IN HIS WORDS: AL PILONG DISCUSSES RECRUITING, REFORM, AND WHAT HE S LEARNED

GETTING TO KNOW YOU Andrea Ludka In my January column, I mentioned that one of our New Year s resolutions is to spend more one-on-one time with physicians and their staff so as to better understand your challenges and how Munson can be a stronger partner. Although every practice is unique; there are also many things held in common and we can all learn from each other. In late 2013 Al Pilong, Munson Medical Center President, and I started visiting primary care physicians at their practice to learn how Munson can better meet your needs. We plan to continue this in 2014 and will expand our visits to include specialists. So far we have received great feedback on services, process improvements, and technology needs to name a few. Your input helps to make Munson a better colleague in our health care community. If Al hasn t yet met with your physicians and they d be interested in a personal meeting with him, please call me to schedule. We look forward to talking with you! Andrea is available at (231) 935-3391 or aludka@mhc.net. IN HIS WORDS: AL PILONG DISCUSSES RECRUITING, REFORM, AND WHAT HE S LEARNED In April, 2013, Munson Medical Center welcomed Alfred E. Pilong, Jr. as its new president. Since then, he has been diving deep into Munson s complex operations, with a focus on Munson s commitment to quality care, its medical and administrative staff of 3,700, and its reputation in the community. To help, the former pharmacist has been making rounds of his own. Al has been visiting with physicians to better understand the challenges they face, especially in the areas of health care reform, EHR, and recruitment. Al would like to meet with your physicians, if he hasn t already, as these conversations are very important to him. To schedule, please call Andrea Ludka, Physician Liaison, at 935-3391. Below are his reflections from the visits and on relationship-building, health care reform, and the challenges facing the physicians today. In this past year, what has been your biggest aha moment? There have been a few, but I would say how strong our legacy is. As a result, a trusting relationship with our regional community has evolved. This trust has been earned and is deserved as a result of the physicians and staff we have here. How do you build positive relationships? It takes time and a lot of hard work, requiring strong two-way communication. I often say that God has given us two ears and one mouth for a reason. We must take the time to listen and understand the other person s or group s viewpoint. This applies to all relationships, personal and professional. Regarding health care reform, what will be the biggest change for our health care community? The most significant change is that it is going to get very tight financially, with even stronger accountability for quality and patient safety. It will require the medical center and physicians to work more collaboratively together than we have in the past. What have you learned in your visits with physician practices? I ve learned that there are a lot of Al Pilong wonderfully dedicated physicians in our community that are deeply committed to their patients. There are common concerns within this group. As a whole, they would like to see a more functional electronic health record and improved connectivity between the hospital and practices, and physician to physician. There s also a significant focus on patient-centered medical homes. All physicians are working hard to adjust to the Affordable Care Act [ACA] as it is evolving. Continued on page 2 Page 1 Practice Pro February 2014

IN HIS WORDS: AL PILONG DISCUSSES RECRUITING, REFORM, AND WHAT HE S LEARNED Continued from page 1 Another common theme centers on physician recruitment and succession planning, something that is affecting physicians nationwide. It s challenging primary care offices most significantly, but is really a concern for everyone. What would you like physicians to know about you and Munson Medical Center? I think that, regardless of the challenges that the ACA and health care reform present, Munson Medical Center remains committed to delivering comprehensive, quality care. For myself personally, I would like them to know that I want to continue building strong physician partnerships. What might people be surprised to know about you? I m one of nine children who were raised in New Jersey just outside of Philadelphia. My six sisters and two brothers live all over the country and overseas. In addition to graduating with a BS degree in Pharmacy from Rutgers University in New Jersey and working as a pharmacist for 15 years, I have two Masters degrees: one in business administration from St. Joseph s University in Philadelphia, the other in divinity from Alliance Theological Seminary. My wife and I have been married 30 years and have two daughters and a son. The two oldest are in grad school and college; my youngest daughter is a freshman at Traverse City West. I enjoy golf, working out, and