connectLawrence MeMoriaL HospitaL

Spring 2012

Your hometown doctor LMH family practice clinics serve rural communities

In this issueInternal Medicine Group’s pilot program

Most Wired

Hearts of Gold Ball

To get more information, visit www.lmh.org2

“Partners in caring” is more than just a slogan for the family practice clinics affiliated with Lawrence Memorial Hospital. It’s a philosophy that guides the care and services delivered at the practices, and patients feel the difference.

Like many Baldwin City residents, Bambi Andrews is very close to her family. They share many things in common, including the same doctor. Since 2001, Kevin Hughes, MD, at Family Medicine of Baldwin City has provided primary

care to four generations of Bambi’s family, from her in-laws to her nine “grandbabies.” As patients, Bambi says, they couldn’t be happier.

“Dr. Hughes is an amazing doctor because he gets to know his patients so well,” Bambi says. “When one of us needs extra support at home, he works with our whole family and empowers us to help each other. I feel at-home when I’m at the practice — everyone there is so friendly and wonderful.”

Family Medicine of Baldwin City is one of five family practice offices affiliated with LMH. In Baldwin City, Dr. Hughes has been assisted by nurse practitioners from the hospital. The hospital is recruiting a full-time family practice physician and a part-time physician’s assistant to join Dr. Hughes.

Patients come to Family Medicine of Baldwin City for complete medical and diagnostic services, including on-site X-rays, lab draws and much more. Once a week, as medical director for Baldwin Healthcare and Rehabilitation Center, Dr. Hughes visits patients at the facility to provide the same level of care they would receive in his office.

Lori Roberts, RN, director of nursing at the skilled nursing and rehabilitation facility, says, “Dr. Hughes is very kind and caring with his patients and their families, and he’s always focused on making sure their needs are met.”

Family practice doctors are trained to focus on taking care of families. But it takes compassion and empathy to provide personalized care. Sue Brown, director of Vintage Park, an assisted living facility, is proud to be a lifelong resident of Baldwin City. She has been a patient of Family Medicine of Baldwin City for more than 10 years, along with her husband, her parents, her three daughters — and now her four grandkids. As both a patient and a colleague of Dr. Hughes, Sue offers a unique perspective on the level of patient care provided at Family Medicine of Baldwin City.

Hometown doctors provide personalized family care

Partners in caring

Dr. Kevin Hughes

Family practice doctors are trained to focus on taking care of families, but it takes compassion and empathy to provide personalized care.

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Above: Bambi Andrews of Baldwin City, working at her favorite boutique, The Pink Lady | On the cover: Delma Hitchcock, a Baldwin City resident for 22 years and one of Dr. Hughes’ first patients

“Dr. Hughes is very understanding and down to earth,” Sue says. “He never hesitates to get down on his knees if that’s what it takes to engage with patients at eye level and make them feel comfortable. He shows a lot of empathy for all his patients, especially the elderly. He really gets that their health care needs are different.”

Dr. Hughes and the other providers at the LMH family practice clinics in Eudora, Tonganoxie, McLouth and Lawrence focus on providing personalized family care. Please call for an appointment with any of our providers. —Janice Early

Family Medicine of Baldwin City 785-594-2512 | 406 Ames Street | Baldwin City

Eudora Family Care 785-542-2345 | 600 E. 20th Street | Eudora

Family Medicine of Tonganoxie 913-845-8400 | 410 Woodfield Drive | Tonganoxie

McLouth Medical Clinic 913-796-6116 | 310 S. Union Street | McLouth

Mt. Oread Family Practice 785-842-5070 | 3510 Clinton Place, Ste. 210 | Lawrence

A b r e a t h o f f r e s h a i r PULMONARY SERVICES AT LMH

Pulmonology, the area of medicine dealing with breathing and lungs, doesn’t often get the press that other medical disciplines do, but it is a critical aspect of patient care at LMH.

Lida Osbern, MD, pulmonologist at Reed Medical Center, says, “Pulmonary disease is right up there with the list of serious diseases, including respiratory failure, lung cancer, and chronic obstructive pulmonary disease (COPD). We are well equipped to treat all pulmonary problems here at LMH, with our intensive care unit, pulmonary function testing lab, pulmonary rehabilitation center and the sleep center. And for the diagnosis and treatment of lung cancer, we have our oncology and radiation oncology centers.”

