Governor's Newsletter Spring 2002
Francisco M. Joglar, MD, FACP
Governor, Puerto Rico Chapter
The Annual Meeting of the Puerto Rico Chapter held at the Caribe Hilton Hotel on February 7-9 was a complete success. It was attended by 209 physicians, including students, residents, members and fellows. Highlights of the activity included:
Meet the Professor and Update Sessions
Dr. Jose Cordero, Director of the National Center on Birth Defects from CDC
Evidence Based Medicine
Dr. Richard Gross, Professor of Clinical Medicine, Chief Section of General Internal Medicine, University of Arizona College of Medicine
Topics on gastroenterology
Dr. Joel Levine Regent of the College and Senior Associate Dean of the University of Colorado School of Medicine
Sleep Apnea
Dr. Kingman Perkins Strohl, Professor of Medicine, Case Western Reserve University.
Dr. German Malaret, former Governor and Laureate recipient who conducted a meet the professor session on medico-legal issues
Dr. Jose Ramirez Rivera, a fellow of the College and also former Laureate recipient, conducted a meet the professor session on End of Life Care
Dr. Vilma Rabell who is professor of Medicine at the UPR School of Medicine conducted a meet the professor session on Diabetic Dyslipidemia
Dr. Vanessa Rodriguez, Assistant Professor of Medicine at the University of Puerto Rico School of Medicine delivered a well received update on the treatment of Rheumatoid Arthritis
Dr. Samuel Suarez , Assistant Professor of Medicine at the UPR School of Medicine lectured on Community Acquired Pneumonia
Two outstanding internists from Puerto Rico were recognized during the award ceremony:
- Dr. Carlos Girod a Master of the College and renowned educator was the recipient of the Laureate Award
- Dr. Rafael Ramirez–Gonzalez who has distinguished himself for his leadership in our medical community, first native Puerto Rican to be named center director of the San Juan VA Center was the Special Achievement Award Recipient
The oral and poster presentations by the associates were very competitive and excellent. There were five prizes awarded.
1st prize went to Dr. M. Rodriguez Julbe for the paper - Effect of Albuterol on the QT Interval of Elderly Patients with Obstructive Lung Disease.
2nd prize went to Dr. A. Cedeno for the paper - Acute Respiratory Distress Syndrome/Acute Lung Injury, A Need for Education.
3rd prize went to Dr. C. J. Romero for the paper - TNF Microsatellite Allele Haplotypes in Puerto Ricans with Inflammatory Bowel Disease.
4th prize went to Ms. Liza Hernandez, MSIV for the work - Alkaline Phosphatase as a Non-invasive Marker of Cirrhosis in Patients with Chronic Hepatitis C.
5th prize was awarded to Dr. J Quinones for the paper - Prevalence and Outcome of Depression in a Medical Service.
The Chapter wants to recognize the collaboration of Dr. Norman Maldonado and Dr. Gonzalo Gonzalez Liboy for their participation as judges of the oral and poster competition. The Chapter also wants to acknowledge and thank Merck Sharp and Dohme for the educational grant that made possible the awards.
This year Scientific Program Committee members were:
Dr. Hector Gorbea,Chairman
Dr. Jose Ramirez Rivera
Dr. Samuel B. Suarez
Dr. William Rodriguez
The Chapter and the Governor expresses their gratitude and recognize the excellent work and dedication in setting up the program.
The following firms also merit recognition for their contribution and support:
Merck Sharp & Dohme
Gramas Lindas, Dorado, Puerto Rico
Wyeth Ayerst
SSS of Puerto Rico
Quest Diagnostics Inc. (Las Marias Laboratory Inc.)
GlaxoSmithKline
Puerto Rico Chapter Receives Management Award
For the second year in a row the Puerto Rico Chapter was awarded the Chapter Management Award. The announcement was made by Dr. Joel Levine Regent of the College during the Chapter Annual Meeting celebrated last February 7-9 at the Caribe Hilton Hotel in San Juan.
The Chapter Management Award was introduced in 1995 and recognizes those chapters that meet a basic set of standards in managing a chapter. The criteria used to determine the recipients of this award are the extent of chapter development through various activities. Some examples of these activities include, maintaining a Governors advisory council, producing at least two governors newsletters a year, holding a CME accredited activity and recruiting new members.
