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SOUTH LOUISIANA EDITION YOUR PRIMARY SOURCE FOR PROFESSIONAL HEALTHCARE NEWS On Rounds Read Louisiana Medical News online at www.louisianamedicalnews.com DECEMBER 2014 / $5 State Wellness Program Swells Dr. Yvens Laborde His Brothers’ Keepers It’s been almost five years since the devastating earthquake rocked Haiti on January 12, 2010, killing over 250,000, injuring over 300,000 and displacing over 1.5 million people ... page 3 Hospitals Scramble to Ensure Ebola Training, Equipment in Place The potential threat of Ebola sent Louisiana health officials and hospitals rushing to make sure staff and healthcare providers have the proper training and equipment to deal with the latest infection control protocols ... page 4 LEGISLATIVE AFFAIRS: Health Care Commission November Meeting ... page 7 Physician Spotlight PRINTED ON RECYCLED PAPER PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357 (CONTINUED ON PAGE 8) To promote your business or practice in this high profile spot, contact Scott Cavitt at Louisiana Medical News. [email protected] • 337.235.5455 BY LYNNE JETER In June, the American Medical Association (AMA) adopted a resolution addressing telemedicine as a key innovation in sup- port of healthcare delivery reform. Timing of the resolution melds with legislative advocacy action being made at the local, state and national levels as telemedicine goes mainstream. Among the high points: a universally-accepted telemedicine payment model, licensure portability, ethical guidance, clinical concerns and recommendations. “The umbrella of the reason and purpose of the resolution is that we recognized the technology of telemedicine was a very im- portant tool we could use to take better care of our patients,” said AMA’s Telemedicine Push Evolution improves health outcomes, accelerates medical education change, and enhances physician satisfaction and practice sustainability (CONTINUED ON PAGE 6) BY TED GRIGGS A state program designed to en- courage healthy behaviors has grown from one WellSpot to more than five dozen in just six months. Coletta C. Barrett, vice presi- dent of mission at Our Lady of the Lake Regional Medical Center, said Well-Ahead Louisiana is needed. The Department of Health and Hospitals launched the ini- tiative to improve the health and wellness of residents. Chronic diseases sucked $4.5 billion out of the state’s economy in 2003, according to the Milken Institute. Making smart choices – going tobacco-free, eating a healthy lunch, or workplace fitness programs – could reduce economic costs by an estimated $17 billion in 2023 and increase the state’s economic output by $62 billion in 2050. “I think it’s a good start in the right direction for highlighting … how busi- nesses can be a part of creating a culture and environment of health,” Barrett said. “I encourage others to evaluate the criteria, see what fits for them and join us.” The Lake was the first hospital in the state recognized as a Level 1 WellSpot, the highest of three levels in the program. Our Lady of the Lake College was the second university to receive a WellSpot designation. In order to achieve Level One, the Lake had to meet all of the program’s criteria. Those requirements include a tobacco-free policy; investing in a community-based obesity prevention program; providing healthy dining options in the cafeteria; diabetes self-management education training or prevention programs; and promoting the 5-2-1-0 pro-

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Page 1: Louisiana Medical News December 2015

SOUTH LOUISIANA EDITION

yOUR PRIMARy SOURCE FOR PROFESSIONAL HEALTHCARE NEWS

make blend:Type wordOUtlinecopy and pasteselect both sets of wordshold shift key and select gradientchoose reverse front to back

text:100 Helv. Ultra comp-20 AV(one on right)-100 (between words)stroke .25 pt.

On Rounds

Read Louisiana Medical News online at www.louisianamedicalnews.com

DECEMBER 2014 / $5

State Wellness Program Swells

Dr. Yvens LabordeHis Brothers’ Keepers

It’s been almost fi ve years since the devastating earthquake rocked Haiti on January 12, 2010, killing over 250,000, injuring over 300,000 and displacing over 1.5 million people ... page 3

Hospitals Scramble to Ensure Ebola Training, Equipment in PlaceThe potential threat of Ebola sent Louisiana health offi cials and hospitals rushing to make sure staff and healthcare providers have the proper training and equipment to deal with the latest infection control protocols ... page 4

LEGISLATIVE AFFAIRS: Health Care Commission November Meeting ... page 7

Physician Spotlight

PRINTED ON RECYCLED PAPER

PRSRT STDU.S.POSTAGE

PAIDFRANKLIN, TN

PERMIT NO.357

(CONTINUED ON PAGE 8)

To promote your business or practice in this high profi le spot, contact Scott Cavitt at Louisiana Medical News.

[email protected] • 337.235.5455

By LyNNE JETER

In June, the American Medical Association (AMA) adopted a resolution addressing telemedicine as a key innovation in sup-port of healthcare delivery reform. Timing of the resolution melds with legislative advocacy action being made at the local, state and national levels as telemedicine goes mainstream.

