Clinical Innovation Summit

May 2 – 3, 2020. Virtual Conference.

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Day 1 – Saturday: May 2nd

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11:00am – 11:20am EST

Opening Statements

Roger Cox, FNP

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11:20am – 12:20pm EST

ProactiveMD Institute – A Technological Enabler of Disruption

Tony Brown, MD, FAPCR, PhD.
(1.0 CME)

To acknowledge that we produce data with relentlessly increasing volume and are therefore capable of applying it to improve healthcare by:
  1. Appreciating the application of Data Analytics to healthcare
  2. Understanding Disruptive technology
  3. Comprehending the Direct Primary Care business model
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12:20pm – 1:20pm EST

Cervical Cancer Screening and Menopause/HRT

Sandra Luyindula, MD
(1.0 CME)

Cervical cancer has caused more than 7% mortality worldwide.
With adequate screening, mortality has decreased in the US. However patient without adequate access to preventive care continue to be at higher risk.

Hormone replacement therapy, with appropriate use, can provide relief from vasomotor symptoms in postmenopausal women

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1:20pm – 1:30pm EST

Break

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1:30pm – 2:30pm EST

Workup & Treatment of Autoimmune Joint Pain & Rash

Philip Eskew, DO, JD, MBA
(1.0 CME)

This session will cover the following:
  1. When should a practitioner’s “autoimmune antenna” go up? Which chief complaints or unexplained lab findings warrant an autoimmune workup? How many tests should be ordered and when should they be stopped (in the likely event a clear answer has not been found)?
  2. Why do all my patients appear to obsess over every rash? Is it related to their diet, their stress, etc.
  3. Autoimmune medications – Which medications should be attempted first? What are the most common risks and complications with these medications?
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2:30pm – 3:30pm EST

Psych

Jennifer Cox, PMHNP-C, FNP-C
(1.0 CME)

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3:30pm – 3:45pm EST

Opening Remarks: Factors Impacting Your Direct Primary Care Practice

Kayur Patel, MD, FACP, FACPE, FACHE, FACEP

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3:45pm – 4:45pm EST

A DPC Medicare Pilot in Ten Codes or Less

Philip Eskew, DO, JD, MBA
(1.0 CME)

Review a potential Medicare backdoor DPC pilot opportunity in detail by discussing the flexibility of these CCM codes, preventive codes, electronic visit codes and consultation codes.
We would also review the proposed civil monetary penalties law changes and discuss potential updates that might take place when a final rule is released.
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4:45pm – 5:15pm EST

Managing Clinical Risks

Kayur Patel, MD, FACP, FACPE, FACHE, FACEP
(0.5 CME)

The threat of litigation following a misdiagnosis or improper treatment in high-risk medical conditions presents a challenge to healthcare providers.
In a continuously moving healthcare industry, with the pendulum swinging or the dynamics changing, we are in a constant flux of information that we can use, misuse, overuse or underuse; and by better understanding where our risks lie, we may be able to unfold some of these risks before they actually occur, delivering high-quality care. No time is better than today to use a multidisciplinary approach to risk management.
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5:15pm – 6:15pm EST

For Employers Seeking Tax Favored DPC Vehicles Look to (EB)HRAs and telemedicine for HSAs

Philip Eskew, DO, JD, MBA
(1.0 CME)

The telemedicine HSA changes enacted with the CARES Act in March 2020 and The HRA reforms that were enacted as of January 1, 2020 have DPC physicians and employers asking more questions than ever.
This talk reviews the new broad HSA exception for telemedicine purposes, the differences between the old traditional health reimbursement accounts (HRAs), Qualified Small Employer Health Reimbursement Accounts (QSEHRAs), Individual Coverage Health Reimbursement Accounts (ICHRAs) and Excepted Benefit Health Reimbursement Accounts (EBHRAs). Attendees will have a better idea of where each type of HRA is most likely to be used and how these new regulations interplay with the tax treatment of direct primary care when sponsored by an employer.

