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Auburn Community Hospital (ACH) is the First in the U.S. to Implement Abbott’s Newest & Most Advanced Laboratory Technology

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Auburn Community Hospital (ACH) is the first institution in the United States to integrate Abbott’s Alinity h‐series into the ACH Core Laboratory. This cutting‐edge hematology automation system is set to transform the capabilities of the Auburn Laboratory. The new system will facilitate the seamless measurement of complete blood counts, a crucial healthcare test widely ordered for patients.

In addition to conducting complete blood counts, this new system will have significant benefits for our physicians and patients allowing for increased specificity in the screening of numerous disorders such as infections, anemia, immune system diseases, and blood cancers. Not only will the Lab offer complete blood counts but will do this with increased accuracy, speed, and efficiency, and places the ACH Core Lab on the level of the largest and most prestigious healthcare institutions and clinical laboratories in the world.

The ACH Laboratory has been working with Abbott on securing this new technology for over two years and has a long and established relationship with Abbott. The ACH Core Lab has been recognized by the Joint Commission and the Department of Health for its high level of performance, including an exceptionally high volume of tests performed annually, and maintaining operations during the pandemic while carrying out thousands of tests and allowing necessary surgeries to continue, while keeping patients and employees safe.

This new system is particularly important to ACH because the hospital will open a comprehensive cancer center Spring 2024 and will be breaking ground soon for the Auburn Heart Institute. “These patient groups, known for their complex blood samples, pose challenges in analysis and this advanced technology promises enhanced accuracy and efficiency which will allow for healthcare professionals treating cardiology patients or cancer patients better data to care for patients right in our own backyard,” stated Ronald Kirshner, MD, and Chair of the Auburn Heart Institute.

Dr. John Riccio, former Chief Medical Officer and Lab Director says, “This is truly an innovation that we’ve been waiting on for a long time.  For Abbott to choose us to be their partner in release of this new technology is phenomenal.”  This new system was approved by the U.S. Food and Drug Administration (FDA) in August 2023.

Neal Nash, managing director for Abbott shared, “Our longtime partnership with Auburn made for the right choice to unveil the next line of laboratory technology.  When you launch something new, it’s the first time you’re doing it and you’re installing the first one, you want to make sure you’ve got the right partner who is going to work with you hand-in-hand who’s going to make sure it’s going to go very well.”

By securing this latest technology the ACH Lab will have the capability to process 119 CBCs per hour, and the Alinity HS slide maker stainer automates and standardizes the formerly manual blood smear creation process. This innovation holds particular significance in labs where time, resources, and staff are under strain. The Abbott Alinity systems are also designed for efficiency, conducting more tests in less space, delivering faster test results, and minimizing human errors—all contributing to improved care for a greater number of patients.

Dr. James Syrett, Auburn hospital’s chief medical officer, provided an example of a patient who requires regular blood transfusions. “Using the old system, this patient would need to wait two hours for results before receiving the transfusion. Now, with Abbott’s Alinity h-series technology, the results will be available in 20 minutes.” 

“This investment by ACH is significant because it is another example of how a rural community hospital can be a model for other institutions who are committed to offering the best care for patients. Our lab, now equipped with cutting‐edge technology, empowers physicians with swift and accurate information, facilitating timely communication with patients eagerly awaiting results,” affirmed Scott Berlucchi, President & CEO of ACH.

John Bagenski, Technical Director of the ACH Core Laboratory, expressed excitement, stating, “We are thrilled to be the inaugural laboratory in the country integrating this state‐of‐the‐art hematology testing technology. ACH and Abbott share a longstanding commitment to enhancing patient care at every life stage. With the implementation of the Abbott system in Auburn, we are positioned to elevate the standard of quality care in our community and across New York state.”

Jessica Giacona, ACH Core Laboratory Supervisor stated that “Securing this new system is humbling because we are the first laboratory in the country to integrate this technology into our facility, and it is meaningful recognition of the quality of our lab and the amazing team that works here.”

Bagenski, Giacona, and the team collaborated with Abbott for several months, seamlessly integrating the new system into the ACH lab and undergoing comprehensive training on the Alinity‐h system at Abbott’s Training Center in Dallas, Texas.

