Information from your UNC Physicians Network partners. Some patients

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1 Information from your UNC Physicians Network partners Fall 2012 Discovering Added Value in Practice-Based Research By Robert Gianforcaro, D.O., F.A.A.F.P., Executive Medical Director INSIDE THIS ISSUE Letter from the President Making Tracks Around the Globe UNC Surgical Care at Chatham Hospital Provider Spotlight Dr. R.M. Herring, Jr. Dr. Cody Deen New Physicians UNCPN s Legal Department UNCPN is Hiring UNC & Rex News Fall Biannual Meeting UNCPN Practices UNCPN Location Map Some patients wonder why their physicians become involved in research. Cynically, they suspect that the answer is to enhance their wallets, their egos and their professional standing. Although that may be partially true, I believe there is another view. Research allows physicians not only to treat their patients, but also to participate in the advancement of knowledge that may lead to improvements in medicine. It is an opportunity for us to remember why we chose medicine as a career, satisfy our intellectual curiosity, avoid burnout, add value to our practice and advance patient care. Practice-based research (PBR) involves practices devoted principally to the care of patients, with an interest in investigating questions related to community-based practice and improving the quality of primary care. PBR links practicing clinicians with investigators experienced in clinical and quality research, while developing and enhancing the research skills of interested network physicians. PBR is an opportunity for UNCPN clinicians, patients and community members to begin collaborating and engaging with UNC-CH academic researchers. UNCPN will team up with the North Carolina Translational and Clinical Sciences (NC TraCS) Institute at UNC-CH, one of 60 medical research institutions nationwide working to improve the way biomedical research is conducted, and the NC Network Consortium (NCNC), a diverse statewide consortium of seven PBR research networks that represents 277 practices in 52 counties and includes all three primary care specialties -- family medicine, internal medicine and pediatrics. The common vision is to engage physician communities in clinical research efforts and reduce the time it takes for bench discoveries to translate into effective clinical practice. PBR promotes physician engagement on several levels. The process of research with practices, rather than in practices, engages the physicians, nurses, office staff and patients. This approach develops a variety of research partnerships, long-term relationships, trust, recognition and exposure to UNC expertise. Physicians can participate in research that addresses relevant clinical questions and identifies gaps between recommended care and actual care, system improvements and workflow changes to improve patient care and treatment. You may think, It s hard to be on time most days doing research is overwhelming my staff will revolt. NC TraCS and the NCNC offer a number of ways to support interested physicians through all phases of the research process. Together, we are aligning appropriate research opportunities with UNC-CH principal investigators and our interested practices. Consider participating in PBR to advance evidence-based practice!

2 LETTER From the President One Patient, One Record, One Problem List, One Medication List, One Bill In my last article, I made the case for how critical integrated clinical and administrative IT systems are to excellent patient care in a health care system moving toward reimbursement for value instead of volume. Many of you participated in our UNC Health Care System IT vendor-selection process. Cerner, Epic, and Siemens each had three-day demonstrations. We literally had thousands of evaluations from the myriad of sessions presented by each vendor. I thank those of you who volunteered your time to participate. It is clear that there are powerful IT tools that can improve patient care and physician-patient communication and provide physicians with the data that we need to manage that care. There are analytic tools that will also enable us to intelligently contract with payers and employers in ways that can make high-value health care financially viable. But just like the transition from the typewriter to computers (I know I m showing my Baby Boomer age), there will be a learning curve and time investment. And let s be honest frustration and friction. Ultimately, this means that we will have to learn new systems, as will our staff. I am convinced that we need to do this to survive and thrive financially, but more importantly, to give our patients the care that they deserve. This task would be daunting alone, but I hope you will see that being part of UNC Physicians Network and the larger UNC Health Care System will make this possible. The final vendor selection occurred November 2. We are