Among the high points: a universally-accepted telemedicine payment model, licensure portability, ethical guidance, clinical concerns and recommendations.

“The umbrella of the reason and purpose of the resolution is that we recognized the technology of telemedicine was a very im-portant tool we could use to take better care of our patients,” said

AMA’s Telemedicine PushEvolution improves health outcomes, accelerates medical education change, and enhances physician satisfaction and practice sustainability

(CONTINUED ON PAGE 6)

By TED GRIGGS

A state program designed to en-courage healthy behaviors has grown from one WellSpot to more than fi ve dozen in just six months.

Coletta C. Barrett, vice presi-dent of mission at Our Lady of the Lake Regional Medical Center, said Well-Ahead Louisiana is needed.

The Department of Health and Hospitals launched the ini-tiative to improve the health and wellness of residents.

Chronic diseases sucked $4.5 billion out of the state’s economy in 2003, according to the Milken Institute. Making smart choices – going tobacco-free, eating a healthy lunch, or workplace fi tness programs – could reduce economic costs by an estimated $17 billion in 2023 and increase the state’s economic output by $62 billion in 2050.

“I think it’s a good start in the right direction for highlighting … how busi-nesses can be a part of creating a culture and environment of health,” Barrett said. “I encourage others to evaluate the criteria, see what fi ts for them and join us.”

The Lake was the fi rst hospital in the state recognized as a Level 1 WellSpot,

the highest of three levels in the program. Our Lady of

the Lake College was the second university to receive a WellSpot designation.

In order to achieve Level One, the Lake had to

meet all of the program’s criteria. Those requirements include a tobacco-free policy; investing in a community-based obesity prevention program; providing healthy dining options in the cafeteria; diabetes self-management education training or prevention programs; and promoting the 5-2-1-0 pro-

Notes from the Louisiana

Page 2: Louisiana Medical News December 2015

2 • DECEMBER 2014 Louisiana Medical News

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Decisions made today have career-long consequence.

Page 3: Louisiana Medical News December 2015

Louisiana Medical News DECEMBER 2014 • 3

By LISA HANCHEy

It’s been almost fi ve years since the devastating earthquake rocked Haiti on January 12, 2010, killing over 250,000, injuring over 300,000 and displacing over 1.5 million people. While conditions have improved, the healing and rebuilding is far from over. Ensuring that this impover-ished nation is not forgotten is Dr. Yvens Laborde, a Haitian native who practices right here in Louisiana.

Growing up in Haiti, Laborde always felt a calling to help the less fortunate. His uncle, an epidemiologist, taught him about the diseases ravaging the Haitian population. “He used to bring slides and his microscope with him,” Laborde re-called. “I was always fascinated with his ability to identify the particular specialties in the area and the science behind ma-laria as it related to Haiti. That was some-thing that struck my interest pretty young, maybe at age 8 or 9.”

Since childhood, Laborde knew that he wanted to become a doctor and study in the United States. “In Haiti, education is valued a tremendous amount,” he ex-plained. “Once you’ve done your studies there, most families that have means and the capability, try to send their children to the States or to Europe for their edu-cation.”

After graduating from high school, he decided to head to New Orleans be-cause of its similar climate and culture. “Haiti contributed a great deal to the cultural, economic, architectual and in-tellectual development of New Orleans, since many of the French colonists, freed men of color, intellectuals, land owners, architects, etc., fl ed to New Orleans after the Haitian revolution,” the history buff explained. ”That led to New Orleans’ Renaissance, which nearly doubled the population of New Orleans. So, a signi-fi cant portion of New Orleans’ culture, architecture and cuisine was strongly infl uenced by this migration.”

Laborde attended Loyola and gra-duated from UNO. He studied medi-cine at LSU, followed by an internship at Tulane and residency at Ochsner. He decided to specialize in internal medi-cine. “I’ve always had in my mind that I wanted to go into a fi eld that would allow me to care for a broad, general base of pa-tients,” he explained. “But, I also always had Haiti in mind in terms of the ability to apply the value I would get in my training to actually have an impact there.”

In 1995, Laborde offi cially joined Ochsner, becoming a member of the Ochsner Health System Board. He cur-

rently serves as the regional medical di-rector of Ochsner Medical Center West Bank. “I’m a New Orleans resident by proxy,” he said with a laugh.

But, back-to-back disasters called him back to his native country. In 2008, Hurricanes Fay, Gustav, Hanna and Ike caused massive fl ooding in Haiti, sparking Laborde to establish a relief effort. Imme-diately following the disastrous 2010 ear-thquake, Laborde returned for more than two weeks to provide medical care to vic-tims. Under the leadership of Dr. Patrick Quinlan, Warner Thomas and Michael Hulefeld, Laborde launched the Ochsner Haitian Relief Fund. He returned to Haiti that November after the ensuing cho-lera epidemic which killed almost 10,000 people.

