Thursday, October 23, 2014

San Francisco Medical Society Blog


Providing news to the San Francisco Medical Community.

11/5 CMS Provider Call: ICD-10 Transition

With less than a year remaining to transition to ICD-10, the Centers for Medicare & Medicaid Services (CMS) is hosting a call to give insights into implementation issues, opportunities for testing, and available resources. A question and answer session will follow the presentations.

Wednesday, November 5

10:30 am PST (1:30 pm EST)

Click here to register for the CMS National Provider Call.

CMS experts will discuss:

  • National implementation of ICD-10
  • Medicare Fee-For-Service testing
  • Partial code freeze and annual code updates
  • Home health conversions
  • Claims that span the implementation date

Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers are encouraged to participate on the call.

Click here to register or for more information.

CDC Issues New Ebola Guidelines to Protect Health Professionals

The Centers for Disease Control and Prevention (CDC) Monday released tightened guidance on use of personal protective equipment (PPE) for U.S. health care workers to ensure they are better prepared to treat Ebola patients.

The guidance focuses on specific PPE health care workers should use and offers detailed, step-by-step instructions for how to put the equipment on and take it off safely.

The enhanced guidelines center on three principles:

  • All health care workers undergo rigorous training and are practiced and competent with PPE, including taking it on and off in a systemic manner.
  • No skin is exposed when PPE is worn.
  • All workers are supervised by a trained monitor who watches each worker taking PPE on and off.

The guidance reflects recent experience from safely treating patients with Ebola at Emory University Hospital, Nebraska Medical Center, and National Institutes of Health Clinical Center.

Click here to view the CDC guidelines on PPE usage for health care workers treating Ebola patients.

Click here for the CDC fact sheet on the updated changes in the PPE guidance

California Issues Report Cards for HMOs, PPOs and Large Medical Groups

The California Office of the Patient Advocate released the 2014-2015 “California Health Care Quality Report Cards” that rate health plans and medical groups on a four-star scale.

The report cards allow consumers to compare the quality of care that more than 16 million commercially insured consumers receive from the state’s 10 largest HMOs, 6 largest PPOs, and more than 200 medical groups. The data for the report cards is drawn from claims data and patient surveys for 2013.

Although the report cards are usually published annually in January, officials have changed the release date so it would coincide with the fall open enrollment period for many Californians and their families, including those purchasing coverage through Covered California, the state's health benefit exchange. Covered California's next open enrollment period runs from November 15 to February 15. The report cards are part of a larger national push to bring greater transparency to the health care industry and help consumers choose services that best fit their needs.

Click here to access the California Health Care Quality Report Cards.

Click here to view the report card for large medical groups in San Francisco.

SFMS, Community and Education Leaders Highlight Negative Health Effects of Soda and Sugary Beverages

Health, education, and community leaders met at the Chinatown YMCA to discuss Proposition E, San Francisco’s proposed soda tax.

Supervisor Eric Mar, one of the lead sponsors for Proposition E, expressed his concern for the growing Type 2 diabetes epidemic, with soda and sugary beverages as a leading cause. “I want to help people have a better understanding of why Proposition E is on the ballot, and why this is specifically about soda and sugary beverages,” said Supervisor Mar. “These drinks are having a disproportionately negative impact on public health,” he continued. “Mexico’s soda tax is working. Consumption of soda and sugary beverages is down 10% and people are making healthier choices.

SFMS was one of the earliest endorsers of Proposition E and has continued to support Yes on E. San Francisco Medical Society President Lawrence Cheung, MD has testified in favor of Proposition E at numerous hearings and community meetings, explaining how our bodies process liquid sugar differently. “The liquid sugar in these sodas and sugary beverages isn’t processed the same way by our bodies as foods,” he explained. “For Asians Americans, the risk for Type 2 diabetes is higher than the general population. We need both education and incentives for people to make healthier choices.” He continued, “Type 2 diabetes impacts every system in the body, and is a major health public health problem.

San Francisco Board of Education Commissioner Rachel Norton expressed how the revenue from Proposition E would benefit children. “Proposition E will bring more physical education to our schools, and help expand the new school lunch program that is getting healthier foods— that kids will eat—onto their plates, and so much more.

A tax of $0.02/oz on the distribution of soda and other sugar-sweetened beverages in San Francisco is estimated to generate up to $54 million annually, which will be legally dedicated to fund active recreation and nutrition programs in schools, parks, and recreation centers; food access initiatives, drinking fountain and water bottle filling stations; and dental health services.

Researchers at UCSF have been at the epicenter of the research linking sugary beverages with the diabetes epidemic and other health ailments, as well as the role of tax policy in reducing consumption. In addition to SFMS, many local organizations have endorsed Yes on E including the North East Medical Services, San Francisco Community Clinic Consortium, California Dental Hygienists’ Association, San Francisco Dental Hygienist Society, San Francisco Dental Society, San Francisco Board of Education, San Francisco PTA, United Educators of San Francisco, San Francisco Food Bank, Parents for Public Schools, and many more.

Click here for more information on the research and supports the soda tax.

Ebola Guidelines & Recommendations for EMS and 911 Call Center

The San Francisco Department of Emergency Management-EMS Agency is working closely with the Department of Public Health to monitor the Ebola outbreak situation in Africa and to develop the local response within San Francisco. It is important to remember that while Ebola is a contagious disease, transmission can be completely prevented by strict adherence to personal protective measures. Current local response goals are focused on providing information about the situation as it evolves, communicating personal protection measures and ensuring early identification and containment of any potential cases.


The 2014 Ebola outbreak is one of the largest in history. This outbreak first appeared in West Africa affecting the countries of Guinea, Liberia, and Sierra Leone (Although small numbers of cases occurred in Nigeria and Senegal, these countries do not have active spread of Ebola at this time). The first case of Ebola diagnosed in the U.S. was confirmed by the CDC on September 30 and occurred in a traveler from Liberia to Dallas, Texas who died. Two nurses who cared for the patient are now hospitalized with Ebola. As of the date of this post, there are no confirmed cases of Ebola in San Francisco. 

Ebola is a viral disease that initially causes non-specific symptoms like fever, chills, headaches, muscle ache, loss of strength and fatigue. As the disease progresses patients develop high fever, diarrhea, vomiting, rash and abdominal pain, along with decreased liver and kidney function. As the illness progresses, affected people may experience both internal and external bleeding.


Ebola is only infectious when the patient is symptomatic. Risk for transmission is associated with direct contact with blood or body fluids (urine, fecal material, saliva, perspiration, or aerosolized secretions) of an individual who is SICK with the disease. Individuals without symptoms cannot transmit the disease.

Click on the links to below to view recommendations and screening guidelines for EMS and 911 dispatch about the Ebola virus from SFMS member and DEM-EMS Agency Medical Director John Brown, MD.

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