Quality Insights: Well, good morning, everyone, and welcome to Today's Webinar coffee and prevention with Dr. Penson, Medicare's Annual. Wellness visit.
Quality Insights: We're going to get started in just a few minutes. But first we want to go over a few housekeeping items
Quality Insights: first. All participants entered Today's Webinar in listen only mode.
Quality Insights: If you have a question or a comment during the call Today we just ask that you please type that into either the Q. A. Feature or the chat box. Both of those are located at the bottom of your zoom window. You may need to hover your mouse around the bottom of the window to get those icons to appear if you don't see them.
Quality Insights: And at the end of today's program, you're going to be directed to an evaluation and some reflective questions. Once you complete those, you'll be presented with a certificate for you to fill out and print as your proof of Webinar completion.
Quality Insights: And even if you don't need the continuing education credits. We hope that you still complete the evaluation because it helps. Tell us how we did, and it can help shape our future programming.
Quality Insights: So I just want to go over a couple of housekeeping items and slides
Quality Insights: first to talk about continuing education credits.
Quality Insights: So to obtain the contact hours for today. Participants must watch the Webinar today either live or the recorded version that will be posted later
Quality Insights: and complete. The evaluation with the reflective questions
Quality Insights: regarding the continuing education credits
Quality Insights: in support of improving patient care. This activity has been planned and implemented by quality insights and Cmc institute for academic medicine.
Quality Insights: cmc institute for Academic medicine is jointly accredited by the Accreditation Council for continuing Medical Education, the Accreditation Council from pharmacy, education, and the American nurses credentialing Center to provide continuing education for the health care team
Quality Insights: so specifically for today positions. The Cmc Institute for Academic Medicine designates this live activity for a maximum of 1 h for am a pra category one credits
Quality Insights: physicians. Should only Clinton excuse me. Positions should only claim credit commensurate with the extent of their participation in the activity.
Quality Insights: and for nurses. The Cmc. Institute of Academic Medicine as an approved provider for continuing nursing education by the American nurses. Credentialing Centers Commission on accreditation this offering has been approved for one contact hour for nursing
Quality Insights: Cynthia Pins and Md. And other planners for this educational activity have no relevant disclosures, and the expiration for this material is January, 18 of 2025.
Quality Insights: So after this course, learners will be able to identify annual wellness, visit components, state who can conduct an annual wellness, visit and describe annual wellness, visit assessments for nursing home residents.
Quality Insights: We have a lot of excellent information to deliver today. So without further ado, i'd like to introduce our guest speaker today. Dr. Cindy Pinson.
Quality Insights: Dr. Pinson was born and raised in China until the age of 18. She came to study abroad in the Us. In 1,987.
Quality Insights: She graduated Magna cum laude from Marshall University in 1,992, and she earned her Md. Degree from Marshall University, Jones, C. Edwards School of Medicine in 1,996 and went on to be trained with the department of family and community health. At Marshall
Quality Insights: she founded travel and D in 2,005,
Quality Insights: and for the following 13 years travel Md. Became the largest house call practice for the tri-state area
Quality Insights: travel. Md. Joined Caval Huntington Hospital and Martial Health in March in February of 2,018,
Quality Insights: and Dr. Penson, is the medical director of multiple, skilled.
Quality Insights: multiple, local, skilled nursing facilities, as well as for the division of cable Huntington Hospital, home care, medicine.
Quality Insights: She visits patients and skilled nursing facilities, assistant living living facilities, and private homes.
Quality Insights: She was selected as the house called Doctor of the Year, in 2,013, by the American Academy of Home Care Medicine.
Quality Insights: She's an assistant professor at the Department of Family and Community Health.
Quality Insights: and she teaches geriatric practice to medical students, resident doctors, nursing staff, and other professionals.
Quality Insights: She is the chairperson of the post acute care work group of the Mhc Aco, leading the collaborative effort to improve communication between all care settings.
Quality Insights: She has 4 children. She's active in the Faith community and volunteers her time in recovery programs
Quality Insights: so welcome Dr. Penson. I am very excited to turn things over to you this morning.
Dr. Cynthia Pinson: Thank you very much.
Dr. Cynthia Pinson: We'll get right home to it
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: so we will
Dr. Cynthia Pinson: start. Well. Thank you. When Baby asked me to do this, and I thought to myself, she must really hate me, because this is
Dr. Cynthia Pinson: such a big topic, and honestly, compared to everything I do every day is a very boring subject, but I will try to make it interesting for you. So just hang in there. There's really a lot of material, but none of these things are anything that's different from what we do every day, and I think most of you have done a.
Dr. Cynthia Pinson: Wv. Visits, and are probably quite good at it. So I appreciate you still paying attention
Dr. Cynthia Pinson: if you are Star or Fan, or have ever watched our wars, and you know that Yoda has the same? He says, do or do not. There is no trial which means you gotta go all the way. So my subtitle for this lecture. But this talk is, do or do not. There is no choice, because there really isn't, you gotta do it on those things
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: So here's our friend Yoga. Okay.
Dr. Cynthia Pinson: looks of this thing. There are definitely times that this is what I look like underneath my my smiles.
Dr. Cynthia Pinson: All right.
Dr. Cynthia Pinson: So like any good story. We're going to talk about the who, the what in the where, and why, and how, and because it is medicine we're going to talk about the cost and reimbursement
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: and but the bulk of the top is going to be on the what.
Dr. Cynthia Pinson: So you know that that
Dr. Cynthia Pinson: the thing. We got to push through a lot of slides on that, but afterwards it's just smooth sailing.
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: Starvator says, who is going to need the annual bonus exam, and who is going to do it?
Dr. Cynthia Pinson: Well.
Dr. Cynthia Pinson: So
Dr. Cynthia Pinson: who needs it?
Dr. Cynthia Pinson: You know that's basically. Everyone. So either your Medicare or you're not. So it's almost 50 50, and most of the markets.
Dr. Cynthia Pinson: and Medicare makes all the rules, but managed care
Dr. Cynthia Pinson: who takes
Dr. Cynthia Pinson: over in a way with their self risk for Medicare. They are required to do as well. Now who can do it, or it's you because you're here. Either you are a physician, a nurse practitioner, or a physician or assistant. You're doing this now. In some other
Dr. Cynthia Pinson: areas of practice a Dietitian can do it or certified health educator can do this, or a team that's led by a physician can do it. That's not common here. I've never seen this done before, and I think the building will be a little bit tricky.
Dr. Cynthia Pinson: so we just stick with what we know. So that's just you
Dr. Cynthia Pinson: all right. This is a very busy slide. There are actually busier slice in this I just simplified it, and you have to remember these wordings are written by lawyers. So although you master English, and you can't read this, but you don't really understand the content that is normal. It's okay.