Auburn Community Hospital (ACH) is a not‐for‐profit, 99‐bed acute care facility with a mission to provide compassionate quality care to our community. ACH is the sole provider of acute and general hospital services in Cayuga County and the surrounding areas located in the Finger Lakes region of Central New York including one of the highest rated 80‐bed Long Term Care and Rehabilitation Center in the state.

Call Out:

Auburn Community Hospital – Core Lab

 

  • First in the U.S. to be Awarded Abbott Laboratories Newest & Most Advanced Laboratory Technology. (Alinity-h)
  • Offer complete blood counts with increased accuracy and efficiency.
  • Increased specificity for the screening of numerous disorders including infections, anemia, immune system diseases, and blood cancers.
  • Places the ACH Core Lab on the level of the largest and most prestigious healthcare clinical laboratories in the world.

When to Report a Potential Medical Malpractice Claim: Protecting Yourself and Your Practice

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by Jenn Negley

Peace of mind is paramount for healthcare providers. However, some physicians hesitate to report potential medical malpractice claims to their insurance carriers for fear of jeopardizing their coverage. This article aims to clarify the importance of timely reporting and dispel common misconceptions.

Understanding “Claims-Made” and “Occurrence” Policies and Incident Triggers

With a claim-made policy the carrier defends incidents reported during the policy period, even if the incident itself occurred earlier (within the retroactive date). Crucially, both the incident report and the claim itself must happen while the policy is active.

An Occurrence policy protects you from any incident that “occurs” during the policy period, regardless of when a claim is filed. Meaning, the carrier you are insured with when the incident occurred covers you for the claim and is who you need to report to.

Why Early Reporting Matters

Delaying an incident report can have serious consequences. If a potential claim later materializes, the insurer may deny coverage due to non-disclosure. Even when switching insurers, a past unreported incident could negatively impact future coverage options.

What is an Incident? What is a Claim?

An incident is any event that could potentially lead to a future claim. This includes situations causing injury, potential injury, or even dissatisfaction with a service. Claims come in two forms: formal and informal.

  • Formal claims: Receiving a legal document, a demand letter from an attorney, or even a seemingly innocuous request for medical records by a patient’s lawyer (unless unrelated to your care).
  • Informal claims: Verbal threats of litigation, requests to waive fees, or patient harassment.

Examples of Incidents to Report:

  • Patient deaths
  • Birth injuries
  • Serious injuries
  • Disfigurement
  • Loss of limbs
  • Sensory impairment
  • Verbal threats
  • Patient family harassment

Additional Reporting Recommendations

Report any instance involving:

  • Demands for money
  • Legal threats
  • Lawsuits naming you
  • Notices of intent to sue
  • Requests for arbitration or depositions

Protecting Yourself After Reporting

Once you report an incident, communication is key:

  • Only discuss the case with your claims manager, a lawyer representing you, protected peer-review attendees, or your spouse.
  • Never alter medical records, even for seemingly minor corrections.
  • Do not include claim correspondence in patient records.
  • Maintain copies of all claim-related documents in a secure location.

A Word on “Background” Interviews

Be wary of requests from plaintiff attorneys to discuss a case you’re not directly involved in. These seemingly casual interviews can be traps leading to future lawsuits against you. Always contact your insurer and request legal representation for such inquiries.

By understanding reporting requirements and taking proactive steps, healthcare providers can protect themselves and ensure their medical malpractice insurance provides the valuable protection they deserve.

For more information, please contact Jenn Negley, Vice President, Risk Strategies Company at 267 251-2233 or JNegley@ Risk-Strategies.com.

Sidebar:

Risk Strategies, National Health Care malpractice team by the numbers:

  • Supports over 6,000 clients representing over $200,000,000 in physician premiums.
  • Representing every major medical malpractice insurance carrier in the market. In New York, we represent MLMIC, EmPro(PRI), The Doctors Company (TDC), HIC, MedPro RRG, Coverys RRG, ProAssurance RRG, TDC RRG, AMS RRG.
  • Specialists with over 25 years’ experience in medical malpractice insurance
  • Programs designed for independent physicians and self-insured programs as well as large practices and hospitals.