Dr. Osbern, who is approaching 30 years of pulmonary practice at Reed Medical Group, is the medical director of pulmonary services at LMH. She oversees the respira-tory therapies and rehabilitation of patients, reviewing individual treatment plans and meeting with them in a monthly interactive educational seminar.

A large part of the pulmonary services that LMH offers is through the pulmonary rehabilitation center. Here, patients engage in physical conditioning and education in a multidisciplinary approach to pulmonary disease treatment. Staff, including RNs, exercise specialists and respiratory therapists, work with patients to improve their physical capacity and activity tolerance. Patients go through a treatment plan that lasts six to 12 weeks, and may continue exercising with the wellness maintenance program.

The pulmonary rehabilitation center will obtain a three-year recertification from the American Association of Cardiovascular and Pulmonary Rehabilitation in August.

Patrick McCool, director of pulmonary care at LMH, says, “We are held to meeting and exceeding measures for positive patient outcomes. This involves aggressive inter-vention and enhanced education even after patients have been released from the hospital in order to reduce rehospitalization.”

Another major part of LMH’s pulmonary service line is the accredited sleep center on 23rd Street and Kasold Drive. Sleep apnea, the disruption of sleep because of blocked airways, is an increasing part of pulmonary care.

Dr. Osbern says, “We used to think only 2-4% of the population had sleep apnea, but now we think it’s closer to 25%. Part of this is because of the general rising awareness of sleep apnea. This is a part of my practice that has definitely increased. We are proud that we have a sleep center right here in Lawrence. We can get patients in for a sleep study in a short amount of time and start treatment sooner.”

Untreated sleep apnea can increase risk of many serious conditions, including heart attack, stroke and impotence. It can also significantly shorten the life span.

The sleep center houses four bedrooms in a home-like environment. Sleep technicians monitor patients throughout the night, and patients go over their test results with their sleep medicine physician.

The LMH Board of Trustees has also recently approved plans for expansion of the current pulmonary lab at LMH, with construction to be completed this fall. The lab will house a metabolic cardiopulmonary exercise machine, which will allow patients to walk on a treadmill while their breathing, heart rate and other vital signs are being monitored. This will give a good indication of whether they are having trouble with their heart or their lungs.

“Currently 10,000 people are turning 65 daily. COPD is the third leading cause of death. There’s a huge population that is at risk for needing pulmonary treatment,” says pulmonologist Charles Yockey, MD, of Lawrence Pulmonary Specialists. “If we can do a better job with prevention, then we can decrease hospitalizations and increase quality of life. That’s why LMH is being proactive with pulmonary medicine. We want to make LMH a pulmonary referral center for cities within a 50-100 mile radius.”

Two more physicians, Amanda Gudgell, MD, and Krishna Rangarajan, MD, will join the pulmonology practice in August. —Daisy Wakefield

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Hospitals & Health Networks magazine has recognized Lawrence Memorial Hospital as one of the nation’s

“Most Wired” hospitals. The 2011 Most Wired Survey

represented 1,388 hospitals, and 154 hospitals and health systems were designated as Most Wired.

“Being named one of the country’s Most Wired hospitals is an honor that recognizes our long-term vision that LMH distinguish itself by producing measurable outcomes, higher quality, enhanced patient care and improved patient safety through the use of information technology,” says Gene Meyer, LMH president and CEO. “We embarked on this journey with our medical staff in early 2000, and we knew it was a long-term commitment. A decade later, we continue to invest in technology and services to advance and enhance patient care and safety.”

The Most Wired Survey assesses organizations based on progress in adoption, implementation and use of information technology in four critical areas:• Infrastructure — security, wireless networks,

telecommunications, biomedical systems, disaster planning• Business and administrative management — automation

of functions, including purchasing, electronic invoicing, e-requisition, payer automation

• Clinical quality and safety — including demographic collection, medication administration, online documentation for all clinicians, imaging, computerized physician order entry, use of a certified electronic medical record

• Care continuum — including ambulatory, physician and community integration, pre-registration options, ePrescribe and online bill pay

The methodology used to select Most Wired facilities sets specific requirements in each of the four focus areas. If any of these requirements are not met, the organization does not achieve the Most Wired designation, meaning an organization may have many advanced capabilities in the focus areas and still not achieve Most Wired status.