Working with Ochsner’s support and in collaboration with the Health Ministry of the North, Laborde founded FON-DYLSAHH, a Haitian-based non-profi t promoting health, education, agriculture and economic development in Haiti with a focus on resiliency and self-reliance. “Growing up in Haiti actually helped form me and has always been a driving force in the things that I’ve tried to accom-plish,” he said. “Although I’ve been in the States since 1982, I’ve always had a sense of cultural and historical obligation to help my native country.”

Since the earthquake, he has gone to Haiti at least once a year with a team of senior residents from The University of Queensland School of Medicine in Bris-bane, Australia, which entered into a part-nership with Ochsner in 2009. Recently, Ochsner and the University of Queensland established a relationship with a hospital

and clinic near Cap-Haïtien. “Over the last fi ve years, Haiti has improved, consid-ering the devastation that was caused by the earthquake,” he said. “At one point, there were close to one million displaced

people in Port-au-Prince living in tempo-rary housing and shelters. The last num-bers were less than 100,000. The cleanup has improved signifi cantly.”

Still, circumstances remain dire for many residents. Infectious disease, such as acute diarrheal illnesses, malaria, TB, Dengue fever, Chikunguaya, typhoid and cholera, as well as other non-commu-nicable conditions, continue to prevail. “Malnutrition is still a signifi cant issue, es-pecially in the pediatric population where defi ciencies of certain vitamins, like Vita-min A, have adverse effects on young, de-veloping children,” Laborde said. “There is also a signifi cant problem with intestinal parasitic illnesses, because infestation is fairly common over there.”

Laborde stresses that doctors should not forget about Haiti. ”The beauty of being a physician lies in our appreciation and understanding that our purpose, fi rst and foremost, is to serve,” he said. “As physicians, we are all our brothers’ kee-pers, and we will all continue to work to eradicate the ‘disease’ of poverty – the root cause of the suffering and loss of life.”

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For more information about the Ochsner Haitian Relief Fund, visit the website at www.ochsner.org/lp/haitianrelief or call (504) 872-7120.

Page 4: Louisiana Medical News December 2015

4 • DECEMBER 2014 Louisiana Medical News

By TED GRIGGS

The potential threat of Ebola sent Louisiana health officials and hospitals rushing to make sure staff and healthcare providers have the proper training and equipment to deal with the latest infection control protocols.

Dr. Frank Welch, medical director for community preparedness at the Depart-ment of Health and Hospital’s Office of Public Health, said the Dallas Ebola case where two nurses were exposed changed the guidelines for Personal Protective Equipment (PPE).

“Many hospitals and healthcare in-stitutions are kind of scrambling to get

the appropriate personal protective equipment and make sure they have enough of it in stock,” Welch said. “Now, I hear that’s going well, but there really has been a rush on personal protective equip-ment, that’s for sure.”

In late October, Baton Rouge-based Convergence Equity LLC announced an agreement to provide around 350,000 Ebola-resistant suits to fed-eral departments and agencies.

The Louisiana Hospital Association is encouraging hospitals to conduct drills and training sessions with key staff and health-

care providers to implement the latest in-fection-control procedures, President and Chief Executive Officer Paul A. Salles said.

Welch said all of the hospitals, in Lou-isiana and elsewhere, are updating their PPE caches to support the most recent rec-ommendations from the federal Centers for Disease Control.

That doesn’t mean anyone expects the United States to see anything remotely like the 13,000 to 14,000 Ebola infections reported in Guinea, Liberia and Sierra Leone, Welch said. Ebola doesn’t spread like a pandemic.

“I think over the next 12 to 18 to 24 months we possibly could expect one (case) in Louisiana,” Welch said.

The United States is really encourag-ing healthcare and humanitarian workers to go over to Africa and treat people and control the outbreak at its source, he said. So given that that is the way the disease will be stopped one has to expect that “every once in a while” a healthcare worker is going to come back after being exposed to Ebola.

“What we need to do is make sure we can identify and recognize it, catch it early because that’s when they’re not infectious, appropriately contain them, and treat the workers appropriately,” Welch said.

This approach has generated good results among the healthcare workers who have come back to the U.S. after being ex-posed to Ebola, Welch said. The method has also prevented secondary infections from those workers.

However, Louisiana public health of-ficials and the federal Centers for Disease Control, not to mention other health ex-perts, differ when it comes to determining what is appropriate where Ebola is con-cerned.

Louisiana officials told healthcare pro-fessionals who’ve been to Ebola-stricken countries to skip two major conventions in New Orleans.

The state’s medical director, Dr. Jimmy Guidry, told members of the media Louisiana’s response is in no way an over-reaction.

Lowering the number of convention attendees may mean a temporary hit to the New Orleans economy, but that’s prefer-able to even one person with Ebola attend-ing a convention of thousands of healthcare providers, he said.