now asking for your help as we enter a design phase for the EMR over the next year. Implementation of the EMR and billing systems is planned for spring 2014 in time to meet Meaningful Use Stage 2 and ICD10 deadlines. Obviously, there will be more to come and lots of opportunities for input along the way. As always, please ask questions. Allen Daugird, M.D., M.B.A. Making Tracks Around the Globe UNCPN employees participating in the Making Tracks walking program logged a total of 24,954 miles during a 12-week wellness initiative between July 9 and October 8, Employees were challenged to increase their daily steps with a goal of walking 10,000 steps per day. A total of 119 employees completed the program; the cumulative miles walked was greater than the Earth s circumference (circumference at equator equals 24,901 miles). Employees who walked 177 miles during the first eight weeks of the program were entered into a drawing to win a two-night stay at the Holiday Inn Resort at Wrightsville Beach; 44 employees qualified for the drawing. The lucky recipient of the incentive prize was Laura Messer at Carolina Advanced Health. The employee who recorded the most miles was Veronica Wilson at Cardiovascular Care of Northern Carolina in Oxford. She achieved 1,313.6 miles by cycling indoors and walking. Veronica received a $100 gift card for her high level of achievement. Look for additional wellness incentives to be announced during the benefits open-enrollment period in November. NOW OPEN NOW OPEN NOW OPEN NOW OPEN NOW OPEN NOW OPEN NOW OPEN NOW OPEN NOW OPEN UNC Surgical Care at Chatham Hospital UNC Surgical Care at Chatham Hospital opened in Siler City on November 1. This practice is managed by UNCPN and owned by Chatham Hospital. The practice sees patients at the Chatham Hospital Medical Office Building (first floor below Chatham Primary Care) and will perform surgery at Chatham Hospital beginning January 1, The practice serves patients from Chatham, Moore, Lee and Randolph counties. Surgical specialties include the following: Gynecologic Ophthalmologic (retina, glaucoma, cataracts) Ear, nose and throat General Orthopedic If you d like more information or wish to refer a patient, please contact UNC Surgical Care at Chatham Hospital, 163 Medical Park Drive, Suite 110, Siler City, NC Phone: (919) Fax: (919) Fall 2012

3 PROVIDER SPOTLIGHT Dr. R.M. Herring, Jr. Dr. R.M. Herring, Jr., a U.S. Air Force veteran, has been practicing pediatrics at Clinton Medical Clinic for 38 years. Earlier in his career, he was very active in the NC Pediatric Society, serving on the executive committee and several other committees. He has been a child medical examiner for the State of North Carolina and has served eight years on the Clinton City Schools Board of Education. He recently resigned from hospital practice at Sampson Regional Medical Center after caring for more than 9,000 newborns. When Dr. Herring is not taking care of children, he enjoys shooting sports, specifically shooting shotguns and competitive shooting. He also quail hunts with his fatherin-law and participates in competitive trap shooting, even being named to the NC State Team on two different occasions. He actively manages a local gun club and teaches gun safety and shooting skills to interested young people. These days, he concentrates mostly on target shooting. He has often wondered what he might do differently if given the opportunity to choose another career path, but the only thing he can think of is spending more time with his family. Sometimes he does daydream about being a professional shooter or hunting guide, though! With so many years of experience, Dr. Herring is most often doing the mentoring, but he does credit his mentor, Dr. John Nance, the founder of Clinton Medical Clinic, with the best piece of career advice he s ever received. Focus on the three A s for a successful practice have the ability, be available and be affable. As for pertinent reading, Dr. Herring has a few recommendations of his own. He wholeheartedly recommends the AAP.org and immunize.org websites. He also enjoys the AAP CME publication Pediatrics in Review and the monthly journal Contemporary Pediatrics, which has more relevant articles for his practice than the more scholarly journals. To reach Dr. Herring, please call his office at (919) Dr. Cody Deen Cardiologist Dr. Cody Deen is the medical director of Cardiac Rehab at Chatham Hospital, and he sees patients at Chatham Primary Care. His areas of expertise include nuclear studies, transthoracic echocardiograms, cardioversions, stress echocardiograms and electrocardiograms. He has special interest in coronary artery disease, congestive heart failure, echocardiography and the interplay of arrhythmia and its effect on congestive heart failure. Dr. Deen attended medical school at the University of New Mexico Health Science Center in Albuquerque, NM, where he also completed his residency in