Dr. Cynthia Pinson: But
Dr. Cynthia Pinson: this is really for your reference. Later, there are 3 columns here. The good thing about this is the very left column tells you what the welcome to Medicare visit requires. Not that's the first
Dr. Cynthia Pinson: visit that you get to Bill
Dr. Cynthia Pinson: for someone that just started getting their Medicare be coverage.
Dr. Cynthia Pinson: pay part b coverage, and then the middle part is the very first annual honest visit that you get to do. And this is what entails, and the next one is your subsequent follow up Visit now, for all in 10 purposes. If you look at it, they're really about the same when it's update once we view whatever.
Dr. Cynthia Pinson: So in this talk I do not distinguish between the 2 of them, because they are really the same, and the amount of work is the same.
Dr. Cynthia Pinson: So life is struggle.
Dr. Cynthia Pinson: The practice of medicine is even more of a struggle.
Dr. Cynthia Pinson: just a lot to do so
Dr. Cynthia Pinson: So the what this I told you this is the bulk
Dr. Cynthia Pinson: of what needs to happen for this visit.
Dr. Cynthia Pinson: whether you're practicing in like a home setting or clinic, or nursing homes, or whatever
Dr. Cynthia Pinson: everything is really the same. But
Dr. Cynthia Pinson: what's different in different setting is the amount of information that's already available to you. That's already in your Ehr, or even ehr of
Dr. Cynthia Pinson: the facility you are working, and
Dr. Cynthia Pinson: that's vastly different.
Dr. Cynthia Pinson: So when you think about
Dr. Cynthia Pinson: annual wellness, visit
Dr. Cynthia Pinson: well really
Dr. Cynthia Pinson: has to happen here
Dr. Cynthia Pinson: is that there is a certain amount of money allotted to a patient to take care of their medical expense for the year; that same.
Dr. Cynthia Pinson: So in this visit you're trying to identify the things that's going to cause you money
Dr. Cynthia Pinson: now and later.
Dr. Cynthia Pinson: right. If this person has high risk for fall. You want to identify that you want to treat, that you want to make that better to prevent that fall. That, you see is coming because that fall.
Dr. Cynthia Pinson: It's some costs a lot of money. If she or he has a hip fracture, goes to the hospital and stays there and gets pneumonia, and uti gets a fully it goes to rehab at, You know one of the nursing homes and then cannot go home anymore.
Dr. Cynthia Pinson: Right? So that's what you want to prevent. That's really what this is all about you on the identify what is going to happen to these people later for side for side. You got to identify what is going to happen to them and address those problems ahead of time to prevent that huge cost later.
Dr. Cynthia Pinson: All right.
Dr. Cynthia Pinson: So nothing is free.
Dr. Cynthia Pinson: Even addressing all these problems. It is not free. What's going to cost you is time.
Dr. Cynthia Pinson: if you think about that.
Dr. Cynthia Pinson: to address all these problems in a practice that's usually busy.
Dr. Cynthia Pinson: It is things you don't even really talk about with your patient on a one on basis, on the day to day basis. You really don't talk about these things. You talk about their diabetes, or have
Dr. Cynthia Pinson: hypertension, or their toenail herds or their knee herds
Dr. Cynthia Pinson: whatever. But some of these questions we're going to address you. Don't like to get a chance to talk about it. Okay, but
Dr. Cynthia Pinson: that's why. Awb pays very well, because it's paying for you to spend that time. It could take up to an hour, sometimes more, to address everything else that you don't get to talk about usually.
Dr. Cynthia Pinson: and that's why it's only one time I care
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: So the
Dr. Cynthia Pinson: that's overall. And all of these things we're going to touch later.
Dr. Cynthia Pinson: So what
Dr. Cynthia Pinson: This is
Dr. Cynthia Pinson: not hard, because this is already in it. Hopefully, all of your charts. You already have
Dr. Cynthia Pinson: their family history, you know, who has had cancer, who has a father that died at age 36, on massive party tag.
Dr. Cynthia Pinson: So some of these things applies to the patient that you're that's in front of you right now.
Dr. Cynthia Pinson: and their past medical history. One surgery they've already had, and what are their exposure to to medications well prescribed and not prescribed.
Dr. Cynthia Pinson: So these things at a minimum
Dr. Cynthia Pinson: to already being a chart. So thank goodness for that.
Dr. Cynthia Pinson: Who are their providers? Who is there? A cardiologist who is your pulmonologist? Who is there a cancer doctor?
Dr. Cynthia Pinson: And the suppliers well, who gives their Cp.
Dr. Cynthia Pinson: Although there's very limited
Dr. Cynthia Pinson: suppliers now. But these are things that that's necessary
Dr. Cynthia Pinson: measures.
Dr. Cynthia Pinson: A Wb Doesn't include and doesn't require a physical exam.
Dr. Cynthia Pinson: So all right, You can save like 5 min in your time, but it does require some measurements, and luckily this measurements are already done for us usually by our nursing stack.
Dr. Cynthia Pinson: If these are normal stuff, hide and wait.
Dr. Cynthia Pinson: You know how how are you?
Dr. Cynthia Pinson: How big are you? You know how, how, what's your blood pressure? That type, stuff or other things that you feel is permanent to finish your your assessment.
Dr. Cynthia Pinson: Yeah.
Dr. Cynthia Pinson: this is the part I like to do the most to detect any cognitive impairment the patient may have
Dr. Cynthia Pinson: it. It is important in my line of work, because I, you know, really only see older people, and I do have some younger people, but these younger people have some other kind of impairment already that makes them disabled.
Dr. Cynthia Pinson: all right. So they maybe at the nursing home. They may be kind of let me at home with their caregivers.
so
Dr. Cynthia Pinson: the cognitive test we are going to discuss later. But it's important to do this exam, because people can walk around with mild
Dr. Cynthia Pinson: dementia or some kind of cognitive deficit for a long time before even their closest loved ones notice.
Dr. Cynthia Pinson: So I feel if you detect this early and deliver that, and use to them in a compassionate way.
Dr. Cynthia Pinson: This gives them a chance to go and
Dr. Cynthia Pinson: understand the disease, progress themselves, to set their affairs in place, and to have that
Dr. Cynthia Pinson: discussion about advanced care planning
Dr. Cynthia Pinson: while they're still with it while they are still thinking in the correct way, because there's definitely a way
Dr. Cynthia Pinson: that people start thinking later when they have called to the impairment what they can't really think
Dr. Cynthia Pinson: correctly, and they can come to a rational decision anymore.
Dr. Cynthia Pinson: So do this for them for a favor. So while they're still rational, they can walk away from you and start making some plans for their life and their death.
Dr. Cynthia Pinson: And you know there are treatment options as well.
Dr. Cynthia Pinson: All right.
Dr. Cynthia Pinson: So the 3 things we are commonly used, and maybe you guys use some other tools. But these are the 3 things that we use commonly in our practice.
Dr. Cynthia Pinson: So meaningco is very simple. It's the one with the 3 words, you know apple table and penny, and then you make them draw clock with the time 10 after 11 on it, and then come back and tell us what the 3 words are. This takes 3 min to do it's a very, very short test and a very good test.