Welch said there was a little discrep-ancy between the state’s protocol and that of the CDC.

Louisiana basically says anyone who has visited Guinea, Liberia or Sierra Leone – countries where roughly 14,000 people have died from Ebola in the last few months – must be isolated for 21 days.

The CDC’s most recent protocols as-sign people different risk categories, with the levels of monitoring or action depend-ing on the category, Welch said.

For example, a person who has been to any of the three affected countries and falls ill before leaving is encouraged to stay in that country.

People who aren’t sick and return to the United States are funneled through five major U.S. airports where CDC workers interview them. The questions include ask-ing whether visitors treated Ebola patients, how long they were in the affected coun-try, if they encountered anyone who was ill while there, Welch said. Those visitors and their risk categories are reported to the state departments of health, and the visitors are then monitored for 21 days.

That’s true whether the visitor was a doctor who treated Ebola patients but didn’t have access to all of the recom-

Hospitals Scramble to Ensure Ebola Training, Equipment in Place

Dr. Frank Welch

(CONTINUED ON PAGE 7)

Page 5: Louisiana Medical News December 2015

Louisiana Medical News DECEMBER 2014 • 5

By CINDy SANDERS

On average, it takes 12 years and more than $500 million … sometimes significantly more … to move a new drug from bench to bedside in the United States. But what happens when there is an urgent or emergent need for new drugs, vaccines and biologics to be developed in the wake of a public health crisis?

The recent attention on Ebola brought with it an increased interest in the approval process of the U.S. Food and Drug Administration. The FDA is tasked with finding the critical balance between urgent public need and overall safety and efficacy of drugs being distributed … even in a limited, experimental manner.

Under Normal Circumstances Of the 5,000-10,000 compounds

entering the research and development pipeline at any given time, only about 250 make it to the pre-clinical phase of testing. From there, only about five will make it to clinical trials in humans with only one drug ultimately receiving FDA approval.

Generally, developers should expect to spend three-six years in the discovery and pre-clinical phase of the process. If enough supportive data results from conducting research and animal model

studies, then a company approaches the FDA to ask for consideration of clinical trials. Only about one of every 1,000 com-pounds being tested will prove promising enough for a company to file an Investigational New Drug (IND) application.

Approval of the IND by the FDA and an Institutional Review Board leads to another six-seven years being invested in phased human trials. If, after run-ning that gauntlet, the product has the evidence to back its efficacy and safety, a New Drug Application (NDA) is filed for FDA review. From there, drug developers will probably wait another six months-two years for the FDA to complete the review process.

Speeding Up the TimelineHowever, noted Jennifer Rodriquez,

a spokesperson for the FDA, “There are several paths for making drugs and bio-logics that qualify available as rapidly as possible … such as Fast Track, Priority Review, Accelerated Approval and Break-through Designation.”

Fast Track is a process to facilitate development and expedite review for drugs to treat serious conditions and fill

unmet medical needs, which is defined as providing a therapy where none exists or providing a therapy that could potentially be better than anything currently avail-able.

Priority Review allows for a quicker process and indicates the FDA’s goal is to take action on an application within six months of receiving data.

Accelerated Approval gives the FDA a mechanism to get drugs that fill an unmet condition approved using a surro-gate or an intermediate clinical endpoint rather than waiting the years it could take to fully show a drug is clinically meaning-ful over the long haul. Such surrogate or intermediate endpoints – ranging from laboratory measures to improved mor-bidity and mortality rates – are reason-ably likely to predict the clinical benefit of a drug.

Breakthrough Designation is

given to drugs or therapies in-tended to treat serious conditions that are deemed to offer substan-

tial improvement over other avail-able therapies.

“Under certain circumstances, the FDA can also enable access for individuals to investigational products through mech-anisms outside of a clinical trial, such as through an Emergency Investigational New Drug (EIND) application under the FDA’s Expanded Access program,” Ro-driguez said. “In order for an experimen-tal treatment to be administered in the United States, a request must be submit-ted to and authorized by the FDA.”

She added the FDA is ready and will-ing to work with companies and investi-gators focused on serious public health issues, such as caring for Ebola patients in dire need of treatment, “to enable access to an experimental product where appro-priate.”

Rodriguez continued, “Under the FDA’s Emergency Use Authorization (EUA) mechanism, the agency can also enable the use of an unapproved medical product, or the unapproved use of an ap-proved medical product, during emergen-cies when … among other circumstances … there are no adequate, approved and

Urgent & EmergentGetting new treatments through the FDA pipeline

(CONTINUED ON PAGE 9)

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Dr. Flannery has almost 30 years of experience in the field of neurosurgery, specializing in pediatric and general neurosurgery. Most recently, she has been leading a group of pediatric neurosurgeons in developing evidence-based guidelines for the treatment of common pediatric neurosurgical disorders.

