UMass FMCH Tuesday Talk - August 1, 2023/CLINICAL

Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to FMCHtuesdaytalk@umassmed.edu

Table of Contents

Message From the Chair

Focus of the Week – Clinical

Announcements

Frankly Speaking Podcast

Clinical Services Spotlight

Message From the Chair

M. Diane McKee, MD, MS


It is with a heavy heart that I share the news that Judy Savageau, MPH, Associate Professor of Family Medicine and Community Health, passed away this weekend. Judy was a stalwart in our department and school for more than 33 years – contributing across our educational, research, community health and clinical pillars. She was everywhere- working with learners at all levels, advocating for those we serve with her annual coat and baskets drives, applying her analytical skills in our practices related to care outcomes, collaborating with Commonwealth Medicine/ForHealth Consulting, and summarizing and synthesizing our research for publication. She knew everyone and supported our mission with her passion and expertise. In the fall we will recognize her many contributions to our department, school, and community. My sympathies to her colleagues, friends and family.

Focus of the Week - Clinical

Josephine Fowler, MD, MBA, Vice Chair of Clinical Services


Check out the UMass Memorial Center for Mindfulness and what they have to offer.

https://www.ummhealth.org/center-mindfulness

Center for Mindfulness Upcoming Courses - UMass Memorial Medical Center

Below is the link to the Summer Courses 2023.

https://www.ummhealth.org/umass-memorial-medical-center/services-treatments/center-for-mindfulness/mindfulness-classes


Wellness Committee UMass Department of Family Medicine- WOW

The committee is searching for new members to join our team. We meet monthly on the 4th Friday at noon. If you are interested in joining send an email to Maryanne Adams at maryanne.adams@umassmemorial.org to get on the monthly invite list.

Announcements


Past editions of the Tuesday Talk Newsletter are available

at https://www.umassmed.edu/fmch/ under Resources.

Welcome to recent new hires:  Amandeep Singh joining Dr. Karasz’s team as a Research Program Manager I, Peter Blake, PA joining the Barre Family Health Center, Vida Asante, NP joining Benedict Family Medicine, and Mark Quirk, EdD, returning to the department to work on educational efforts.


Summary of New Training Requirements to obtain or renew DEA registration.

Beginning June 27, 2023, practitioners applying for a new or renewed Drug Enforcement Administration (DEA) registration will need to attest to having completed a total of 8 hours of training on opioid or substance use disorders, as well as safe pharmacological management of dental pain. To renew your DEA Registration or apply for a new DEA Registration to prescribe Schedule II – V controlled medications, you will need to attest on your DEA application that you have either:

  • Completed at least 8-hours of training (training can be cumulative from the last 5 years; it does not have to be completed in one session) on opioid/other substance use disorders that has been approved by certain specified organizations; or
  • Hold a current board certification in addiction medicine or addiction psychiatry from the American Board of Medical Specialties, American Board of Addiction Medicine, or the American Osteopathic Association; or
  • Graduated within five (5) years in good standing from a medical, advanced practice nursing, or physician assistant school in the United States that included successful completion of an opioid or other substance use disorder curriculum. Training must include treatment and management of patients with opioid/substance use disorders.

If you previously held a waiver from the DEA and SAMHSA that was granted because you met the training requirements to prescribe buprenorphine, you have already met the criteria, and can attest to meeting the training requirement. More information can be found here: 

https://www.samhsa.gov/medications-substance-use-disorders/training-requirements-mate-act-resources

 

Training opportunities:

These FMCH grand rounds from the past 5 years can be part of your 8-hour attestation if you attended them:

Opioid/Substance Abuse Grand Rounds since 2018 – each worth 1 CME credit

  • Navigating the Substance Use Disorder System in Massachusetts – Referrals, Consults, and More (1-24-2023) Hugh Silk, MD, MPH; James Ledwith, MD; Jay Broadhurst, MD; Heidi Ginter, MD; Jillian Joseph, MPAS, PA-C; Jennifer Bradford, MD; Justin LaPorte
  • Effecting Change in Primary Care that Benefits Patients and Providers: What Makes It Easy, What Makes It Hard, and What to Expect Next for Opioid Prescribing and Integrating Care (5-31-2022) Constance van Eeghen, DrPH, MHSA, MBA
  • Management of Complex Patients: Substance Misuse and Difficult Pain Management

(11-26-2019) James Ledwith, MD 

  • The Physiology of Addiction (2-13-2018) Ruth Potee, MD 
  • Update on the Opioid Epidemic: Might Safe Injection Facilities be Part of the Solution?

