Healthcare Archives - Page 19 of 25

Common Foot Injuries – Top Docs Radio

April 9, 2015 by angishields

Top Docs Radio

Common Foot Injuries - Top Docs Radio

00:00 / 01:01:27

Common Foot Injuries

This week our friend, Dr. Shamir Bhikha, DPM with Ankle & Foot Centers of Georgia stopped by to talk about common foot injuries often seen as the weather begins to warm and people decide to get out and start running/walking. He talked about the fact that after the New Year as folks set goals to lose weight and especially during spring, folks tend to go out and jump into a training regimen that doesn’t allow for adaptation to occur in the connective tissues, muscles, and bones of the lower legs and feet.

This leads to several common injuries that can derail our ability to continue training for months (or even longer). We talked about plantar fasciitis, which causes often-debilitating heel pain that is particularly painful after having been at rest or in bed for a period of time, Morton’s neuroma, an injury to the nerve between the toes that makes affected toes feel like they’re broken, Achilles tendonitis, which is a painful aggravation of the tendon behind the heel bone, and issues that can occur with poorly-fitted shoes.

Shamir talked about the importance of having a running pro help you choose a training shoe that is appropriate for your gait as well as properly fitted for the activities you plan to use them for. Not doing this can result in toenail injury (including loss of the nail), toenail fungus, toe deformities, stress fractures, and other painful problems.

Before you head out to the trail you need to take a few minutes and listen to this foot/ankle expert who focuses his clinical practice on sports-related injuries through a conservative approach to helping his clients recover and ideally prevent further problems. We readily recommend Dr. Bhikha as an expert for foot/ankle-related problems.

Special Guest:

Dr. Shamir Bhikha, DPM of Ankle & Foot Centers of Georgia

Doctorate with Honors, Podiatric Medicine, Barry University School of Podiatric Medicine
Residency, Inova Fairfax Hospital 2010-13 & Limb Salvage Center at Georgetown University Hospital 2013
Skilled in Sports Medicine/Trauma to the foot/ankle, Podopediatrics and Reconstructive foot/ankle surgery
Comprehensive training in diabetic limb salvage, plastic surgery and wound care

Hyperbaric Oxygen Therapy

April 9, 2015 by angishields

Health Connect South

Hyperbaric Oxygen Therapy

00:00 / 00:58:22

Hyperbaric Oxygen Therapy

This week we sat down with internationally-known expert on the subject of Hyperbaric Oxygen Therapy, Dr. Helen Gelly. This treatment modality has been available to patients with poorly-healing wounds, thermal injuries, decompression sickness, late effects of radiation, and several other problems for decades. And while there is a quality body of evidence supporting the use of this treatment for clinically-appropriate patients, many of the patients who could benefit from access to it never get to know it’s available.

This is due in large part to the fact that of ~159 US medical colleges, only ~30 offer hyperbaric oxygen therapy and wound resolution as taught specialties. That means that approximately 85% of graduating physicians have had very little (if any) exposure to academic information about the modality. The result is that they often miss opportunities to add the treatment to the patient’s care plan, which in turn delays (or even prevents) these problem wounds from healing.

Dr. Gelly shared information about the history of hyperbaric oxygen therapy and we talked about the physiology of what’s happening during the course of therapy. We discussed a couple of major groups of patients whose clinical outcomes tend to be significantly improved with access to hyperbaric medicine, diabetic ulcer patients and patients experiencing persistent late effects of radiation. The aim is to get credible information to the public so that both physicians and patients in need can educate themselves about it. Atlanta is unique in that both inside the city and in numerous suburbs, patients can receive hyperbaric oxygen therapy in hospital-based or UHMS accredited free-standing programs. It’s also paid for by Medicare, Medicaid, and commercial insurance companies for these evidence-based indications.