hiking. What is the advice you most often give friends and colleagues? It s all about people and positive relationships, and we need to build trust at every turn. It all comes back to communication, listening, investing time, engaging people, and following through. I also feel strongly that effective leadership begins with servanthood. It s about serving others effectively. There was a book written in the 1970s [ The Servant as Leader by Robert K. Greenleaf] that introduced this theme, and it remains very important to me. ipath PROJECT TEAM WORKS THROUGH LAUNCH CHALLENGES Improving access to information for patients and clinicians as well as meeting some of the regulatory requirements for Meaningful Use Stage 2 is the goal of ipath (Improving Patient Access to Health), which went live January 28. Medical Director of Quality Douglas McKay, MD, said as with the launch of any new software, there have been challenges to the project. We are working through significant issues related to physician work flow to ensure the safe care of our patients, and have already instituted several positive changes based on provider input, he said. We appreciate all of the physicians and providers who have provided feedback and suggestions to further this process and the dedication of the IS department in making these changes occur in such a timely fashion. For questions, concerns, or kudos, please call the Help Desk at (231) 935-6053. For more information on ipath, go to munsonhealthcare.org/ipath2014. Thank you for your patience as we work to improve the patient discharge process. Meaningful Use Stage 2 Seminar At the request of physician practices, we will be offering another seminar on Meaningful Use Stage 2. THURSDAY, MARCH 27, 2014 11:30 AM 1:30 PM PARK PLACE HOTEL, LAKE ROOMS Presenting are: Joe Cook, DO, Munson Family Practice Center Randi Terry, Director of Information Systems Lunch will be provided. Space is limited. To RSVP, please contact the Physician Liaison Program at (231) 935-5873 or physicianliaison@mhc.net. Page 2 Practice Pro February 2014

RECAP OF ICD-10 WORKSHOP 3 As of October 1, 2014, physicians, hospitals, and health plans are federally-mandated to transition to the use of ICD-10 codes for clinical diagnosis and procedure information. This gives us less than 7 months to prepare for ICD-10 implementation. To help prepare practices for ICD-10, Munson Medical Center and Whittle Advisors are providing a series of workshops. The first ICD-10 workshop (October 2013) covered assembling a team, developing education strategies and budgets, and creating a work plan. The second ICD-10 workshop (December 2013) covered vendor assessment and process remediation. The third ICD-10 workshop (February 2014) covered: Education pilot Documentation Medical necessity CPT and diagnoses Non-specific and unspecified codes Process remediation Step-by-step strategies Prior to attending Workshop #4 (April 2014), practices should: Educate impacted roles Complete technology upgrades Conduct dual coding Register for Workshop #4 If you were unable to attend any of the first three workshops but would like to participate in the final workshop in April, you can request the PowerPoint presentation slides with a corresponding voice recording by contacting Kelly Whittle, ICD-10 Program Manager, at kwhittle@mhc.net. ICD-10 COUNTDOWN ICD-10 CHECKLIST Should be completed: Vendor assessment and inventory Technology inventory and strategy Education strategy Physicians: ICD-10 Awareness Education (available via HealthStream) Providers: ICD-10 Awareness Education Staff: begin education FY14 & FY15 Budgets Process remediation plan Review of business processes Should be working on now: Staff: continue education Conduct internal and external testing Business process modifications Educate impacted roles Complete technology upgrades Develop strategy for dual coding Up next: Physicians: ICD-10 HealthStream (specialty-specific) Attend Workshop #4: April 8 & 9, 2014 August July ICD-10 Countdown Clock September OCTOBER 2014 148 Business Days Remaining (as of 3.1.14) November December January SAVE THE DATE: ICD-10 WORKSHOP #4 June February To make the ICD-10 transition easier, practice managers are invited to attend the last workshop in our four-part series. April 8 8:30 am - 10:30 am Lake Rooms, Park Place Hotel April 9 11:30 am - 1:30 pm Lake Rooms, Park Place Hotel Note: only need to attend one NOTE: Office managers should be familiar with the materials covered in Workshop #1-3, and complete the homework assignments prior to attending Workshop #4. Lunch will be provided. Space is limited. To RSVP, please contact the Physician Liaison Program at (231) 935-5873 or physicianliaison@mhc.net. May April March WANT TO RECEIVE ICD-10 TIPS AND REMINDERS? Munson will be emailing ICD-10 tips and reminders to help practice managers, billers, and coders be prepared. If you re not already on our email list and would like to receive these, please send a request to the Physician Liaison Program at (231) 935-5873 or physicianliaison@mhc.net. Page 3 Practice Pro February 2014