New Rule to Determine Worker Status Under the Fair Labor Standards Act

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by Allison B. Cherundolo

A new final rule from the United States Department of Labor (“DOL”) went into effect on March 11, 2024 that changes how to determine whether a worker is an employee or an independent contractor under the Fair Labor Standards Act (“FLSA”). Rescinding the 2021 rule under which two key factors – control over the work and opportunity for profit or loss – carried greater weight, the final rule applies a six-factor test to ensure that an employer’s classification of its workers complies with the protections of the FLSA, primarily appropriate minimum wage payments and entitlement to overtime.

The six-factor test applies a “totality of the circumstances” analysis of the “economic realities” of the work relationship meaning that each factor is weighed equally on a case-by-case basis. The DOL has stated that its intent is not to give one factor a predetermined weight over the others. Thus, no single factor listed is determinative.

The following provides an overview of each of the factors that must now be considered in classifying workers as employees or independent contractors.

  1. The Opportunity for Profit or Loss for the Worker

When evaluating the opportunity for profit and loss, an employer should consider facts such as whether the worker determines or can meaningfully negotiate the charge or pay for the work provided; whether the worker accepts or declines jobs or chooses the order and/or time in which the jobs are performed; whether the worker engages in marketing, advertising, or other efforts to expand their business or secure more work; and whether the worker makes decisions to hire others, purchase materials and equipment, and/or rent space. The more of these things a worker does the more likely it is that they would be determined an independent contractor as opposed to an employee.

  1. Investments of the Parties

This factor considers whether the worker’s investments “support an independent business and serve a business-like function, such as increasing the worker’s ability to perform different types of or more work, reducing costs, or extending market reach” – and how that compares to the employer’s investment in the business overall.

  1. The Degree of Permanency of the Work Relationship

A work relationship that is “definite in duration, non-exclusive, project-based, or sporadic based on the worker being in business for themselves and marketing their services or labor to multiple entities” would weigh towards classification as an independent contractor whereas a work relationship that “is indefinite in duration, continuous, or exclusive of work for other employers” would weigh in favor of classification as an employee.

  1. The Nature and Degree of the Employer’s Control Over the Work

When considering this factor, an employer should evaluate whether it sets the worker’s schedule, supervises the performance of the work,…explicitly limits the worker’s ability to work for others, uses technological means to supervise the performance of the work, reserves the right to supervise or discipline workers,…places demands or restrictions on workers that do not allow them to work for others or work when they choose [, and/or] controls economic aspects of the working relationship…, including control over prices or rates for services and the marketing of the services or products provided by the worker. The more control an employer exercises over a worker the more likely this factor will favor classification as an employee as opposed to an independent contractor. Notably, control within legal requirements for safety, quality, and customer/patient standards may not necessarily dictate an employer-employee relationship.

  1. The Degree to Which the Work is an Integral Part of the Employer’s Business

This factor considers not whether the worker is an integral part of the organization, but whether the work being performed is “critical, necessary, or central” to the company’s primary business. The less critical the work is to the organization, the more likely this factor favors classification as an independent contractor.

  1. The Worker’s Skill and Initiative

The final factor focuses on the worker’s use of specialized skills. Where “those skills contribute to business-like initiative” this factor will favor classification as an independent contractor. However, where workers rely on the company for training to perform the work this factor will favor classification as an employee.

Allison Cherundolo is a partner at CCB Law, a boutique law firm focused on providing counsel to physicians and healthcare professionals. She can be reached at 315-477-6282 or acherundolo@ccblaw.com.

Oneida Health Pursues Another 125 Years of Exceptional Care

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By Becca Taurisano

From investments in facilities, technology, and medical staff to strategic partnerships, Oneida Heath is committed to providing the best quality outcomes and patient experience today and in the future.

THE EARLY YEARS

From the very beginning, Oneida Health’s mission has been driven by the community’s need for exceptional care, close to home. In 1894, a railroad accident in Oneida brought to light the need for immediate health care services. With a makeshift treatment room established at the Presbyterian Church to treat the railroad victims, the concept of delivering organized healthcare services in the community was born.

In 1899, Oneida Mayor, J.M. Goldstein donated a plot of land on Williams Street and Oneida Health opened the doors to its first hospital, a four-bed city-operated facility. After an expansion a few years later, it was clear more was needed and the first Broad Street Hospital was built in 1906, followed by a new 80-bed Board Street facility in 1938. 

