Monday, December 18, 2017

OCMA Blog

Women’s Imaging Centers Will Operate Under Breastlink Name


For more than 15 years, breast imaging specialists of West Coast Radiology have worked with referring physicians of Orange County to provide comprehensive breast imaging services through a network of dedicated women’s imaging centers. As of April 11, 2015, the dedicated women’s imaging centers where these radiologists work will be rebranded as Breastlink Women’s Imaging Centers. 

The current team of expert breast imaging specialists working out of these locations will continue interpreting women’s imaging exams performed at these centers, with the added benefit of being able to work more closely with Breastlink’s multidisciplinary team of breast cancer experts. While the name has changed, patients and referring physicians can continue to expect the same exceptional services from the same expert team. 

Breastlink physicians and staff are excited to continue working with these talented radiologists, who possess decades of combined sub-specialty experience in breast imaging, and to expand imaging options available to women under the Breastlink name as part of a comprehensive breast health care model. 

Where to Find Breastlink Imaging Centers 

The dedicated women’s imaging centers now known as Breastlink Women’s Imaging Centers were previously known as: 

  • West Coast Breast Center Irvine 
  • West Coast Breast Center Laguna Hills 
  • Breast Care & Imaging Center of Orange
  • West Coast Breast Center Santa Ana
  • Breast Care Center Temecula Valley

Patients and referring physicians can visit or call these five centers at: 

Breastlink Women’s Imaging Center Irvine
16300 Sand Canyon Avenue, Suite 203
Irvine, CA 92618 
949-752-9090

Breastlink Women’s Imaging Center Laguna Hills 
23961 Calle de la Magdalena, Suite 130 
Laguna Hills, CA 92653
949-272-2202

Breastlink Women’s Imaging Center Orange 
230 S Main Street, Suite 100 
Orange, CA 92868
714-541-0101

Breastlink Women’s Imaging Center Santa Ana 
1100-A N Tustin Avenue
Santa Ana, CA 92705
714-543-9927

Breastlink Women’s Imaging Center Temecula Valley 
25455 Medical Center Drive, Suite 210 
Murrieta, CA 92562
951-600-2839

For more information, please visit Breastlink.com


OC In+Care Newsletter-Issue 5

Newsletter for providers serving people living with HIV/AIDS in Orange County

In the last issue of the In+Care newsletter, we discussed the importance of engaging clients in medical care. In this issue, we will talk about the Continuum of Care, also known as the Treatment Cascade, and how you can help your patients/clients understand the importance of HIV viral load suppression.

The Continuum of Care explains the following stages of HIV care:

  • HIV Infected the total number of people who are estimated to be HIV positive.
  • HIV Diagnosed is the total number of people who have been diagnosed with HIV disease.
  • In HIV Care is the total number of people who see their doctor regularly (at least once every 6 months).
  • Undetectable HIV Viral Load is a HIV viral load count below 200 copies/mL in the blood.stages of HIV care:

According to the Centers for Disease Control and Prevention (CDC), an estimated 14% (or about one in seven) of all people living with HIV disease (PLWHD) in the United States (US) do not know they are positive. Furthermore, about half (52%) of all PLWHD are in HIV care and only 40% of all are virally suppressed in the US.

In Orange County, an estimated 6,698 individuals were living with HIV as of 2014. Of that, 67% (4,492 of 6,698) were linked to a HIV primary care provider and 58% (3,912 of 6,698) had an undetectable HIV viral load. In comparison to national and California data, Orange County fairs better in all stages of the cascade.d count below 200 copies/mL in the blood.stages of HIV care:

Orange County goal for PLWHD by the end of 2015 are:

  • 85% will be in HIV care 
  • 67% with undetectable HIV viral load

Viral load suppression is the key to staying healthy. If your patients/clients have been prescribed antiretroviral therapy, help remind them the importance of taking their HIV medication as prescribed.

According to the CDC, those who are currently on HIV medication will live more than twice as long as individuals who are not on HIV medication.1 Furthermore, suppressed viral load reduces the risk of transmitting the virus to others. A suppressed viral load may also slow the progression towards AIDS.2

In late 2014, Orange County implemented a campaign to remind PLWHD of the importance of seeing their doctor regularly. Due to the implementation of the Affordable Care Act (ACA), nearly 700 PLWHD have transitioned from Ryan White-funded medical care to public and private insurance. This transition has significantly changed how PLWHD access medical care. As a service provider, it is important to support and facilitate continued medical care access and adherence. The following are simple tips to promote medical care adherence:

If you are a medical provider, ask your patients...

