NCMS Morning Rounds 10-10-19

Happy Thursday!

Enjoy your NCMS Morning Rounds.

Oct. 10, 2019

Duty to Report Law Effective Oct. 1

The NC General Assembly recently passed House Bill 228 — Modernize NC Medical Board Laws, which includes a new legal obligation for physicians and physician assistants to report certain misconduct by any individual licensed by the NC Medical Board (NCMB). This new “duty to report” provision (N.C. Gen. Stat. §90-5.4) went into effect Oct. 1, 2019.

Specifically, the law obligates any individual licensed by the NCMB to report:
1. Sexual misconduct involving a patient by a licensee.
2. Fraudulent prescribing, drug diversion or theft of any controlled substances by a licensee.

Medical professionals need not have definitive evidence of misconduct to make a report. The law specifies that licensed medical professionals should submit a report if they “reasonably believe” that misconduct has occurred. Licensees who report suspected misconduct in good faith are granted civil immunity.

The NCMB has created a new online form to receive reports from health care professionals or institutions. The form may be used to report information required by statute, or to report any other concern the reporting individual believes NCMB should investigate. Access the online form. The page also includes FAQs and other information to help licensees understand their reporting obligations under the law.

Issue Brief Released on CenteringPregnancy

As part of last week’s Maternal and Infant Health Summit convened by the NCMS, The Centering Healthcare Institute (CHI) released an issue brief titled ‘How CenteringPregnancy Can Support Birth Equity.’ The Summit focused discussion on the challenges affecting maternal and infant health outcomes in North Carolina especially among minorities. Carmen Strickland, MD, MPH, chair of CHI’s Board of Directors and Associate Professor at Wake Forest Department of Family and Community Medicine., spoke at the Summit as part of a panel discussion on CenteringPregnancy.

Prepared independently by Health Management Associates with input from experts in birth equity, the issue brief examines the need for new approaches to maternal child health care to increase birth equity and reduce the growing disparities among mothers and infants, particularly African Americans.

The brief highlights CenteringPregnancy, which is a model of group prenatal care bringing women due at the same time out of exam rooms and into a group setting, as a strategy to address racial and social inequities and discusses the promising outcomes seen by medical professionals who practice the model with patients.

“CenteringPregnancy provides a unique opportunity for change,” Dr. Strickland said. “The facilitative model emphasizes the provider-patient relationship, as well as peer support among mothers. It provides the opportunity for group participants and facilitators to develop the mutual trust and supportive relationships that are so important in building strong, resilient families. For patients it means they are heard and more empowered to partner with clinicians in health care decision-making. For providers, there is time and a platform to learn from the lived experience of their patients allowing enhanced care delivery, resulting in better outcomes.”

Evidence highlighted by the issue brief points to improved outcomes associated with the group prenatal care model. One study found that CenteringPregnancy:
• reduced early preterm delivery (before 32 weeks) to 1.3 percent compared to 3.1 percent for individual care,
• reduced preterm delivery to 7.9 percent compared to 12.1 percent for individual care, and
• virtually eliminated the racial disparity in preterm birth for Black women relative to white and Hispanic women.

In light of these latest findings, Angie Truesdale, Chief Executive Officer of CHI urged policymakers and payers “to invest in multi-layered strategies to address this very complex problem in our health care system.”

Read the issue brief.

Kudos to Dr. Mims and Dr. Cummings!

Two NCMS Foundation Kanof Institute Leadership College alumni received awards last week at the 14th Annual Jim Bernstein Health Leadership Dinner.

Susan Mims, MD, MPH, received the Foundation for Health Leadership & Innovation Community Achievement Award and Robin Gary Cummings, MD, received the Jim Bernstein Community Health Career Achievement Award.

Dr. Mims holds a variety of leadership roles at Mission Health and is Chief of Pediatrics for Mission Children’s Hospital. She has served as the chief executive for Mission Children’s Hospital for over a decade and has been instrumental in promoting health throughout western North Carolina and working to meet the health care needs of the people and families of the region. Under Dr. Mims’ leadership, Mission Children’s Hospital has grown to serve children across western NC and beyond with pediatric specialty care in 24 disciplines, a child life program, a child advocacy center and other outreach programs, several attaining national recognition such as The ToothBus mobile dental care, Asthma Outreach and UNC Safe Kids injury prevention programs.

Dr. Cummings has served as the sixth Chancellor of the University of North Carolina, Pembroke (UNCP) for the last four years. Under his leadership UNCP has increased access to high quality education, expanded academic opportunities through institutional partnerships, enhanced the university’s role in regional economic development and set records for philanthropic giving. A graduate of the Duke University Medical School, Dr. Cummings practiced cardiothoracic surgery at the Pinehurst Surgical Clinic and Moore Regional Hospital. After retiring from surgical practice he became medical director and executive director of Community Care of the Sandhills before joining the NC Department of Health and Human Services, first as Director of the NC Office of Rural Health and Community Care and then, just six months later, as Deputy Secretary for Health Services and Acting State Health Director.

Congratulations to both deserving award recipients!

In the News

CDC: 9 Tips for Diagnosing and Treating Vaping Related Illnesses, Becker’s Hospital Review, 10-7-19

Learning Opportunity

transcript  is available from the Sept. 17 Medicare Learning Network listening session on Opioids: What’s an “Outlier Prescriber”? The Centers for Medicare and Medicaid Services (CMS) is required to notify opioid prescribers with prescription patterns identified as “outliers” compared to their peers and encourage them to reference established opioid prescribing guidelines. Read the transcript.


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