Newsletter
June 2023
Upcoming CME Events
IU Health CME Events
12:00-1:00
Link for all virtual events: https://live.iuhcpe.org/
Wed, June 28th - Gene Therapy 2023 and Beyond 12:0p-1:00p (In-Person)
Kenneth Cornetta, MD, Professor of Clinical Medical & Molecular Genetics, IUSOM
Wed, June 28th - Virtual Lactation Series - Opioid Use and Breastfeeding 1:00p-2:00p
Brandi Brinkerhoff
Thurs, June 29th – An Intimate Conversation on Women In Leadership with Adrienne Sims, Senior Vice President-Chief Human Resources Officer
Adrienne Sims & Christa Porter
Wed, July 12th - Melanoma
Cesar Perez, MD, Director of Drug Development, Sarah Cannon Research Institute-Florida Cancer Specialists, Orlando, Florida
Wed, July 19th - Fighting the Flu: Clinical Pearls for Healthcare Professionals
John J. Russell, MD, FAAP, Clinical Professor of Family and Community Medicine, Thomas Jefferson University Sidney
Wed, July 26th - Healthcare Reform 12:00p-1:00p (In-Person)
Robert Stone, MD, Palliative Care, Bloomington, IN
To view previously recorded presentations from the On Demand Videos and earn CME's Click here
To view the list of your completed CME's Click here
Visit The Center for Physician Education - Main Page (iuhcpe.org)
Announcements
Changes to state law regarding Emergency Detention – Coming July 1
- Outside law enforcement can no longer bring a patient into our facility under Immediate Detention. They will now transport the patient to our facility and request the patient be admitted under Emergency Detention and provide documentation.
- A patient can be held for up to 48 hours under Emergency Detention with no paperwork filed by an ED provider.
- If a patient requires an Emergency Detention beyond the initial 48 hours, an Application for Emergency Detention (see form attached) must be filed before the expiration of 48 hours.
- If the Court finds probable cause to hold the patient under an Emergency Detention, the patient can be held for up to 14 days from admission, defined in a system ED policy. If the Court denies the Emergency Detention, the patient should be discharged no later than 72 hours from admission.
- During these 14 days, when the patient is held under an Emergency Detention Order, a physician may authorize and begin a mental health or substance use disorder treatment plan using accepted clinical care guidelines, including medications.
New dictation and transcription services launch Aug. 29; Traditional services retiring
- In 2022, IU Health transitioned to Dragon One Medical (DMO) for dictation and transcription services. The next phase of the DMO rollout will result in the discontinuation of traditional Fluency dictation for physicians and advanced practice providers. This transition is set to officially impact the AAHC on August 29. Remember: This only impacts those that are on Cerner. You can view current, published DMO education prepared by the IS Clinical Education team HERE.
- Providers can use DMO outside of Cerner to document or dictate into other products like Microsoft Word. There is also a desktop version of Dragon that can be downloaded to provider computers and easily works with any application, just not Cerner.
Coming Aug. 30th: Sunsetting of TSPOT test
- The QuantiFERON-TB Gold Plus assay, known as interferon gamma release assay (IGRA) offers an optimized analysis with tuberculosis (TB)-specific antigens that elicit both CD8+ and CD4+ T-cell responses, enabling a more comprehensive assessment of cell-medicated immune response to TB infection. CDC recommends interferon-y release assay (IGRA) over tuberculin skin test (TST), and there is also a lower percentage of indeterminate results for less risk of redraw. As a result, this test will be replacing TSPOT beginning August 30. See the attached document for more on ordering information.
Hospital at Home expanding to treatment based program
As of 06/06/23, the IU Health Hospital at Home (H@H) program will begin accepting a broader range of diagnoses under the new “Treatment-Based Model.” We will begin accepting disease states beyond AVRI/COVID, PNA, UTI, CHF, and Cellulitis initially within the Central Region Only.
Affected Locations:
- Methodist Hospital
- University Hospital
- West Hospital
- North Hospital
- Saxony Hospital
- Tipton Hospital
Overview of Workflow Changes Affecting Referring IP Providers:
- New Treatment-Based Eligibility Criteria (link below)
- Medication Routing
- Place new Hospital at Home Infusion Pharmacy Order (as needed)
- Nearing Discharge, enter appropriate medication orders: (locations should appear at top of list when pt is enrolled in meds in hand)
- Select Home Care Infusion Pharmacy location for infusion orders
- For H@H-specific meds, select appropriate IP Retail pharmacy
iii. For standard medications, select patient's preferred outpatient pharmacy
- Hospital at Home requests hand-off report from IP Provider to H@H providers via phone call (you may elect to provide a phone number or our H@H RN Care Coordinator can provide you with a phone number to contact the H@H providers).
As part of the hand-off the H@H team will ask for the patient's expected H@H plan/length of stay (LOS)
Clinical Council Updates
- Clinical Counsels
- Infectious Disease
- United Medical Group Quality Metric: Dr. Paul Calkins shared with providers about the United Medical Group (UMG) quality metric which will be implemented in January 2024. Through a survey, providers ranked the top 3 choices for an UMG metric: pneumococcal vaccination in the HIV population; proportion of patients with Staph aureus bacteremia that have an ID consult; and pneumococcal vaccination in outpatient setting. This information was forwarded to Dr. Calkins and Lindsey Biggs.
- Formulary Request for Live Fecal Microbiota (RebyotaTM): Council approved a request to add live fecal microbiota (RebyotaTM) to formulary for use in the outpatient setting to aid in prevention of recurrence of C. diff infection for patients with two or more failed appropriate antibiotic treatments. This is not a treatment option but used for prevention in specific patient populations. Due to high costs (approximately $9K per treatment), the preventative nature of the treatment, and lack of evidence for use inpatient, approval is limited to outpatient use.
- 5-Yr Review: Expanded Neurosurgery IntraVENTRICULAR Antimicrobials Order Set: Council approved the 5-year review of the Intraventricular Antibiotic order set that in was expanded to include amikacin and amphotericin dosing and renamed the Neurosurgery-IntraVENTRICULAR Antimicrobials order set.
- Radiation Oncology
- Unified Medical Group Metric Selection: Dr. Paul Calkins shared with providers about the upcoming Unified Medical Group (UMG) metric that will apply to all service line providers, starting in January 2024. Using a poll, providers ranked their top three choices for a service line metric: depression screening >= 12 years, tobacco screening & cessation, and advance care plans.
- Diagnostic Coronary CT Angiogram
- Cardiology and radiology physicians have created a power plan for ordering the Coronary Diagnostic CT Angiogram and metoprolol at the same time. When a patient has no contraindications for the use of a beta-blocker, the metoprolol prescription can be sent directly to the patient’s pharmacy.
Statin Alternative Significantly Reduces Heart Disease Deaths
An alternative to statins may help reduce deaths from heart disease among people with high levels of LDL, new research finds. Click here to read more.
