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March 14, 2018

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Making inroads to reduce the administrative load for providers

In understanding root causes of the physician burnout problem across the nation, administrative workload and time drain associated with the electronic medical record (EMR) are leading contributors. The IU Health Cerner Uplift program works to improve efficiency and reduce unnecessary time in the EMR. This year the program is expanding to seven teams working with 15 additional physician service lines this year.

According to IU Health’s informatics leadership team, nearly 1,300 physicians participated in Cerner Uplift in 2017. Physicians who have been through the program are able to shave three minutes per patient from their EMR time (saving 45 minutes for a physician seeing 15 patients a day).

“I have been fortunate to be able to get my charts done at work recently, thanks to Dyn Doc,” says Girish Vitalpur, MD, pediatric allergist—immunologist, IU Health Physicians.

Providing updated functionality through the Uplift program is one aspect of the effort to make the EMR more efficient and reduce the burden on physicians.

“We are doing this to enable ourselves to connect to the mission of delivering excellent clinical care to our patients,” says Emily Webber, MD, pediatric hospitalist and chief medical information officer at Riley Hospital for Children at IU Health. Webber also serves as associate chief medical information officer for IU Health, and is part of IU Health’s informatics leadership team.

The informatics team is also working with IU Health Information Services on performance initiatives to speed up how the EMR performs, reduce unnecessary alerting and remove other waste in EMR.

“This is a critical part of the effort,” says Webber. “Slower EMR performance means I’m staring at the hourglass, and those seconds add up. Improving performance is like upgrading the engine of EMR itself, so that it searches and displays data more quickly.”

These efforts do not change the way clinicians work, but were shown to save all physicians, nurses and pharmacists 15 seconds per patient per day on average.

“I’m using PC Touch (mobile Cerner application) and my documentation time went down,” says Tim Imler, MD, gastroenterology, IU Health Physicians Digestive and Liver Disorders. “What used to take me three hours takes one hour now.”

 Other inroads to reduce provider administrative time include:
  • The consolidation of a single conflict of interest form for dually employed physicians (IU Health Physicians and IU School of Medicine) and affiliated faculty that historically required separate completion at both locations.
  • Similar treatment for HIPAA annual mandatory training, with access and completion available via smart phone.
Pending a successful roll out of these consolidated enterprise requirements, the health system will consider expanding this approach to other requirements for dually employed providers. By the end of this year, over 2,500 physicians will have received help from the Uplift program alone.

“I feel now we have an action plan that will continue to yield results,” Webber said.

Tait Shanafelt, MD, has conducted research in physician well-being that has involved physicians at all stages of their career from medical school to practice and has included several multi-center and national studies.

Plan to attend physician wellness event on May 3

With physician burnout at epidemic levels, IU Health Physicians has an opportunity to hear from a leading expert on the subject.

Tait Shanafelt, MD, chief wellness officer, Stanford Medicine, will be a featured speaker at meetings on Thursday, May 3, to address the burnout issue and improve provider wellness. One of the first wellness officers at a U.S. academic medical center, Shanafelt is a pioneer in physician burnout research.

“Finding Meaning Balance and Personal Satisfaction in the Practice of Medicine,” will feature a discussion by Shanafelt on Thursday, May 3, from 11:30 am — 1 pm, at Hine Hall Auditorium. Click here to register.
The event is sponsored by: IU Health Physicians, IU School of Medicine Office of Faculty Affairs, Professional Development and Diversity.

Ammon appointed vice president, Practice Operations

Kim Ammon, PT, MHA, has been appointed IU Health Physicians vice president, Practice Operations. Since October 2016, Ammon has served as vice chair, clinical and academic administration, Department of Orthopaedic Surgery, serving the academic and research mission for the department within IU School of Medicine.

In her new role, Ammon will work to facilitate organizational improvement and meaningful team member engagement to remove obstacles to patient care delivery. She will report to her predecessor, Brian Kremer, who was named IU Health Physicians chief operating officer in January.

“We are thrilled to add Kim to the IU Health Physicians leadership team. Her expertise, humility and servant leadership will be a powerful catalyst for positive change across all of our clinical departments," says Kremer.

Ammon has been with IU Health Physicians for nearly a decade, overseeing operations for seven sites for the orthopaedic service line and more than 100 team members. She also brings more than two decades of clinical and managerial experience serving in various roles with healthcare organizations in Indiana and surrounding states.

Ammon received her combined bachelor’s and master’s degree in physical therapy from University of Evansville, and a second master’s degree in health administration from IUPUI.
The inaugural Fitzgerald leadership award will honor the legacy of IU Health Physicians' past president.

Award nominations open through March 31

There is still time to nominate a standout colleague or team member for a Pillar Award, an honor presented annually in recognition of the exceptional efforts of IU Health Physicians team members. Individuals honored with a Pillar Award make significant improvements in service to patients, are instrumental in driving excellence and help IU Health Physicians deliver the best care to those it serves.

