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Minutes:November 9, 2011

 

                                                         MINUTES

                                           403rd  MEETING OF THE MEDICAL SCHOOL COUNCIL

                                                                3 p.m., Wednesday, October 19, 2011

                                                 School of Medicine Administration, Board Room 103

   

PRESENT: Drs. Ahn, Akpek, Barone, Bienvenu, Carroll, Chanmugam, Claypool, Comfort, Crino, Dlhosh, Gonzalez-Fernandez, Gottesman, J. Green, James Herman, Joseph Herman, Ishii, Molinaro, Puttgen, Shuler, Tan, Taverna, Williams, Zachara, Messrs. Johnson, Mandell and Rini, Ms. Foy

 ABSENT: Drs. Ahuja, Barker, Fine, R. Green, Keefer, Matunis, Nyhan, Pavlovich, Poynton, Resar, Solomon, Tis, Tufaro, Wade, Wolfgang, Ms. Matthys

 GUESTS: Drs. Clements and Regan

  

I.  Minutes

 

The minutes of the June 22, 2011 and September 21, 2011 meetings were approved.

 

II. Chair’s Report – Dr. Ishii

                Dr. Ishii reported on an AMBF Agenda Committee presentation on the new HIPAA requirements that will require recertification and training of all JHM faculty, staff, and students.  The federal government has recently levied fines on several academic medical centers found to be out of compliance with HIPAA requirements.

 

III. Updating Charter and Renaming the Medical School Council- Dr. Ishii  

                As a follow-up to discussion at the September meeting, Dr. Ishii circulated the MSC Charter with suggested modifications for Council consideration.  Discussion focused primarily on changing the MSC name to a label that more accurately reflects its function and would be consistent with other University elected faculty groups.  Dr. Ishii recommended the name be changed to Senate of the Johns Hopkins University School of Medicine.

                In the new JHM 3.0 structure the MSC Chair has a seat at the table in representing the views of the faculty.  Discussion focused on current membership that includes student, housestaff, and postdoctoral fellow representatives and whether such groups shall continue to be included in a restructured council as each of these groups now has an organization recognized by the School as representing their interests.  Such was not the case when the MSC was created in early 1970.

                The role of the Council and whether it should be a legislative or an advisory group was discussed.  After lengthy discussion and upon motion duly made and seconded, the MSC voted to 1) change the name to Faculty Senate (25 for, 2 against) and 2) appoint a sub-committee to revise the charter to reflect the role and membership of the new organization (unanimous vote).  It was felt that membership should be more inclusive than exclusive.  Dr. Ishii asked for volunteers to work on the charter revision.

              

IV. Update on Employee Benefits Advisory Committee Work – Dr. Clements  

 

               As a School of Medicine representative, Dr. Clements brought the council up-to-date on discussion of the Benefits Advisory Committee.  This University-wide committee has been charged with reviewing the faculty and staff benefit plans with the goal of finding $15 million in sustained savings.  The committee surveyed faculty and staff in Spring 2011 to determine what benefits are viewed as most important.

                The University spends $400 million per year in benefits.  Health care costs continue to drive the increased costs of benefits. At Johns Hopkins University employees pay approximately 16% of the actual cost of health benefits; at many peer institutions the employee share is 24%.  It is estimated if the JHU employee share was 22%, close to $12.5 million could be saved. 

               The retirement benefits program has recently been changed from a 6%-12% to a 4%-8% for new staff as of 7/1/2011.  The faculty plan remains at the 6%-12% level.

                Dr. Clements noted that the tuition grant and retirement benefits are “off the table” in current discussions.  She stressed that no changes in the benefit plans have been recommended to date and any forthcoming changes must be approved by the University Finance Committee before implementation.

                There was discussion about the lack of a wellness program for University employees.  There was strong sentiment expressed that the University implement a health/wellness program.

                Dr. Clements responded to questions related to benefits and compensation levels.

                Dr. Ishii thanked Dr. Clements for her presentation.