Dr. Francisco Joglar, Governor of the Puerto Rico Chapter shared the award with the following PR advisory council members:
Ivonne Jimenez, MD, Member, President
Julian Vazquez Plard, MD, FACP, Vice President
Luis Ghigliotti, MD, Treasurer
Hector F. Gorbea MD, FACP, Secretary
Carmen Cortes, MD, FACP
Carlos Girod, MD, MACP
Gonzalo Gonzalez Liboy MD, FACP
Esther Torres, MD, FACP
Call for candidates for Governor-Elect
Dr. Lillian Haddock, MACP, former governor of the Puerto Rico Chapter, accepted to be the chair of the Committee that will identify the Candidates for Governor-Elect elections. The Governor-Elect is elected one year prior to assuming the responsibility of Governor of the chapter.
Members of the Puerto RicoChapter interested in participating in this important activity should contact Dr. Haddock at the following address: 402 Minerva St., Dos Pinos, Rio Piedras, PR00923. Email: haddoc8@attglobal.net
Annual Meeting Chapter Reception
The traditional Chapter Reception during the Annual ACP-ASIM Meeting to be held in Philadelphia will be held at the Loews Philadelphia Hotel, room Washington B&C on Friday, April 12 from 6:30 to 8:00pm. All those members of the Chapter members attending the meeting are cordially invited.
Free College Help with HIPAA - Coming Soon!
In the long run HIPAA should yield huge savings for the US healthcare system, but in the coming months HIPAA will pose a major administrative challenge for providers, payors, and vendors. The Administrative Simplification section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will require practices to protect patients’ identifiable health information in any form - written, oral or electronic. The specific HIPAA regulations now being promulgated are divided into three basic Rules-Electronic Data Transactions, Privacy and Security. Physician practices will need to do substantial advance preparation to meet the following legally enforceable compliance deadlines:
| Rule | Compliance Deadline |
| Electronic Transactions | October 16, 2002 |
| Privacy | April 14, 2003 |
| Security | 26 months from release of final rule (expected late 2001) |
HIPAA Components
The Transactions Rule is designed to simplify the administrative processing of electronic claim and remittance forms and other patient encounter information through standardized electronic formatting. While the ultimate outcome could simplify various aspects of practice management and yield enormous savings by transforming information exchange between healthcare organizations, it will be no easy task getting to that point. Computer software programs as well as office procedures will need to be rewritten to accommodate the new requirements. For the most part, practices will depend on their computer vendors and payers to make these technical changes. However, if any one of the practice’s business partners is not ready on time, transactions and therefore practice reimbursement and cash flow will be disrupted. Thus, it is critical that practices understand what needs to be done, make sure that their vendors and other business partners are supporting the practice appropriately, and know what to do if they are not.
The Privacy Rule mandates how providers, health plans, and clearinghouses may use and transmit personal health information. As a result of media and consultant attention, many physicians are generally aware of the potential impact that the privacy rule can have on their practices. While many practices probably already do some of the things required by the Privacy Rule, compliance with its specific legal provisions will require significant effort, including implementation of new forms, policies and procedures, staff training, and patient education.
The Security Rule, which is still only in proposed form, has to do with the physical and electronic security of the information that is stored, maintained, used or transmitted. In other words, technological controls on computer systems and the security of data transmissions will be required for compliance. The "proposed" rule is generally intended to be scalable to small practices and technologically neutral. As of this date, however, it is still unknown what changes the "final" Rule may bring, especially with regard to oral and printed communications (such non-electronic information was not addressed in the original proposed security rule but has since been added to HIPAA’s purview). It may be prudent to put in place a risk management process now that can be revised and updated later, recognizing that the final security rule, when published, could require significant adjustments in the practice’s security planning and operations.
Practice Management Center Assistance to Members
Few physicians truly understand the potential impact HIPAA will have on their practices. Although the HIPAA rules are still in various stages of finalization, a host of consultants have already begun marketing manuals, seminars, and advice to physicians. Before sifting through such often-costly options, College members should be aware that ACP-ASIM’s Practice Management Center (PMC) is developing sound, practical tools to be offered as free member benefits.
The "HIPAA Overview" is already posted on PMC’s web page for members needing a basic explanation of these complex regulations. Very soon PMC will also begin releasing three separate manuals, each covering one of the HIPAA rules. These valuable tools will provide practical guidance, sample templates, forms, job descriptions, contracts, checklists, and other resources that members will need to comply with the new HIPAA rules. They are being developed with special emphasis on the compliance needs of small practices.