Over the next 30 years, the Broad Street Hospital continued to expand to meet the needs of the community driving the need for a new site. In 1972, a 126-bed hospital opened its doors at 321 Genesee Street which serves as the hospital’s primary location today. Two years later, the Broad Street facility was converted into a skilled nursing facility, marking the beginning stages of Oneida Health’s healthcare system.

“Since 1899, the growth of Oneida Health has been a reflection of the needs of our community,” says Michael Kallet, Chair, Board of Trustees of Oneida Health. “From our humble beginnings to today, our organization continues to be driven to provide convenient access to the highest quality of care possible.”

TRANSFORMATION TO AN INTEGRATED HEALTH CARE SYSTEM

With the hospital location firmly established on the hill overlooking Genesee Street and a skilled nursing facility downtown, the city-owned and operated healthcare system in Oneida continued to deliver care for the next 20 years without much change. It wasn’t until the 1990s that Oneida Health started to expand its services beyond the hospital and skilled nursing
facility.

Throughout the 1990s and 2000s, Oneida Health saw tremendous growth in services offered with the expansion of outpatient locations. This transformed Oneida Health into an integrated healthcare system.

“To best care for your community, you need to invest in providing preventative care,” says Kallet. “As an organization, we recognized this as the next step to meet the needs of our community by supporting population health and preventing more intensive and costly care
down the road.”

Recognizing the need for primary and preventive care services, Oneida Health opened its first outpatient office in Camden in 1991 marking the beginning of what is now a six-location primary care network with 18 primary care providers. To support access to diagnostic services, Oneida Health expanded its lab and imaging services with the development of five outpatient lab draw locations and two outpatient imaging centers.

In addition to the expansion of primary care, Oneida Health recognized the need for increased access to specialty services close to home. “The need for increased access to specialty services in healthcare has grown with the advancement of medicine,” says Felissa Koernig, President and CEO of Oneida Health. “Developing and nurturing a network of preventative and specialty services is instrumental to improving care in our communities.”

This commitment has created an integrated healthcare network offering specialty services that include: Allergy; Breast Surgery; Cardiology; Convenient Care; Ear, Nose, and Throat; Gastroenterology; Neurology; Obstetrics and Gynecology; Oncology; Orthopedics; Podiatry;

 Pulmonology; Sleep; Vascular; and Wound Care.

A LEADER IN COMMUNITY HEALTHCARE:WORLD CLASS TECHNOLOGY

Along the way, Oneida Health has taken a strategic approach to providing convenient access to services with leading-edge technology. “As a rural healthcare organization, it is not enough to provide patients convenient access to healthcare services,” says Koernig. “Our mission is to provide patients with the best healthcare services, and to achieve this you need to pair
talented medical staff and the best technology.”

Oneida Health has had a history of investing in state-of the-art technology to support the diagnosis and treatment of its patients. In 2002, Oneida Health was the first hospital in Central New York (CNY) to introduce computeraided mammography. This was later followed by being among the first in CNY to invest in 3D mammography, the new gold standard in early breast cancer detection. With continued new investments in advanced imaging over the last decade which includes a 3-Tesla MRI and Advanced PET/CT, to name a few, Oneida Health has become a destination for imaging services.

From instituting robotic surgery in 2012 to providing TrueBeam radiotherapy, the most advanced linear accelerator and radiosurgery treatment system available, 

Oneida Health ensures providers have access to the best technology when it comes to treating patients. 

“It’s a common misconception that the best technology exists only in big cities,” says Kallet. “At Oneida Health, we have taken every step to ensure our talented Medical Staff has access to the best technology to treat their patients.”

 

STRATEGIC PARTNERSHIPS

For rural-based healthcare networks, the ability to develop highly specialized service lines can often be hindered by a lack of expertise and their ability to recruit Medical Specialists. Oneida Health has leveraged key strategic partnerships to help bridge the gap and bring
highly specialized care to Oneida.

In 2017, Oneida Health opened the William L. Griffin Medical Oncology Center followed by the Dorothy G. Griffin Radiation Oncology Center, both centers are members of the Roswell Park Care Network. The collaboration provides the Oneida region with quality cancer care that meets National Cancer Institute (NCI) guidelines, creating local access to some of the latest treatment options from a nationally ranked cancer center.