Dr. Cynthia Pinson: It's a good screening test when they don't score 5 out of 5, because you know 3 words.
Dr. Cynthia Pinson: but drawing and the time, so there are 5 points. So if they don't get a perfect 5, you don't have to ask some more questions. Kind of they are, which part of missing.
Dr. Cynthia Pinson: and if they get
Dr. Cynthia Pinson: like 3 out of 5, you're really all online. They are to do more test, and they they only get one or 2 out of 5. Most likely this person has a pretty advanced impairment, and really needs to be addressed.
Dr. Cynthia Pinson: So the next
Dr. Cynthia Pinson: 2 tests slums takes 8 min to do. The many mental takes 7 min to do. Slams is what I like to do best is the same. Louis University, and one of the smartest speech therapist introduced this to me, and
Dr. Cynthia Pinson: it's more just like a memory. Test it. Really test your concentration, your
Dr. Cynthia Pinson: visual spatial, and you know, story recall. And there's a lot of math in there. So this test is very good, and it gives you a scoring right here at the bottom, so it's very simple to administer
Dr. Cynthia Pinson: right. The many mental status exams what I was trained in when I was in the school.
Dr. Cynthia Pinson: Not a bad test, but I
Dr. Cynthia Pinson: really not done this test since I started loving all the slums.
Dr. Cynthia Pinson: All right.
Dr. Cynthia Pinson: So what to do next? You know you feel familiar with Star Wars, and I can Sky Walker turn bad in this movie.
Dr. Cynthia Pinson: right? So look at his red eyes.
Dr. Cynthia Pinson: You don't want your patients to get to that shape right with their mood disorder, and you don't want them to be so angry that they start really hating the world, and wants to destroy everyone in their path.
Dr. Cynthia Pinson: So the way to do is, you know, Catch them early before they get this way.
Dr. Cynthia Pinson: and there are depression tools to, you know. Depression. Only one of the new disorders, of course, but in your observation in your one-hour conversation with the patient, you probably will be able to pick up some of their mood disorders if it's obvious, but screening for depression is actually required.
Dr. Cynthia Pinson: I like this one. So this is the geriatric depression scale. This is the short form. There is a long form. The short form has 15 questions. The long form has 30, for I will choose the 15,
Dr. Cynthia Pinson: and it's very telltale.
Dr. Cynthia Pinson: I am sometimes surprised actually, by the answers. There are some patients I feel like they are just like really depressed, and they are so unmotivated, and they don't do anything all day.
Dr. Cynthia Pinson: and they completely come out with like
Dr. Cynthia Pinson: no positive answers. I guess all good answers to everyone.
Dr. Cynthia Pinson: And then there are some people that are just doing great. You feel like life is wonderful for them, and then they get like 11 positive answers out of 15.
Dr. Cynthia Pinson: So it's really good to do this exercise.
Dr. Cynthia Pinson: and I think in Appalachian. You know most patients. We we are women. So in that age group they are all about
Dr. Cynthia Pinson: doing things that you like, and not to offend people, and not be a burden to other people.
Dr. Cynthia Pinson: So what I tell them is.
Dr. Cynthia Pinson: don't think too much, and you don't have to explain your answers to me or justify why you feel that way, or I apologize for thinking that way. It's just how you feel for the last week. You know just the first question I asked you. You just say yes or no, and that's it, whatever it comes to your mind for just say it, you don't have to apologize for it.
Dr. Cynthia Pinson: So I seem to get more honest results that way.
Dr. Cynthia Pinson: Functional abilities.
Dr. Cynthia Pinson: So we're all about function, no abilities, because this
Dr. Cynthia Pinson: people can live, you know to 90 and still play tennis, and people can live to 65. It's in no wheelchair it's all about functions right. So you want to kind of figure out where they are.
Dr. Cynthia Pinson: All right. Let's top on the basics. On the left side of your screen is the a
Dr. Cynthia Pinson: activities of daily living.
Dr. Cynthia Pinson: my acronym for aviation
Dr. Cynthia Pinson: right? Because I think if you can do some of these things, you're just that you ability that pretty soon
Dr. Cynthia Pinson: d for dress e for eat. They don't have to meal prep. They just have to eat
Dr. Cynthia Pinson: ambulation with us a
Dr. Cynthia Pinson: toilet.
Dr. Cynthia Pinson: You got one Pm. P. By yourself and clean it up. That's very important. That's very important.
Dr. Cynthia Pinson: There are multiple patients we have had because of this one issue. They end up in a nursing home or having to have around the call care because they can't toilet themselves
Dr. Cynthia Pinson: Right? You can't sit in your own thing all day waiting for your daughter to come home from work that is not sanitary right?
Dr. Cynthia Pinson: And then age for hygiene, and you clean yourself up all right. So that's your very basics.
Dr. Cynthia Pinson: only 5.
Dr. Cynthia Pinson: If you cannot meet some of these, if you need help with 2 out of 5 days. You you're pretty impaired.
Dr. Cynthia Pinson: all right, the iadl my acronym, for that is it from home. You know that, moody it. So it phone home. E stands for errands. Can you make a list
Dr. Cynthia Pinson: and say.
Dr. Cynthia Pinson: today, I gotta go to the bank. I gotta go visit Frank. I gotta go, you know. Take some soup to Suzy, and I gotta go to, you know grocery store. Can you make a plan and run all your errands in transportation. Oh, there is a title
Dr. Cynthia Pinson: so can you drive yourself places? Can you get your cell phone, Point a. To Point B.
Dr. Cynthia Pinson: If you're within walking distance of your groceries, or can you walk over there with a cart and bring on yourself back and fall? Can you call people internal emergency housekeeping. Can you keep your place a little bit neat and clean and free of clutter?
Dr. Cynthia Pinson: Hmm. That's that's questionable. And N. Stands for that
Dr. Cynthia Pinson: meals and money.
Dr. Cynthia Pinson: Can you manage your medications? Take them on time, pick up the refill, call for a refill.
Dr. Cynthia Pinson: Can you remember? Take your night medications at night and day medications in day
Dr. Cynthia Pinson: meals. This involves meal. Prep. Not Tom out elaborate Thanksgiving dinner is just come out. Can you make a sandwich? Can you make some steady? Can you make food to feed yourself? It could be TV dinner. Can you pop something in the microwave
Dr. Cynthia Pinson: and put just the right amount of time on it. So it doesn't
Dr. Cynthia Pinson: Catch your house on fire
Dr. Cynthia Pinson: or money. Can you manage your finance?
Dr. Cynthia Pinson: These are basics
Dr. Cynthia Pinson: alright.
Dr. Cynthia Pinson: Full risk assessment. We will talk about that. There.
