Stories from Texas Medicine, September 2019

Five Best Practices for More Effective Use of Ambulatory Electronic Health Records to Manage Chronic Disease - 09/11/2019

The prevalence of diabetes mellitus, which affects 30.3 million adults in the United States, is increasing with 1.5 million newly diagnosed cases of diabetes each year.  An additional 84 million adults are affected by prediabetes.  Consequently, this chronic disease has become the seventh leading cause of death in our nation.1 Statistics like these have caused the Centers for Medicare & Medicaid Services (CMS) and state health departments to encourage primary care physicians to not only adopt electronic health records (EHRs) but to use them more effectively to improve management of diabetes and other chronic diseases.  This paper discusses how small physician practices in North Texas improved their tracking of quality metrics for hypertension, obesity, and diabetes by leveraging available but underused EHR functionalities.  We also describe five “best practices” for more effective use of ambulatory EHRs to manage chronic disease based on findings in this study.


A New Understanding: Improving Care for LGBTQ Patients - 09/06/2019

Like everyone else, LGBTQ patients can face some unusual medical problems. But many of these patients’ biggest challenge is that their health problems can be amplified by hostility from others. Meanwhile, structural problems within the health care system frequently discourage LGBTQ patients from visiting physicians. LGBTQ patients frequently avoid physicians because of previous bad experiences. Many physicians who would like to treat LGBTQ patients often hesitate because they fear they lack the training.


Unlocking Doors: Minority Scholarship Program Connects Students with Mentors - 09/04/2019

When the Texas Medical Association founded its Minority Scholarship Program in 1998 to diversify the physician workforce, Dr. Ramamurthy became both a contributor and a mentor to students who receive the scholarships. “When you’re mentoring students, one of the things that you want them to understand is that you’re somebody they can talk to who is not only there as a teacher, but as a friend,” she said. Other top donors to the Minority Scholarship serve voluntarily as mentors to student awardees. TMA encourages those arrangements because they can benefit both parties.


Talk to Patients About: Vaccines During Pregnancy - 09/04/2019

Protecting moms and babies from certain diseases often starts with pregnant women. Child-bearing women may not realize they pass on disease-fighting antibodies to their babies, protecting them early in life. That protection improves greatly when women get certain vaccines before and during pregnancy. They also may not realize getting vaccinated right after pregnancy can stop the spread of illnesses.  


Fighting Back: Practice Wins Court Battle Over Defamatory Online Reviews - 09/03/2019

One practice’s recent legal battle epitomizes physicians’ worst nightmares when it comes to online reviews. Here’s an extreme but glaring real world example, straight from the documents in a lawsuit that Austin Eye first filed in October 2017 over


Doctors Drive New Opioid Laws - 09/03/2019

Several new laws will affect how physicians practice and how they prescribe controlled substances, including a delay on required checks of the state’s prescription monitoring program (PMP); a limit on opioid prescriptions for acute pain; and a new electronic prescribing requirement coming in 2021.


Q&A: Pediatrician Turns Passion into Leadership - 09/03/2019

Pediatrician Danielle Arnold, MD, was looking for a way to give the family medicine residents at Baylor Scott and White Medical Center – Round Rock a first-hand look at the health benefits of breast milk for preterm and medically fragile newborns. “I wanted them to understand how to support breastfeeding moms. So I thought, ‘What better way to expose them to how important breast milk is than to send them to Mothers’ Milk Bank in Austin?’” Those visits soon turned into discussions with the nonprofit’s leadership about how she could get involved, which led to Dr. Arnold joining the board of directors in January.  


Clearing the Air on Cannabis: New Texas Laws Create Challenges for Physicians - 09/03/2019

Before the 2019 Texas Legislature passed House Bill 3703, the medical use of cannabidiol (CBD) products in Texas was confusing for physicians and authorized only a narrow group of patients: people with intractable epilepsy. Thanks in part to the new state law, it’s still confusing and includes a somewhat larger group of patients – all patients with epilepsy as well as those with seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis (ALS), autism, terminal cancer, and incurable neurodegenerative diseases. Confusion has been fueled by another 2019 measure: House Bill 1325 legalized the production and sale of hemp and some products derived from hemp that have high levels of CBD, which is non-euphoric and has low levels of tetrahydrocannabinol (or THC), the psychoactive element in marijuana.


Quality Care Pilot Takes Flight - 09/03/2019

How one children's clinic uses a targeted program to dramatically improve care, lower costs.