MUNSON OUTPATIENT SERVICES EXPANDING IN YOUR AREA Munson Outpatient Services is expanding to meet the increasing needs of northern Michigan residents. To better serve the Kingsley area, a hearing clinic, physical therapy, X-ray, and lab services are available at the Crystal Lake Health Center Building at 2291 M-113 East, Kingsley, Mich. The Kingsley Lab is open from 8 am noon, and 12:30 5 pm, Monday through Friday. Services include blood draws and other specimen collections. Other services there are available by appointment. Munson Medical Center Vice President of Operations Derk Pronger said the hospital is expanding services because it makes sense to everyone. We want services to be closer and more convenient for our patients and to provide the same level of Munson quality that people would drive to the hospital for, Pronger said. We can now deliver that same type of quality at these outlying locations, like Kingsley. Additional Munson Outpatient Services locations include: Benzonia Lab: (231) 882-1062 or (231) 882-1066 Physical and Aqua Therapy: (231) 882-0083 X-ray: (231) 882-4958 6277 Frankfort Hwy., Benzonia Elk Rapids Lab: (231) 264-0399 115 Bridge St., Elk Rapids Empire Lab and Physical Therapy: (231) 326-2053 9973 Ottawa Ave., Empire Frankfort Lab: (231) 352-5271 826 Forest Ave., Frankfort Interlochen Lab: (231) 275-6980 Physical Therapy: (231) 275-0166 X-ray: (231) 275-0170 1975 Stirling Dr., Interlochen Kingsley Hearing Clinic Lab X-ray Physical Therapy: (231) 392-7890 2291 M-113 East, Kingsley Traverse City Hearing Clinic Lab X-ray Physical Therapy Pharmacy Sleep Center Urgent Care: (231) 935-5000 Munson Community Health Center 550 Munson Ave., Traverse City Traverse City Lab: (231) 392-0380 Munson Laboratories at Grand Traverse Commerce Centre 3287 S. Airport Rd., Traverse City LAB UPDATES Name changes: Munson Lab Kingsley is now Munson Outpatient Services Kingsley. The phone number is (231) 392-7891. Paul Oliver Memorial Hospital Offsite Laboratory in Empire is now Munson Outpatient Services:Empire. Hours: Mon. Fri., 8 am 12:30 pm, 1 pm 5 pm New Saturday hours: Munson Lab at Grand Traverse Commerce Centre is open Sat., 7 am 12:30 pm New phone numbers: Munson Medical Center Main Lobby: (231) 935-6105 Suttons Bay Medical Clinic: (231) 271-0350 Practice name change: The practice of Michael J. Ziter, MD, is now called Creekside Clinic Northport New lab locations: Creekside Clinic Chums Village 4025 Chums Village Dr., Traverse City Hours: Mon. Fri., 8 am 1 pm (231) 935-0788 For a complete list of Munson Outpatient Services and hours, go to munsonhealthcare.org/outpatient. If Munson Results are Interfaced to Your EMR: Please Call Us Prior to Any EMR Upgrade Due to meaningful use and ICD-10 preparation, many practices are going through upgrades to their EMRs. These upgrades typically involve changes to your cable modem or servers. Unfortunately if Munson is not aware of an EMR upgrade, you may not receive Munson interfaced reports as the VPN may need to be reconfigured or rebuilt. When you are planning an upgrade to your EMR, please contact Munson so that we can work with you to help ensure a smooth transition. If Munson results are interfaced to your EMR, please notify us prior to any EMR upgrade by contacting the Help Desk at 935-6053 or Crystal Campbell, Manager of Ambulatory Applications, at 935-6922 or ccampbell@mhc.net. Page 4 Practice Pro February 2014

NSA AND HIPAA: A STUDY IN CONTRASTS It s good to know that healthcare, including Munson Health care, seems to be leading the nation in privacy protections. With all the breaking news on the National Security Agency (NSA) and their sophisticated eavesdropping methods, HIPAA s standard of access remains. HIPAA mandates that we disclose only the minimum information necessary, that patient charts are accessed only by those with a job-related need to know, and that we limit disclosures to staff who need to know the information to do their jobs. So while NSA is legally using cell towers, fiber optics, and satellites to track your travel, email, and social media, HIPAA mandates that access to medical records remains tightly controlled for treatment, payment, or operations unless a signed patient consent is obtained. In contrast, the NSA surveys international banking transactions, and works with or without phone and internet company knowledge to siphon data; Munson Health care pro-actively monitors chart access to prevent inappropriate access to all patient records. Rochelle Steimel Auditing prevents access due to curiosity, or for malicious intent, such as identity theft or fraud. The NSA can detect phone numbers used and duration of call; Munson audits can detect who accessed which chart, duration of access, and what was viewed, in order to protect your chart and all patient charts. The NSA can access content of cell phones, emails, and text messages. Munson Health care has policy in place to password protect and encrypt all Munson-owned mobile