Tony DeFrance, MD FSCCT

If this resonates… maybe time for a change Weekends are not for sleeping in or recuperating from the week. These are signs that we are investing more in others wants, desires and needs before our own self wellness and development. Giving your all to others before yourself… one may leave you with too little for self growth but also this means you can’t ever give anyone your best because you haven’t been able to invest in becoming your best you. #dammgoodsleep #wordstoliveby #investinyou

15

The track record of innovative telehealth programs requiring major changes is poor due to lack of adoption and sustainability. Long term sustainability and spread can be attained by evaluating the 7 areas identified below. Lets continue the conversation in the comments section

10

It has to become a value. Education is one part, for sure. Competency is another. I am in favor, with a caution that mandatory education is less effective than desired education.

2

Dear Cardiologist,   Join our partner GE HealthCare for Season 3 of their “Cardiology Coffee Breaks: The Path to Connected Care!” In just 15 minutes, unlock insights into how enterprise imaging, analytics, workflow optimizations, and more can revolutionize efficiency in your cardiology department.   Mark your calendars for the upcoming episode "Patient Work, Not Paperwork - Digitize Your Department KPI's" airing on Wednesday, May 15th. Reserve your spot today: https://lnkd.in/eEGQWEfd   Can't wait until then? Dive into the first episode, "The Road to Enterprise Imaging in Cardiology," available on demand, via the link above. Discover how enterprise imaging connects care, streamlines workflows, and saves invaluable time and resources for clinicians.   Don't miss out on this opportunity to be at the forefront of the conversation shaping the future of cardiology IT. Secure your spot now! Sign up today!   #CardiologyCoffeeBreaks #ConnectedCare #EnterpriseImaging #HealthcareInnovation #Duomed

24

The yin-yang of policy and regulation.... While these words are sometimes used interchangeably, be aware that they can land quite differently, depending upon your audience. Policy: a fairly neutral term....what you want to do for others. Regulation- not neutral, and can be received quite negatively, almost punitively. Be aware that this can be perceived as "what others want to inflict on you". My recommendation: be careful when using these terms to motivate action. Saying, "let's enact regulations to do ....." will immediately put some on the defensive. Better to talk about policy changes and their benefits.

6

A condition that may be primarily relevant to Anesthesia, and Rarely to any other Medical Specialty, is Malignant Hyperthermia. And even these events are quite rare to occur during Anesthesia Procedures, but essentially ALL Licensed Anesthesia Providers, whether MD/DO, CRNA, or CAA are Educated and Trained, including yearly Simulation Excercises, on this condition. This being said, even with all this training, these events are (almost) “vanishingly rare”, and many providers will not have a true “M.H.Crisis” more than a couple of times in their career. However, Access to medications to Manage or Treat this condition, can be “variable”. Major Hospitals and busy Freestanding Surgical Centers will have an ample supply of Dantrolene, or the newer agent Ryanodex. However it is possible that smaller ambulatory facilities may not have as much of a supply, or may rely on “proximity” to a nearby Hospital in the event of an M.H. Crisis. If you have cases where a significant temperature elevation occurs during or shortly following the Anesthesia for a procedure, consider contacting me for clarification of the nature of the event. Also- SPOILER ALERT: During these “Warmer Months” - HOT-HOT - HOT - M.H. Events can occur to people involved in significant physical activity during these exceptionally Hot Days!!! Not all “heat related conditions” are just dehydration, Heat Exhaustion or Heat Stroke! Rare, YES, but if a patient who is brought to the E.R. And CONTINUES to have a Rising Core Temp, M.H. should be Considered, and - yes - Dantrolene or Ryanodex should be administered! Thanks for your time and your consideration.

1

It may be surprising to hear, but Americans living in rural areas often face unique challenges that can contribute to a shorter life span compared to those in more populated locations. ⁠ ⁠ One significant factor is limited access to healthcare services. Rural areas typically have fewer healthcare facilities and providers, making it harder for residents to receive timely and adequate medical care, especially as it relates to CVD. Rural populations often have higher rates of chronic diseases such as diabetes and heart disease, partly due to limited access to healthy food options and recreational facilities. ⁠ ⁠ Economic factors also play a role, as rural areas tend to have higher poverty rates and fewer employment opportunities, which can impact overall health and well-being. Environmental factors, such as exposure to hazardous occupations and limited access to clean water, further exacerbate health disparities. ⁠ ⁠ Everyone, but especially people living in rural areas, should focus on a healthy diet and consistent exercise routine to help keep them healthy. Establishing a primary care physician and knowing where the nearest hospital is can also help manage health more effectively. Addressing these challenges requires targeted strategies and increased investment in rural healthcare infrastructure and services. ⁠ ⁠ ⁠ #healthcaresystem #hearthealth #heartdoctor #meded #heartdisease #heartdiseaseawareness #heartdiseaseprevention