  • What Questions do you have about your health?
  • Do you understand your numbers (viral load, CD4, etc.)?

As a provider, you can also...

  • Do reminder calls before visits
  • Follow up on missed visits
  • Coordinate care/adherence with the patient's Ryan White case manager, when appropriate

If you are a support service provider, ask your clients... 

  • When did you last see your HIV doctor?
  • Do you know your numbers (HIV viral load and CD4)?
  • Is your next appointment with your HIV doctor within 6 months?
  • Do you have any questions for your doctor?

The HIV Planning and Coordination website has resources for persons living with HIV. The website can be accessed via the link below:
http://ochealthinfo.com/phs/about/dcepi/hiv/libehiv

1 Centers for Disease Control and Prevention, Vital Signs, November 2014
2 http://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/458/plasma-hiv-1-rna--viral-load--and-cd4-count-monitoring

Our+Care OC is a project of the Orange County HIV Quality Management Committee. The HIV Quality Management Committee works to increase the quality of Ryan White services. For more information about the committee, please call (714) 834-8063. If you have feedback or suggestions for future newsletters, please contact Mindy He at MHe@ochca.com.

Tamarra Jones, DrPH

Program Manager

HIV Planning and Coordination

Orange County Health Care Agency 

 


Ensure your practice information is up-to-date with contracted payors

Physician Advocate Tip of the Month 

  • Reason #1 Up-to-date practice information such as specialty, address, tax identification number (TIN), practice name, and complete list of physicians in the practice (along with their national provider identification (NPI) numbers) ensures that payments and other vital contractual notices are received by the practice.
  • Reason #2 Providing updated, accurate practice information to payors ensures that your information is displayed correctly to patients looking for a physician through payors' provider directories. It also helps reduce the potential for delayed or denied payments for the practice.
  • Reason #3 It will likely keep your practice compliant with your contracts. Most payors have language in their contracts that requires physicians to notify the payor in writing of any changes in their practice. 

Be sure to download the free member resource "Updating Provider Demographic Information with Payors," at: www.cmanet.org/ces

Mitzi Young
OCMA Physician Advocate, CMA Center for Economic Services
(888) 236-0267
myoung@cmanet.org 

 


Autism Spectrum Disorder — The Importance of Early Identification and Behavior Intervention

By Donald Sharps, M.D.
CalOptima Behavioral Health Medical Director

 

Early identification of children with delays in development or those at risk of delays provides primary care providers with a critical opportunity to pinpoint special health care needs. 

The main path to the early identification is a developmental screening in the primary care setting. In particular, early identification of autism spectrum disorder (ASD) can help a child significantly. According to the Centers for Disease Control and Prevention (CDC), early treatment services can improve a child’s development by helping the child talk, walk and interact with others. Therefore, it is important to screen children for ASD or any other developmental problems in their early years. 


The CDC and CalOptima recommend that all children be screened for developmental delays and disabilities during regular well-child doctor visits at: 
  • 9 months
  • 18 months
  • 24 or 30 months

If a child is at high risk for developmental problems due to preterm birth, low birth weight or other reasons, additional screenings might be required.

Additionally, all children should be screened specifically for ASD during regular well-child doctor visits at:

  • 18 months
  • 24 motnhs

Further screenings might be needed if a child is at high risk for ASD (e.g., having a sibling or other family member with ASD) or if behaviors sometimes associated with ASD are present.

Identifying a child as having a special health care need is only the first step. Once developmental delays are identified then an appropriate diagnostic work-up and follow-up must occur. It is in this next step that the relationship between the primary care provider and an early behavior intervention service becomes critical.

Effective September 15, 2014, CalOptima covers behavioral health treatment for ASD. This treatment includes Applied Behavior Analysis and other behavior intervention services. The services help develop or restore, as much as possible, the daily functioning of a member with ASD.

If the developmental screening is positive for signs of developmental delays associated with ASD, you may be able to conduct the additional assessment for ASD, or you may refer the patient to a specialist for a comprehensive diagnostic evaluation. Alternatively, Medi-Cal members can call the Orange County Mental Health Plan Access Line at 1-800-723-8641 to request the evaluation or to access other mental health services.

Resources:

http://www.cdc.gov/ncbddd/autism/screening.html

http://www.cdc.gov/ncbddd/autism/facts.html

 


Community Partnerships: Bringing Health and Wellness to Where We Live and Work

By Annette Walker, Executive Vice President, Strategic Services at St. Joseph Hoag Health

Keeping people – and communities – healthy means more than treating illness and injury. It means partnering with people before they get sick and making it easy and convenient for them to exercise, get preventive care like vaccines and screenings and learn how to eat right.