Becoming Most WiredAt LMH, the process to become “wired” has been a

challenge embraced by the whole team, from physicians and pharmacists to bedside nurses and information technol-ogy staff. This process began with careful planning, and over the years the hospital implemented many new processes.

In 2010, LMH began hospital-wide Computerized Physician Documentation and Physician Order Entry

(CPOE). In the past, physicians entered orders for patient care, including medication orders, in the paper form of the patient’s chart. Because the orders were on paper, if a clinician wanted to view this information, he or she would physically need to locate the chart and read the information.

CPOE took this order process and put it online. Now physicians, from any location with Internet access, can enter an

National recognition forLMH information technology

2011

LMH becomes one of 15 Kansas hospitals to attest to meaningful use of electronic health records in the first year of the program.

LMH and eligible providers are also early achievers of meaningful use.

2010

LMH becomes first hospital in the region to roll out hospital-wide Computerized Physician Order Entry.

LMH becomes first HIMSS Level 6 hospital in the area, ranking in the top 3% of hospitals surveyed.

2009

LMH automates numerous manual physician communication tasks, including electronic signature for online review of lab results, radiology reports and other clinical communications critical to patient care.

Physicians in the emergency depart-ment begin documenting care online.

LMH milestones on journey to electronic health records

5www.lmh.org

order for patient care and these orders are available immediately to every member of the patient’s care team. This is convenient and saves time — and because orders are now typed, no one is required to interpret handwriting. This reduces the possibility for misinterpreting an order and increases patient safety.

Marcus L. Scarbrough, MD, a hospitalist at LMH, has been part of a team of physicians who spearheaded the process. This group of physicians helps choose the specific technologies the hospital looks to adopt and they help plan the implementation of the new processes. They also assist other physicians in learning the new systems and help troubleshoot any issues that may arise.

Dr. Scarbrough notes that the process to become wired is all about improving patient outcomes and safety. “We save a lot of time,” he says. “We are no longer waiting for hard charts and sifting through unorganized reams of paper. Now we can find and read through a patient’s history much more quickly.”

He goes on to illustrate how using CPOE has changed the way physicians practice. For example, in the past, if a patient being seen in the emergency department needed to be admitted to the hospital, the admitting physician would visit the emergency department to review the patient’s information, look at X-rays and check other test results. Today, physicians can access this patient’s chart and view test results and other vital information online, in real time. No need to pick up a phone or walk across the hospital. The ability to access information quickly can help physicians make choices about a patient’s treatment plan even faster than before.

Leading advancementsCPOE is just one of LMH’s information technology

advancements. Here are a few examples of others: • Online clinical documentation — All nursing staff

document the patient’s progress electronically including what medications they took, when they took them and other relevant medical information.

• Medication scanners — When giving medications, the clinician scans the bar-coded medication and a bar code on the patient’s wrist band to ensure that the correct patient is getting the correct medication at the correct time.

• Wireless Internet — This not only allows patients and family members the opportunity to access the Internet; it also allows physicians to log on at any time to view patient information or document on a patient’s chart.

• PACS — This diagnostic imaging system allows physicians to view digital images such as X-rays and MRIs within the electronic chart.

• Physician offices’ integrated records — All of the hospital-affiliated physician practices document information from office visits online. This information is available to care providers when a patient is admitted to the hospital or there for an outpatient procedure. Practitioners in these offices also are able to view all of the hospital documentation and can even send orders to the hospital for items such as lab work or radiology exams, digitally. Hospital-affiliated practices include Cardiovascular Specialists of Lawrence, Eudora Family Care, Family Medicine of Baldwin City, Family Medicine of Tonganoxie, Lawrence General Surgery, Lawrence GI Consultants, Lawrence Neurology Specialists, Lawrence OB-GYN Specialists, Lawrence Pulmonary Specialists, Lawrence Vein Center, McLouth Medical Clinic, Mt. Oread Family Practice, Internal Medicine Group and LMH Oncology Center.