11

2 Comments

You are invited to our Artificial Intelligence Webinar. Register at: https://lnkd.in/gqWqqksZ In this ExecHQ Entrepreneurial Solutions (ESS) webinar series entitled: Maximizing AI for Business Growth: Strategies, Success Stories, and Solutions learn the following: Session 1: How to Convert AI Promise into ROI for Your Business Description: Learn strategies to bridge the gap between AI potential and financial returns. This webinar will cover how to think about potential AI use cases, including aligning AI initiatives with business goals, and optimizing AI investments for maximum ROI. Session 2: AI Case Studies: Thinking About AI Use Cases Across Various Parts of Your Business Description: Explore real-world examples of successful AI deployments across different business functions. This session will provide insights into how AI can enhance marketing, sales, operations, customer service, and more, using case studies to illustrate best practices and innovative approaches. Session 3: Overcoming Internal Challenges: Addressing Pain Points to Kickstart AI Implementation Description: Understand the common internal issues and pain points that businesses face when starting AI projects. This webinar will discuss strategies for overcoming resistance to change, addressing data quality and integration challenges, and ensuring executive buy-in and support for AI initiatives.

18

2 Comments

It's known that imaging is the largest single source (25-40%) of hospital revenue, annually a >$100B market in the US. But, reimbursement has declined 44% over the past decade (Solventum site). We get paid for the REPORT... not fancy images, length of exam, or even sexy AI. So what are we going to do about it? .... how about proving our value and using ICD-10 codes to address the few MACRA measures available as mandated by CMS? While the vast majority focus on the shiny coins of imaging AI, scant few are using NLP or generative AI to help us get paid via optimizing "impact reporting" and showing direct value... e.g. calling appendicitis on CT, with the resultant urgent surgery due to a radiologist's read. That surgery (and improvement) is direct impact. I opine that this is critical as the World Health Organization's (WHO's) ICD codes were designed for this over 100 years ago to track outcomes, morbidity, and mortality. Please check out our seminal article, which I believe is the only algorithm validated by neuroradiologists actually coding their own reports. Ultimately, the goal is to provide impact, particularly from "pertinent positive findings" (PPF's, e.g. appendicitis). This is distinct from non-actionable "incidental findings", which are all the rave, but may rack up unnecessary costs. Note: Poor documentation of Pertinent Negative Findings (PNF's) and the Reason For Exam (RFE) are some critical reasons we don't get paid; a range of 5-20% of imaging billing not reimbursed due to medical necessity write-off's, "procedure-diagnosis mismatch", deficient pre-authorization, etc. An example: simply having "headache" (or "neck pain") as the RFE for a head CT or cervical CT... good luck getting paid and following impact! Adding "high speed motor vehicle accident", "facial contusion" (or "neck contusion or hematoma") not only ensures get paid, but actually enables following our IMPACT for the real reason it is ordered. (Example attached) This is a hint of how the imaging report should be tied to recent and future clinical encounters to document radiologists' Provenance (confirming authenticity akin to a painter's signature between oil emulsion layers) via ICD codes, where the "Medical Imaging Life Cycle" (MILC) shows where we impart our impact, thereby confirming radiologists' value and preserving legitimate reimbursement. Future posts to discuss the concepts of Provenance, Relevance, Appropriateness, etc. within the scope of the MILC. Let's prevent the COMMODITIZATION and APPROPRIATION of Radiology! Please see our recent article here: https://lnkd.in/e22XSbVr

80

6 Comments

Communication before and during treatment plays a crucial role in enhancing patient satisfaction, as highlighted by d'Apuzzo et al. I align with @Dr. Fabrizia d'Apuzzo, MS, PhD on this important aspect. At In Hand Dental, we have observed a significant increase in positive patient reviews through improved engagement and compliance for clear aligners. Learn more: https://lnkd.in/gWNiUVcD

26

3 Comments

Chronic kidney disease has tremendous clinical needs in terms of high level of care, follow up monitoring and costs (up to $100,593 for those requiring hemodialysis). Telemedicine in chronic kidney disease can change outcomes with improved compliance, prevention of complications and financial improvements.