Page 6: Louisiana Medical News December 2015

6 • DECEMBER 2014 Louisiana Medical News

AMA President Robert Wah, MD. “Un-derneath that umbrella, we firmly believe this technology shouldn’t necessarily re-place face-to-face interaction between the physician and the patient. We view face-to-face interaction as the highest qual-ity action to have with a patient because there’s so much detail and information that comes out with direct interaction with our patients. We recognize that in some cases, after a patient-physician interaction has been established, telemedicine can be very helpful. In some instances, such as urgent matters requiring a consult, the technology may be used without an initial face-to-face interaction. But we still be-lieve strongly that face-to-face is optimal for our patients.”

Licensure RequirementsIn its resolution, the AMA made it

clear that the physician providing tele-medicine should be licensed in the state the patient resides.

“We believe it’s important for physi-cians and patients to be treated within the parameter of local regu-lations and laws, which differ widely across the country,” said Wah. “We want to respect those differences and not try to supersede them via the use of telemedicine. For instance, if I as an OB-GYN am going to prescribe birth control for a patient under the age of consent, some states require a parent to be notified. The best way to comply with local regulations and laws is to make sure the physician is licensed in the state he’s using telemedicine.”

BackgroundIn 1996, the Institute of Medicine

(IOM) released the nation’s first com-prehensive report on telemedicine, “Telemedicine: A Guide to Assessing Telecommunications for Health Care.” Despite the evolution of the practice, there remains no consensus on the definition of telemedicine and telehealth, often viewed as interchangeable terms. Instead, three broad categories of telemedicine technol-ogies are defined as: store-and-forward, remote monitoring, and (real-time) inter-active services.

Regardless of the verbiage, “the evolu-tion of telemedicine impacts all three stra-tegic focus areas of the AMA: improving health outcomes, accelerating change in medical education, and enhancing physi-cian satisfaction and practice sustainability by shaping delivery and payment models,” said Charles F. Willson, MD, a pediatrician from Greenville, NC, and presenter of the Report of the Council on Medical Service that preceded the AMA’s adoption of the resolution on telemedicine.

Payment Reform In the report, Willson addressed how

coverage of and payment for telemedi-cine has varied widely after the passage of the Balanced Budget Act of 1997 and the Telemedicine Communications Act

of 1996 enabled payment for professional telemedicine consultation in 1999, and how inconsistencies remain to create bar-riers to the further adoption of telemedi-cine as public and private payers have continued to develop formal mechanisms to pay for telemedicine services.

“Each year, Medicare pays approxi-mately $6 million for telemedicine ser-vices,” according to the report, “In 2009, there were approximately 40,000 tele-medicine visits, involving some 14,000 Medicare beneficiaries. That same year, 369 practitioners, including physicians, provided 10 or more telemedicine services to Medicare beneficiaries – most of which were mental health services.

“Psychiatrists, psychologists and clini-cal social workers comprised 49 percent of the practitioners who provided 10 or more telemedicine services in Medicare. While physician assistants, nurse practitioners and clinical nurse specialists accounted for 19 percent of such practitioners, fam-ily medicine and internal medicine physi-cians accounted for 7 percent.”

The District of Columbia (DC) and 46 states offer some form of Medicaid pay-ment for telemedicine services. Also, 19 states and DC have adopted laws mandat-ing that private payers cover telemedicine services, as defined by various states.

“When any developing therapy or technology in medicine becomes main-stream, we want to make sure there’s a payment for the benefit that gets accrued by using the technology,” said Wah.

Case StudiesHighlighted in the AMA’s Report of

the Council on Medical Service are two case studies resulting from telemedicine outreach and research efforts:

The University of Virginia (UVA) Center for Telehealth across the UVA Telemedicine Partner Networks includes 118 sites offering telemedicine services in more than 40 specialties and sub-special-ties. The center has provided more than 33,000 patient encounters in Virginia, and provides more than 30,000 teleradiology services annually.

The Arkansas ANGELS (Antena-tal & Neonatal Guidelines, Education & Learning System) provides patients with round-the-clock and telemedical support at approximately 30 telemedicine sites statewide to address high-risk obstetrical care needs. In 2012, Arkansas ANGELS reported 5,221 telemedicine visits, 2,062 telemedicine obstetric ultrasound visits, and 130 fetal echocardiogram visits. Also the same year, 1,629 colposcopy exams were performed, which identified 303 women with high-grade lesions requiring treatment and five diagnosed with cancer.

“We made a strong statement in our resolution to lobby for continued research on the most optimal way to use telemedicine and integrate it into our current delivery sys-tem to take better care of our patients,” said Wah. “I don’t have specific thoughts about how that research would proceed. Yet, as with any therapy or technology that I use to care for my patients, I’m always looking for ways to improve that care.”

