A series of 1-hour audio conferences designed for even the busiest physicians.

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1 A series of 1-hour audio conferences designed for even the busiest physicians. Offered the first Tuesday of every month from 1:00 2:00 p.m. (Eastern Time) Just $1,850 if you register for all 12 conferences. All registrants receive the MP3 at no extra charge following the conference. These activities have been approved for AMA PRA Category 1 Credit(s) Jointly Sponsored by the University of Pittsburgh School of Medicine Center for Continuing Education in the Health Sciences and HortySpringer Seminars The University of Pittsburgh is an affirmative action, equal opportunity institution.

2 When Worlds Collide: HIPAA Privacy in a Tell-All World January 7, 2014 Phil Zarone & Rachel Remaley It seems that, nowadays, everyone shares everything on Facebook, Twitter, YouTube, and more. Check out these headlines from the past few years: Doctor Gripes About Patient on Facebook Largest HIPAA Violation in History Happens on Facebook Nurses Fired Over Cell Phone Photos of Patients Case Referred to FBI for Possible HIPAA Violations Doctor Loses Laptop While Travelling Abroad: Leads to $1.5 Million Fine Health care professionals live in a modern, tell-all world and need clear leadership regarding patient privacy and their role in preventing leaks via social media. We will review some recent HIPAA debacles and the steps you can take to prevent them at your hospital. Identify common HIPAA breaches related to social media. Develop a plan to prevent HIPAA breaches in your hospital. When Malpractice Becomes a Federal Case Defending Medical Necessity Suits February 4, 2014 Dan Mulholland & Ian Donaldson If the care provided is not as expected or not within the standard of care is it any better than nothing at all? Can (and should) a health care provider bill for that care? If it does, is that bill fraudulent? We will ask and answer in our thought-provoking session, focusing on medical necessity suits being brought against health care organizations that provide care of allegedly substandard quality. Determine whether providers can bill for care that is not within the standard of care. Identify when billing for care not within the standard of care is fraudulent.

3 Patient Safety Organizations the Time Is Now! March 4, 2014 Ian Donaldson & Charlie Chulack By January 1, 2015, the Affordable Care Act requires hospitals with 50 or more beds to establish a Patient Safety Evaluation System under the Patient Safety and Quality Improvement Act ( PSQIA ) to be eligible to offer services to patients who purchase insurance on the insurance exchanges. Under the PSQIA, the use of a Patient Safety Evaluation System and a Patient Safety Organization ( PSO ) offers an opportunity to analyze your quality and safety information, or Patient Safety Work Product, in a safe and secure structure. In most cases, the protections offered by the PSQIA for Patient Safety Work Product are much stronger than state peer review privileges. Ian Donaldson and Charlie Chulack will discuss the details of the law, including the requirements for setting up a PSO, and provide answers to the following questions and more: Can we use a PSO to protect our peer review information? If so, how? Can we share Patient Safety Work Product developed under the law with providers that share a corporate affiliation with us? Is it possible to waive the protections under the PSQIA? How do we handle Patient Safety Work Product that we may have to report to the state medical board or another licensing/accreditation entity? Have any courts upheld the protections offered by the PSQIA? What do we have to do to contract with a PSO or develop our own PSO? Determine whether your organization can use a PSO to protect peer review information. Describe how PSQIA protections can be waived. Identify how to contract with a PSO or set up your own PSO.

4 Physicians on Board in Management and Knowing the Difference April 1, 2014 Linda Haddad & Susan Lapenta Are physicians different from other Board members? They may be if their position is ex officio because they were elected by the medical staff. Does the clinical expertise of physician Board members create the potential for disproportionate influence or does it give the organization a welcomed competitive advantage? If the hospital is non-profit, should the prospect of disclosures on the IRS Form 990 matter? How do Board members learn where governance ends, management starts and how not to intrude? Are physician-led health care organizations more likely to succeed and, if so, why? Identify the challenges and complexities faced by physician Board members that non-physicians do not encounter. Identify potential conflicts created by having physicians on the Board, and know the tools available to address them.