What is “meaningful use”?In 2011, LMH and 27 individual providers completed

attestation for Stage 1 Meaningful Use. Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible health care entities can qualify for Medicare and Medicaid incentive payments when they adopt certified electronic health records (EHR) technology and use it to achieve specified objectives. These objectives are called “meaningful use” objectives, which simply define the measurable benchmarks hospitals and providers must meet to qualify for the incentive payments.

In November, Lawrence Memorial Hospital received a $1.6 million Medicare incentive payment for meeting 2011 meaningful use objectives for adopting and using electronic health records technology. Payments for meaningful use providers are expected in the first quarter of 2012.

“It has always been the goal of LMH to be ‘meaningful users’ of technology and electronic medical records. It’s assur-ing to our clinicians and patients to know we are doing the right thing as leaders in the industry, using electronic health records to improve efficiency, quality and patient safety,” says Jane Maskus, LMH vice president/chief information officer and meaningful use coordinator. —Janice Early

2008

LMH implements new WAN (Wide Area Network) and portal access for caregivers across the Internet.

2007

LMH optimizes the cardiovascular workflow by digitizing and automating electrocardiogram data, reducing turnaround time for physician review from 48 to 8 hours.

2006

LMH automates medication administration process using bar code technology, enhancing patient safety.

LMH implements electronic nursing orders at the bedside using hand-held devices.

2004

LMH automates patient care processes with the goal of practicing safe and paperless medicine by adopting use of electronic medical records.

LMH creates clinical data repository, which provides online, real-time delivery of clinical results and nursing notes.

6 www.lmh.org

More than 20 years ago, Stephen Segebrecht, MD, and his family donated funds to Lawrence Memorial Hospital’s Mother/Baby unit to create a room where parents and families could stay should their new-born need to remain in the hospital longer than usual. It’s important for families to be close to the baby in order to nurse and bond, even after mother no longer needs a hospital room or medical care herself. The Segebrechts saw a need for such a room after the birth of their own son.

Over the years, the room has been used often by families of premature babies or newborns with special needs. According to LuAnn Baumchen, RN, clinical nurse educator, more than 60 families a year take advantage of the room, which is provided free of charge and houses a bed, bathroom and other basic needs so that parents, particularly nursing moth-ers, can stay near infants who require a longer-than-usual hospital stay.

After two decades of regular use, The Segebrecht Room was in need of a facelift. That makeover recently came in the form of a gener-ous donation from the Girard family, who were pleased to have the facility available to them when they needed it after the recent birth of their baby. The Girards asked that people donate to the remodel fund by way of the birth announcement they sent out upon the birth of their daughter, Megan, who was born with an infection that required her to stay in the hospital a week longer than usual.

Julie Girard, Megan’s mother, started the Miss Megan Fund . “We felt so grateful to have the room, but I thought it could be a little nicer

and more functional for families,” she says. The bed in the room was getting tired and soft, and there was not a place to put clothes or other necessary items like phones, clocks and drinks. There was not a chair for nursing babies, and the room wasn’t as well designed as it could be. The Girards planned to give $1,000 to the hospital in honor of Megan’s birth to be used for the room remodel, and they thought they might get a few hundred dollars more from friends and family. To their elation, more than $3,000 came in through the mail, from family and friends in at least 10 states. “People who will never visit Kansas or need to use Lawrence Memorial Hospital sent checks,” Julie says. “We were just overwhelmed with the interest in this project.”

The funds they raised provided a new armoire, headboard, glider and table so the room is now more updated and functional for families to feel as comfortable as possible. Many families have been grateful for the opportunity to stay together, close to baby and comfortable during what can be a very difficult time. A hearty thanks to the Segebrechts and the Girards for their generosity to the LMH community. —Megan Stuke

Lawrence Memorial Hospital is proud to have joined forces with the National Healthy Mothers, Healthy Babies Coalition to help expecting and new parents get

vital information about their pregnancies and babies. Text4Baby is a free service available to expecting moms who would like to receive personal and timely information

via text to their phones about prenatal care, nutrition and infant care. It is made available through a broad, public-private partnership that includes government, corporations,

academic institutions, professional associations, non-profit organizations and more. Delivery of this information via text message is an excellent resource, since 85 percent

of all Americans own cell phones. A large majority of those people send and receive text messages. Free messaging services have been generously provided by participating mobile operators such as AT&T, Sprint, T-Mobile, Verizon Wireless, Virgin Mobile and many others. This way, moms can receive their Text4Baby messages for free regardless of their cell phone plans. Few other avenues are as sure-fire a delivery method as the text message, making this effort vital in the fight against the infant mortality rate and number of premature babies born each year. Participants simply need to text the word “BABY” (or BEBE, if they prefer Spanish texts) to 511411 to start receiving texts. In addition, they can “like” the Text4Baby Facebook Fan Page at www.facebook.com/text4baby for further information and helpful hints.

