Through our exceptional health
care services, we reveal
the healing presence of God.

March 2014 

Meaningful Use Requirements Bring Important Changes to MyChart
Learn How Much Weight These Carry in Practice: Process, Patient Experience, Outcomes, Efficiency
Joint Commission Certifies Total Joint Program
New Era for Pharmacy and Therapeutics Committee
Medical Staff Goes Electronic
Epic Updates: MyChart Results & ICD-10 Changes
Take Action to Improve Communication with Patients
2013 Yields First Grads of Physician Leadership Program
New Faces on the Medical Staff
In Memory: Jeffery Patterson, DO
Physicians and Guests: Save the Date!
All Keyed Up!
Honors and Recognitions

Doctors' Day is March 30
Join us for lunch on March 31 in the Physician Resource Center
Click here for details.

Physician Breakfast:
7 a.m.
March 27, April 24, May 22

Upcoming CME Conferences
4/25 - Trauma and Resilience: A Lifespan Perspective
Donald Meichenbaum, PhD*
8:00 a.m. – 3:15 p.m.
Monona Terrace
Sponsored by Dean Psychiatry
*Dr. Meichenbaum, author of "Roadmap to Resilience" is one of the ten most influential psychotherapists of the 20thCentury”

4/25 Under the Radar — Identifying & Responding to Chronic Neglect
7:30 a.m. - 12:30 p.m.
American Family Insurance Conference Center

CME-CPD Grand Rounds:
7-8 a.m. (breakfast at 6:30 a.m.)
St. Mary's Conference Center, Bay 1
4/3 - Transitions in Care: Shannon Dean, MD & Philip Bain, MD
5/1 - The Highs and Lows of Diabetes Management: Clarisse Ethridge, MD
6/5 - Cerebral Aneurysms: Michael Koltz, MD

From the St. Mary's Hospital Medical Staff Directors:
Meaningful Use Requirements Bring Important Changes to MyChart

Beginning March 11, MyChart patients will receive more types of test results in a shorter time frame than previously available. This raises important physician concerns about the ability to communicate with patients directly before they see the results on MyChart.

    These changes include the following:
  • Routine lab tests will continue to be released to MyChart; however, the timeframe for release will decrease from three days down to less than one business day.
  • Genetic screens, PSAs, PAPs and tumor markers previously released to MyChart after seven days will begin releasing to MyChart at four days.
  • Imaging tests previously not available to MyChart users will be auto-released to users four days after being finalized.
  • Additional pathology results are being evaluated for inclusion before June 2014.

Blocked results that will not be released to MyChart users due to regulatory issues include HIV screening tests as well as tests considered likely to cause substantial harm, such as PET scans, select pathology and select genetic testing.

As clinicians, you may wonder why we will be providing patients with tests that may be alarming to them potentially before you as a clinician have had the opportunity to review the results. This is due to the fact that Meaningful Use requires all tests not documented as likely to cause substantial harm be made available within the timeframes set above.

This is not unique to St. Mary’s Hospital. Every clinician across the country will be dealing with these same issues as we move further along the Meaningful Use timeline.

We wanted to make sure that you as clinicians are aware of these important changes before they “go live” in Epic. Please contact us with questions or concerns.

St. Mary’s Hospital Medical Staff Directors

(front row) Dr. Greg Burnett (VPMA), Dr. Kay Barrett, Dr. Lee Carter, Dr. Jeff Welch
(back row) Dr. Tim Crummy, Dr. Anne-Marie Lozeau, Dr. Kyle Martin

Learn How Much Weight These Carry in Practice:
Process, Patient Experience, Outcomes, Efficiency
In the shift within health care from volume to value, there’s been a shift in the measurements that matter.

The Value-Based Purchasing (VBP) program developed by the Centers for Medicare and Medicaid as a key element of the Patient Protection and Affordable Care Act (PPACA) is now in its fourth year. The VBP program is part of the shift from volume to value in which hospitals are reimbursed for the quality and safety of care, and not just the quantity of services we provide.

When the program was launched in 2011, a participating hospital's score was based entirely on two domains: Core Measures (clinical processes of care) and HCAHPS (patient experience of care). Clinical processes accounted for 70% of the score, while patient experience made up the remaining 30%. The scoring model has evolved over the past three years with a shift away from a primary emphasis on processes to a focus on clinical and patient satisfaction outcomes.