internal medicine. He then completed a fellowship in cardiology at the University of North Carolina at Chapel Hill. When he is not treating patients, Dr. Deen enjoys spending time with his wife of 11 years and their two young daughters, ages 2 and 6. He also enjoys trout fishing, and he says that if he had not become a doctor, he would have loved to be a Sports Center anchor, ideally reporting on the National Football League or college basketball. Dr. Deen said the greatest challenge his practice will face in the next five years is how to deal with health care changes under health care reform. To be successful, he is hopeful that everyone will be insured, and together with the resources offered through UNC Health Care, he is excited to address the changes and challenges that are on the horizon with improved access and quality of care. The greatest piece of advice Dr. Deen ever received that he still uses today is First doctor, do no harm. To reach Dr. Deen, please call his office at (919) WELCOME New Physicians Highgate Family Medical Center Sarah Ruff, M.D. Family medicine and obstetrics Heart & Hand Family Medicine Sujatha Sajeevan, M.D. Family medicine 3

4 UNCPN s Legal Department By Jenny Markham, Assistant Legal Director UNCPN s legal department is here to answer your questions. Below is a recent question we ve received. Please contact us as questions arise or if you d like to see a question answered in a future issue of the newsletter. Question: I have a patient who records appointments on his ipad or cellphone. Does the patient have a right to record our appointments? ANSWER: No, the patient does not have a right to record the appointment, but he does not legally need your consent to make the recording. You should first have a conversation with the patient to express that you are not comfortable with the appointment being recorded and ask why the patient wants to record it. Is he worried about capturing all of your instructions in an accurate manner so that he can refer to them later or share them with another provider? If so, consider whether you could provide him with written instructions or explain the instructions slowly while he writes. You could also suggest someone accompany the patient to the appointment to document your instructions. Or, if you are comfortable, he could record the portion of the appointment in which you provide the care instructions, but you would need to present your instructions knowing that they are being recorded, and document in the medical record exactly what you said during the recording. If the patient s reason for recording the appointment makes you uncomfortable, or the patient hides the recording device and/or refuses to stop recording the appointment despite your request, then you can terminate the patient-physician relationship when you feel it is best to do so. If you are uncomfortable with continuing to see the patient while being recorded and feel that you cannot trust the patient anymore, you may discharge him from the practice. Please remember to follow the North Carolina Medical Board s position statement regarding the appropriate manner and time frame for terminating a patient-physician relationship, and make sure that you advise the patient of any continuity-of-care issues. Please contact your practice manager or RPA regarding UNCPN s process for terminating a patient-physician relationship. If you are having persistent problems in your practice with patients recording appointments in a secret or suspicious manner, please contact us so that we can consider whether additional steps should be taken at the practice level to prevent this. Announcements Announcements Announcements Announcements Announcements Announcements UNCPN IS HIRING! Medical Director Carolina Clinic Executive Health Program, Chapel Hill The medical director is responsible for patient care and the overall day-to-day functions of the Executive Wellness Program, in collaboration with the practice manager, regional practice administrator and director of operations. The medical director will also participate in development, planning, marketing and directing of all aspects of the clinic s medical programs. Physician Staffing Pool UNC Urgent Care at Carolina Pointe II, Chapel Hill We are developing a network physician staffing pool for the urgent care to provide coverage when needed. Shifts are available to anyone interested. Please contact Nicole Slepsky, HR generalist at (919) or nicole.slepsky@. Please share with your colleagues and learn more online at Medical Director UNC Urgent Care at Carolina Pointe II, Chapel Hill The medical director is responsible for patient care and collaborating with administrative support staff to lead the overall clinical operations and programs, including development and marketing. Physicians Family Practice, Internal Medicine and Pediatrics Currently seeking physicians interested in full-time positions to join established practices in Clinton, Durham, Fuquay-Varina, Garner and Siler City. 24 Fall 2012