Mothers delivering at LMH and receiving services at Lawrence OB/GYN specialists are encouraged to sign up for the free service and to spread the word to other community members who can benefit from prenatal and postnatal education. Text4Baby information is available on the Lawrence OB/GYN website at www.lmh.org/obgyn and at www.text4baby.com. —Megan Stuke

The Segebrecht Room gets a freshening-up

LMH teams up to improve mother and baby health

The Girard family

Become a member of the LMH community. Gifts of time and resources are welcome. 7

Chad R. Tate, MD

Chad R. Tate, MD, has joined Lawrence General Surgery. He graduated from the University of Notre Dame with a bachelor’s degree in business admin-istration/accounting. He

earned a CPA license working in “Big Six” public accounting in Dallas, Texas. He then earned a medical degree at the University of Texas-Southwestern. He completed a surgical intern-ship and residency at Baylor University Medical Center (BUMC), also in Dallas. Since completing residency, he has been a staff surgeon at BUMC. He is board certified by the American Board of Surgery and is a Fellow of the American College of Surgeons.

Dr. Tate’s professional interests include most aspects of general and endocrine surgery and surgical oncology, including thyroid and para- thyroid disease; advanced laparoscopic and robotic surgery, including various esophageal surgeries; and surgeries of the stomach, spleen, adrenal glands, pancreas, small and large intestine and laparoscopic ventral hernia repairs; and management of skin cancers, including melanoma.

Dr. Tate is a native of Garden City. His family’s farming and ranching interests in Kansas go back to 1885, and he enjoys riding horses and roping calves. He is also a cyclist and enjoys playing tennis and other sports.

DocTalkGregory Schnose, MD, of Lawrence’s Internal Medicine Group, PA, recalls when the

practice used a system of handwritten accordion files to set reminders for patients’ exams one to two years out, such as mammograms or physicals. But for colonoscopies, which are done only every 10 years, the “tickler files” fell short. Now using the electronic health records system, a query can immediately select all patients who have hit the 10-year mark and send out reminders to them to make an appointment.

“That is so much easier to manage and much more efficient than tracking it on paper,” says Dr. Schnose.

This is just one of the components in the pilot program of the Kansas Patient Centered Medical Home Initiative in which the Internal Medicine Group is participating. IMG was selected as one of eight primary practices

in the state to work in the two-year pilot. Funded by the Kansas Health Foundation, the Sunflower Foundation and the United Methodist Health Ministry Fund, the Initiative seeks to implement core principles of the Patient Centered Medical Home (PCMH).

The PCMH is a model of primary care that focuses on the patient first as the center of his or her own medical care management. It was initially developed in the 1960s by the American Academy of Pediatrics. In 2007, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association released the Joint Principles of the Patient Centered Medical Home which detailed the core principles of PCMH. They are summarized as follows:• Eachpatientshouldhaveapersonalphysicianwhoisthefirstcontactof continuousand

comprehensive care. • Thepersonalphysicianleadsateamof otherhealthprofessionalsandarrangesforcare

in all stages of life. • Careiscoordinatedacrossthehealthcaresystemandcommunitysothatthepatient

can access care in a timely and culturally appropriate manner. • Patientcarecontinuouslyimprovesinstandardsof qualityandsafetythroughadvocacy,

use of technology, education and engagement. • Accesstocareisenhancedthroughwideroptionsforschedulingandcommunication

between patients and their personal physician and staff. • Paymentshouldreflectthevalueof providingaPCMHstructuretopatients.