Day 2 – Sunday: May 3rd

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08:30am – 09:30am EST

Office-based Buprenorphine Therapy for Opioid Dependence: Medication Assisted Treatment

Michael Steelman, DO
(1.0 CME)

Addiction is a chronic disease.
Primary care providers are skilled at treating chronic disorders such as diabetes, hypertension, and depression. Treatment of addiction requires learning a new skill set and incorporating these principles into daily practice. This presentation will identify Addiction as a chronic disease, review the basic requirements to implement a MAT program, review diagnoses and treatment, and explore various patient types. Resources will also be identified to support continued growth in knowledge and skill.
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09:30am – 10:30am EST

Imaging: Ordering and Common Pitfalls

Glenn Tuckman, MD
(1.0 CME)

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10:30am – 11:30am EST

Interpreting Lab Results for Liver/Gallbladder Conditions

Christopher Roman, MA, MMC, PA-C
(1.0 CME)

This interactive lecture will discuss several cases to illustrate common patterns of hepatobiliary diseases and their diagnosis.
With adequate screening, mortality has decreased in the US. However patient without adequate access to preventive care continue to be at higher risk.

Hormone replacement therapy, with appropriate use, can provide relief from vasomotor symptoms in postmenopausal women

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11:30am – 12:30pm EST

Lunch Awards

John Collier, MBA, MHA

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12:30pm – 1:30pm EST

HIPAA, OSHA, CLIA, & Dispensing

Philip Eskew, DO, JD, MBA
(1.0 CME)

This session will cover the following:
  1. Which HIPAA forms are required? How do you request and provide information to other practices? What if the email was sent to the wrong person? What if a patient starts texting and emailing instead of using the patient portal?
  2. What do the OSHA blood born pathogen standards mean for me? What if a patient presents to the clinic complaining about a hazardous chemical exposure? When do CLIA rules apply?
  3. Who may dispense medications in my state? The patient wants me to just mail the medications to his house instead – is this ok?
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1:30pm – 2:15pm EST

Prostate Cancer Screening Update

Richard Kosierowski, MD
(0.75 CME)

Prostate cancer is a common malignancy in American males.
There is limited data to suggest that early diagnosis/treatment results in a survival benefit. The role and methods of PSA screening will be reviewed as well as what to do with an elevated PSA. Patient options in terms of molecular and germline testing will be reviewed.

Therapy options for prostate cancer include active surveillance, surgery or radiation therapy. The pro’s and cons of each option will be reviewed. After definitive therapy, patients will need lifelong surveillance to detect PSA relapse. The natural history of prostate cancer will be reviewed.

Educational Objectives:

  1. Identify the ideal patients for early detection
  2. Risk stratify patients to order to identify patient who need additional testing
  3. Review therapy options and side effects of therapy
  4. Understand the significance of PSA relapse
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2:15pm – 2:20pm EST

Break

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2:20pm – 3:15pm EST

Immunotherapy and Target-Directed Cancer Care

Richard Kosierowski, MD
(0.75 CME)

Cancer therapy has changed markedly over the last decade.
Traditional cytotoxic chemotherapy has been supplemented by the addition of precise immune oncology agents. Agents such as immune checkpoint inhibitors serve to ramp up the body’s native immune system to directly attack cancer cells. The results of the human genome project has led to innovations in DNA sequence technology has led to specific target directed treatments that focus on individual DNA mutations. Advances in monoclonal antibody technology has led to disease specific targeted therapy.

The era of precision medicine has led to overall improvements in patient outcomes. The transition from conventional chemotherapy based cancer treatment to targeted precision anti cancer therapy has numerous implications for the correctional primary care provider. Traditional cytotoxic complications such as neutropenic fever have been replaced by toxicities caused by immune hepatitis and pneumonitis immune system hyperactivity leading to an altered toxicity profile

Technology is not cheap, and the value of current cancer therapy must be defined

Educational Objectives:

  1. Understand the role of the immune system and check point inhibitors in cancer care
  2. Understand role of monoclonal antibodies in cancer care
  3. Outline the role of small molecules in targeting cellular pathways
  4. Differentiate between “ground shot” and” moon shot” cancer research
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3:15pm – 3:20pm EST

Break

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3:20pm – 3:50pm EST

Politics of Healthcare

Kendrick Johhnson, DO
Jeremy Schupbach
(0.5 CME)

This session will focus upon the national debate over public plans, the effect of political decisions on the practice of medicine (debates over vaccines and stockpiles for PPE), and what this means for practicing clinicians – how to prepare and respond when you’re not in control.
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3:50pm – 4:20pm EST

LeadNow!

Kayur Patel, MD, FACP, FACPE, FACEP, FACHE
(0.5 CME)

US per capita healthcare cost is approximately $8,713, spending $3 trillion, or 18% of the national economy.
We have the most expensive system in the world, yet it fails us when it comes to quality outcomes. When one thinks of reducing costs – we assume that quality of care will suffer, and that the changes will lead to more medical errors, but often we can simply cut back on unnecessary and inappropriate services.
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4:20pm EST

Adjourned

Speakers

Kayur Patel, MD, FACP, FACPE, FACHE, FACEP

Chief Medical Officer
Proactive MD

 

Dr. Kayur Patel, is a Practicing Emergency Department Physician. He is trained and boarded in both Emergency Medicine and Internal Medicine.  Dr. Patel is also a highly experienced physician executive. He has over twenty years of practical experience in Healthcare management.