2

vistaECG waveform is exactly the same as conventional ECG. As long as you can read ECG, you can read vistaECG. The difference is that the color wave consists of different segments (SAN-Atrium-AVN-HIS-BB-Purkinje-Fiber-Endocardium-Epicardium-M-wide QRS). The waveform is not changed. Solve the problems of physicians who cannot read the ECG. - Electrocardiogram digitized for the first time in 120 years with all invasive and invasive undetectable parameters (new data)! - Abnormalities can be detected even without manifestation of disease occur (AVNRT/AVRT/SVT/heart failure/CAD/MI without ST elevation etc.) - Medical-grade AI interpretation with 15 million clinical test data AI mapping Test time: 12 seconds Unit of measurement: millisecond Graphic display rate: 99.99% - Scientific article published in the International Journal of Cardiology in 2016 - 15 million clinical trials completed in 2015 in 6 countries - 53 US & International patents obtained PhysioSign USA

22

Recognizing how and where our health and human service systems fail BY DESIGN is the first step at sustainably improving. The second is empowering front-line staff and leadership to make and measure key changes. There should be no sacred cows when we deal so intimately with people's lives. Listen to Amy Boutwell, MD, MPP. She gets things done for #healthequity and #datadriven care.

21

4 Comments

FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://buff.ly/4bmZQeL

7

Save the Dates and Join Dr. Stephen Grinstead, LMFT, ACRPS & Leonardo Martinez LCSW, CADCII, ACRPS, SAP, In Folsom California for This Live Gorski-CENAPS® Corporation Dynamic 20 Hour Denial Management Counseling (DMC) Advanced Training November 14-16, 2024 – Sign up Now https://lnkd.in/ei8EsSMX Effectively Manage Treatment Resistance And Denial By attending and participating in this 3 day (DMC) Advanced Training you will be able to deal more effectively with clients exhibiting treatment resistance and denial. An important goal of this training is to educate, normalize and de-pathologize the psychological defense mechanism known as denial so you can help your clients recognize that it is a normal part of being human. You will learn how to identify and manage your own personal denial patterns in order to be more effective in helping your clients see theirs. You will be encouraged to explore your own personal defenses and how they developed to be more effective with the clients you serve. Special emphasis will be placed on building a collaborative, motivational, and strength-based relationship with your clients.    You will also learn the general steps of the Denial Management Interactional Process that is designed to manage denial in here-and-now interactions with clients and how to directly deal with the twelve most common denial patterns used by people with self-defeating patterns of behavior. Finally, this training teaches you how to develop the tools necessary to implement a successful treatment plan for helping your clients develop strategic self-sabotage/denial management skills.   You will walk away with a toolbox of skills that you can put to immediate use to be even more successful with people who exhibit treatment resistance and denial. In addition, when completing the three-day training, you will also meet the classroom hours needed to apply for the optional Competency Certification by submitting a DMC Certification Portfolio for an additional $150.00 portfolio review fee through the Gorski-CENAPS® Corporation.    This 20 CE Hour Advanced Training meets the classroom requirements for an Optional Competency Certification as a Certified Denial Management Specialist (CDMS) for an additional $150 Competency Portfolio Review Fee. Early Registration Training Fee $555.00 Before October 1st - After That $595.00   To register and for more information please visit https://lnkd.in/ei8EsSMX – you can also contact Stephen at drgrinstead@yahoo.com or (919) 893-3155 for more information. Dr. Stephen Grinstead, LMFT, ACRPS   #Addiction #Addictiontreatment #Mentalhealth #Mentalhealthtreatment #Recovery #Relapseprevention #behavioralhealth #denialmanagement

2

The LIBERTY-CSU CUPID Study reveals insights into the management of Chronic Spontaneous Urticaria. Learn more about the latest findings and treatment options in this study. Discover how to effectively address this chronic condition. #CSU #ChronicUrticaria

4

Good paper with important message

7

TIDBIT TUESDAY! Qualifying as an Expert Witness Victoria Powell RN CCM LNCC CNLCP CLCP MSCC CEASII Excerpt Fall Spring 2013 An expert witness is one who is allowed to provide opinion testimony at trial which is based upon his or her specialized knowledge, experience, or training. The expert witness was created and the use is maintained by the legal system. The courts and their legal counsel have focused much energy in litigation on defining the parameters of expert testi- mony. Because the expert’s ability to offer opinions can be a powerful influence in trials, the courts must ensure that the expert’s testimony is an effective aid to the court rather than a burden or hindrance. In an attempt to ensure this, the courts have defined the role of expert witness and developed formal rules regarding evidence. The expert witness performs two primary functions. The expert serves a scientific function by collecting, testing, and evaluating evidence and forming an opinion as to that evidence. The nurse life care plan- ner as an expert typically collects data, assesses, and evaluates then produces a report which confirms, documents, demonstrates, authenticates, establishes, substantiates, and concludes. He or she also serves in a forensic role by then communicating that con- clusion or opinion (and its basis) to the court. The purpose is to provide information that makes some- thing more evident than it was before. The state- ments made by an expert should be those on which a juror or judge can base a belief as to their accuracy. #nurses #ot #pt #crc #casemanagement #legalnurseconsultant

1