(11-26-2019) Dennis Dimitri, MD, FAAFP 


The Center for Integrated Primary Care offers free, online training in the assessment of OUD and treatment with buprenorphine and naltrexone. This content takes ~2 hours to complete and those who complete it will receive free CME. 

The Massachusetts Medical Society (MMS) has courses as well: 

https://www.massmed.org/Continuing-Education-and-Events/Online-CME/Pain-Management/

Boston Medical Center has 16 hours of free CME in 30-minute increments:

https://www.addictiontraining.org/training/pre-recorded/

See attached for other answers and options.


Social Determinants of Health Poster Session

Wednesday, August 23rd, 3:15-5:30pm, Faculty Conference Room,

UMass Chan Medical School. (see attached flyer for additional information)

Events: 

  • 3:15-3:45: Poster Session and Judging 
  • 3:45-3:50: Welcome by Dr. Patricia Seymour, Associate Professor, Family Medicine and Community Health, Assistant Dean of Clinical Curriculum 
  • 3:50-4:20: Keynote Address by Dr. Crista Johnson-Agbakwu, Professor, Obstetrics and Gynecology, Professor, Population and Quantitative Health Sciences, Executive Director, Collaborative in Health Equity 
  • 4:20-4:30: Closing Remarks and Presentation of Awards by Dr. Susan Hogan, Assistant Professor Family Medicine and Community Health and Longitudinal Leader of Societal Forces of Health and Disease 
  • 4:30-5:30: Reception 


Hepatitis C and General Hepatology Project ECHO

(Extension for Community Healthcare Outcomes)

You are invited to join an exciting virtual collaborative learning opportunity which will allow you to build expertise in the evaluation and management of patients living with chronic

Hepatitis C. (see attached brochure and curriculum schedule)

What? Hepatitis C ECHO, a virtual case-based tele-mentoring educational model

Who? Primary care interdisciplinary team members (providers, nurses, social workers, community health workers, patient navigators, etc.)

Why? Tele-mentoring model that links specialists to primary care providers (PCPs) via video conferencing from any computer; Case based, iterative learning facilitated by specialists and related experts; through guided practice, PCPs become proficient in specialty care

When? A new cohort begins Friday, September 8th, 2023, 12:30 - 1:30pm ~ with 10 sessions held bi-monthly.

Register Today!


Center for Integrated Primary Care and the Center for Integrated Medical Group Visits, will hold their 3rd annual one-day, virtual event on Friday, September 8th. “Growing Group Visits” will center around all aspects of group visits, from patients to policy, to delivering whole person care with a focus on financial and community health implications. Jon Porter, MD, and Joshua Plavin, MD, MPH, MBA, Larner College of Medicine at UVM, will provide a keynote, “Creating an integrative, effective, and financially sustainable program”. Another keynote “The Power of Group Visits” will be led by Beth Frates, MD, president of the American College of Lifestyle Medicine. For registration go to https://icgmv.org/2023-conference.

Scholarships provided as all are welcome.


1st Year Longitudinal Preceptors needed:

The MassAHEC Urban and Rural Health Scholars(U/RHS) program is recruiting longitudinal preceptors for incoming students. The Longitudinal Preceptor Program (LPP) goals are here. There are 7 sessions during year 1 and 6 sessions in year 2. Students apply to MassAHEC expressing their interest in primary care of underserved populations and are matched with a family medicine preceptor only (other students are matched to primary care/specialist duo). Second year residents and fellows can participate. 

Contact Linda.Cragin@umassmed.edu


Funding Opportunity: The Blue Cross Shields of MA Foundation Special Initiatives

grant program provides organizations with a one-time grant of up to $50,000 to pilot or launch a new project over a one-year period which empowers communities to advance health equity. Visit their website for more details:

https://www.bluecrossmafoundation.org/grant/special-initiatives.