5 UNC & REX NEWS UNC Women s Care New Faces and New Places Dr. Kenneth H. Kim joined UNC Gynecologic Oncology in July. Dr. Kim will allow us to increase access for patient care in Chapel Hill at the NC Women s Hospital and in Raleigh at the Rex Cancer Center. At Rex, we will now be able to provide Monday through Friday coverage for gynecologic oncology consultative services, both inpatient and outpatient, and operative consultation and procedures. Dr. Neeta Vora joined UNC Maternal-Fetal Medicine in April as assistant professor and director of the Maternal Serum Screening Laboratory. Dr. Vora will become an important part of the prenatal screening process at the NC Women s Hospital in Chapel Hill and at Rex in Raleigh by primarily focusing on ultrasound and prenatal diagnosis and supervising the genetic counselors as UNC director of reproductive genetics. Rex Ear, Nose and Throat Specialists opened on October 1. The practice is located in Cary and is led by Dr. John Garside, a long-time and wellrespected Cary otolaryngologist. Dr. Garside began practicing in Cary 10 years ago and has a long-standing partnership with Rex Surgery Center of Cary. The new practice provides a wide range of advanced medical and surgical services for diseases and disorders that affect the ears, nose, sinuses and throat. CONGRATULATIONS! Rex Family Practice of Wakefield was named the Best of the Best for Family Health Care in the community by Wake Weekly. Dr. Grace Tang was also recognized by Wake Weekly for providing the area s best holistic care with her medical acupuncture services. Dr. Venkat Prasad with Rex Family Practice of Wakefield and Dr. Arthur Apolinario with Clinton Medical Clinic were named fellows of the American Academy of Family Physicians. Dr. Vandana Devalapalli with Rex Primary Care of Cary was announced as a North Carolina Medical Society 2013 Leadership Scholar. On November 1, 2012, UNC opened UNC Surgical Care at Chatham Hospital in Siler City where Dr. Mike Evers will see patients and perform gynecological surgeries on Mondays. For a referral just call them at In addition to our current locations in Chapel Hill, Raleigh and Greensboro, UNC Women s Care will be relocating the following services in early 2013: UNC Fertility will be moving all of their services into a beautiful clinic in the Brier Creek medical complex in Raleigh. Providers with UNC Urogynecology will head up the new Rex Hospital Pelvic Health Center. The new center will provide onestop services for treatment of pelvic-floor disorders. For a complete listing of locations, learn more about the services we offer or to refer a patient, visit UNCwomenscare.org. Rex Ear, Nose and Throat Specialists Now Open It also offers comprehensive audiology services, including hearing aids and speech, voice and swallowing therapy. For patient convenience, Dr. Garside also will be able to provide more in-office procedures, including sinus treatments. As part of UNC Health Care, the practice gives patients more access to research on new therapies and clinical trials at one of the world s top academic medical centers. Rex Ear, Nose and Throat Specialists is located at 790 SE Cary Parkway, Suite 110. To refer a patient, call (919) , or visit rexearnosethroat.com. Announcements Announcements Announcements Announcements Announcements Announcements If you have updates or news from your practice to be featured in future issues of Well Thinking, please contact your regional practice administrator. Dr. Grace Tang 5

6 Fall Biannual Meeting The UNCPN Biannual Provider Meeting was held on October 24 at Brier Creek Country Club in Raleigh. The event featured our first poster presentation where all of our network practices provided a best practice or innovative idea. Meeting attendees spent time evaluating and discussing the poster concepts and voted to recognize outstanding achievement. University Pediatrics at Highgate was awarded the best overall poster concept and execution for their submission about making time for patient needs. Rex Family Practice of Wakefield was recognized as having the best poster design for their entry on closing the loop with patient referrals and follow-up. The meeting also featured presentations by Dr. Jackie Halladay, who shared general information about the practice-based research network, the North Carolina Network Consortium. We were also joined by specialists from Rex and UNC. Dr. Matthew Strouch from Rex Surgical Specialists shared information about colorectal surgery, Dr. John Garside spoke about the new Rex ENT Specialists practice and Dr. Bill Adamson (division chief, UNC Pediatric Surgery) and Dr. Sang Lee (assistant professor, UNC Pediatric Surgery) presented on the pediatric surgery program at UNC. Dr. Aaron Miller provided network IT updates, and Dr. Allen Daugird closed the event with the president s address to the group of over 140 network colleagues. Rex/UNC Family Practice of Panther Creek team Best Design poster from Rex Family Practice of Wakefield Dr. Daugird addresses the crowd Our first annual poster presentation Best Overall Poster Concept awarded to University Pediatrics at Highgate Guests review the posters Bob Ricker introduces the event guests Dr. Daugird presents award to Rex Family Practice of Wakefield team Over 140 network members attended the fall meeting 26 Fall 2012