One award will be presented for work done to enhance the mission, vision and values of the organization in each of the five pillar categories:
  • Quality and Safety
  • People
  • Education and Research
  • Finance and Growth
  • Service
Here’s an excerpt from a past Pillar award nomination (Quality category):

“The Clinical Business Information and Analytics (CIBA) team has been instrumental in providing IU Health Physicians with near real-time, accurate, complete business and operations information through a series of interactive reports or dashboards provided through the use of "Tableau.” This has been transformational in the way department vice chairs of Clinical and Academic Administration perform their leadership responsibilities.” – IU Health Physicians Executive Team

Click here to download the Pillar Awards nomination form. Nominations are due March 31.

In addition to the Pillar Award, the inaugural John F. Fitzgerald Leadership Award will honor the legacy of the organization’s past president who is credited with founding and building IU Health Physicians as one of the country’s largest academic physician practices. The Fitzgerald leadership award will be presented to the IU Health Physicians leader who exemplifies leadership traits that include:
  • Putting patients first
  • Servant leadership
  • Humble integrity
  • Decision-making that benefits the healthcare system
Click here to download the Fitzgerald leadership award nomination form.
Sign up for educational opportunities

The cascading effects of Hurricane Harvey
Join Todd Senters, MHA, Wednesday, March 28, from 1:30 — 3 pm, at IU Health Methodist Hospital Petticrew Auditorium for a discussion on how Beaumont (Texas) Baptist Hospital prepared and responded to the devastating effects of Hurricane Harvey.

Physicians, medical staff, emergency responders and public health professionals will learn about the dynamics and complications healthcare responders experience during major weather-related events.

Click here to learn more and register.

CHIIS Agile Implementation Bootcamp
The Center for Health Innovation and Implementation Science (CHIIS) is a standalone center under Indiana University School of Medicine that offers many educational programs throughout the year. CHIIS is hosting an AgiIe Implementation (AI) Bootcamp April 17-20 in the Health Information and Translational Science (HITS) Building, Conference Room 1110.

The AI Bootcamp is a four-day course that will guide participants through identifying the right opportunities, assembling effective teams, implementing evidence-based solutions as well as sustaining improvement. Attendees will learn how implementation science integrates with quality improvement principles to improve population health outcomes and be provided with the tools to aid you in this complicated process. This event qualifies for a maximum of 21.50 AMA PRA Category 1 CreditsTM or 21.50 CEU Category I credits.

For additional information, discounted pricing and registration, click here 
or visit the website.

Help a student make their college dreams come true

To honor retiring IU Health board members and support the next generation of outstanding healthcare providers,the IU Health Board of Directors Scholarship program is accepting applications. Two $5,000 scholarshipsrenewable for up to four yearswill be awarded to ethnic minority dependents of IU Health team members who are seeking a healthcare-related degree.
This is the second year the board of directors scholarships have been awarded. Marisa Villarreal, one of last year’s recipients, believes the support has made a significant difference in her college experience.

“This scholarship alleviated a financial burden and allowed me to focus and thrive in my collegiate academics,” says Villarreal. “It’s because of scholarships like this that minorities in similar situations have a shot at a college education.”

Application submission will close Friday, March 16, and winners will be announced by Friday, April 27.

Who can apply?
Dependents of active IU Health team members system-wide who are:
  • Ethnic minority students
  • Students pursuing a healthcare-related degree
  • Students enrolled or who plan to enroll as a full-time student
  • Students in good academic standing
  • Students who demonstrate financial need
Learn more about the scholarship here.
"We’re doing everything we can to make it the safest possible place to give and receive care.” - Carrie Lahr, vice president, Operations, Riley Health

Riley enhances security measures

To help ensure Riley Hospital for Children at IU Health is as safe as it can be for patients,families, visitors and team members, the hospital is enhancing security measures. Team members will notice security measures that include:
  • Increased police staffing
  • Staffed metal detectors at public entrances
  • Video monitoring systems
  • Restricted access by badge only via the Atrium lobby
“Wide-open access to the Riley campus and all its buildings is a thing of the past,” says Carrie Lahr, vice president of Operations at Riley. “In today’s world, we need to continually assess the environment to ensure we’re doing everything we can to make it the safest possible place to give and receive care.”

Team members can expect to show their badges to security officers when entering Riley at three main entrances—Simon Family Tower, Riley Outpatient Center and the Atrium Lobby. Security screening will be required for those without a badge.

The Emergency Department entrance will continue to serve as an after-hours entry point for the public. Team members, however, should plan to use badge-only entrances (such as across from the Wilson Street garage) when coming and going after hours.