AMA’s Telemedicine Push, continued from page 1

Dr. Robert Wah

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Page 7: Louisiana Medical News December 2015

Louisiana Medical News DECEMBER 2014 • 7

Legislative AffairsBY CINDY BISHOP

Notes from the Louisiana Health Care Commission November Meeting

Chairman Donna Fraiche called the meeting to order on November 7. She welcomed the newest member of the coun-cil Diana Davison from Roy O. Martin Lumber Company headquartered in Al-exandria.

Marilyn Reynaud, Office of Public Health, gave an update on the Ebola Virus, presenting a Power Point presentation on behalf of Dr. Jimmy Guidry, state health officer.

Ebola was first identified in 1976 in what is now the Democratic Republic of the Congo.

Bats are the reservoir. Ebola is not spread through air, food or water but its incubation period is 2 to 21 days with the average being 8-10 days.

It is not contagious until the patient develops symptoms such as weakness, muscle pain or sore throat.

If someone must travel – avoid handling items that are contaminated. Wash your hands often or use an alcoholic based sani-tizer regularly. Avoid facilities in West Africa where Ebola patients are treated. Avoid fu-neral or burial rituals that require handling the body of a deceased Ebola patient.

The CDC recently came out with risk exposure categories.

For more information, go to the CDC website (www.cdc.gov) or the DHH web-site at dhh.state.la.us.

You can also email [email protected] or call 855-523-2652 for general information.

Navigators UpdatesJackie Riley – Capital Area Agency

on Aging, Karla Wilburn – Family Road Healthy Start and Brian Burton – South-west AHEC gave presentations on their activities as contracted navigators.

During the 2014 Regular Session leg-islators enacted a law requiring navigators to become licensed under the Department of Insurance.

Korey Harvey, Deputy Commissioner gave an update on the Affordable Care Act.

Dr. Eric Bumgartner gave an update on the Affordable Care Act Working Group that he chairs. Dr. Bumgartner works for the Louisiana Public Health Institute.

Commissioner Donelon gave a brief update. He thanked the members of the Louisiana Health Care Commission for their collective brain power and contribu-

tions. He acknowledged that now is the time for open enrollment. The penalty for not signing up for insurance is increasing this year to $325 so this may result in more folks enrolling in health plans.

Regarding insurance rates in the health insurance market, they went up 12-15 percent in Louisiana. Donelon said that the DOI has been asking for prior-ap-proval on rates. Donelon said he will con-tinue to ask the legislators for the authority. The legislature did, however, give DOI the ability to obtain informational rates from health insurers. Now the Department of Insurance will receive all rate filings.

DOI received a grant from the fed-eral government and they’ve been able to communicate with the carriers about their rates. This has resulted in a $4 million rate reduction for policy holders in Louisiana.

Legislative Affairs content is provided by Checkmate Strategies, publisher of Health Care Information Services. All content © Checkmate

Strategies and Louisiana Medical News, LLC. For more information, readers may contact Cindy

Bishop at 225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to [email protected]. Our website is www.checkmate-strategies.com

mended PPE or worked on an offshore rig and never saw another person, Welch said. The rig worker might be able to self-report his temperature twice a day rather than having a public health worker do the temperature check.

Welch said it will take the state a little while to catch up to the CDC policy.

The state wants the full 21-day quar-antine because Louisiana has no way to know what risk category a visitor fell into before the new CDC protocol was estab-lished, Welch said.

The Louisiana requirements drew criticism from the American Public Health Association and the American Society of Tropical Medicine and Hygiene, among others. Both associations scheduled Novem-ber conferences in New Orleans. Although both objected to the state requirement as non-scientific, both groups agreed to abide by the request. The APHA convention was expected to draw 14,000 people, while at-tendance at the Tropical Medicine confer-ence was estimated at around 3,500 people.

“We have gotten a little kickback…. People say the medical science supports the position: ‘If I didn’t come into contact with anyone, I couldn’t have Ebola, even if I went to Liberia,’” Welch said. “They’re right. The medical science supports that. But we as a state can’t assure the other residents that we know that to be true, until that full program is implemented for 21 days.”

Hospitals, continued from page 4

Page 8: Louisiana Medical News December 2015

8 • DECEMBER 2014 Louisiana Medical News

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Call 1-800-716-2299 Email [email protected] Visit www.bcbsla.com/QBprograms

01MK5881 10/14

Good Health Has Its Rewards

Blue Cross and Blue Shield of Louisiana is incorporated as Louisiana Health Service & Indemnity Company and is an independent licensee of the Blue Cross and Blue Shield Association.

gram – fi ve or more fruits and vegetables, two or few hours of recreational screen time, one or more hours of physical activity, and zero sodas or sweetened drinks every day.

Getting to Level One, with the attendant staff participation, en-gagement and outcomes takes a long time, Bar-rett said. When the state Department of Health and Hospitals an-nounced the Well-Ahead program, it sounded interesting because the Lake had

already been on a “wellness journey” for some time.