7 UNCPN Practices CHATHAM Chatham Crossing Medical Center Manns Chapel Road & US US N, Suite 308 Chapel Hill, NC (919) Chatham Medical Specialists 421 N. Holly Avenue Siler City, NC (919) Chatham Primary Care 163 Medical Park Drive, Suite 210 Siler City, NC (919) Pittsboro Family Medicine 855 East Street Pittsboro, NC (919) DURHAM Carolina Advanced Health 6101 Quadrangle Drive, Suite 100 Chapel Hill, NC (919) Carolina Primary Care 6011 Fayetteville Road, Suite 104A Durham, NC (919) Highgate Family Medical Center 5317 Highgate Drive, Suite 117 Durham, NC (919) Southpoint Medicine and Women s Health Associates 6216 Fayetteville Road, Suite 105 Durham, NC (919) UNC Urgent Care at Carolina Pointe II 6013 Farrington Road, Suite 101 Chapel Hill, NC (919) University Pediatrics at Highgate 5322 Highgate Drive, Suite 144 Durham, NC (919) GRANVILLE L. Allen Kindman, M.D. 102-A Professional Park Drive Oxford, NC (919) LEE Sanford Hematology Oncology 1212 Central Drive, Suite 201 Sanford, NC (919) Sanford Specialty Clinics 1301 Central Drive Sanford, NC (919) William E. Hall, M.D K M Wicker Memorial Drive Sanford, NC (919) ORANGE Chapel Hill Internal Medicine 940 Martin Luther King, Jr. Boulevard Chapel Hill, NC (919) Executive Health (The Carolina Clinic) 315 Meadowmont Village Circle Chapel Hill, NC (919) UNC Family Medicine at Hillsborough 2201 Old NC Highway 86 Hillsborough, NC (919) University Internal Medicine at Chapel Hill North 1838 Martin Luther King, Jr. Boulevard Suite B19 Chapel Hill, NC (919) University Pediatrics at Chapel Hill North 1838 Martin Luther King, Jr. Boulevard Suite B19 Chapel Hill, NC (919) PERSON L. Allen Kindman, M.D Durham Road, Suite B Roxboro, NC (336) SAMPSON Clinton Medical Clinic 403 Fairview Street Clinton, NC (910) WAKE Boylan Healthcare (Browning Place) 3900 Browning Place, Suite 101 Raleigh, NC (919) Boylan Healthcare (Health Park) 8300 Health Park, Suite 309 Raleigh, NC (919) Garner Family Practice 801 Poole Drive Garner, NC (919) Gibbons Family Medicine 114 Brady Court Cary, NC (919) Heart & Hand Family Medicine 800 W Williams Street, Suite 200 Apex, NC (919) Knightdale Family Medicine 6905 Knightdale Boulevard, Suite 106 Knightdale, NC (919) Rex Family Practice of Knightdale 6602 Knightdale Boulevard, Suite 202 Knightdale, NC (919) Rex Family Practice of Wakefield Governor Manly Way, Suite 205 Raleigh, NC (919) Rex Primary Care of Cary 1515 SW Cary Parkway, Suite 200 Cary, NC (919) Rex Primary Care of Holly Springs 781 Avent Ferry Road, Suite 206 Holly Springs, NC (919) Rex/UNC Family Practice of Panther Creek Green Level Church Road Suite 808 Cary, NC (919) Riverbend Family Medicine 1006 Procure Drive, Suite 100 Fuquay-Varina, NC (919) Rolesville Family Practice 102 Southtown Circle Rolesville, NC (919)

8 UNCPN LOCATION MAP 501 ALAMANCE 3 Chatham Hospital SILER CITY ORANGE HILLSBOROUGH UNC Hospitals Main Campus 12 1 PERSON 16 CHATHAM LEE 501 DURHAM APEX PITTSBORO CHAPEL HILL 20 DURHAM ROXBORO HARNETT CARY Rex Healthcare Main Campus WAKE FUQUAY-VARINA CREEDMOOR GRANVILLE WAKE OXFORD RALEIGH GARNER SAMPSON 21 VANCE FRANKLIN WAKE FOREST 540 CLAYTON 28 JOHNSTON 27 CHATHAM 1 Chatham Crossing Medical Center 2 Chatham Medical Specialists 3 Chatham Primary Care 4 Pittsboro Family Medicine DURHAM 5 Carolina Advanced Health 6 Carolina Primary Care 7 Highgate Family Medical Center 8 Southpoint Medicine and Women s Health Associates 9 UNC Urgent Care at Carolina Pointe II 10 University Pediatrics at Highgate GRANVILLE 11 L. Allen Kindman, M.D. LEE 12 Sanford Specialty Clinics 13 Sanford Hematology Oncology 14 William E. Hall, M.D. ORANGE 15 Chapel Hill Internal Medicine 16 Executive Health (The Carolina Clinic) 17 UNC Family Medicine at Hillsborough 18 University Internal Medicine at Chapel Hill North 19 University Pediatrics at Chapel Hill North PERSON 20 L. Allen Kindman, M.D. SAMPSON 21 Clinton Medical Clinic WAKE Boylan Healthcare (Browning Place) Boylan Healthcare (Health Park) Garner Family Practice Gibbons Family Medicine Heart & Hand Family Medicine Knightdale Family Medicine Rex Family Practice of Knightdale Rex Family Practice of Wakefield Rex Primary Care of Holly Springs Rex Primary Care of Cary Rex/UNC Family Practice of Panther Creek Riverbend Family Medicine 34 Rolesville Family Practice PLEASE SEE PAGE 4 for current UNCPN Openings & SPREAD THE WORD! Learn more online at 1600 Perimeter Park Drive, Suite 225, Morrisville, NC phone: (919) fax: (919)