Clinician Burnout is a National Problem   “A recent Health Affairs study reported that U.S. physicians and their staff in four common specialties spend, on average, 15.1 hours per week and more than $40,000 per year reporting quality measures. This equates to 785 hours per physician and more than $15.4 billion annually. The vast majority – 81 percent – of practices reported that they now spend more effort dealing with quality measures than three years ago, and only 27 percent said current measures are representative of the quality of care. A Family Practice Management said an unintended consequence of the burden has been the devaluing of the patient-physician relationship and has contributed to clinician burnout.”  (Health Finance News, September 17, 2018)

Final Membership Dues Notice   A certified letter will be sent next week to members who have not yet paid their 2018 dues with a final invoice for payment due October 1, 2018. If payment is not received by this date, we will assume that the member is no longer interested in membership. Providers who are not members are not able to participate in HMSA’s Payment Transformation contract and their patients that are part of the EHI IPA Health Center will need to be assigned to another IPA.. If you have any questions about your payment, please contact Joyce at jvitales@ehiipa.com or 808-797-3113.

Ask the EHI Pharmacist   The following is information on Treating Diabetic Neuropathy that we thought might be of interest from Jessica Ku, PharmD, EHI IPA’s pharmacist. Please feel free to contact her for advice and consultation on any pharmacy related questions.  Her email address is jku@ehiipa.com.

  • TCA’s are first-line and inexpensive: Amitryptiline is commonly used but Nortriptyline and Desipramine are better tolerated.

  • TCA’s can be combined with pregabalin or gabapentin; one study shows that the combination of gabapentin + nortiptyline is more effective than either drug alone for diabetic neuropathy or postherpetic neuralgia.

  • Use SNRI’s in patients with comorbid depression, Duloxetine target dose is 60-120 mg daily.

  • Gabapentin and pregabalin come with some risk of euphoria, abuse, and dependence, this seems to be dose dependent. Pregabalin has a more predictable dose response, it works faster, and the narrow dosage range allows it to be titrated faster as well.

  • Topical options with FDA approval are the Lidocaine 5% patch and the capsaicin patch.

  • Meds non-preferred include: Tramadol, opioids, anticonvulsants (other than gabapentinoids), and SSRIs.

EHI IPA Future Plans   All provider members are invited on Wednesday, October 17 at 6:00 PM to hear about the IPA’s future plans for restructuring to provide Management Services Organization (MSO) support to members and give members an opportunity to form a Medical Group that employs providers. The Board will present details on how to join the Medical Group and explain how the MSO would benefit the group practice and members at large. Providers (principals) and their business partners invited. Flyer will be sent shortly.

Save the Date – Super Huddle for PCPs – Tuesday, October 16, 12:00-1:15 PM   The next super huddle that was originally scheduled on September 18 will now be held on October 16 at noon at ‘Imiloa Astronomy Center. Flyers will be sent soon.

Beacon Health – PCP Referral to for Behavioral Health Support   Beacon Health offers behavioral health services for HMSA patients. Attached is the referral form (here) and the overview of services (here).

Facing Addiction in America – New Surgeon General Report & Press Release   The Surgeon General, in coordination with SAMHSA and HHS released the newest edition of Facing Addiction in America (attached here). The Surgeon General also released a digital postcard (here) to distribute.

Announcements:

  • 2018 Walk to End Alzheimer’s Hilo – Saturday, September 29. Registration at 7:00 AM, Walk at 8:00 AM. Register here. Or, help the IPA Team raise money here!

  • KTA Diabetes Self-Management Education Classes — Refer your patients to diabetes education classes presented by KTA Pharmacist Dayna Wong-Otis on Thursdays at 9:00-11:30 AM or 4:00-6:30 PM, starting October 4, 2018. One-on-one sessions available on September 24 & 27. Fax the COMPLETE and signed referral form to EHI IPA at 808-935-4472. Referral form attached.

  • Advance Health Care Directive Fill-out at ADRC – New dates attached.

  • UPDATED Aging & Disability Resource Center (ADRC) Referral Form – Please use the attached referral form to refer patients to their programs. Also attached is a list of what their Kupuna Care services provide.

  • Ola Hou I Ka Hula: Hula & Hypertension – Refer your patients to this culturally-based program for those seeking healing from health problems! Mondays & Wednesdays, 5:30-6:30 PM, starting August 20. Flyer attached.

  • Mountain-Pacific Quality Health WEBINAR: “Making a Meaningful Clinical Interventions in the Community Pharmacy – Thursday, October 4, 8:00 AM HST. Join HERE at time of the meeting.

  • Hilo + Puna Community Medical Center Rat Lungworm Disease Support Group – Oct. 10, Nov. 14, Dec. 12, 4:00-6:00 PM at the Kea‘au Community Center. Flyer attached.

  • Symposium on the Clinical Diagnosis and Management of Neuroangiostrongyliasis (Rat Lungworm Disease) – Wednesday, October 10, 8:00 AM at Hilo Medical Center Nursing Conference Room. Flyer attached.

  • Project ECHO Geriatric Clinic – Free CME Opportunities from September 2018 to April 2019. Schedule attached here and memo attached here.

  • NKFH Chronic Disease Self-Management Program – Friday, September 28, 9:00-11:30 AM, EHI IPA office – Refer your patients with ANY chronic disease to this six-week program by calling Mary at 808-829-4115 or 895-2730, or fax patient name(s) to 808-935-4472. Flyer attached.

  • Hilo Medical Center Diabetes Support Group – “Carbs You Can Count On” Flyers attached here. Will continue every first Tuesday of the month from 4:00-5:00 PM for the rest of 2018.