 

V.  Professionalism in Patient Care- Dr. Linda Regan 

                Dr. Regan presented a program initiated by the Department of Emergency Medicine to improve professionalism in patient care.  She noted the use of the word “Professionalism” instead of “Patient Satisfaction”.  The department’s low Press-Ganey Patient Satisfaction Survey scores indicated a change in culture was warranted.  The department hired the Studer Group to provide tools to improve the Press-Ganey scores.  The Studer Group strategy focused on anyone who came in contact with patients.  Dr. Regan described the process the Studer Group implemented.   She commented on a strategy known as the AIDET process which has been implemented in the ER.  This process 1) Acknowledges the patient upon arrival; 2) Introduces the caregiver to the patient; 3) Duration (time) expected for visit; 4) Expectation- tell patients what tests will be done and when to expect results; and 5) Tie together- thank patient for coming to the ER; tell patients we value their comments.

                Dr. Regan commented on staff reaction and initial push-back issues.  She summarized the lessons learned and the sustained high level effort required for success in changing the department culture.

                Dr. Regan responded to several questions regarding costs and time commitment.

                Dr. Ishii thanked Dr. Regan for her presentation.

 

VI.   Other Business

                            There being no further business this meeting was adjourned at 5:00 p.m.

  

                                                                                                         Respectfully submitted,

 

                                                                                                         Mary E. Foy

                                                                                                         Secretary

 

Future Medical School Council meetings:

All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.

 November 9, 2011

December 7, 2011

January 18, 2012

February 8, 2012

March 21, 2012

April 18, 2012

May 9, 2012

June 20, 2012

                                                         MINUTES

                                           404th  MEETING OF THE MEDICAL SCHOOL COUNCIL

                                                               3 p.m., Wednesday, November 9, 2011

                                                 School of Medicine Administration, Board Room 103

 

 

PRESENT: Drs. Akpek, Barker, Bienvenu, Carroll, Chanmugam, Claypool, Comfort, Crino, Gonzalez-Fernandez, J. Green, James Herman, Joseph Herman, Ishii, Matunis, Molinaro, Nyhan, Puttgen, Tan, Taverna, Tufaro, Williams, Wolfgang, Messrs. Johnson and Rini, Ms. Foy

 ABSENT: Drs. Ahn, Ahuja, Barone, Dlhosh, Fine, Gottesman, R. Green, Keefer, Pavlovich, Poynton, Resar, Shuler, Solomon, Tis, Wade, Zachara, Mr. Mandell Ms. Matthys

 GUESTS: Dr. Dillon Jones, Mss. Campbell, Pollak, and Ungar

  

I.  Minutes

 

The minutes of the October 19, 2011 were approved.

  

II. Chair’s Report – Dr. Ishii

 

               Dr. Ishii reported:

 

               1) The Medical School Council name change to Faculty Senate was presented to the Advisory Board at the October meeting and was favorably received.

                2) A committee has been formed to recommend changes in the MSC By-Laws.  Dr. Jude Crino will chair the working group.

                3) The Institute for Excellence in Education Peer Nominated and Peer Selected Education Awards were announced with a December 1, 2011 deadline for applications.  A new award honoring Lisa Heiser was also announced. The award will recognize a junior faculty member’s contribution in education.

                4) The Clinical Systems Advisory Committee will next meet on November 14th.  Interested faculty should contact Steve Mandell.

 III. Johns Hopkins Medicine 3.0 – Ms. Joanne Pollak, Senior Vice-President and General Counsel  

                As background, Ms. Pollak gave a brief history of her involvement in health care issues as a member of a private law firm prior to joining Johns Hopkins.  As the landscape was rapidly changing due to the managed care frenzy in the early 1990’s, the University and Hospital were frequently on different sides of health care issues.  It was in the best interest of both institutions to come together to speak as one in this rapidly changing environment.  A virtual entity, Johns Hopkins Medicine (JHM) was created with certain powers delegated to JHM by both the Johns Hopkins Hospital (JHH) and the Johns Hopkins University Board of Trustees.  In January 1996, JHM was created with Dr. Edward Miller as Dean of the Medical Faculty and CEO of JHM, followed by the appointment of Ronald Peterson as President of the JHH and Johns Hopkins Health Care System (JHHS).  Over time additional hospitals were brought into the system with the expansion of the JHHS which today includes the JHH, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Sibley, Suburban, and All Children’s Hospital in Florida.  The JHHS also has limited affiliations with other local hospitals which over time might become full-fledged members of the health system.