Special Guest:

Dr. Helen Gelly, MD of HyperbaRXs

Doctor of Medicine, Emory University School of Medicine
Internship/Residency: Pediatrics/Emergency Medicine at Emory University Affiliated Hospitals
Board Certified in Emergency Medicine
Fellow of the American College of Emergency Physicians
Fellow of the American College of Certified Wound Specialists
Subspecialty Certified Undersea and Hyperbaric Medicine

Intellimedix and Life University

April 1, 2015 by angishields

Health Connect South

Intellimedix and Life University

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Intellimedix and Life University

This week we sat down with experts from Intellimedix and Life University. Intellimedix is an Atlanta-based company that uses high-powered computing algorithms, coupled with genetic testing to identify existing medications that could potentially be re-purposed to effectively treat illnesses other than the ones they were originally designed to treat. One of the company’s founders has a child who suffers from a severe form of epilepsy. Unfortunately, there are limited treatments known to be available that will provide relief from this debilitating condition. His daughter’s story influenced the decision to focus the company’s initial efforts on uncovering existing medications that could be successfully re-purposed to help folks dealing with this type of epilepsy and other neurologic disorders.

Chief Science Officer, Jeff Skolnick shared the example of how a blood pressure medication (Viagra) was re-purposed to treat erectile dysfunction. He went on the discuss the physiology/chemistry behind why this is possible and why it makes sense to look for existing, approved medications that have the ability to improve quality of life for patients dealing with illnesses different from those the medications are initially intended to treat. This approach saves a great deal of time and money over the years-long, massively-expensive process of developing a medication from ground zero to treat a particular condition; allowing patients in need to receive access to an effective treatment sooner.

Dr. Gilles LeMarche, VP of Professional Relations at Life University came by to talk about the undergraduate and graduate programs available at their Marietta, GA-based campus. They offer a number of health, wellness, and sports-related degrees ranging from chiropractic medicine, to vitalistic nutrition, functional kinesiology, and others. He shared their approach to wellness, applying the philosphy of “vitalism” allows their graduates to help their clients/patients by helping the body to heal itself; as it is ideally capable of doing when interfering factors are removed.

Special Guests:

Steven Hickson, CFO, Intellimedix

MBA, Global Executive MBA Program, IESE Business School, Barcelona Spain
BA Accounting, NC State University
Previous Senior Auditor, Turner Broadcasting System
Former SVP, New Media & Premium Channels, Fox International Channels- Asia

Jeff Skolnick, PhD, Chief Science Officer, Intellimedix

Director, Center for Study of Systems Biology, Georgia Institute of Technology
PhD, Chemistry, Yale University
Mary and Maisie Gibson Chair in Computational Systems Biology
Associate Director, Integrated Biosystems Institute, Georgia Institute of Technology

Gilles Lamarche, DCM, VP, Professional Relations, Life University

Doctor of Chiropractic Medicine, Canadian Memorial Chiropractic College
Certified Six Advisors Coach, 6 Advisors Coaching Academy
Former Vice President, Parker College of Chiropractic
Fluent in French

Some backing music provided by: www.pacdv.com/sounds/

Start Exercise Fitness Training Without Injury – Top Docs Radio

March 20, 2015 by angishields

Top Docs Radio

Start Exercise Fitness Training Without Injury - Top Docs Radio

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Start Exercise Fitness Training Without Injury

This week, our new monthly partner, Dr. Andrew Pugliese stopped by to introduce us to Randy Nicholson, of Fitness Firm Studio. He’s a certified trainer who shared some very helpful information on how folks who have not previously trained or former athletes who haven’t trained in a while start exercise fitness training without injury.

As a former athlete who has experience in high intensity and high volume cardiovascular and weight/resistance training, I know too well what it’s like to resume working out after a prolonged layoff and experience overuse injuries. These come from a burst of activity with or without heavy weight/resistance. Too much exercise too soon can easily result in a incapacitating measure of pain or even injury that prevents continuing without another break to recover.

Randy shared what a person who’s motivated to start or resume training should ask a prospective personal trainer to determine what their philosophy is regarding the initial training phase. He also shared the value of using a roller to help facilitate muscle recovery as well as releasing trigger points that can cause muscle spasm.

We talked about the best way to approach beginning training in a step-wise fashion to insure that muscular imbalances, postural weaknesses, and flexibility have been improved upon before moving on to more intense training moves/activities. If you or someone you care about is thinking about resuming or wants to start exercise fitness training without injury they need to check out this week’s episode.