Effective Monday, March 19, the Atrium Lobby entrance will become a badge-only entrance. Badges that provide access to Riley today will continue to work after the Atrium Lobby security enhancement, giving team members ongoing access to that entrance.

More security updates are planned later this year, including additional badge readers at strategic locations, a visitor pass system at monitored entrances, and the deployment of team member safety advocates who will help identify ways to strengthen (even more) the culture and environment of safety at Riley.

Team members who get questions about the security measures from patients, families or visitors can share these key points, as needed:
  • “We want Riley to be as safe as possible for all who visit, stay and work here.”
  • “Safety improvements are always in development to strengthen security and create the best space for healthcare to happen.”
  • “New security measures—restricted entry points, metal detectors, video monitoring and more
     police officers —are for everyone’s benefit.”
Have questions or suggestions? Contact Carrie Lahr,
Pearls for better documentation

In 2018, the IU Health Physician Advisor Team continues to share short “pearls” or tips to assist medical professionals who document in the medical record.

Contributed by William Rutherford, MD, associate medical director, IU Health Revenue Cycle Services, this new installment explains SIRS plus infection DOES NOT equal SEPSIS.

The Systemic Immune Response Syndrome (SIRS) is nonspecific and occurs in multiple clinical situations including infection, ischemia (e.g. myocardial infarction), hypoxia, trauma and burns, and as the result of multiple simultaneous medical issues. Properly used, SIRS is an alert to the possibility of sepsis and NOT a set of diagnostic criteria. SIRS parameters are common with the normal response to infections such as pneumonia or even a UTI, yet the patient is not truly septic as defined below.

The SEPSIS-3 Conference (2015) returned to the original concept of “sepsis” – widespread deleterious effects seen remotely to the site of the infection, termed “systemic dysregulation.” Such effects (carrying with them greatly increased mortality) include sustained hypotension, elevated lactate due to anaerobic metabolism and failure of organs other than the site of infection – e.g. renal failure in pneumonia. SEPSIS-3 also advocated replacing SIRS with SOFA (for the ICU) and qSOFA (non-ICU patients), which are similarly NOT diagnostic criteria but only predictors of all-cause mortality.

While any of these scoring systems might properly stimulate aggressive initial empiric treatment with antibiotics, assigning a diagnosis of sepsis must be based on evidence of systemic dysregulation.

Direct questions on this or other topics concerning documentation to Jeff Amodeo, MD, or Bill Rutherford,


We’re doing great things

IU Health Physicians doctors and team members do great things every day. If you or someone on your team has been recognized for professional achievement or community service, submit details to If you have a story to share about great things happening in your practice, contact Dick Rea, IU Health Physicians communications coordinator, at

18th annual Indianapolis Business Journal Health Care Heroes Breakfast

Elisabeth von der Lohe, MD, FACC, FSCAI, IU Health Physicians Cardiology (Physician), was honored Feb. 28 at the IBJ breakfast. An established and respected cardiologist in her native country of Germany, von der Lohe came to the United States along with her husband, a fellow cardiologist, in 1994. While putting in 60-hour weeks learning a new language to pass exams and practice in the U.S., she discovered a new passion: women’s health. She started a women’s clinic at IU Health Methodist Hospital in 1998, developing the Women’s Heart Program at IU Health and played a major role in developing IU’s National Center of Excellence in Women’s Health.

American Medical Women's Association

Theresa M. Rohr-Kirchgraber, MD, IU Health Physicians Pediatrics, will receive the Bertha Van Hoosen Award from the American Medical Women’s Association (AMWA) on March 24. The award, named in honor of the founder and first president of the AMWA, honors one or more women physicians who have demonstrated execeptional leadership and service to women physicians and students through AMWA.
“Dr. Theresa Rohr-Kirchgraber is a highly influential AMWA leader, at both the local and national level. She has been a mentor for me, especially last year when she was immediate past-president and I was president-elect. I am grateful for her service, her guidance and her willingness to continue to contribute in a meaningful way. There really isn’t a better candidate for this award.” – Suzanne Harrison, MD, FAAFP, FAMWA, president, AMWA, professor, Family Medicine and Rural Health, Florida State College of Medicine, Tallahassee

Heart mission team, Riley Hospital for Children at IU Health

On February 28, Mark Turrentine, MD, Cardiothoracic Surgery, Riley Physicians, and the Heart Team from Riley Hospital at IU Health, departed on their 34th overseas trip to help children in Amman, Jordan, receive medical care and surgeries that they otherwise would not get. The team was interviewed by WRTV-6 News in Indianapolis as they left on their latest mission, which focuses on children with congenital heart defects.

“It’s an opportunity for us to extend ourselves to people who are less fortunate,” says Turrentine. “We provide them with an element of care that they would not receive in their own countries.”

Many of the patients are from countries surrounding Jordan, with some in refugee camps.
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