In 2014, the program has evolved to include four domains that are weighted as follows: Clinical Processes of Care = 10%; Patient Experience of Care = 25%; Clinical Outcomes = 40%; and Efficiency = 25%. Not only have domains been added, and their weighting adjusted to de-emphasize processes, but metrics not based in best evidence have been deleted (e.g., antibiotic administered to patients with pneumonia within six hours of admission), and new measures that reflect value for patients have been added. For example, the Outcomes domain now includes Catheter-Associated UTI and certain surgical site infection rates. Efficiency is assessed using a metric titled "Medicare spending per beneficiary," which captures costs incurred from three days before a hospital admission to 30 days post-discharge from the hospital.

Our VPB dashboard can be reviewed on the electronic monitor in the Physician Resource Center and on the St. Mary’s Hospital Intranet. The dashboard is updated on a monthly basis as new data become available. Future VBP articles for Medical Connections (our medical staff website) will focus on the individual domains, highlighting opportunities for improvement as well as areas where we shine.

Joint Commission Certifies Total Joint Program
"Your patients are lucky to have you" was the overall sentiment resulting from a rigorous Jan. 10 review by the Joint Commission of Dean & St. Mary’s total joint replacement program. Using tracer methodology, the reviewer followed the progress of several patients from the time they entered the Surgery & Procedure Center, through surgery and recovery, onto 3SW and Rehab, and discharge. In addition, the reviewer evaluated the patient education program, staff education and competencies, and surgeon credentialing. Multiple best practices were gleaned from Dean & St. Mary’s total joint program that will be shared with other centers.

New Era for Pharmacy and Therapeutics Committee

The Pharmacy and Therapeutics committee (P&T) at St. Mary’s Hospital has merged with the committees at Baraboo and Janesville to form one Wisconsin Regional P&T Committee starting in January 2014. This group meets on a monthly basis to review the safety and efficacy of medications on the formulary and the associated policies and protocols.

This change is in line with the SSM effort to reduce duplication of effort across the system. The structure consists of a centralized System P&T, which prioritizes formulary reviews and provides the final vote on formulary decisions. Five regional P&T committees provide clinical input and voting members to the System P&T. The System P&T voting members from the Wisconsin region are Dr. Greg Burnett (St. Mary’s vice president for medical affairs, Madison), Dr. Nicole Christian (Madison), and Scott Coller, Director of Pharmacy (Janesville).

The System P&T is currently working on a standardized formulary request form to use across the system and identifying significant cost-savings opportunities in our collective formulary. The Wisconsin Regional P&T is working on local policy and protocol issues and a communication platform for all three hospitals.

Medical Staff Office Goes Electronic

A new Medical Staff Services Office website provides detailed information regarding medical staff events/meetings, focused professional practice evaluation (FPPE), policies and procedures, orientation, frequently asked questions, and contact information. Read more.

Epic Updates: MyChart Results and ICD-10 Changes
Many results from inpatient lab orders and imaging will automatically populate in MyChart, and Epic will soon accommodate the 10th revision of the International Classification of Diseases (ICD-10).

Inpatient MyChart Results: Starting on March 11, most inpatient laboratory and imaging results (except PETs) will be released automatically to a patient’s MyChart account 30 hours after hospital discharge. In the clinics, these results will be released four days after finalized. Some tests (including HIV screens, PETs,  and select genetic screens) will not be released. Pathology tests are being evaluated for release in the near future. PAPs are already available.

Upgrades: The 2014 Epic upgrade is scheduled for June 7, and ICD-10 changes will be adopted within Epic on April 1 – well ahead of the federal compliance date of Oct. 1, 2014. This schedule allows training to be complete and operational changes to be initiated in advance while also mitigating the risk to revenue. The following key changes will occur on April 1:
  • Epic will be updated with the new, detailed ICD-10 diagnoses descriptions.
  • New Epic functionality (the Diagnosis Calculator) will be added to assist providers with choosing diagnoses.
  • ICD-10 documentation standards will require more detail and specificity in provider documentation (progress notes).
Training for providers and staff will continue in March within their department meetings and online. Further details will be sent directly to all providers and staff who are required to complete training.

Take Action to Improve Communication with Patients
A patient’s literacy skills – especially understanding health and instructions for care – is the strongest predictor of a person’s health status. Take home a few tips that could help you be a better care provider.

2013 Yields First Grads of Physician Leadership Program

It’s back to school time for physicians being selected for the 2014 Physician Leadership Development Program, which will begin later this month. The first class of the new program recently completed the year-long professional development course.

Dean Clinic and SSM Health Care have collaborated with the Wisconsin School of Business (UW-Madison) to create a physician leadership development program for current and future physician leaders at Dean Clinic and SSMHC hospitals in Wisconsin. The annual course is composed of 10 sessions, each one and a half days long, and takes place at the UW-Madison Fluno Center for Executive Education. The curriculum has been designed specifically for physicians, with the goal of enhancing strategic leadership skills and overall business acumen. Professors from the Wisconsin School of Business comprise the majority of the program’s faculty with additional experts from around the nation.