In response to an increase in diabetic patients with difficulty healing wounds, Oneida Health recently partnered with Restorix, an expert in wound care and hyperbaric medicine, to open the Wound Care Center in 2018. By developing this partnership, Oneida Health was able to bring in a high level of expertise in this specialized area to become operational in a very short time frame.

“Anytime we offer a service, we should be among the best in the area providing it, otherwise why would patients choose us,” says Koernig. “Strategic partnerships with Roswell Park, Restorix, and other healthcare systems have allowed us to leverage expertise in a collaborative effort to provide the highest quality of care on day one.”

NATIONALLY RECOGNIZED CARE

Oneida Health prides itself on exceptional care, always and has received numerous awards for high-quality care and patient experience for many years. Some of the most impressive recent highlights include:
The region’s only 5-star rated hospital by the Centers for Medicaid and Medicare (CMS) for quality care in 2021

Ranked in the top 2% of hospitals nationally for patient safety and patient experience by Healthgrades in 2019.

Women’s Choice Award for Best 100 Hospitals for Patient Experience four years in a row, 2020-2023.

A five-star recipient for Vaginal Delivery from Healthgrades for 5 years in a row (2015-2019)

“As an organization, we have a history of being committed to excellence,” says Koernig. “Awards at the national and state level are a testament to the talented Medical Staff we have at Oneida Health and their dedication to providing patients with the highest level of care at every visit.”

BUILT ON COMMUNITY SUPPORT

From a four-bed hospital to an integrated healthcare network, Oneida Health today includes a 101-bed acute care hospital, stateof-the-art robotic surgery center, 160 bed extended-care facility, multiple primary and urgent care offices, comprehensive lab and imaging services, outpatient and inpatient therapy, and a variety of specialty services providing care to approximately 29 communities with a population of over a 100,000 throughout Madison and Oneida counties.

The incredible growth and success the organization has seen over the last 125 years would not be possible without significant community support throughout its history.

Recent donations have helped support technology, expansions, and renovations of facilities like the William L. Griffin Medical Oncology Center, the Alice M. Gorman Imaging Center, the Dorothy G. Griffin Radiation Oncology Center, and the expansion of the Emergency Department and Operating Rooms including the Chapman Foundation main hospital entrance.

“So much of what we’ve achieved has been made possible 

by our generous donors,” says Kallet. “From the original land donation by the mayor to our most recent donations  by the Griffin Foundation for the expansion of oncology, these contributions to our mission have elevated our network to what it is today.”

Support from community groups has been essential as well, from the Oneida Health Foundation to individual volunteers and groups like the Oneida Health Auxiliary. Their combined efforts have provided valuable resources to Oneida Health’s success.

“Community-based organizations have provided their support throughout our 125 years because they believe in our vision,” says Koernig “From a single volunteer fulfilling hours of service to large financial gifts from area nonprofits, these generous acts have helped make our patient care exceptional. I extend our thanks to everyone in the community who has contributed so selflessly
over our organization’s history.”

THE NEXT 125 YEARS

As the future of healthcare changes, Oneida Health plans to stay agile to adapt to the ever-changing healthcare landscape.

“As an organization, we need to continue to look for opportunities to deliver care where it is needed and how patients want to receive it,” says Koernig. “Our ability to connect patients digitally with their providers and patient information is going to become more
essential as we move forward.”

While the method of delivering care may be changing, Oneida Health’s approach to patient care looks to remain consistent. “Our commitment to providing the highest quality of care and patient experience will continue to set us apart and remain an important reason why patients will choose us for years to come,” says Koernig.

The future of Oneida Health will continue to rest on its most important asset: its people. “As a healthcare organization, we will need to continue to recruit the highest level of talent while providing an environment where healthcare providers and professionals can thrive. 

Investing in our people will ensure we’re providing care for the next century and beyond,” adds Koernig.

The Evolution of Primary Care

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BY KATHRYN RUSCITTO, ADVISOR

For many years we have lived with the concept that primary care is delivered by an office based physician who treats and coordinates all our care. The wisdom and experience primary care physicians have brought to this practice has been remarkable. Over the last several years environmental pressures have brought about an evolution in the Primary Care model leading to unique new access points for patients.

Covid added to an existing workforce shortage and many physicians faced burnout from growing demands. From 2005 to 2015 there was an 11% drop in primary care physicians. Recent tracking suggests that decline has continued.