Special Guests:

Randy Nicholson Fitness Firm Studio

NASM
EGOUSE
4th Degree Black Belt in Tae Kwon Do
BS Engineering, University of Chattanooga

Andrew Pugliese, MD, Infectious Disease Consultants

Doctorate in Medicine, St. George University School of Medicine
Fellowship, Infectious Disease, Winthrop University Hospital
Triple Board Certified in Internal Medicine and Infectious Disease
Pioneer in non-surgical treatment of acute and chronic sinusitis
President of Sinus Solutions

Liv2BGirl

March 18, 2015 by angishields

Health Connect South

Liv2BGirl

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Liv2BGirl

We’ve all heard the news stories about young people who have been victims of cyberbullying through social media. In some cases, kids have even gone so far as attempting or committing suicide over the experience. This week we sat down with Cindy Abel and Tosha Marks, co-founders of Liv2BGirl. It’s a social media environment they’re building as a mobile app that will give girls a social media environment exclusive to them. The site will be free from cyberbullying and negative, attacking/abusive behaviors—these being clearly prohibited when a user sets up their profile.

A recent article by Cindy and Tosha published on Momeomagazine.com states these statistics cited from dosomething.org:

Nearly 43% of kids have been bullied online
68% of teens agree that cyberbullying is a serious problem
81% of young people think bullying online is easier to get away with than bullying in person
90% of teens who have seen cyberbullying ignored it
Girls are twice as likely as boys to be victims of cyberbullying
Only 1 in 10 victims tell there parent or trusted adult of the abuse.

In this short clip, Tosha Marks shares why they are building the Liv2BGirl app:

The concept proved to have traction with girls when they launched their beta website to evaluate interest and content offerings, gaining roughly 700 users who tested the site. Cindy and Tosha quickly found that the idea of a social media space free from hurtful, hateful behaviors is appealing to girls—enough so that average time per visit was ~30 mins.

We talked about some of the troubling statistics around cyberbullying as well as negative experiences Cindy and Tosha saw their own daughters face in various social media platforms. We also discussed the resources they need to bring their app to full realization and how folks can get involved to get this source of positive peer pressure and encouragement for our daughters into their hands.

Special Guests:

Tosha Marks, Co-founder, Liv2BGirl

BS, Liberal Arts and Sciences, Middle Tennessee State University
Previous Sole Proprietor, The Silver Sak
Former Sales Representative, Dixie Packing and Seal Company

Cindy Abel, Co-founder, Liv2BGirl

BS in Management Information Systems, University of Dayton
Co-President, North Springs Charter High School
Member, Advisory Board, Hands On Atlanta
Co-founder/Owner, Abel Solutions
7 years as information technology consultant, Accenture

This program made possible by ShareWIK Media Group

Medical Reserve Corps – Top Docs Radio

March 12, 2015 by angishields

Top Docs Radio

Medical Reserve Corps - Top Docs Radio

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Medical Reserve Corps

The U.S. Department of Health and Human Services (HHS) has approved MAG’s request to form the nation’s first medical society-sponsored statewide volunteer medical reserve corps (MRC). MAG and the Georgia Department of Public Health would oversee MAG’s MRC. MAG is now eligible for limited federal capacity building funds and has in fact received a 2015 grant for $2,500 – though the MAG MRC will require funding from private sources to fully maximize its vision.

The MAG MRC will train physicians to respond to declared emergencies in Georgia, and it will establish a system to coordinate the deployment of those physicians during any such emergencies. The MAG MRC will supplement the official medical and public health and emergency services resources that are available in the state. MAG MRC units will be capable of setting up mobile hospital systems. And under extreme circumstances (e.g., a shortage of health care providers in a given area), MAG MRC units can be called upon to perform some of the functions that would otherwise be performed by the full-time emergency medical response personnel in the state. MAG formed the MRC as a result of 2013 House of Delegates meeting action.

The MRC is a national network of volunteers, organized locally to improve the health and safety of their communities. The MRC network comprises 993 community-based units and 207,783 volunteers located throughout the United States and its territories. Georgia has 19 approved MRCs.

MRC volunteers include medical and public health professionals, as well as other community members without healthcare backgrounds. MRC units engage these volunteers to strengthen public health, improve emergency response capabilities and build community resiliency. They prepare for and respond to natural disasters, such as wildfires, hurricanes, tornados, blizzards, and floods, as well as other emergencies affecting public health, such as disease outbreaks. They frequently contribute to community health activities that promote healthy habits.