The Lake’s wellness effort centers on its Healthy Lives program. The data-driven endeavor identifi es the workers most at risk for serious health issues and provides a path to prevention and wellness. The assistance includes coaching and an environment that helps people get healthier.

Barrett said after examining the Well-Ahead criteria, the Lake realized it was al-ready doing most of the program.

However, the hospital did have to pull some additional data and perform some analysis, Barrett said. For example, the

Lake had to look at how much it was spend-ing in different areas, such as anti-obesity and community education programs.

“We were doing the program and the function and the work, but we didn’t nec-essarily report it as an outcome,” she said. “We had to do the analysis to make sure we could tell the story.”

The Lake doesn’t have data showing the cost savings from Well-Ahead Louisi-ana.

But the Healthy Lives program has helped the Lake prevent its health insurance premiums from rising for four years, with only a slight increase this year, Barrett said.

Barrett said the biggest hurdle Lake employees had to overcome may have been going tobacco-free, Barrett said. That means not only cigarettes, but chew-ing, dipping and even electronic nicotine dispensers.

The Lake had a surprising number of tobacco chewers and snuff dippers, Bar-rett said. The hospital helped workers with smoking-cessation classes and support.

In their annual health assessments, workers are asked if they’re tobacco-free, Barrett said. They are also required to prove they are by blowing into a device that measures the nicotine in their system, whether they smoke, dip or chew.

“In God we trust. Everybody else you gotta bring the data,” Barrett said.

The most diffi cult ongoing challenge is weight loss.

This is probably even harder than giv-ing up tobacco because weight issues are even more rampant, Barrett said.

Most people lack a structured, built-in environment that helps them be more physically active. Jobs have evolved to be less physically challenging. Meanwhile, Louisiana’s culture revolves around phe-nomenal food, food that is often prepared in the least healthy way possible.

The Lake can put up a sign that says “no smoking” or prohibit the use of to-bacco in certain locations, and people fol-low the rules, Barrett said.

“But you pull the fryer out of our kitchen, and you don’t give people their fried chicken on Thursdays, oh my word!” she said.

The Lake has added healthier options to vending machines and steers people toward snacks with less salt, fat and sugar. There are baked chips and dark-chocolate selections available. The hospital has also sharply reduced the sugary drinks avail-able, adding fl avored waters, no-calorie energy drinks and diet teas.

The options mean people can still get the crunch and the salt, or the sugar and the chocolate, while consuming less of the things that are bad for them, Barrett said. But the reality is that the unhealthy stuff sells.

Still, it will be interesting to see how the Lake can continue to change the envi-ronment for healthier eating options, Bar-rett said.

State Wellness Program Swells, continued from page 1

Coletta C. Barrett

Page 9: Louisiana Medical News December 2015

Louisiana Medical News DECEMBER 2014 • 9

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available alternatives.”She explained the EUA is an impor-

tant way for the FDA to allow broader access to available products. It was the mechanism put in play this past August that allowed the FDA to authorize use of a diagnostic test developed by the U.S. De-partment of Defense to detect the Ebola Zaire virus in individuals.

In times of public health crisis or epi-demic, Rodriguez noted, “The FDA’s role during situations like this involves sharing information about medical products in development, as well as communicating our assessment of product readiness and clarifying regulatory pathways for devel-opment.” She added the FDA works with other U.S. government agencies, inter-national partners, and medical product sponsors to move products forward in de-velopment as quickly as possible without

compromising patient safety.She also noted the FDA plays an im-

portant role in disseminating evidence-based information to the public. “Unfortunately, during outbreak situations, fraudulent prod-ucts claiming to prevent, treat or cure a dis-ease almost always appear,” she said of those who play on public fears.

While the agency has a number of mechanisms to move the science more rapidly through the pipeline, Rodriguez stressed that doesn’t mean the agency gets away from its primary goal of making sure the American public has access to safe, ef-fective treatment options.

“It’s important to note that every FDA regulatory decision is based on a risk-benefi t assessment of scientifi c data that includes the context of use for the product and the patient population being studied,” she concluded.

Urgent & Emergent, continued from page 5

In the News

2014 LAMMICO Scholarship Recipients Named

METAIRIE- For the 14th consecutive year, LAMMICO has assisted recent col-lege graduates with the cost of attend-ing medical school in Louisiana.

“LAMMICO’s unique scholarship program offers support to these local students as they continue their medical training to become excellent contribu-tors to our state’s healthcare system,” said Thomas H. Grimstad, M.D., LAMMI-CO’s President/Chief Executive Offi cer.