The result is the evolution of a broader model of primary care access ranging from Urgent Care, Retail Clinics to Online Telemedicine consults, and Paramedicine Pilots. 

Heather Drake Bianchi, CEO of Drakos Dynamics, a provider of urgent care and family medicine in CNY underscores the importance of accessibility. In a recent interview she emphasized the value of being available when patients need care, outside traditional office hours, aligning with the shifting demands of today’s workforce and lifestyle.

Another essential change, is that many sub specialties are now seen as key or integral to the primary care provider. Integrated primary care considers the input from Pharmacy, Dental, Mental Health, Physical Therapy and Health coaching in an integrated record. These teams, often system based, believe primary care has to include a balanced view across all providers. The blending of all these perspectives across an integrated team allows for better delivery of care in a patient collaborative model.

Dr. Julie Colvin a busy Family Physician and Medical Director of Northeast Family Physicians at St. Joseph’s HHC states, “Healthcare has to change and evolve, and those options will also give patients and providers more flexibility, and will help the healthcare workforce shortage. We want to make sure that the quality of care in those extended fields is the same as traditional medical care.”

These new access points are exploding using technology, remote access to physicians and even algorithms that direct care based on AI analysis of patients answers to questions. 

In many ways these new access points are part of an Integrated Primary Care model. In order for that information to be readily available from any access point, it must be integrated across the medical record, or accessible to providers through the Regional Health Information Organization.

It is not unusual for me to find younger patients using these new access points and not having a primary care physician. For specialty practices I pose the question, have you adjusted your outreach approaches for patients based on these new access points?

The health care environment continues to evolve utilizing the opportunities from technology, and helping patients find the right care, at the right time, in the right setting.

Kruscitto 1/24
Krusct@gmail.com
Board member and advisor

Resources:
Primary Care in the US, a brief history
https://www.ncbi.nlm.nih.gov/books/
NBK571806/#:~:text=New%20models%20
of%20care%2C%20such,of%20quality%
2C%20and%20more%20formally

Primary Care: Past, Present and Future
https://www.medpagetoday.com/opinion/focusonpolicy/
103811

https://www.sjhsyr.org/find-a-service-or-specialty/
primary-care

https://www.drakosdynamics.com/

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

Enhancing Patient Care Through Clinical Research with Velocity

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In the rapidly evolving landscape of healthcare staying at the forefront of medical advancements is crucial. Velocity Clinical Research, a global leader in conducting clinical trials with almost 100 sites worldwide, offers an 

avenue for healthcare professionals in the Central New York region to contribute to this evolution and significantly impact the future of patient care. By referring patients to clinical trials at Velocity Syracuse, you not only provide them with access to next-generation healthcare options but also participate in the advancement of medical knowledge and treatment.

Transforming Patient Engagement with Clinical Research
Velocity Syracuse is currently spearheading several clinical trials covering a wide range of medical conditions. Current studies include; cognitive decline, Alzheimer’s disease and

agitation associated with it, non-alcoholic fatty liver disease, diabetes, secondary treatment of hypercholesterolemia, severe hypertriglyceridemia, gastroparesis, hepatic encephalopathy, obesity, and several vaccine trials. 

We are also participating in a unique clinical trial involving the evaluation of a new PET scan tracer to better identify brain changes in early Alzheimer’s disease. The study is looking for patients with a projected life expectancy of less than one year, with and without Alzheimer’s, who are willing to undergo a PET scan and donate their brain postmortem for comparison and evaluation.

A Step Towards Better Healthcare
Referring patients to clinical trials at Velocity is not just about accessing new treatment options, it is about being part of the larger community and movement toward the future of healthcare. It is also an opportunity to contribute to the advancement of medicine while simultaneously enhancing patient care and distinguishing your practice as one that is evidenced based and forward thinking.

These trials are more than just research studies; they are potential advanced treatment options for those patients with conditions not adequately addressed by existing therapies. Referring patients to clinical trials empowers and enables them to play a more active role in their healthcare journey.

Collaboration and Compensation
Participants in all studies receive compensation for their time and effort. Other advantages for individuals who participate in clinical trials include but are not limited to; access to medications irrespective of cost, transportation to/from our office if necessary, and additional medical testing that may not otherwise be available through the course of routine medical care.