5 Advance Practice Clinicians/Allied Health Practitioners May 6, 2014 Barbara Blackmond & Susan Lapenta Whether they are called mid-levels, physician extenders or advanced practice clinicians, non-physicians (especially PAs and APRNs) are providing more care in hospitals. Even experienced medical staff leaders may feel ill-equipped to deal with these non-physicians yet CMS believes that the medical staff credentialing, privileging, and peer review process protects patients for those providing a medical level of care. How can physician leaders design privileging, OPPE, FPPE, collaboration, supervision, and oversight requirements in hospitals? What should be considered in developing threshold eligibility criteria? How does physician oversight differ for PAs and APRNs? How can the oversight be documented and measured? Should there be a category of the medical staff? A separate staff? Can a hospital design internal training programs to guide the evolution of skills for PAs trained in generalist programs who seek to practice under the supervision of specialists? Can APCs perform H&Ps? Consults? How frequently should medical record entries be countersigned? What role can non-physicians play in ED call and screening? Determine how privileging and peer review for APCs/AHPs should be handled. Identify whether APCs/AHPs duties can include H&Ps, consults and ED call and screening.

6 Help Is Just a Phone Call Away Making the Most of Telemedicine June 3, 2014 Barbara Blackmond & Phil Zarone Health reform calls on the health care industry to change the way it provides care and focus not only on care improvement but also cost control. Telemedicine can be an important part of the survival of your institution. Would immediate access to super-specialists help to prevent transfers from your facility to a more expensive, tertiary care center? There are plenty of ways that telemedicine can be incorporated into the hospital to improve patient care. And, in the future, you might also be able to drive telemedicine straight into your patients homes. But, before you can get there, you need a reliable method of credentialing telemedicine practitioners and monitoring their performance. Don t let out of sight mean out of mind. Determine the best ways to credential telemedicine practitioners. Develop a plan to monitor telemedicine practitioners performance.

7 How Little Is Too Little? Credentialing Low-Volume Providers July 1, 2014 Charlotte Jefferies & Lauren Massucci Hospitals struggle to assess the competence of providers who have only limited or no activity in their facilities. It is important to recognize the various reasons for this, including such factors as office-based practice, practice centered at another hospital, limited practice and gaps in practice. Depending on the type of provider, there may be benefits, as well as liability risks, to the hospital in maintaining a relationship with that provider. A lack of information about a practitioner could very well lead to liability for negligent credentialing, accreditation deficiencies, and extra time and expense recredentialing providers who are not active. Charlotte and Lauren will discuss the following issues: Should low/no-volume providers be permitted to participate in medical staff affairs? Serve as medical staff leaders? Perform peer review functions? Can the Active Staff include low/no-volume providers who demonstrate a high level of commitment to medical staff and hospital affairs? Will the creation of new staff categories help resolve the problem? Can the low/no-volume provider help address service call needs? What appointment criteria should apply to staff categories with no clinical privileges? Do minimum patient contact requirements make sense for some clinical privileges? Should the costs of recredentialing the low/no-volume provider be shifted to the provider? Can meaningful peer review information regarding low/no-volume providers be obtained from other health care facilities and managed care organizations without violating state peer review laws? Can credentialing extend to the office or other practice setting of a low/no-volume provider? Consider creating medical staff categories for low volume/no-volume practitioners with clinical privileges commensurate with demonstrated current clinical competence. Obtain relevant information regarding low volume/no-volume practitioners current clinical competence to exercise the clinical privileges requested or granted. Comply with Joint Commission Standards regarding ongoing professional practice evaluation and focused professional practice evaluation for low volume/no volume practitioners.

8 Informed Consent Practical Questions and Answers August 5, 2014 Alan Steinberg & Phil Zarone Every physician is familiar with the general concept that patients must be provided enough information to make an informed choice about their health care treatment. But step outside of the usual situation, and consent answers can be less clear. Such as: Can I get consent from a questionably competent patient who has no family? When does a guardian have to be involved to make consent choices for that patient? What kind of consent conversations and forms work best for treatment that will be repeated several times over a known time period? What role, if any, can a mid-level provider or a nurse play in the consent process? For how long is the patient s consent good? How is medical information available on the internet affecting the consent process? What is cyberchondria? How will patients direct electronic access to medical record information through patient portals affect consents? Identify who can provide informed consent. Determine whether APCs/AHPs can be involved in the consent process. Describe how best to address consent for long-term treatment.