Since 2000 – 2001, LAMMICO has awarded merit scholarships to qualify-ing medical students for their fi rst year enrollment at every Louisiana medical and dental school. Including this year’s class, a total of 55 incoming freshmen students have earned the LAMMICO scholarship to help defray tuition and other expenses. Eligible students are incoming freshmen from Louisiana. The following institutions award the scholar-ships based upon criteria established at each medical school:

LSU School of Dentistry - New Or-leans: Blaine P. Adams from Cut Off, Louisiana graduated cum laude from Nicholls State University in May 2010 with a degree in biology. He then con-tinued his education at Nicholls, where he fi nished required course work toward a Master of Science degree in Marine and Environmental Biology. Blaine is cur-rently in the process of defending his master’s thesis, which includes extensive research of molecular cloning of mobile elements in the genome of Louisiana’s commercial red swamp crawfi sh.

The LSU School of Dentistry is the only dental school in the state and educates nearly 75 percent of all practicing dentists in Louisiana. LAMMICO has awarded a scholarship to a student at LSU Dental School since 2005.

LSU Medical School: New Orleans: Edward-Michael Dussom graduated from Harvard College in 2012 with a bachelor of arts degree in romance lan-

guages and literatures. Originally from Covington, he has spent the last two years enrolled in a post-baccalaureate program at the University of New Or-leans, taking advance course work in im-munology, microbiology and biochem-istry. Before enrolling in medical school, Dussom worked at Lakeview Regional Medical Center in Covington, providing patient care as an emergency room tech-nician. Dussom was valedictorian of his class at Covington’s St. Paul High School.

LSU Medical School: Shreveport: Kyle P. Schuler of Shreveport gradu-ated from LSU-Baton Rouge in May 2014 with bachelor of sciences degree in biology. Because of his 4.0 cumulative grade point average, Schuler received the University Medal for having one of the highest GPA’s in his graduating class at LSU. He was also on the LSU Chan-cellor’s Honor Roll during his freshman, sophomore and junior years. Schuler worked as a medical transport every summer as an undergraduate student at Christus Schumpert Highland Hospital in Shreveport, where he coordinated with physicians, nurses and other healthcare professionals to take patients from their rooms to various locations for X-rays, scans, surgery and other medical tests or procedures.

Tulane University Medical School: Madeline O. Jansen of Metairie gradu-ated from Stanford University in 2012 with a bachelor of arts degree in human biol-ogy. She received the Dean of Student’s Outstanding Achievement Award during her sophomore, junior and senior years at Stanford. Jansen stayed on the West Coast after receiving her undergraduate degree, conducting research in the psychiatry and behavioral sciences department at Stan-ford University School of Medicine. While there, Jansen wrote a resource guide for students with eating disorders and created an Internet-based obesity prevention pro-gram. Her future goal is to practice in the fi eld of adolescent psychiatry.

Page 10: Louisiana Medical News December 2015

10 • DECEMBER 2014 Louisiana Medical News

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Louisiana Health Care Quality Forum Names New Offi cers and Board Members

BATON ROUGE – The Louisiana Health Care Quality Forum has named new offi cers and board members to its Board of Directors for 2014-2015.

The new offi cers are Louis Minsky, MD, President, private practitioner with Minsky & Carver Medical Center for Wellness in Baton Rouge; John Car-roll, CFM, ARPC, CRPC, CSNA, AAMS, President-Elect, Vice President with Merrill Lynch Wealth Management in Alexandria; Stephen Wright, Secretary/Treasurer, President/CEO of CHRISTUS Health Louisiana in Alexandria; and Donna D. Fraiche, Esq., Member at Large, attorney with Baker, Donelson, Bearman, Caldwell & Berkowitz in New Orleans and Baton Rouge.

In addition, three individuals have joined the Quality Forum Board: Chuck Burnell, MD, lead Medical Director with Acadian Companies in Lafayette; Teri Fontenot, FACHE, President/CEO of Woman’s Hospital in Baton Rouge; and Wes Hataway, JD, director of the Offi ce of Workers’ Compensation Administra-tion for the Louisiana Workforce Com-mission in Baton Rouge.

Returning board members include: Daniel Burke, SPHR, director of Corpo-rate Benefi ts with Turner Industries in Baton Rouge; David Carmouche, MD, Executive Vice President of External Operations and Chief Medical Offi cer with Blue Cross Blue Shield of Louisiana in Baton Rouge; Catherine Fairchild, JD, Right of Way Manager for CSRS, Inc. in Baton Rouge; Glen Golemi, President and CEO of UnitedHealthcare’s Gulf States Region in Metairie; Sandra Kem-merly, MD, MACP, FIDSA, Medical Di-rector of Clinical Practice Improvement for Ochsner Health System in New Or-leans; Susan E. Nelson, MD, FACP, FAAHPM, Medical Director of Senior Services for the Franciscan Missionar-ies of Our Lady Health System in Baton Rouge; and Leonard Weather, Jr., R.Ph, MD, Director of the Omni Fertility and Laser Institute in Shreveport.

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Page 11: Louisiana Medical News December 2015

Louisiana Medical News DECEMBER 2014 • 11

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