Dr. Cynthia Pinson: There are a lot of reasons why people will fall. It's a very complicated process. Not always, you know, medication related, or whatever. But there's a risk scale so we can discuss later. Home. Safety is your home safe. Do you feel safe in your home? There are throw rocks everywhere, other clutters everywhere. That's usually what I see there.
Dr. Cynthia Pinson: Things in your way. When you try to navigate between your chair to the bathroom you can not be removed hearing impairment. I don't really know
Dr. Cynthia Pinson: how you cannot detect that like you speak to someone in a normal tone. You can detect that. I'm amazed how
Dr. Cynthia Pinson: much better people got as we were wearing mask more and more in the beginning no one could understand, but at the end, you know, we were getting pretty good at speaking with a mask on, and patients were getting really good at hearing us
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: So after you've done all of that, you want to have a schedule, you know. You guys want to write it down. If they're in the office and office setting and in our zoom room, we just write it in our chart right? And and you have this in your mind already, as you'll be doing the the last 6 items.
Dr. Cynthia Pinson: You know what they're gonna need, and you know their age, and you kind of know what their function level is, right. So there's a schedule
Dr. Cynthia Pinson: so to do and not to do. It.
Dr. Cynthia Pinson: Is this exact.
Dr. Cynthia Pinson: not exactly exact, because there are different organizations that wants to do different things for people at different age. Now the Us. Pst. F our cheeks, gates. They always want to do things. A little bit later i'd save a little bit more money, money, and benefit most people.
Dr. Cynthia Pinson: I'm not saying anything bad about them. I just find that they are always a little bit different from the specialty groups, such as the cancer association. They always want to do things a little bit earlier.
Dr. Cynthia Pinson: Obviously they are made up for, you know, people that
Dr. Cynthia Pinson: treat cancer.
Dr. Cynthia Pinson: So. Colon Cancer
Dr. Cynthia Pinson: 45 to 75
Dr. Cynthia Pinson: years of age, maybe every 10 years. If everything's normal.
Dr. Cynthia Pinson: Once in our past age of 75,
Dr. Cynthia Pinson: you can just be like I really don't need to do that anymore.
Dr. Cynthia Pinson: except if this person you're seeing is very functional.
Dr. Cynthia Pinson: But he doesn't have a lot of things around with them, and looks like may live another 10 years. You can talk to them or the Mpoa and try to decide
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: But
Dr. Cynthia Pinson: for breast cancer, basically a 70
Dr. Cynthia Pinson: 4 is our last meal. Grant.
Dr. Cynthia Pinson: Thank God, I am still looking forward to that. But after that, if someone's really functional like they are patients I have. They are in their nineties. They are still leading the choir, you know, conducting milical and driving themselves around, and.
Dr. Cynthia Pinson: you know, going across the country with our son.
Dr. Cynthia Pinson: So those kind of people it really is a discussion I have to with them every year. But if you think about my grand, you know what If this happens with you? Text something. What would you want to do? This is what's gonna happen if there's treatment.
Dr. Cynthia Pinson: So that's kind of personalized. But
Dr. Cynthia Pinson: the cut off is 74
Dr. Cynthia Pinson: lung cancer
Dr. Cynthia Pinson: in this area.
Dr. Cynthia Pinson: Unfortunately, we have a lot of smokers. The only time they quit smoking for a lot of people is when they come to a nursing home.
Dr. Cynthia Pinson: although in our Zoom Rooms do allow people to smoke. But it's so inconvenient. Most people just kind of face down and and quit.
Dr. Cynthia Pinson: So these people, that, being a smoker from the age of 55 to 80, they are supposed to have an annual casket.
Dr. Cynthia Pinson: right.
Dr. Cynthia Pinson: or if they having a smoker and quit, but it's less than 15 years ago, less than 1 5 years ago.
Dr. Cynthia Pinson: So that is discussion I have with them. Well, you're you know you're 60 years old now, and
Dr. Cynthia Pinson: you, Haven't, had this done, and you having a smoker, and you continue to smoke, you know. There's a protocol for this type of caskets, and they can't be ordered.
Dr. Cynthia Pinson: Once they reach the age of 80. We can stop talking about it, stop ordering it.
Dr. Cynthia Pinson: and then, once they have quit smoking for 15 years. You can stop ordering
Dr. Cynthia Pinson: cervical cancer screening.
Dr. Cynthia Pinson: Older adults
Dr. Cynthia Pinson: have
Dr. Cynthia Pinson: sexual activities.
Dr. Cynthia Pinson: whether you like it or not. Maybe
Dr. Cynthia Pinson: too much information. But in nursing homes we find this in
Dr. Cynthia Pinson: which is thing is hilarious when we do find it so. I mean, is there a chance of these women getting cervical? Cancer. Chances are no so lucky for us we can stop doing cervical cancer screening can imagine putting these people on a stir. Up. I'm not doing that.
Dr. Cynthia Pinson: So it's h 65. You can kind of write them off. You don't have to do that.
Dr. Cynthia Pinson: All right
Dr. Cynthia Pinson: prostate cancer screening very sensitive topic for man. It's completely individual decision. There's no one's gonna say
Dr. Cynthia Pinson: If someone says, I want a Psa, I want a screaming, and you discuss with them. They still wanted. You can't really say no to that. So you just order a psa every year. So they have some, you know, peace, peaceful, thinking that they are being screened for the
Dr. Cynthia Pinson: once. They're 70 years old, though you can stop ordering that test. You can explain to them. It basically stops here, and no one recommends any further testing after that
Dr. Cynthia Pinson: Also, Porosis. If you are 65 and older, your patient 65 older, you can start screening for it with a dice, scan you can do that for about
Dr. Cynthia Pinson: 10 years out every couple of years it'll be 5 just depends on the finding. I' to say 75 You can stop doing it.
Dr. Cynthia Pinson: and if someone that's younger than 65, but they have increased risk. Like as they said, Hello, you can start waiting for sooner
Dr. Cynthia Pinson: I put over you on this picture here because he is just so handsome. So, for if he were smoker he is aged 65 to 75, because he is so handsome. You will not want to him to die of a ruptured, a triple? A. So you want to drink him for that.
Dr. Cynthia Pinson: Okay, but that's about the only time you only do mail you don't scream for female
Dr. Cynthia Pinson: all right.
Dr. Cynthia Pinson: down to the last 2, 3
Dr. Cynthia Pinson: in this one.
Dr. Cynthia Pinson: All right.
Dr. Cynthia Pinson: So once you figure out what their risk. Factors are
Dr. Cynthia Pinson: by the risk factors. It's only cost a lot of money and lot of heartaches and lot of disability. You want to go ahead and address that some of these things you can address right the end, and some of these things are a little bit extensive that you may need to bring them back on a second look.
Dr. Cynthia Pinson: as busy as we are. If I do, you detect things
Dr. Cynthia Pinson: like depression.