9 EMTALA & ED Call - What s Hot Now? September 2, 2014 Linda Haddad & Alan Steinberg Have all of your ED call issues been resolved? Whose obligation is it? Hospital? Medical Staff? Medical Staff members? With so much CMS two midnights attention being paid to inpatients and observation patients, are observation patients also EMTALA patients? (Inpatients are not.) If yes, what does that mean? With all the hospital mergers and acquisitions, what are the responsibilities on the physicians of the one medical staff and the two or more hospital campuses? Do you know you can use allied health professionals in the on-call process? Do you know how to do that in an EMTALA-compliant way? An on-call specialist doesn t participate in any payment program other than cash. When billed, the patients can be livid. Can the hospital tell the patient in advance and let her know her options? For hospitals that pay for call, and many can t afford it, paying stipends to physicians is not the only way to skin the on-call cat. There are other approaches contracts with individuals or groups, referral to employed hospitalists and/or specialists, and our favorite, deferred compensation. We ll talk about the pros and cons of each. Identify who is ultimately responsible for resolving ED call issues. Be able to address a range of on-call process issues. Determine whether compensating physicians in any way for call is a solution or a bigger problem.

10 Fit for Duty: Assessing and Addressing Practitioner Health October 7, 2014 Rachel Remaley & Charlie Chulack Do you feel confident that your approach to the following issues is compliant with the Americans with Disabilities Act ( ADA ), Age Discrimination in Employment Act ( ADEA ), and any state discrimination laws? If not, this session is for you. We will discuss each of these scenarios and their legal implications: Can we ask health questions on our medical staff application form? Can we ask about illegal drug use? Can we use a separate form to ask health questions and look at it only after deciding the applicant is otherwise qualified? What are the essential functions of the job for medical staff appointment and clinical privileges? We require all employees involved in care to have tuberculosis testing and a flu shot. Can we require evidence of such with the initial application? If an applicant reveals health problems on the application form or if references raise issues can we ask follow-up questions? Can we make the applicant obtain an exam? If the applicant must obtain an exam, who pays for the exam? Can we choose the examiner? Can we require physicians over the age of 70 to submit a health assessment at reappointment? If an employed physician takes leave under the Family and Medical Leave Act (FMLA), can we require the physician to obtain an examination prior to returning to reinstatement on the medical staff? Can we choose the examiner? If a physician requests an accommodation, do the hospital and medical staff have to comply? Who pays for the accommodation? Determine what and how you can ask applicants about health and drug use. Define essential functions of the job for appointment and clinical privileges. Explain the risks and benefits associated with different methods of addressing aging, including separate staff categories and annual physical examinations.

11 The Non-Compliant Patient and Patient Abandonment November 4, 2014 Alan Steinberg & Phil Zarone Patients don t always follow the advice of their health care providers. Worse yet, sometimes they waste their time and disrupt their practice. Many physicians feel they are prevented from taking action by ethical rules prohibiting patient abandonment. This session will provide physicians with tips for dealing with difficult patients, documenting their efforts, and dismissing patients as a last resort without violating the legal (or moral) principles that prohibit patient abandonment. Identify ways to manage patients who refuse to comply with medical advice. Develop a plan to document actions taken to deal with difficult patients. Identify when a physician-patient relationship can be terminated. Locum Tenens: A Runaway Train? December 2, 2014 Barbara Blackmond & Linda Haddad Locum tenens can be a valuable avenue for filling vacant specialties while recruitment is conducted, covering a solo practitioner who needs an occasional vacation, and managing an overwhelmed emergency department. But, locum tenens also provides an opportunity for individuals with questionable or borderline histories to move around before their performance catches up with them. This session will offer suggestions for credentialing locum tenens physicians and incorporating them into your medical staff in a way that protects and preserves patient safety. Identify when locum tenens physicians are needed. Develop a plan to effectively credential locum tenens physicians.

12 Horty Springer TO REGISTER: (Please register by noon the day of the audio conference.) FAX this completed form to the Seminar Department at PHONE ONLINE at HortySpringer.com Hospital City/State/Zip Phone # Fax # Contact Person Title address: Audio Conference Audio Conference Participation CD only MP3 only January: HIPAA Privacy February: Malpractice March: PSOs April: Physicians on Board May: Advanced Practice Clinicians/AHPs June: Telemedicine July: Credentialing Low-Volume Providers August: Informed Consent September: EMTALA & ED Call October: Practitioner Health November: The Non-Compliant Patient & Patient Abandonment December: Locum Tenens PAYMENT $250 per audio conference (includes MP3) or $250 for MP3/CD only Register for the entire series: $1,850 Visa / # Exp. date Sec. Code MasterCard / # Exp. date Sec. Code American Express / # Exp. date Sec. Code Name on credit card Check enclosed. (Please make payable to HSM Enterprises, our sponsoring company.) Please bill P.O. # (not required)

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