                The initial governance structure served the institutions well over the first ten to twelve years, but as the system expanded, the department directors felt more input into decision-making from the directors was required.  Some 18 months ago, Dean Miller hired a consultant who studied the governance structure and met with some 40 institutional leaders.  Two themes evolved from the consultant’s review: 1) JHH had not been as mindful as it should have been in decision-making and; 2) the current decision-making structure, a ten person Business Review Group, needed to expand to include additional stakeholders.  The new JHM 3.0 structure creates seven operating committees: Research, Education, Managed Care and Population Health, Patient Safety and Quality, Office of Physicians, Community Division, and International Division.  Each of these committees will have a working group that will make recommendations to a JHM Operating Committee which will consist of some 35 members including all Vice-Deans, 6 clinical chairs, 2 basic science chairs, MSC representation, as well as institutional leadership.  Two new JHM entities; Brand Equity Committee and the Office for Transformation and Strategy have also been created.

                The question of why make changes as the JHM leadership position will soon be changing was addressed.  It was felt that health care reform legislation is driving payers into making reductions and JHM must be ready to respond with one voice in a complex marketplace.

                The Operating Committee has met three times to date and has discussed IT initiatives (EPIC) and made the decision not to expand the JHHS at this time by acquiring another hospital.

                In responding to questions it was noted that the new structure provides more faculty input than ever into decision-making and the new system can be changed if it doesn’t work.

                Dr. Ishii thanked Ms. Pollak for her presentation.

  

IV. CPA PQRS Update- Ms. Nina Ungar, Associate Director, Contract Services and Ms. Michelle Campbell, Director Practice Management

                Ms. Ungar described the Physician Quality Reporting System which allows participating physicians to receive financial incentives for reporting adherence to certain quality-related measures in treating Medicare patients.  The CPA has provided assistance to faculty that compile data from multiple sources both electronic and non-electronic that generates the quality data required by the incentive program.  Physicians must agree in writing to participate in the program before data is released to CMS.  Hopkins received over $450,000 last year from the program.  Over 540 CPA providers participated in 2010.  At the present the pay for reporting program is optional but becomes mandatory in 2015, at which time Medicare payments will be reduced if physicians don’t participate.  Eventually this program will merge into “pay for performance” and the earlier Hopkins gets into the program, the better we become at establishing quality measures.  Dr. Baumgartner encouraged MSC members to bring this topic to faculty meetings and to encourage faculty to sign the PQRS participation form.

                Ms. Campbell described the electronic prescribing initiative that began in 2009.  The two approved systems at Johns Hopkins are Sunrise and Allscripts E-Prescribe.  The systems provide outside medication history, formulary information, and checks for duplicate therapies and interactions.  Medicare provides a combination of incentives and payment adjustments for e-prescribing.  A timeline listing the incentives and penalties was presented.  In order to get a Medicare credit the script must be sent electronically, it must be for a Medicare patient, and it must be in conjunction with an office visit.

                Dr. Ishii thanked Ms Ungar and Ms. Campbell for their presentations.

 V.  Other Business 

                Dr. Ishii announced the following sentence will be added to the faculty appointment letter in 2012:  “Would you like more information about your compensation plan”.  MSC members were asked to encourage their departments to share compensation plans with faculty.

                The issue of “training over-load” was brought up for discussion.  Faculty feel there are too many online training requirements and there needs to be central control as to who can require online training.  The MSC will seek information on the number of required courses to determine the scope of the problem.

          

               There being no further business this meeting was adjourned at 4:55 p.m.

  

                                                                                                         Respectfully submitted,

 

                                                                                                         Mary E. Foy

                                                                                                         Secretary

 

 Future Medical School Council meetings:

All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.

 

December 7, 2011

January 18, 2012

February 8, 2012

March 21, 2012

April 18, 2012

May 9, 2012

June 20, 2012

 

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