This includes serving as the;

  1. Former Chief Medical Officer of a 278-bed Community Hospital in Terre Haute
  2. Former Director to Health Care Excel, An Quality Improvement Organization for Indiana
  3. Currently he also serves as consultant to KEPRO, the Quality Improvement Organization (QIO)

Dr. Patel is a frequent speaker on the subject of quality in healthcare.  His focus has been on improving methodology in care delivery to ensure Right Care at the Right Time at the Right Price.

Philip Eskew, DO, JD, MBA

Vice President, Clinical Development and General Counsel
Proactive MD

 

Dr. Eskew is the VP of Clinical Development and General Counsel for Proactive MD. He is also the Founder & CEO of DPC Frontier, a legal, regulatory, and growth resource for Direct Primary Care Practices. He also serves as a Site Medical Director for Corizon Health. He routinely researches all regulatory aspects surrounding direct primary care and is also volunteering his time as the General Counsel of the DPC Coalition.

Tony Brown, MD, FAPCR, PhD.

 

Dr. Tony L. Brown is a Harvard University graduate and former United States Army Medical Service Corps officer. He is an approved Harvard Brain Bank investigator and a former volunteer researcher in the Department of Neurology at Columbia College of Physicians and Surgeons, New York State Psychiatric Institute.

Dr. Brown has authored dozens of articles for magazines, websites and medical blogs. Additionally, he has authored or co-authored dozens of manuscripts in peer-reviewed science journals on topics such as neurology, family medicine, gastroenterology, dermatology, psychiatry, oncology, endocrinology, and others.

Sandra Luyindula, MD

Vice President of Clinical Outreach
Proactive MD

 

Dr. Luyindula earned her Bachelors in Biology Premed with minors in Chemistry and French from Xavier University of Louisiana. She then attended Ross University School of Medicine and completed her family residency at Greenville Health System where she received the Greenville Health System Gold Award. She enjoyed providing primary care for patients of all ages, along with making house calls for her geriatric patients prior to joining Proactive MD. She has a special interest in women’s health and lifestyle medicine. What she loves about practicing medicine is the connection she makes with her patients and the ability to cheer them on as they work to achieve their various goals.

Jennifer Cox, PMHNP-C, FNP-C

 

Jennifer has been working in healthcare for over 23 years in a wide variety of settings.  Working as a FNP for many years in ED, ICU and as first assist in surgery for a cardio-thoracic surgeon.  After discovering talent and passion for psychiatry early in her career, she began specializing in child trauma all over Indiana,  specializing in RAD and ASD.  She then obtained another degree in psychiatry as a PMHNP.  She has been state boarded in many states.  She also has worked tele-health for the last 4 years, while also continuing to work in person as a medical and psychiatric provider for a long term residential facility for children and adolescents, with the highest acuity of traumatized children in the state.

Jennifer has been currently specializing in addictions and PTSD for 2 years, and has been asked to run one of only 8 “Help for Hero’s” programs in the nation, this is for active duty soldiers and VA clients suffering from severe PTSD and/or severe addictions.

Michael Steelman, DO

Program Director, Family Medicine Residency
UPMC – Lititz, PA

 

Michael T. Steelman DO is the program director for the Family Medicine Residency at UPMC-Lititz in Pennsylvania. The doctor is a graduate of PCOM class of 1984, a former Navy Flight Surgeon, and completed his Family Medicine residency at Memorial Hospital in York,PA. After 23 years in private practice, Dr. Steelman transitioned to Graduate Medical Education and now directs residents at two Medication Assisted Treatment (MAT) programs providing service to a high risk urban population. Dr. Steelman is board certified in Family Medicine by ACOFP and a member of American Osteopathic Academy of Addiction Medicine and Pennsylvania Pain Society.

Glenn Tuckman, MD

Diagnostic Radiologist
Center for Diagnostic Imaging

 

Glenn Tuckman received his MD degree from the University of Pennsylvania in 1982, completed his residency in Diagnostic Radiology at the University of Vermont in 1986, and was certified by the American Board of Radiology that June. He finished a Body Imaging Fellowship at Tufts New England Medical Center in Boston, MA in 1987. Immediately thereafter, Dr. Tuckman began his clinical career as a general radiologist with special skills in MR and CT.