But in today's fast-paced lifestyle, a lifestyle where we're eating breakfast in the car and checking emails at night on our phones, our health sometimes takes a back seat. But what's the solution? Health and wellness professionals need to meet people where they live and work.

One way we are addressing this at St. Joseph Hoag Health is through our Wellness Corners which are located in neighborhood and office settings. This is helping local employees and residents get their screenings, making them healthier than ever because health care services are available within steps of their offices and front doors.

Offering basic medical care, the Wellness Corner focus on services that help to improve our overall health and wellness and prevent chronic conditions through lifestyle management programs. Members of the local workforce and residential community can stop by to get a flu shot, review his lab test results to ensure that his cholesterol levels have gone down (due to a new healthy eating routine) and attend a seminar about the benefits of mindful meditation.

Our centers located at Four Park Plaza at Jamboree Center, the Park Place business community and The Village at Irvine Spectrum neighborhood are emerging as successful clinics that empower people to take control of their health to prevent illnesses and increase their well-being. We are planning to open additional locations throughout Orange County soon, each with the goal to make healthy living for our family, friends and neighbors more convenient, flexible and accessible.

By making access to health care and wellness programs convenient, we can help people manage their health and ward off illness. This is the health care model of the present and of the future.

Annette Walker is executive vice president, strategic services for St. Joseph Hoag Health where she is responsible for the strategy, business development, marketing and communications. She works directly with senior executives and physicians to develop, support and implement the strategic objectives and competitive positioning of the health ministry. For additional information about the Wellness Corners, click here.


Rising Number of Measles Cases Creates Numerous Patient Safety Issues

As more measles cases are diagnosed, physicians should implement effective screening protocols, infection control techniques, and patient education to reduce liability risks and promote patient safety. Since initial presenting symptoms of measles are similar to those of upper respiratory infections, measles may be misdiagnosed before a patient presents with the familiar red rash.


Exposure to measles in a medical office or facility is a serious patient safety issue because of the potential for complications from the disease, including death. The disease is airborne and extremely contagious. An infected individual is considered contagious from four days before to four days after the rash appears. The rash usually appears 14 days after a person is exposed; however, the incubation period ranges from 7 to 21 days.

Your practice can reduce liability risks and promote patient safety by:

  • Developing screening protocol for patients calling in with symptoms of upper respiratory infections and measles. Staff should query the individual regarding exposure to known measles cases, travel abroad, and immunization status.
  • Documenting all discussions with patients and parents of minors regarding measles, including the risks and benefits of inoculation. When patients/parents decline measles immunization, consider using an informed refusal form: www.thedoctors.com/ecm/groups/public/@tdc/@web/@kc/@patientsafety/documents/form/con_id_001221.pdf. Patients who contract measles and claim that their physician never discussed inoculation represent a potentially significant liability.
  • Providing serologic testing for immunity, when necessary, and documenting all related discussions with patients who are unsure of their immunity status against measles.
  • Ensuring that immunization tracking is up to date and well documented in the medical record.
  • Complying with state laws for the provision of vaccines to healthcare workers. For more information, go to www2a.cdc.gov/nip/statevaccapp/statevaccsapp/default.asp.
  • Advising those who may have come in contact with an infected individual to contact their physician immediately.
  • Ensuring that office staff members are trained to use personal protective equipment and proper isolation techniques.

Follow these tips if you or your staff suspects a patient has measles symptoms:

  • Minimize the risk of exposure to others by admitting the patient through a separate entrance and isolating him or her in an exam room. If possible, schedule the patient at the end of the day. The exam room should not be used until the following day since the virus can live on surfaces for up to two hours. Keep the exam room door closed.
  • Place a surgical mask on the patient and ensure that all office staff members wear protective equipment.
  • Follow standard disinfection and sterilization procedures for exam rooms.
  • Report suspected cases to the local health department.
  • Consider making post-exposure prophylaxis available to those who have been exposed. Post-exposure vaccination can be effective in preventing measles in some individuals. As an alternative, Immunoglobulin, if administered within six days, can offer some protection.

Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety


Mental Health Services Access Hotline for Patients and Physicians

The Orange County Mental Health Plan has a hotline available to help Orange County patients locate mental health services. This includes outpatient mental health services provided by mental health professionals and psychiatric inpatient services. Physicians can also utilize the number to locate services for patients. 

Click here for more information.