Applications are due September 11th, 2023.


Teaching of Tomorrow (TOT) is a nationally recognized and highly acclaimed faculty development program that focuses on building and refining foundational skills for effective clinical teaching in inpatient and ambulatory settings. Preceptors from any specialty and discipline will enhance their clinical teaching skills through discourse and practice. Workshop dates are November 17-18, 2023, and March 8-9, 2024, and will be held at the Hotel Northampton. Participants must attend all four days. See the brochure for details and

register at https://umassmed.co1.qualtrics.com/jfe/form/SV_0GUbJ2w3HifJC8S.

Frankly Speaking Podcast


A weekly Podcast series covering newsworthy topics in primary care medicine.

Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/frankly-speaking-about-family-medicine/id1194659367.


Please join us for an overview: In this episode, we dive into a recent systematic review and meta-analysis confirming the association between cannabidiol (CBD) use and hepatotoxicity. Gain a deeper understanding of clinical applications and the delicate balance of risks and benefits when discussing CBD use with your patients. Guest: Jillian Joseph, MPAS, PA-C, presents: "CBD Use and Liver Injury: Practical Considerations for Primary Care" - Frankly Speaking Ep 339.

Clinical Services Spotlight:

Josephine Fowler, MD, MBA, Vice Chair of Clinical Services

COVID-19 US

  • Although the CDC no longer tracks the number of COVID cases, they have noted an increase in COVID hospitalizations.


COVID-MA

  • New cases of COVID in the last 7 days of July 2023 was 901.
  • The 7-day average percent positivity is 6.53%.
  • There were 6 new confirmed deaths in the last 7 days.


COVID-19-UMMMC

  • The 7-day average percent positivity is 10.6%. This is an increase of 4.6%.
  • Patients in-house as of 7/31 is 11 (73% are fully vaccinated).


Summer Viruses

  • The summer viruses commonly seen in the summer are enterovirus, Lyme Disease, and most recently an increase in Babesiosis.


Babesiosis is a flu-like illness presenting the following within a week of the tick bite. Diagnosis is only through laboratory testing.

  • Fever
  • Chills
  • Sweats
  • Headache
  • Body aches
  • Loss of appetite
  • Nausea
  • Tiredness
  • Hemolytic anemia (infects red blood cells)


DEA Update

The DEA has issued an update. If you are a provider writing prescriptions for controlled substances, please go to the enclosed link to review the updates.


DEA’s Diversion Control Division updated the Q&As related to Electronic Prescriptions for Controlled Substances (EPCS) Q&A. This revised guidance reflects the following changes:

  • Changes made to the question defining EPCS (electronic prescribing for controlled substances) are made pursuant to updated information published in the Federal Register.
  • Changes made to the question on remote identity proofing were made to mirror guidance published on DEA’s guidance portal on April 8, 2020. DEA-DC-26. This guidance was published pursuant to the COVID-19 Public Health Emergency (PHE) and was rescinded on May 11, 2023, when the PHE ended.
  • Changes made to the question on practitioners using EPCS to issue prescriptions for maintenance and detoxification were made pursuant to Congress’s elimination of the X-waiver (DATA-Waiver) requirement in the Consolidated Appropriations Act (CAA) of 2023, only DATA-waived practitioners were allowed to prescribe buprenorphine for opioid use disorder.


Source noted below:

This updated guidance can be viewed at the below links: DEA Guidance Portal: https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-09R1)(EO-DEA022R1)_Questions_and_Answers_for_Prescribing_Practitioners_(EPCS)_7-24-2023.pdf

DEA Question and Answer Page https://www.deadiversion.usdoj.gov/faq/epcs_faq.htm

Wellness Resources


The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or www.LiveandWorkWell.com, [company code: UmassMemorial]. 

More information is available on the Caring for the Caregiver page.

Yoga Classes with Dr. Liz Erban



New members always welcome. 

Please join for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.

Much appreciation to Dr. Liz Erban for hosting these outstanding classes. 

Join Zoom Meeting ID: 923 9393 3653 Passcode: 764113

https://umassmemorial-org.zoom.us/j/92393933653?pwd=RW9TL3FhZGtLUVZBa09oMWhIQzZDUT09