularly by designated personnel

Removes any doubt of services provided by Hospitals






FCEP will continue to work with AHCA and other partners to improve and ensure our patients have access to quality emergency services and care

Questions?

Documents

Dr. Kelly Gray-Eurom, MD, MMM, FACEP President, Florida College of Emergency Physicians March 15, 2013