Orange County Mental Health Plan:

1-800-723-8641


Measles Outbreak Update February 2015

Measles Outbreak Update
February 17, 2015


Measles cases have continued to occur in Orange County with 35 cases confirmed this year. In California, as of February 13, 2015, 113 cases have been confirmed since December 2014; 20% of those with known hospitalization status have been hospitalized. Of those with known vaccination status, the majority are unvaccinated, with most of these because of personal belief exemptions.

Orange County Cases
Of the 35 Orange County cases, 14 are children, 13 of whom were not vaccinated.
Thirteen of our cases spent time at the Disneyland Parks since mid-December, 2014. Sixteen cases had no known source, signaling ongoing transmission in the community. The most recent cases were contacts to previously known cases.

Vaccination is Key to Prevention
Although some of the confirmed cases occurred in people with a history of vaccination, their illness is generally milder and typically not as infectious. Vaccination is critical to prevent the ongoing spread of disease.

  • Although the overall risk of getting measles in Orange County remains low, residents who have not received any measles-containing vaccine and do not have any other evidence of immunity should get a dose of MMR vaccine.
  • Two doses of measles-containing vaccine (MMR vaccine) are more than 99% effective in preventing measles. The first dose is routinely given at 12-15 months of age, with the second dose usually at age 4-6 years. The second dose may be given any time ≥28 days after the first dose.
  • All healthcare workers (HCW), including those born before 1957, should have two documented doses of MMR or serologic evidence of measles immunity. HCW who are exposed to a case of measles may be excluded from work until they provide evidence of immunity.
  • If exposed to measles, all, children and school/child care staff without documented immunity will be removed from work/school/child care from day 7 after the first exposure to day 21 after the last exposure.

Report any suspect case of measles to the Orange County Health Care Agency immediately at 714-834-8180 (714-628-7008 after hours).

For more information on measles, see www.ochealthinfo.com/measles. Information on vaccination recommendations by age group is available in the previous advisory dated 1/26/2015 and guidance on clinical presentation, infection control, reporting, and testing is in the 1/21/2015 advisory.

click here to download this measles outbreak update.


Measles Outbreak Update

Measles has now been confirmed in 22 Orange County (OC) residents, signaling ongoing transmission in the community and at the Disneyland Parks. Thirteen of these cases spent time at the Disneyland Parks since mid-December, 2014. In California, as of today, 59 cases of measles have been confirmed since the end of December; 42 of these had an exposure in December at Disneyland or California Adventure Park. Additional cases have been identified that were at the park while infectious in January, including within the last week. Nine of the OC cases have no Disney or other known measles exposure. Additional cases are expected in Orange County.
 

Of the 22 Orange County cases, five are children, of whom four were not vaccinated and two were hospitalized. Although some of the confirmed cases occurred in people with a history of vaccination, their illness is generally milder and typically not as infectious. Vaccination is critical to prevent the ongoing spread of disease.

  • Although the overall risk of getting measles in Orange County remains low, residents who have not received any measles-containing vaccine should get a dose of MMR vaccine.
  • Two doses of measles-containing vaccine (MMR vaccine) are more than 99% effective in preventing measles. The first dose is routinely given at 12-15 months of age, with the second dose usually at age 4-6 years. The second dose may be given any time ≥28 days after the first dose.
  • All healthcare workers (HCW) should have two documented doses of MMR or serologic evidence of measles immunity. HCW who are exposed to a case of measles may be excluded from work until they provide evidence of immunity.
  • If exposed to measles, all, children and school/child care staff without documented immunity will be removed from work/school/child care from day 7 after the first exposure to day 21 after the last exposure.

Measles is highly contagious and people can be exposed by just being in the same room as a measles case during their infectious period (4 days before onset of rash until 4 days after). Several of the cases have potentially exposed patients in healthcare facilities, resulting in large contact investigations and persons needing immune globulin administration, post-exposure vaccination, or serologic testing for immunity.

  • Any patient suspected of having measles should be masked immediately and promptly moved to a negative pressure room when available. Providers seeing patients in an office or clinic setting should consider options such as arranging to see suspect measles cases after all other patients have left the office, or assessing patients outside of the building to avoid having a potentially infectious patient enter the office.
  • Notify Orange County Public Health Epidemiology immediately at 714-834-8180 (or 714-628-7008 after hours) about any suspect cases. Do not wait for laboratory confirmation before reporting a suspect case. Do NOT refer patients to Public Health without first discussing with one of our staff.
  • DO NOT send potentially infectious suspect measles patients to a reference laboratory for specimen collection.

For more information on measles, see www.ochealthinfo.com/measles.


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