The requirements of the electronic data transactions rule are the most rigid, the least well understood, and the first of the three rules with which practices must comply. PMC therefore believes that transactions should be the initial focus of HIPAA compliance efforts by College members. PMC’s Electronic Transactions Manual will be available in January 2002. ACP-ASIM and the American Academy of Pediatrics have contracted with one of the most recognized experts in this field, Margret\A Consulting, LLC, to develop a transactions toolset that will provide members what they need to prepare for compliance with the electronic transactions regulations. The toolset is expected to be available on PMC’s web page in early 2002. Members should check the web page’s "What’s New" listing for announcement of this and other manuals.
ACP-ASIM is also one of ten medical specialty societies, representing over 400,000 physicians that have contracted with a leading consulting firm, Gates, Moore & Company, to develop Privacy and Security Manuals for members. The Privacy Manual will be available in December and the Security Manual shortly after the final Security Rule has been published. The Privacy and Security Manuals will also be available in Spanish.
Free to Members Online
College members will be able to download all of these manuals free of charge from the PMC web page. Members who do not have good Internet access will be offered hard copy, CD-ROM or diskette versions (shipping and handling charges apply). Keep your eye on the PMC web site for release of the latest HIPAA compliance tools. They will be valuable benefits of your College membership.
Lend a Hand to Tobacco Prevention
Tobacco use, primarily smoking, causes heart disease, lung disease and many cancers. More than 400,000 deaths in the United States every year are a direct result of tobacco use. According to the American Lung Association, 100 billion dollars a year are spent in health care costs and lost productivity due to tobacco use. Tobacco use and addiction is the leading preventable cause of death and disease in the United States.
The amount of CME time devoted to educating physicians and medical students about the health effects of tobacco use and the treatment of tobacco addiction is extremely small in proportion to the health importance of tobacco use and addiction. As a result, the College encourages members to join local anti-smoking campaigns and discourage the use of tobacco, particularly by young people.
Get involved in the campaign to limit tobacco. Help educate the public on the prevention of tobacco use and cessation of smoking. The following organizations maintain websites that will help get you started in the fight against tobacco:
Center for Disease Control (CDC) -
The CDC hosts a "tip" page that contains specific information on smoking cessation.
Campaign for Tobacco Free Kids -
An organization dedicated to protecting kids and adolescents from tobacco exposure. The website features tobacco initiatives on the state, federal and global levels.
American Lung Association -
Articles, data and statistics educating on the use and effects of tobacco products.
The Truth.com -
A site funded by the American Legacy Foundation, established in November 1998 after the Master Settlement Agreement (MSA) between 46 states, 5 US territories and the tobacco industry. Exposes the truth about tobacco and the companies that sell it.
ACP-ASIM Survey Finds Nearly Half of U.S. Members Use Handheld Computers
America’s internists are making room in their pockets for handheld computers, according to a recent survey ACP-ASIM that shows 47 percent of respondents use them. Considering respondents who plan to use handheld computers in the future, the survey suggests 67 percent of members will be using them by the end of 2002.
The 489 members responding to the survey were under 60 and involved in the direct care of adult patients. Usage among men and women was almost equal. Sixty percent of respondents 40 years of age or younger use a handheld computer, while the devices are only used by 42 percent of respondents between ages 41 and 50, and 34 percent of respondents over 51.The Palm(TM) operating system was most popular, in use by 81 percent of the internists who use handheld computers, with seven percent using a Pocket PC(TM).
Eighty percent of respondents using handheld computers used them to access drug information. The survey found other top medical uses for handheld computers included references for normal lab values (32 percent), reading medical textbooks (21 percent), and billing or coding (21 percent).
ACP-ASIM is considering the results of the survey as it expands its handheld-based educational resources. The College has developed a Personal Digital Assistant (PDA) Portal on ACP-ASIM Online that includes clinical references from ACP-ASIM publications; a weekly newsletter, Observer Express; reference tables for office-based instruction of medical students and residents; the Ethics Manual, and other materials. In addition, the popular ACP-ASIM book, "Drug Prescribing in Renal Failure" is currently under development for sale as a Palm-based application.
What's New
Contact Information
Carlos Gonzalez-Oppenheimer, MD, FACP,
Governor, Puerto Rico Chapter
E-mail: carlos.gonzalez48@upr.edu
Lisa Gonzalez
Chapter Support Staff
Phone: 787-504-4926
Fax: 787-767-6703
E-mail: lisagonzalez1@gmail.com