The designated point of contact is the Director of Health Protection with DPH. The MAG MRC may also be activated by MAG MRC leadership team as necessary. The MAG MRC Unit will supplement the State of Georgia Public Health Emergency Preparedness’ and Response Unit. The unit will not replace or supplant the existing emergency medical response system or its resources including locally based MRC units.

Special Guests:

John S. Harvey, M.D.

Chief of Surgery, Gwinnett Medical Center
Acting Colonel and Command Surgeon, Georgia State Defense Force
MAG’s President-elect.
Missions have included the Katrina/Rita hurricane and Haiti earthquake victim airlifts. He dealt with the Centennial Park bombing that took place during the 1996 Olympics as a medical command officer.
Doctor of Medicine, Medical College of Georgia

Susan Moore

Susan Moore has been MAG’s Director of Health Policy and Third Party Payer Advocacy since 2013. She helps MAG members resolve third party payer claim disputes and grievances. She has spent 30 years in the health care industry – more than half of those focused on patient safety and health care quality. Moore has a degree in nursing from the Emory University School of Nursing and a Master’s Degree in Public Health from the Yale School of Public Health at Yale University.

Paul Hildreth

Paul Hildreth is the emergency management coordinator/grant coordinator for REMS for the Fulton County School District. He has 14 years of experience in emergency response and crisis management. He is a certified emergency manager and master certified emergency manager. He has been an integral part of the Georgia State Defense Force for 10 years. He has a degree in business operations from DeVry University and an MBA from the University of Phoenix.

Telemedicine

March 12, 2015 by angishields

Health Connect South

Telemedicine

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Telemedicine

This week I sat down with the founder of MedZed, a hybrid telemedicine platform that enables parents with sick children to receive care for their child with an in-home RN who establishes a remote link with a physician. Today, there are a growing number of urgent care centers available, along with after-hours pediatric care centers. These care centers are typically better options than being seen in an emergency room where wait times and exposure to very ill patients are a concern.

However, urgent care centers also frequently come with a long wait and exposure to numerous sick persons in the waiting room as well. Telemedicine is a health care delivery model where patients interface with a provider via phone and/or face-to-face video conferencing platform that allows patient and doctor to see each other. This week’s guests joined us to talk about how they are innovating with this technology to deliver quality health care in a patient’s home.

With the MedZed platform (and soon a mobile app) parents with sick children can request an in-home examination of their children. After a phone triage conversation, a registered nurse or nurse specialist is dispatched to the home to conduct the exam. The in-home clinician links up with the patient’s physician (when that practice is a MedZed participant) or a thoroughly-vetted, experienced pediatrician on the MedZed medical staff (when the patient’s physician office is NOT a MedZed participant).

Once in the home the nurse establishes an internet connection using either the family’s connection if available or by cellular wi-fi if in-home internet is absent or inadequate. Via the communications link, the physician is able to view the results of otoscopic exams, listen to their stethoscope, and see vitals all in real time. This portal also gives the patient and family the ability to also see what is being visualized by the exam, offering educational opportunities and a decreased measure of anxiety.

We talked about the fact that as more diagnostic equipment such as radiographic devices become more mobile, the scope of care that will be able to be delivered in the home will expand dramatically. This will serve to reduce use of ER and urgent care for more acute, complex complaints. The service is offered as fee-for-service—patients pay using credit cards when the care is delivered. In some cases third party insurors will reimburse for part or all of the visit, depending on plan.

Special Guests:

Scott Schnell, CEO, Co-founder of MedZed

BGS, Accounting & History, University of Michigan
Former CPA
Previous SVP/ CFO of Simply Floored
Previous Chairman/CEO of Pike Family Nursing

Tiffany Holland, RN at MedZed

Katarina Quinterno, Parent, MedZed client

Peripheral Arterial Disease – Top Docs Radio

March 6, 2015 by angishields

Top Docs Radio

Peripheral Arterial Disease - Top Docs Radio

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Peripheral Arterial Disease

As many as 12 million Americans are dealing with peripheral arterial disease (PAD), a progressive blockage of the blood vessels that carry blood to the lower extremities. For many of these patients, amputation is the outcome, leaving them without a foot, or in others, half or more of their leg. Medical literature has shown that in these patients, their risk of death within 1 to 5 years of their amputation they have a 40% likelihood of amputation of the remaining leg and a significant risk of death. It’s clearly a serious problem.