Essentially, a Medical Home focuses on long-term coordinated care, with each patient having a primary doctor who leads and coordinates a team of professionals in providing the patient’s care. The goal is to create an interactive, effective and efficient structure of healthcare that moves away from episodic care to long-term, preventive care. This is accomplished in part through providing the patient with more control over the management of care by using electronic health records, allowing the patient to track test results, request prescriptions or communicate with his or her doctor through email.

This model of care has shown promise in decreasing acute care episodes such as visits to the emergency room. It also is intended to bring down overall costs of medical care by emphasizing preventive and proactive care.

For the Internal Medicine Group, which started the pilot in July 2011, involvement in the pilot program could lead to a PCMH accreditation by the National Committee for Quality Assurance (NCQA).

Dr. Schnose says, “By being on the early side of Patient Centered Medical Home, our patients will benefit from the concept earlier so that we can keep people healthier, with more control and management of the diseases that they have.” —Daisy Wakefield

Doctors participate in statewide pilot program to help keep people healthier

Lawrence Health Plaza330 Arkansas, Ste. 202Lawrence KS 66044785-505-2200www.lmh.org/surgicalservices

325 Maine StreetLawrence, KS 66044

connect is published by Lawrence Memorial Hospital. The information in this newsletter is intended to educate readers about subjects pertinent to their

health and is not a substitute for consultation with a personal physician. To have your name added to or removed from this mailing list, please call 785-505-3317.

Gene Meyer | President and CEO, Lawrence Memorial HospitalEditorial Board | Kathy Clausing Willis, Sherri Vaughn, MD, Janice Early, Melissa Hess

8 Lawrence Memorial Hospital • 325 Maine Street • Lawrence, KS 66044 • 785-505-5000 • www.lmh.org

The Lawrence Memorial Hospital Endowment Association’s Hearts of Gold Ball will be held Saturday, May 5 at Corpus Christi in west Lawrence. The ball, a biennial event, will raise funds to contribute to the upcoming remodel of LMH’s 2-North medical unit.

This is the 6th Hearts of Gold Ball, and it is the result of the efforts of more than 100 volunteers who are working to make this the most successful ball yet. The theme, “Home Is Where the Heart Is,” alludes to the contribution the Lawrence Memorial Hospital Endowment Association hopes to make to the $2.1 million planned remodel of the 2-North wing. LMH hopes to make every patient’s stay as comfortable as possible. To that end, LMHEA is focused on raising at least $250,000 at the Hearts of Gold Ball in order to fund the construction of a family hospitality lounge in the unit. Funds will also go toward a medical dicta-tion area where all medical staff can communicate, chart, take notes and share important information vital to patient success and comfort. “It’s a bold and challenging goal,” says committee co-chair Bev Smith Billings, “but I am confident we’ll meet it. Eleven committees, operating under three co-chairs, coordinate the ball, covering details like décor, food, advertising, auction preparations, ticket sales, logistics and more. The effort by the volunteers is unparalleled, and their work pays off.”

This year’s ball will feature the popular Kansas City dance band Kokomo, and the food will be overseen by Lawrence restaurateurs Chris Hanna (former owner of the five-star Lawrence restaurant The Bleu Jacket) and Matt Llewellyn of 23rd Street Brewery. Peach Madl, owner of The Sandbar, is handling the bar. “There are a lot of great contributors to the menu this year,” Matt

says. “Iwig Dairy, Hilary’s Eat Well and Teller’s are among the businesses making sure we have plenty of food. No one will go away hungry. There will be lots of amazing food and drink.”

There will be a live auction and a silent auction. Attendees can bid on items such as two tickets to the sold-out Kansas City Symphony in the Flint Hills, and a four-night stay at Stonebridge Resort in Branson, among many other unusual and valuable products and packages. “I’m heartened to see the generosity of this community on behalf of our hospital. It’s really extraordinary,” Bev says.

Tickets are $125 apiece, or groups can purchase a table for 10 for $1,500 in order to guarantee seating arrangements. Attendees are encouraged to buy their tickets early. The patients, families and associates of LMH are extremely grateful for the hard work of the volunteers, and to all of the guests at the ball, for making possible part of the new 2-North renovation. The Lawrence Memorial Hospital home away from home is, indeed, where the heart is. —Megan Stuke

Home is where the heart is: Join us May 5 for the Hearts of Gold Ball!