Dr. Cynthia Pinson: I will address it right there, and i'll show you how we can build for that, or if I detect a cognitive impairment, I still have time. I will kind of ease into that conversation, although that's usually a fairly difficult conversation if they Haven't really noticed. If the family Haven't noticed before
Dr. Cynthia Pinson: you want to address them.
Dr. Cynthia Pinson: discuss all the treatment options for everything that you detect
Dr. Cynthia Pinson: and provide a personalized plan.
Dr. Cynthia Pinson: So
Dr. Cynthia Pinson: let's talk about these items. So if they.
Dr. Cynthia Pinson: the score high on the fall risk
Dr. Cynthia Pinson: assessment, you can say, Well, looks like it may help you to use. Okay, because you are. If your knee is bad it may help you to go to physical therapy, and you can do an injection you can refer to, or if your medication is a little too much, you can say, I will think that if you stop taking this this is that you'll follow. This will actually decrease.
Dr. Cynthia Pinson: So these things can be addressed right there. Nutrition.
Dr. Cynthia Pinson: Not a lot of people are now nourished in this area. But if you look at the out human, a lot of people actually have low help you in, so you can address that. There's registered dietitians that can talk to them about that, or they can just Google on healthy eating, you know. Just put them on a Mediterranean diet.
Dr. Cynthia Pinson: Physical activities stay active. They don't necessarily have to join a a gym.
Dr. Cynthia Pinson: but they need to get up out of their bed or their chair at least 3 times a day and just walk around the house in our zoom home. There are activities that we encourage everyone to go attend even chair activities where they raise their.
Dr. Cynthia Pinson: you know arms, and they kick their list. They they do some stretching. Those are all very, very good. Tobacco. Use cessation that goes without saying. But you gotta catch them when they're ready to quit. No need to pound someone who really choice, and they're not ready to put you just going to waste your time
Dr. Cynthia Pinson: we lost.
Dr. Cynthia Pinson: Well, sensitive subject again is all you know. Approach.
Dr. Cynthia Pinson: I tell my patients even just 5 to £10 away. Loss is going to help you so much, and decrease your risk for heart attacks and strokes. So those are obtainable goals, very, very small goals.
Dr. Cynthia Pinson: and give that to them
Dr. Cynthia Pinson: cognition.
Dr. Cynthia Pinson: There are speech therapists, a special license in cognitive therapy, and they are very, very good, very knowledgeable, and very helpful people. I always refer my newly diagnosed patients to speech therapy, but they do so much more things that i'm not able to do, and don't even know how
Dr. Cynthia Pinson: alright, advance, care, planning discussion at patients discretion. You know there's probably been only 2 patients. So when I approach this subject they go scared. They're like. Do you think i'm gonna die? Why are you talking to me about dying.
Dr. Cynthia Pinson: but other than that.
Dr. Cynthia Pinson: most people and families I talked to about this is very welcoming
Dr. Cynthia Pinson: by who doesn't want to talk about how they want to die right? And it's more than that is. Talk about what your wishes are. What's your philosophy in life? How do you look at life. How you look at death.
Dr. Cynthia Pinson: and who is going to make that decision for you when you are brain dead? People are very worried about that. Who is gonna take over there have been patients who told me. I'm not going to point my daughter, because I know she is going to change my post at us.
Dr. Cynthia Pinson: I i'm a DNA, but I know she's on changing me to a full cold, because she rather me live on it's a vegetable that lose me.
Dr. Cynthia Pinson: So there are people that really need to make a decision on this, and most people have living will, but they are not specifically written out, perhaps exactly how they want it, so they can write more. They can write more on like you, an attorney, or just themselves, and write on it.
Dr. Cynthia Pinson: Good thing really good thing about skilled care facilities that we have social service on side. We can help them actually, with some of the stuff. Right, Mpos. At least, i'll point out how they're at least so someone can speak for them.
Dr. Cynthia Pinson: I have very extensive conversations with all of my patients on this all the new ones that come in all the ones I see for any of this. So anytime that seems appropriate. I bring the subject up. I just want them to think about what they want when they are able to still think about it.
Dr. Cynthia Pinson: And I want the children, or the caregivers and family to think about this
Dr. Cynthia Pinson: while they are not in a crisis in an emotional, you know, downward state. I wanted to think about what they want for their loved ones based on
Dr. Cynthia Pinson: who they were, which I don't usually know what their mother was like when she was young and healthy. I only know her as someone I was laying there after a hit fracture right most of the time. So I want them to kind of dig into and really think about their choices. And I also educate a lot People have very.
Dr. Cynthia Pinson: I don't know magical thinking about Cprs, you know. There's Pop goes the we on like it's not like that. It's not the emergency room
Dr. Cynthia Pinson: presentation in the in the shows. Actually, people don't just come back like that. They really don't, and I kind of tell them, and if I feel like they could tolerate more, i'll get a little more gruesome with it. I really try to drive this home, and I think this is a very, very important part of the conversation.
Dr. Cynthia Pinson: All right, opioids. How can we go anywhere without talking about it? This is a top by itself. Probably. Take an hour, and Bd. Don't sign me up for that one.
Dr. Cynthia Pinson: So review opioid, you know. Unfortunately, a lot of our people came from that
Dr. Cynthia Pinson: stage where we were giving a lot of pay medications, whether they are purposely a
Dr. Cynthia Pinson: dependent on it, or they are not purposefully dependent on. They take that
Dr. Cynthia Pinson: by a lot of people actually still take opioids, and it's not good for them anymore. So evaluate They're paying what I started all this and what is bothering you now, have you tried anything else?
Dr. Cynthia Pinson: If you need to go see the pain clinic for some interventions, they do all fancy things now that can prevent pain, you know, and then there's some. But there's other medications. So if all possible, get them off the opioid
Dr. Cynthia Pinson: to the level of functioning right with Hubble function.
Dr. Cynthia Pinson: I have a patient. She takes half a tablet of normal 5, twice a day. She was a a lot more when I inherited her. It's taken us years to get a doubt that you know I couldn't go down any further, but she couldn't do without them. She couldn't really function without them. But with just this 5 mill one per day, divided into 2 times a day.
Dr. Cynthia Pinson: she's able to do all of her own stuff and stay independent. You know that's what I want for her. That's what she wants.
Dr. Cynthia Pinson: That but not least screen for substance use disorders.
Dr. Cynthia Pinson: Alcohol, maybe, is probably.
Dr. Cynthia Pinson: I will think, for this population is very well used in knowing even things about that as being maybe overused. And then there are people that use other drugs as well. You will be surprised what drugs people use. So screen for that?
Dr. Cynthia Pinson: All right.
Dr. Cynthia Pinson: So that's all about the what?
Dr. Cynthia Pinson: There are 2 questions. Should we look at the questions right now?
Dr. Cynthia Pinson: Why do you only scream, man? For Aaa? I think the research says that people is more
Dr. Cynthia Pinson: is less common in women.