Since 1991, his practice has focused almost exclusively on MR and CT. His greatest expertise is in Musculoskeletal MR, including Spine, and in Body CT. He has practiced in Lafayette since 1994.

Dr. Tuckman lives with his wife and Ollie, a Jack Russell terrier in Indianapolis. They have 3 grown children who live on the east coast.

Christopher Roman, MA, MMC, PA-C

Assistant Professor
Butler University Physician Assistant Program

 

Christopher Roman earned a Master’s degree in Neuroscience from the University of Illinois, and went on to complete a Master of Medical Science degree in Physician Assistant Studies at Midwestern University.  He spent four years working as a Physician Assistant in inpatient Infectious Disease at a Tertiary Care Hospital in Indianapolis.  Mr. Roman currently practices Ambulatory Medicine/Urgent Care, and is on faculty at Butler University’s Physician Assistant program.

Jeremy Schupbach

National Director, Strategy & Governmental Relations
Proactive MD

 

Jeremy Schupbach is an experienced strategist – working in policy and government affairs. He has extensive experience in government affairs and lobbying, connecting with diverse stakeholders, helping to create legislation to advance Colorado laws, and shape policy across a vast spectrum of issues.

Jeremy has had the privilege to work with the majority of state agencies and maintains close connections to many political and policy groups. His extensive experience leading public policy initiatives and legislative strategy for a variety of organizations with distinctive agendas has produced a 95% success rate at the Capitol.

Kendrick Johnson, DO

Founder
Ark Family Health

 

Dr. Johnson is a board-certified family physician and a Lifestyle Medicine Specialist.

Before college, Dr. Johnson lived in Denmark for two years as a missionary for the Church of Jesus Christ of Latter-Day Saints. He then studied biology and nutrition at Brigham Young University. Dr. Johnson attended medical school at Touro University Nevada and residency at Phoenix Baptist Family Medicine.

He is the founder of Ark Family Health in Peoria, AZ. On IG @doctorkendrick

Richard Kosierowski, MD

Director, Oncology Services
Corizon Health, Inc.

 

Richard Kosierowski, MD is the director of oncology services for Corizon Health, Inc. His past appointments include medical director of the North Penn Cancer Program of North Penn Hospital and Fox Chase Cancer Center, and medical director for Prudential Healthcare and Aetna US insurance. After 20 years in community oncology, he transitioned to correctional medicine, establishing a statewide chemotherapy treatment center and on-site hospice within a Pennsylvania prison.

He currently performs oncology telemedicine for the state Departments of Corrections in Michigan and Missouri.

Dr. Kosierowski is board certified in internal medicine and medical oncology and a member of the American Society of Clinical Oncology. He has served as a site surveyor for the American College of Surgeons Commission on Cancer.

CE Overview

IU School of Medicine, Division of Continuing Medical Education:
Phone: (317) 274-0104
Email: cme@iu.edu
Website: https://medicine.iu.edu/education/cme

Course Description
Intended for Physicians, Physician Assistants, Nurse Practitioners, and Students, this conference aims to provide valuable information regarding current practices in primary health, risk management, acute care and quality attainment. The conference is focused toward creating a strong foundation for primary health care by adding value to the overall healthcare experience and improving patient care and experience.
Course Objectives
At the conclusion of this activity, participants should be able to:

  • Identify, respect, and care about patients’ differences, values, preferences and expressed needs.
  • Listen to, clearly inform, communicate with, and educate patients.
  • Identify errors and hazards in care.
  • Explain and implement basic safety design principles, such as standardization and simplication.
  • Illustrate the importance of communication and patient hand-off.
  • Describe potential issues that could arise due to lack of communication and follow up between teams.
  • Describe how the optimal use of technology can aid in increasing efficiency and effectiveness
    Discuss strategies that can be used to optimize healthcare delivery.
Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by Indiana University School of Medicine and Access2MD. Indiana University School of Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians

Indiana University School of Medicine designates this live activity for a maximum of 13.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Indiana University School of Medicine (IUSM) policy ensures that those who have influenced the content of a CE activity (e.g. planners, faculty, authors, reviewers and others) disclose all relevant financial relationships with commercial entities so that IUSM may identify and resolve any conflicts of interest prior to the activity. All educational programs sponsored by Indiana University School of Medicine must demonstrate balance, independence, objectivity, and scientific rigor.

*Indiana University School of Medicine (IUSM) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.