devices, and mandates encryption of all protected health information (PHI) sent by email to an address outside of mhc.net. It is also true that staff should not have an expectation of privacy for their email content or internet use while at work. With the explosion of technology in health care, policies and practices are in place to address the proper disposal of devices and machines that contain protected health information, such as copiers and fax machines. In addition, practice policy should not permit anyone other than the person logged into computer to access that computer, to dispose of PHI in confidential containers, to use a confidential fax cover sheet with each fax, and to promote the use of staff identification to access certain areas. Health care workers can take a certain pride in this. What about the popular use of Facebook to discuss work, share feelings about the work day, and the people we treat? Practices should have a Social Media policy that asks staff to not post information about patients, even if the patient is unnamed. Why? Because a person reading the post may be able to identify the patient or the fact that the author is an employee of your practice. Can HIPAA be over-interpreted and misused? Yes. Patient privacy rights are not meant to interfere with treatment or treatment team communication. Staff still needs to keep good public relations! For example, physicians who are listed as active treatment providers for the patient have a right to receive updates when requested. Concerned friends or family can be guided to contact a family member or the patient for further information. Thank you for all you do to protect and advocate for patient privacy! If you have any HIPAA questions, please contact Rochelle Steimel, Privacy Officer, at (231) 935-5765 or rsteimel@mhc.net. Page 5 Practice Pro February 2014

KEEPING PCPS IN THE LOOP ON YOUR HOSPITALIZED PATIENTS Since June 2013, HealthLink has been calling primary care providers to schedule follow-up visits prior to a patient s discharge from the hospital. HealthLink works with practices so that patients receive a scheduled followup appointment on their discharge papers, which helps smooth the transition of care from the hospital to the primary care provider. In addition to facilitating appointments for discharge patients, HealthLink has also started to notify providers when a patient expires at Munson Medical Center, Kalkaska Memorial Health Center, Paul Oliver Memorial Hospital, Mercy Hospital Cadillac, or Mercy Hospital Grayling. We heard from physicians that a timely notification of death for hospital patients would be very helpful, said Jacquie Harding, HealthLink Team Leader for Munson Health care. There have been awkward encounters when physicians would run into the patient s family while out in the community and were unaware the patient had expired in the hospital. We hope this service helps support those relationships. HealthLink is interested in helping to meet physician practice needs by collaborating to bridge communication between the hospital and your office. Your ideas and feedback will improve collaboration and outcomes for patients, your practice, and the hospital(s), encourages Jacquie Harding. Additionally, should a newly implemented HealthLink process create bumps within your current office processes, we want to hear from you to modify for best results. Jacquie Harding Jacquie Harding can be reached at (231) 935-5887 or jharding2@mhc.net. When To Schedule US Aorta Screening Properly scheduling an ULTRASOUND (US) AORTA SCREENING depends on many factors, including the following: Patient hasn t had test before; can only have once in his/her lifetime. Only schedule when the patient is within the first 12 months of Medicare part B eligibility For males and females, check that there is a family history of Abdominal Aortic Aneurysm For males only, check that the patient is between the ages of 65-75 and has smoked at least 100 cigarettes in his lifetime. (Females do not meet the criteria if they are between 65-75 years old and have smoked.) If the patient does not meet the criteria, a US AORTA ABDOMI- NAL with a diagnosis of screening should be scheduled, and the patient must be notified that their insurance may not pay. For more information on scheduling ultrasounds, please call Central Scheduling at (231) 935-2812. Page 6 Practice Pro February 2014 Munson s patient portal launched for patients on Feb. 17. For more information, go to munsonhealthcare.org/myhealthinfo. REMINDER: Medical Equipment Containing Mercury is Banned The State of Michigan bans all medical equipment that contains mercury, such as blood pressure cuffs, thermostats, and thermometers. Having equipment that contains mercury is dangerous and illegal. Munson Healthcare has taken actions to eliminate the use of Mercury and Mercury containing equipment. We encourage all practices that still have medical equipment that contains mercury to contact their local health department regarding the process for proper disposal.