Congratulations to the following graduates of the 2013 Physician Leadership Development Program!

Seated, from left: Meetul Shah, Danielle Gindlesberger, Brian Reeder, Bhawani Ballamudi, Kathryn Dalsing, Jui Haker, Anne-Marie Lozeau. Middle row (begins to the right of the seated woman in the white sweater) Neil Lucchese, Lee Carter, Jeffrey Welch, Stephen Boorstein, Robert Castrovinci, Reid Olson, Premraj Makkuni. Back, from left: Daniel Staddler, Peter Lee, Lawrence Elfman, Randy Heidel, Gary Galvin, Brian Sachs, Eric Lyerla, David Shearer, Gregory Love, William Ranum. Not pictured: Kay Barrett, Franklin Bendewald, Douglas Cowgill, Tim Crummy, and Julie Hildebrand.

Bhawani Ballamudi (Child & Adolescent Psychiatry; Psychiatry)
Kay Barrett (Cardiology)
Franklin Bendewald (General Surgery)
Stephen Boorstein (Ophthalmology)
Richard Carter (Neurosurgery)
Robert Castrovinci (Ophthalmology)
Douglas Cowgill (General Surgery; Thoracic & Cardiac Surgery)
Tim Crummy (Interventional Radiology)
Kathryn Dalsing (Family Medicine & Obstetrics)
Lawrence Elfman (Pediatrics)
Gary Galvin (General Surgery)
Danielle Gindlesberger (Family Medicine & Obstetrics)
Jui Haker (Occupational Medicine)
Randy Heidel (Internal Medicine)
Julie Hildebrand (Rheumatology)
Peter Lee (Cardiology)
Gregory Love (Anesthesiology; Pain Management)
Anne-Marie Lozeau (Family Medicine)
Neil Lucchese (Ophthalmology; Pediatric Ophthalmology)
Eric Lyerla (Family Medicine)
Premraj Makkuni (Cardiology, Internal Medicine)
Reid Olson (Allergy Immunology)
William Ranum (Family Medicine)
Brian Reeder (Sports Medicine)
Brian Sachs (Family Medicine)
Meetul Shah (Family Medicine)
David Shearer (Family Medicine)
Daniel Staddler (Family Medicine)
Jeffrey Welch (Orthopedics; Sports Medicine)

New Faces on the Medical Staff
Click here to download the list of new medical staff.

In Memory: Jeffrey J. Patterson, DO
Jeffrey J. Patterson, DO, died unexpectedly in January while on vacation in New York. He was Professor Emeritus at the University of Wisconsin’s Department of Family Medicine. His affiliation there began in 1973 as a family practice resident. In 1983, he was a founding member of the Wisconsin chapter of Physicians for Social Responsibility and served on the group’s national board of trustees for decades, including two terms as president. In addition, he was president of the board of the Hackett Hemwall Foundation (HHF) for over 20 years, providing medical care in underdeveloped countries. The HHF is a teaching organization that advances prolotherapy – a chronic pain treatment for which Dr. Patterson was world-renowned.

Physicians and Guests: Save the Date!
The Gardens of St. Mary’s will be the setting for a physicians’ garden party on Thursday, Sept. 25, from 5 to 7 p.m. Invitations will be mailed closer to the event.

All Keyed Up!
St. Mary’s hosted a physician appreciation event at the Monona Terrace in February. Featuring the entertainment of Piano Fondue, the event was themed “All Keyed Up for Our Shared Future. Click here for more photos of all the fun.

Honors and Recognitions

Congratulations are in order for institutional successes and for our colleagues who go above and beyond the duty of their day (or night) jobs.

Guardian Angels: Eleven physicians have been honored as Guardian Angels between Nov. 1 and Jan. 31 for their exceptional care. Patients and families have made a gift to St. Mary’s Foundation to honor the following physicians:

Dr. Baher Habeeb

Dr. Amanda Jackson
(Emergency Services)

Dr. Adam Jaffe

Dr. Angela Janis

Dr. Benjamin Kleiber

Dr. Peter Lee

Dr. Alan Lozier
(Neurological Surgery)

Dr. Michelle Mackay

(Radiation Oncology)

Dr. Kartik Reddy

Dr. Russ Reiss
(Cardiovascular Surgery)

Dr. Amit Sanyal




St. Mary's Hospital     700 South Park Street     Madison, WI 53715-0450     (608) 251-6100
Copyright ©     St. Mary's Hospital
All Rights Reserved.     A Member of SSM Health
SSM Health Care Wisconsin