Dr. Cynthia Pinson: If the patient is positive on screening for depression. Must we treat or manage this as the awb, or can we reschedule a visit? You can do Either
Dr. Cynthia Pinson: you can do either, and then there is a slide. Later i'll tell you how to do it during
Dr. Cynthia Pinson: Okay.
Dr. Cynthia Pinson: So when can you do it?
Dr. Cynthia Pinson: It's not just any time you can do this awp visit, You know it sounds like so much fun. You want to do this. I can more more, 2, 3 times a year you can't.
Dr. Cynthia Pinson: so you have to wait till the first 12 months of their initial enrollment is finished.
Dr. Cynthia Pinson: Right? They're well countermatic here. There's a year. You have to wait for that to be done.
Dr. Cynthia Pinson: and then you can do it if someone else already beat you to it within the 12 months period that you're allowed to do them like who is going to be to believe or not? People do because people are mobile, people move, and people will have insurance that change their primary care position. So maybe they were saying somewhere else.
Dr. Cynthia Pinson: and then they had to see you. Now they you just had to figure out when they did that
Dr. Cynthia Pinson: where they're on your schedule. That's how I usually do it. I open up my schedule, and I see that I got like 2 or 3, the scheduled, and I just do them. You know I am really a slave to my scheduler to my office. Whatever they say, you know I just do them.
Dr. Cynthia Pinson: So this is a normal visit, so this one will answer one of your questions about the depression.
Dr. Cynthia Pinson: So while you're doing this visit, you detect this person has depression, and you know that you're booked for the next 3 months, and you don't really want this patient to go away feeling this way for 3 more months
Dr. Cynthia Pinson: and not be treated.
Dr. Cynthia Pinson: You can treat them right then.
Dr. Cynthia Pinson: you know, after you spent all this time with it, you might as well just do it. It literally takes like 5 min, some months to talk about it. Talk about the treatment options and the side effects. I'm going to see you more often, and you know what to expect and
Dr. Cynthia Pinson: benefits
Dr. Cynthia Pinson: in risk of treatment.
Dr. Cynthia Pinson: So just do it. You can do it and bill for it because this is a problem focused
Dr. Cynthia Pinson: Pro: a problem focused visit as well as a. W. We visit now as long as you do a modifier you can build for both codes at the same time, so we absolutely You can treat it right there. I always treat it right then.
Dr. Cynthia Pinson: because I think, move this order and depression is such a terrible thing completely skills joy from your life, and I just can't stand for them to wait for me for my schedule to open up with them to come back all right
Dr. Cynthia Pinson: after I treat them. I often do a very frequent follow up. I actually see these people like 2 weeks or 4 weeks intervals until I feel like they're in admission. Okay.
that's a
Dr. Cynthia Pinson: we'll. We'll come back to the question as well.
Dr. Cynthia Pinson: Where can you do it? You literally can do this everywhere, anywhere, all the same time. Right? You can do it the clinic. You can do it in nursing homes. You can do it in the lobby of assist living. They refuse to go back to their room, you and go to patients home and do this. You can literally do this anywhere.
Dr. Cynthia Pinson: Okay.
Dr. Cynthia Pinson: why do you do it?
Dr. Cynthia Pinson: You know this is the big thing. I have to think about this a lot. Sometimes when i'm really burn out my job. I'm thinking, Why am I doing this.
Dr. Cynthia Pinson: you know, because I want to be like Princess Leia right? I want to be beautiful and nice and brave and fierce
Dr. Cynthia Pinson: and kind of prickly sometimes, so I want to be like her. So I want to take care of my people because I want to be nice, and I want to be a good doctor. I want to keep them healthy as healthy as possible when there's all that healthy.
Dr. Cynthia Pinson: you know, and when they're at this spectrum. Not being healthy, I want to discuss palliative care. I want to see what their ris is. Are they going to fall? Break their hip.
Dr. Cynthia Pinson: and you know we're switching to value based
Dr. Cynthia Pinson: models. If you don't understand what that is, that means before you come to see me, I collect $25 from me, right, you know, fee for service. If you don't come to see me, i'm sure $25. So more. People I see more volume. I see the more money I made.
Dr. Cynthia Pinson: but in the value based model it's actually different. So i'm given
Dr. Cynthia Pinson: $2,000 a year to manage a patient.
Dr. Cynthia Pinson: So when I do really well for them they only cost me $1,500, so that $500 is my right to keep. This is simple. Of course the numbers are all completely fake. It's a lot bigger than that was probably like 2, 3 zero's behind it.
Dr. Cynthia Pinson: But
Dr. Cynthia Pinson: if I don't do a good job if they were diabetic. But I kind of
Dr. Cynthia Pinson: didn't really address it, or they were, you know, depressed. I didn't really address it, or they are too much pedication. They are hired. I didn't really address it
Dr. Cynthia Pinson: so, for patient has some Tommy. They go out and they do things they shouldn't do whatever, and then they have some event that's going to cost $20,000 for that year.
Dr. Cynthia Pinson: Guess what? I only got 2,000,
Dr. Cynthia Pinson: and now someone calls 20,000.
Dr. Cynthia Pinson: Yeah, so that's value base. So I want to do really good job to keep the cost down. Not
Dr. Cynthia Pinson: bye.
Dr. Cynthia Pinson: not allowing to take this medicine, not to do the other test, no taking care of them. So things that will happen to them later. You know. Some people actually don't know what kills them, so I have to tell them you do this. I didn't want to kill you all right.
Dr. Cynthia Pinson: so i'm an expert
Dr. Cynthia Pinson: at that.
Dr. Cynthia Pinson: So if I can prevent all of that. Then I can keep my calls down right, and I take better care of them. I'm hoping they will have a better quality plan than they have now.
Dr. Cynthia Pinson: before they met me right.
Dr. Cynthia Pinson: and then the personal engagement, you know. Once you spend an hour talking to people about everything, including their toenails and their cat as it are. They is their cat in the way, or who's walking a doll for you when you're using. Okay.
Dr. Cynthia Pinson: they are engaged in investing you, because you have invested in them of the most precious thing on earth. Right now in the practice, medicine is time
Dr. Cynthia Pinson: right? And they do feel bonded with you, and hopefully they'll listen to you better once they like you.
Dr. Cynthia Pinson: But how do you do it? You really cannot do this alone. Before we had, Ehrs. It was on like printed paper with your check check check out list.
Dr. Cynthia Pinson: And then I had a yacht system that doesn't really have any along this visit built in, so I have a template which I will show you. So I just roll everything out, and then, as i'm in front of that patient, I just go down my list one by one. Luckily most Ehr now has some kind of thing building. I'll show you one of those things to it's real team effort. The I don't know when these things are due. Someone out there makes a list.
Dr. Cynthia Pinson: and they tell me what it is. And the thing is, you just got to do more of it. Do not be intimidated. Just keep doing them once you get better at them. Now it's a breeze.