But we can reduce the rate of amputation among these patients and we can also reduce the severity of intervention required to address the problem if we catch it early. Dr. Joseph Ricotta, vascular surgeon and director of the Northside Hearth & Vascular program, stopped by the studio to talk about what can be done to improve patient outcomes for those with PAD. We talked about the troublesome statistics around peripheral arterial disease, including the fact that among diabetics with PAD who develop a non-healing wound resulting in amputation, as many as 50% of them never receive a non-invasive study that could prevent the loss of their leg.

That means we need our partners in primary care and foot/ankle surgery to take an aggressive stance when presented with patients who are at risk for PAD or who have a poorly-healing wound on their leg or foot. There are numerous non-invasive studies that take only minutes in the vascular surgeon’s office that can readily identify patients who have blockage affecting blood flow to their feet. In these cases, if caught early, surgeons like Dr. Ricotta have more options and greater probability they can reestablish adequate blood flow that helps a wound to heal, preventing or mitigating extent of amputation.

We talked about the fact that Northside offers access to 2 of the country’s 10 robotic devices that significantly improves the effectiveness of minimally-invasive procedures by allowing the vascular surgeons to access and treat previously-inaccessible locations. Additionally, with the assistance of the robot, the surgeons are able to reduce damage that can occur on the inside of the vessel being treated, which reduces the likelihood that scarring after the procedure will block the vessel off again (a leading cause of reocclusion in PAD lesions).

I also spoke with foot and ankle surgeon, Dr. Michael Bednarz of Ankle & Foot Centers of Georgia, whose office is located in Woodstock, just north of Marietta. He talked about treating PAD patients with wounds from the perspective of the specialist who is tasked with managing the wound and ultimately, treating it surgically as necessary (including amputation when efforts to heal the wound fail and serious infection is a risk).

We talked about the fact that amputation should be viewed as a last-ditch option. And Mike shared that no patient should face amputation without having had a vascular study to determine if poor flow is contributing to the wound not healing. He talked about the fact that when he’s presented with a poorly-healing wound, particularly in a patient with PAD risk factors such as diabetes, one of the first things he does is request a vascular study to assess blood flow. He also utilizes Transcutaneous Oximetry, a non-invasive test that shows how well the tissue at the surface where a wound is located is getting oxygen.

With the results of those studies, he is able to address poor blow flow by referral to a vascular surgeon and/or to hyperbaric medicine (readily available in Atlanta and surrounding suburbs) to address poor oxygen levels in the skin. He also evaluates other risk factors such as glucose levels and presence of infection, often resulting in consults with infectious disease and/or endocrine specialists to help heal the limb-threatening wound. We talked about the fact that a multi-specialty approach insures that more patients can avoid amputation and the resultant high mortality rates that come with them.

Early involvement with an experienced wound specialist, vascular diagnostics/intervention, infection control, and endocrinology are all vital in helping patients avoid an amputation that might also cost them their life.

Special Guests:

Joseph Ricotta, MD, Medical Director, Heart & Vascular Institute, Northside Hospital

Doctor of Medicine, Thomas Jefferson University School of Medicine
Surgical Residency, Johns Hopkins University School of Medicine
Fellowship, Vascular Surgery, Mayo Clinic
Fellowship, Advanced Endovascular Surgery, Cleveland Clinic Foundation
Associate Professor of Surgery, Georgia Regents University, University of Georgia School of Medicine

Michael Bednarz, DPM, Ankle & Foot Centers of Georgia

Doctor of Podiatric Medicine, Kent State University School of Podiatric Medicine
Residency, Department of Veteran Affairs Medical Center, Miami
Board Certified, American Board of Foot/Ankle Surgery
Recognized as a “Top Doc” in the WellStar Health System

Population Health Management

March 4, 2015 by angishields

Health Connect South

Population Health Management

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Population Health Management

The notion of working to improve a population’s awareness of wellness and disease is not new. For decades we have sought to reduce risk factors for cardiovascular disease, including reduced smoking rates, early detection for cancers, and decrease obesity (not to mention containing healthcare costs) But with improving data capabilities, interoperability between EMR’s and data systems, changing laws, and an over-arching goal of improving the general health and wellness of our population we are beginning to see ever-greater emphasis on population health management as a strategy to both contain costs and improve outcomes. Check out this week’s episode to learn more about how your company can save long-term costs while at the same time improving quality- and length of life to their employees.

