Specialty Focus   
Volume VII | Issue 45                                                                                     
Nov. 6, 2018   
Practice specific news, analysis and commentary for Florida's Medical Specialists  
                            From the publisher of FHIweekly & FloridaHealthIndustry.com

Feds Say Heroin, Fentanyl Remain Biggest Drug Threat To U.S.
Michael Balsamo
AP via Health News Florida
Drug overdose deaths hit the highest level ever recorded in the United States last year, with an estimated 200 people dying per day, according to a report by the U.S. Drug Enforcement Administration. Most of that was the result of a record number of opioid-related deaths. Preliminary figures show more than 72,000 people died in 2017 from drug overdoses across the country. About a week ago, U.S. Health and Human Services Secretary Alex Azar said overdose deaths, while still slowly rising, were beginning to level off, citing figures from late last year and early this year.
Join Us!  
Explain hemoglobin A1c in 2 minutes
Adeleke Adesina, DO
It was a slow day in the emergency department. I was sitting across the bedside from my patient who came in for a left forearm infection checkup. She was a 73-year-old female with a history of diabetes. She was elegant and soft-spoken. Prior to examining her wound, which had been worsening, I asked her what her A1c number is. She wondered what an A1c number was, and I explained that it's a lab test wherein your doctor evaluates how well your diabetes is controlled. She was still puzzled and told me that she has been diabetic for 40 years and hadn't heard about that term yet.
I paused for a minute and realized that if my patient has been diabetic for over 40 years and has no clue what hemoglobin A1c is, there are probably thousands of patients in a similar situation. That's when I had an epiphany of - tons of the terms that we use when speaking with the patients make no sense to them since they are medical jargon.  

Like Clockwork: How Daylight Saving Time Stumps Hospital Record-Keeping
Sydney Lupkin | KHN
Modern technology has helped medical professionals do robot-assisted surgeries and sequence whole genomes, but hospital software still can't handle daylight saving time. For example, one of the most popular electronic health records software systems used by hospitals, Epic Systems, can delete records or require cumbersome workarounds when clocks are set back for an hour, prompting many hospitals to opt for paper records for part of the night shift. And it happens every year.

"It's mind-boggling," said Dr. Mark Friedberg, a senior physician policy researcher at the Rand Corp., adding that in 2018 "we expect electronics to handle something as simple as a time change. "Nobody is surprised by daylight savings time. They have years to prep. Only, surprise, it hasn't been fixed."

Dr. Steven Stack, a past president of the American Medical Association, called the glitches "perplexing" and "unacceptable," considering that hospitals spend millions of dollars on these systems, and Apple and Google seem to have dealt with seasonal time changes long ago.
Telehealth Finds Multiple Successful Niches in Miami-Dade 
Rebecca San Juan

Baptist Health South Florida, Nicklaus Children's Hospital, the University of Miami Health System and the MAVEN Project are finding success in the telehealth space and room to expand.

Baptist Health's Care On Demand continues to grow in the number of downloads after launching two years ago to treat minor illnesses. The platform has 20,000 downloads on computers, tablets and smartphones, a 10,000 increase from last year.

A service provided by Nicklaus Children's Health caters to kids. The platform connects pediatricians and specialists with children from Florida and 40-plus countries for consultations. The program started for minors outside the US and has grown in the five years since launching with over 100 international consultations per year. Providers deliver care from the hospital's Telehealth Command Center utilizing fully encrypted software for secure virtual connections.

International patients seeking consultations for urological robotic surgery find a safe haven at the University of Miami Health System. Doctors, primarily from the Caribbean, have been referring patients to the university's international urology telehealth program since it launched in 2016. Chad R. Ritch, assistant professor of urology at the University of Miami and associate co-director of UHealth International Medicine System, says robotic surgery is not available where most international patients come from.

The Medical Alumnae Volunteer Expert Network, or MAVEN Project, a nonprofit with locations across six states, launched last November in Miami with three locations - Florida International University, UHI CommunityCare Clinic, and the University of Miami. The organization works with almost 100 physician volunteers across the country offering 35 specialties providing free consultations over Skype-like technology to its clinic providers, primarily targeting the uninsured.