Dr. Cynthia Pinson: All right. Let me give you
Dr. Cynthia Pinson: okay. How can we determine if a. W. Has already been performed by a person? Oh, you know what you don't have to ask your office manager, your coordinator, your aco. Someone up there knows you are not gonna to have access to any of that.
Dr. Cynthia Pinson: All right.
Oh.
Dr. Cynthia Pinson: Template Wendy, one of the great J guys.
Dr. Cynthia Pinson: this is what I made for the yeah that I had that didn't have anything built in for
Dr. Cynthia Pinson: this pages for people. If you look at a more advanced age, you know, because I we we treat people that
Dr. Cynthia Pinson: are all the same. You know Medicare Age group, but some people are more advanced in their disease with their age. Some people are not. This is what people that are more advanced. So the wordings are a little bit different. Of course I'm always trying to cut out a charting time. So, for instance, the memo i'd already put it, not recommended
Dr. Cynthia Pinson: greater than the age of 75. So if this person's 76, you are covered, you don't have to change anything.
Dr. Cynthia Pinson: but if there are 74, you need to go in there maybe change your wording a little bit to make documentation accurate.
Dr. Cynthia Pinson: This one is for people that are a little bit younger. So the the if you see the wordings are a little bit different.
Dr. Cynthia Pinson: and then this goes down everything that has to be covered.
Dr. Cynthia Pinson: and I already put it in need to help with ads, because the majority of my people do it
Dr. Cynthia Pinson: needed but you can just say no. Me doesn't need who needs no help. You can modify this to fit your need.
Dr. Cynthia Pinson: So this is a vaccination, a record, the health care education. So I just go down the list for prevention. Okay, you need a okay, okay, you need Pt: referral
Dr. Cynthia Pinson: and then depression. I roll all this out. Just so I know what the answers are and give them points at the end
Dr. Cynthia Pinson: right
Dr. Cynthia Pinson: cognitive. I put many there because that's the easiest to
Dr. Cynthia Pinson: short one to do, and if this longer one i'll pull down my slums.
Dr. Cynthia Pinson: Risk
Dr. Cynthia Pinson: assessment for us. Okay, there are a ton of these, my Ehr currently has a different one. But this is the one I used when we didn't have it
Dr. Cynthia Pinson: built in.
Dr. Cynthia Pinson: So you just go through that and give them points, right? It's given points. Okay? Well almost till the end. So this is Luke Sky Walker.
Dr. Cynthia Pinson: the planet of Hop, where it's just all Wintery, which is kind of where we are right now.
Dr. Cynthia Pinson: Alright. So how can you talk about medicine without talking about cost right? So what is the cost to do? A Awb.
Dr. Cynthia Pinson: It's actually 0 for your patients.
Dr. Cynthia Pinson: They don't get any co-pays, and when you build that Acp code right here with a modifier 33.
Dr. Cynthia Pinson: They get. Nope.
Dr. Cynthia Pinson: No, okay for that, either. So it's completely free.
Dr. Cynthia Pinson: Because why? Here for you.
Dr. Cynthia Pinson: But you know that's your problem, right?
Dr. Cynthia Pinson: All right. One heavy family. By the time you do all of this
Dr. Cynthia Pinson: you have fulfilled all the requirements.
Dr. Cynthia Pinson: I want to show you
Dr. Cynthia Pinson: our current
Dr. Cynthia Pinson: hard to help us to in there. But
Dr. Cynthia Pinson: so my current, ehr
Dr. Cynthia Pinson: has something built in, and I wonder if yours does, too, and it's really pretty cool of all the things I can complain about it. Look, Medicare Annual Wellness visit.
Dr. Cynthia Pinson: So it's all built in. And look at all this.
Dr. Cynthia Pinson: So basically you just kind of go down and just ask, where is your pain? Blah blah, blah and's care planning, you know. Do you have a living? Well, do you have this? Do you have that procedures? If this person doesn't, you just add them right.
Dr. Cynthia Pinson: Oops, I don't really want to do that. Family history. Add them social history at them. Health risk, assessment.
Dr. Cynthia Pinson: right? This is what we just talk about.
Dr. Cynthia Pinson: What can you do for yourself? Boom, boom, boom.
Dr. Cynthia Pinson: geriatric screening. They'll do it. Many call this here and there's multiple other things. We're hearing.
Dr. Cynthia Pinson: Okay, Home Safety.
Dr. Cynthia Pinson: The Fall Risk assessment functional assessment. Right?
Dr. Cynthia Pinson: Look out that that's Als right.
Dr. Cynthia Pinson: You're independent.
Dr. Cynthia Pinson: are all here.
Dr. Cynthia Pinson: So then you are saying, okay, this person is screening this person. Doesn't: this is up to date. That's not today. So you just quickly check all this, and at the end you say, okay, you need to have Colonel Cancer screening and blah blah blah you. So you just finish all that, and then that's the end of it. So of course, when you have a tool like this.
Dr. Cynthia Pinson: it's kind of a no-brainer, and it's so much easier for you. You're not trying to memorize anything. I literally cannot
Dr. Cynthia Pinson: memorize these things. If I did not help him.
Okay.
Dr. Cynthia Pinson: it's 9
Dr. Cynthia Pinson: 18. I want to go ahead and stop sharing the screen.
Dr. Cynthia Pinson: All right. So I'm finished. If you
Dr. Cynthia Pinson: I have any other things, Valerie or
Shirley Sullivan: Dr. Pennsylvania is another question.
Shirley Sullivan: Okay.
Shirley Sullivan: that says, when complete and an annual wellness visit in the home. Is this typical? A provider, a. P. Or is there a model where nurses complete the Hr. A.
Dr. Cynthia Pinson: You know I don't. I know we don't use nurses for this, because the code
Dr. Cynthia Pinson: to build that it is for a provider of some sort. So check with your administrator and your billing people about that.
Dr. Cynthia Pinson: Our practice and the practice associated with us. We haven't really sent a nurse out to do that before.
Dr. Cynthia Pinson: so
Dr. Cynthia Pinson: they're completely capable, of course, of doing it.
Dr. Cynthia Pinson: But I think you need to check on that. It really is on the building.
Shirley Sullivan: Thank you
Shirley Sullivan: another question: Does your Ehr automatically give you a depression screen and score, or do you manually have to add the results?
Dr. Cynthia Pinson: Believe it or not, the system actually does use the score
Dr. Cynthia Pinson: with all the faults that they have.
Dr. Cynthia Pinson: And when I do this, if it's on paper like, if you don't have that, I I should just pull this up on my phone. I type in geriatric depression screening
Dr. Cynthia Pinson: short form, and then that pops up Google.
Dr. Cynthia Pinson: And then, as i'm asking them that. Of course I have a notebook always, so I only write down the answers that are positive.
Dr. Cynthia Pinson: So at the end. That's how I score them. If I write down 5
Dr. Cynthia Pinson: calls and answers like I was, if they said, you know, are are you feeling helpless? If they say yes, then I might
Dr. Cynthia Pinson: that number of the question down.