As a health strategy, population health management focuses heavily on preventive care measures, coupled with making such care delivery as convenient as possible for the population involved. Additionally, procedures around work place injuries are assessed and if needed, modified to include triage that can prevent the use of ER to initiate care when such injuries/exposures occur.

We talked about how Dekalb Medical restructured their approach to their own employees’ wellness and work place injuries, successfully reducing their spend on high cost claims, ER visits, and work place injuries. They are now collaborating with businesses in the community to collaborate with them to improve the wellness/safety of their respective employees and helping them achieve the same sort of cost savings on health/risk in their enterprises. These efforts are steadily improving the aggregate health of the Dekalb Medical catchment area patients through more consistent, integrated delivery of preventive/wellness-focused care.

Dekalb Medical, a long-standing pillar of the Atlanta health systems, serving the eastern half of the metro, has proven to be an innovator and thought leaders in the concept of population health management. After a multi-year effort to reduce cost and improve outcomes for their own ~4000 employees, including decreasing work-place accidents and ER visits, they have an impressive list of successes to talk about.

And as a well-established health system with the full complement of services from acute to tertiary, diagnostic and procedural services available, Dekalb Medical is uniquely positioned to exert positive effects on the health of the large metropolitan population they serve.

About DeKalb Medical

Founded in 1961, DeKalb Regional Health System, Inc., known as DeKalb Medical, is comprised of more than 800 doctors skilled in 55 medical specialties across three campuses. The 627-bed system includes DeKalb Medical at North Decatur (451 beds), DeKalb Medical Long Term Acute Care at Downtown Decatur (77 beds), DeKalb Medical at Hillandale (100 beds), DeKalb Medical Physicians Group and the DeKalb Medical Foundation.

This week Diana Keough and I sat down with Dr. Shealynn Buck and Jim Forstner from the health system. We talked about population health management as a concept and how it was put to work as a strategy to the benefit of both its employees and the bottom line of the organization.

Dekalb Medical is now providing similar population health management services to employers within their catchment area around the east perimeter of Atlanta and beyond. They are engaging employers’ employees through gameficiation, on-site services, consulting regarding workplace safety, narrow network benefits that save costs and improve outcomes, and more. We talked about how the notion of population health management is a move from transactional, disease-focused care to a relational, wellness-focused model and how that can save both money and improve lives of employees. We also discussed some positive unintended consequences that can come through offering such a health initiative to an employee population.

The not-for-profit health care system is a HealthGrades® Five-Star Recipient for Treatment of Heart Attack in 2013 and Five-Star Recipient for Peripheral Vascular Bypass in 2012, and earned the Get With The Guidelines®–Stroke Silver Quality Achievement Award from the American Heart/American Stroke Association. Their Maternity Center was selected as a participant in the Best Fed Beginnings project as part of UNICEF/WHO’s Baby-Friendly Hospital Initiative. The Dekalb Medical Cancer Center received the Outstanding Achievement Award and is granted three-year approval by The Commission on Cancer of the American College of Surgeons as a community hospital comprehensive oncology program. Their Joint Solutions Center is a metro Atlanta leader in joint replacement.

In addition, The Dekalb Medical LTAC earned The Joint Commission’s Gold Seal of Approval® for acquired brain injury, wound care and respiratory failure services. Their WorksWell® program is dedicated to supporting employers with solutions to maximize the health, safety and well-being of their employees while improving performance and the bottom line.

Special Guests:

Dr. Shealynn Buck, MD, Executive Director, Dekalb Medical WorksWell and Medical Director of Dekalb Medical Wellness Center

Doctor of Medicine, Emory University School of Medicine
Residency, Pathology, Emory University School of Medicine
Fellow, Transfusion Medicine and Cellular Therapies
Former Assistant Medical Director, American Red Cross

Jim Forstner, SVP & Senior Strategy Officer of Dekalb Medical

>10 years service on Dekalb Medical executive team
Previous Executive Director for Contracting, Physician and Ambulatory Ventures, Dekalb Medical
Previous Director, Patient Financial Services, Dekalb Medical