Physicians Can Now Attend CME Programs Remotely With the many pressures facing physicians in today's health care environment, Munson Medical Center (MMC) is working to keep Continuing Medical Education (CME) relevant to your clinical practice needs and to make the best information available. To make it easier for physicians to stay abreast of new developments, CME now offers the ability for physicians to earn CME credit while attending Tuesday Grand Rounds (TGR) or Friday Medical Conference (FMC) remotely via their computer. Kara Classens, BSN, RN-BC, CME Coordinator, explains, We d heard how challenging it can be for physicians to get away from the office to attend these valuable programs so we developed a way for them to attend TGR and FMC remotely yet still earn CME credit. For a list of upcoming CME programs, go to: munsonhealthcare.org/cme. Also listed on the CME webpage are the links for physicians to register to attend a CME program via the web. To earn CME credit for attending a lecture via GoToWebinar, physicians must: 1. Register individually 2. Be signed in for the duration of the event 3. Complete and return the CME Evaluation form that will be emailed to them after the program A New Face in CME Kara Classens, BSN, RN-BC, is the new CME coordinator following the retirement of Sandra Somers, RN. This is really a unique, fun, dynamic, and fulfilling job to have as a nurse. I am excited about what the future holds for this program and how it impacts patient care. Kara can be reached at 935-6546 and kclassens@mhc.net. SAVE THE DATE Katryna Glettler Jennifer Watkins NEW EXECUTIVE SECRETARY FOR VPMA Katryna Glettler has accepted a position in Medical Staff Services as a Medical Staff Services Specialist. Katryna can be reached at 935-5891. Jennifer Watkins is now the Executive Secretary for David S. McGreaham, MD; VPMA. Jennifer can be reached at 935-6514. John Dunn, MD, Practicing at Leelanau Internal Medicine John Dunn, MD, has relocated his medical practice to Leelanau Internal Medicine. His office is in the same building as Leelanau Urgent Care. Dr. Dunn is accepting new patients and can be reached at: Leelanau Internal Medicine 650 SW Bay Shore Drive, Suttons Bay, MI 49682 (231) 866-4150 phone (231) 271-6519 fax Physicians to be Honored at Doctor,s Day Celebration on March 25 On Tuesday, March 25, area physicians are invited to gather and enjoy the annual Doctor,s Day celebration. There will be a special lunch reception, which includes a drawing of gift certificates to local restaurants. Celebrating National Doctor,s Day Tuesday, March 25 Munson Medical Center Conference Center 12:00 pm Doctor,s Day Lunch Reception 12:30 pm Annual Medical Staff Meeting Page 7 Practice Pro February 2014

1105 Sixth Street Traverse City, MI 49684-2386 A GREAT PLACE TO LIVE AND WORK Do you know a new physician/clinician looking to begin a career, or a seasoned physician/clinician looking for a change? Please take a moment to tell them about opportunities in the Munson Health care system. We have a high quality medical staff that makes sure that the patient care is of a very good quality, said David S. McGreaham, MD, Vice President of Medical Affairs for Munson Medical Center. If you know a health care professional who would like to live and work in a region recognized nationally for its patient care and quality of life, please share the enclosed postcard with them. You can also direct them to munsonhealthcare.org/recruitment to learn about current employment and physician opportunities. They can also join us on Facebook (MunsonHealthcareRecruitment) and Twitter (MHCRecruitment). Page 8 Practice Pro February 2014