Dr. Cynthia Pinson: So that's how I explore.
Shirley Sullivan: Thank you. And there's another question. If they are here to be seen for another problem like pain or uti, etc. Can an annual wellness visit be done the same day?
Dr. Cynthia Pinson: So this is a reversal annual. Well, this is. It takes so much of your time. If someone is a walking for uti, they say, hey, I want my annual on this visit, or your office manager says, hey, this person has. I had to go and do it. Just say no.
Dr. Cynthia Pinson: honestly, you're not doing a justice. The whole point of setting aside a whole hour to do this is, you can actually address everything
Dr. Cynthia Pinson: so. But the reverse is okay, right. If they come in for the schedule and your longest, is it? While you're asking the question, I said, oh, by the way, i'm peeing blood.
Dr. Cynthia Pinson: and it burns when I go.
Dr. Cynthia Pinson: No-brainer treat it. That's not a problem. You just use your modifier you can build for the annual honest physical
Dr. Cynthia Pinson: plus your face to face, visit code in the modifier 25 You get paid for all of it.
Shirley Sullivan: Thank you. Another question. How do you address opioid? Use disorder? Do you use a screening tool?
Dr. Cynthia Pinson: That entirely is Another hour of lecture was about given before. Yes, there are swinging tools
Dr. Cynthia Pinson: for it, and it's very good tools.
Shirley Sullivan: Thank you.
Shirley Sullivan: And I think that's all the questions right now.
Valerie Wood: We can give it maybe 10 s or 20 s. Is anyone else? Have any questions you can put in the Q. A. Or in the chat function. We'll just give it a moment.
and then we can
Valerie Wood: move on.
Valerie Wood: Okay, if any other. Oh, wait to do it. Okay.
Valerie Wood: A comment.
Valerie Wood: Excellent presentation. Love. The Star Wars pictures and analogies.
Dr. Cynthia Pinson: Thank you.
Valerie Wood: And I second that. Thank you, Dr. Penson. It's very, very helpful information.
Valerie Wood: and really appreciate your time today.
Valerie Wood: Next next slide my team.
Valerie Wood: Okay, if any other questions came, come up, be happy to address. We have about 8 min.
Valerie Wood: and we have an annual wellness visit assessment, toolkit. I would like to
Valerie Wood: briefly introduced. It was initially created in 2,017, but we're updating it this year
Valerie Wood: to focus on assessments and to narrow it down from 80 some pages to make it a little bit more user friendly. So this is a provider facing compilation of resources, educational handouts for patients and links to relevant materials
Valerie Wood: for all of the topics that Medicare recommends, and requires, such as anxiety, depression, mobility, self care, memory, medication in the topics. Dr. Pins, who went over.
Valerie Wood: so it covers the overall scope and guidelines, but with an emphasis on assessment tools for each category. And if your Ehr does have this, that is wonderful, and we'll probably, you know, save a lot of time. But this assessment toolkit will also save time.
Valerie Wood: and to help you find them, because it is difficult sometimes when you're Googling to narrow down, especially geriatric focused ones.
Valerie Wood: So i'm going to share my screen
Valerie Wood: and share our assessment toolkit just to show
Valerie Wood: here what we have
Valerie Wood: so assessment and resource toolkit.
Valerie Wood: If you click on the link, it will take you to the part in the in the toolkit for that
Valerie Wood: topic.
Valerie Wood: So we have
Valerie Wood: variety of topics. Flyers to send out in any of these
Valerie Wood: any of these resources with an asterisk are available at the very bottom, and the appendix; otherwise there they will be found in links.
Valerie Wood: So some of the screenings Dr. Penson mentioned some other ones.
Valerie Wood: and some of these may be appropriate for referrals. If there are more extensive screenings and assessments, we have information on Covid and Mutations depression screening. There's you know, one specific to geriatrics.
Valerie Wood: We have a very large amount of mobility and home safety screenings
Valerie Wood: and memory assessments.
Valerie Wood: And there's a little little bit on each topic at the top.
Valerie Wood: and I just wanted to share this quote about diabetes. There's some chronic disease management information here. Patients with diabetes who participate in a free annual on this visit, covered by medicare are 36% less likely to meet major lower extremity amputations
Valerie Wood: according to American diabetes scientific sessions. I just thought it was a really pertinent quote for the Webinar and included in the toolkit.
Valerie Wood: So we have. We have some opioid
Valerie Wood: resources as well.
Valerie Wood: and and then our appendix that has all some of our
Valerie Wood: resources to share.
So
Valerie Wood: kind of stop sharing, and this will be available in February's Newsletter. But if you would like it sooner by contact, information will be in the following slides, but it keep an eye out for it in our neighborhood. Buzz, Newsletter, if you're not receiving that also free, feel free to reach out and let us know that you'd like to receive that to stop sharing.
Valerie Wood: And it looks like we do have another question
Valerie Wood: when Medicare says to address at minimum and list several items, such as sexual health, etc. Does that mean we must address all of that?
Valerie Wood: Oh, you're on me.
Dr. Cynthia Pinson: Sorry, I mean, master or not. My, that's the question like, who is going to read your note? Right?
Dr. Cynthia Pinson: So? Yes, you want to address at least all the ones that's mentioned, but truly is up to your toolkit.
Dr. Cynthia Pinson: like. If it is built into all your questionnaires, you just ask them.
Dr. Cynthia Pinson: But if you miss that You' on your question. You didn't ask them. I mean, it's okay to get missed. It like no one is who might touch you with a license right now. But you do want to address the minimal. All that?
Valerie Wood: Okay. I don't see any other questions this time, and I can definitely share the tool kit with all attendees today
Valerie Wood: because we have your contact information.
Valerie Wood: And now here's our contact information. If there's any, follow up questions. If you're not already, you know in touch with somebody from quality insights. Please reach out, and we'd love to, you know. Have you a part
Valerie Wood: of our organization
Valerie Wood: and next slide, please.
Quality Insights: I just wanted to thank everybody who was able to join us today. And please remember to complete the evaluation and the reflective questions. There is a link to that
Quality Insights: on your screen right now. You can either scan the QR code with your smartphone, or I also provided a link in the chat that will go to that evaluation as well. And for those that haven't seen in the chat, I did type that slides in the recording of today's sharing call are going to be available on our website
Quality Insights: after Today's Webinar. The link to that is also in the chat. It's quality insights.org forward, slash. Q. I. N. And specifically the slides and sharing of the slides, and the recording will be on the multimedia page.
Right
Quality Insights: well, not seeing any further questions.
Quality Insights: Thanks. Everyone for attending Valerie. I don't know if you want to have any closing remarks.
Valerie Wood: Thank you, Dr. Penson. I second the comments in the chat, great presentation, and educating.
Dr. Cynthia Pinson: So thank you for your time.
Dr. Cynthia Pinson: Thank you. Take care.
Quality Insights: Thanks. Everyone have a great day.