We are committed to full collaboration and continuity of care with medical providers and the patients we share. We recognize the importance of sharing this information and the value of working together. We also make every effort to minimize time and work required to make a referral to us. Additionally, Velocity is striving to extend the potential benefits of participation in clinical research to everyone equitably. Historically, minority populations have been significantly underrepresented in research studies. We continue to make efforts to promote diversity in clinical research.

Stay Informed and Involved
We urge you to embrace this possibility to make a significant difference. Join Velocity in shaping the future of healthcare, one patient, one trial at a time.

To stay updated on the latest studies and how they align with your patients’ needs, you can easily reach out to us at Syracuse@VelocityClinical.com. Your proactive engagement ensures that you are always informed about the latest clinical research opportunities available
for your patients.

Can Paid Medical Experts Guarantee Justice in Medical Malpractice Cases?

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Jennifer Negley

Expert witness testimony is essential to all medical malpractice legal proceedings. Usually, without a medical expert, plaintiffs cannot proceed to trial, and defendants are usually doomed to an adverse jury verdict. Medical experts are recruited in many ways, even from proprietary companies that offer a diverse variety of experts.

Finding these crucial experts varies from direct attorney contact to agencies offering a wide range of specialists. Though they’re key figures in court, their most important job is to be unbiased and help decide the case fairly. Professional organizations like the American Academy of Family Physicians have outlined stringent guidelines:

Unwavering Objectivity:
Physicians serving as expert witnesses must hold themselves to the highest ethical standards, ensuring complete and unbiased information is presented. They are not advocates, but impartial guides illuminating the medical realities of the case.

Adherence to Standards:
Their opinions should reflect the established benchmarks within their specialty, both at the time of the alleged incident and in the present. Thorough familiarization with the case and relevant medical standards is paramount.

Fair Compensation:
Recognizing the significant time and effort involved, reasonable and commensurate compensation for expert witnesses is essential.

In this time of shrinking fees and increased costs, physicians are debating if they should offer their services as a paid medical expert. Many questions arise when considering this path. One prominent national insurance carrier has challenged this matter with a few questions that can be beneficial when evaluating this option. Among them are:

Schedule Balancing:
Can you seamlessly integrate court appearances into your patient care schedule without compromising either?

Case Complexity:
Are you prepared for potentially vast medical records, repeated attorney meetings, lengthy depositions, and extended court battles?

Pressure and Performance:
How comfortable are you with verbal sparring and intense scrutiny in a courtroom setting?

Potential Repercussions:
Could your testimony be used against you in the future?

Maintaining Expertise:
Can you resist the pressure to stretch your opinions beyond your areas of expertise to better suit a particular
side?

Many physicians may not realize that their existing professional liability policies don’t automatically cover them for acting as a paid expert witness. This presents a significant financial risk you shouldn’t ignore. To make an informed decision, consulting your insurance advisor is vital. They can clarify your existing coverage and guide you toward securing any additional protection necessary to enter the world of expert witness testimony.

While the role of medical experts in malpractice cases remains crucial, both plaintiffs and defendants should carefully consider the implications before engaging a physician for compensated testimony. It’s a path demanding specialized skills, significant time commitment, and ethical considerations, necessitating a thorough self-evaluation and consultation with one’s insurance advisor. Ultimately, ensuring responsible and unbiased expertise in the courtroom necessitates understanding the complexities and obligations involved for all parties concerned.

For more information on your insurance options, please contact:

Jenn Negley,
Vice President, Risk Strategies Company
at 267-251-2233
or JNegley@Risk-Strategies.com.

Auburn Community Hospital Health System:A Destination For Quality Care

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By: Elizabeth Landry

Dr. James I. Syrett Chief Medical Officer, Dr. Daniel Alexander, Chief Administrative Officer & Chief of Orthopedics, Dr. Emily Brooks, Chief Nursing Officer Joshua Alexander, Chief Operating Officer, Stephen Graziano, MD, Division Chief of Upstate Cancer Center Adult Hematology/Oncology, Scott Berlucchi, President & CEO Christina Sherman, RN, Director of Cancer Services, Auburn Community Hospital, Erik Burch, Sr. VP Administration

It’s hard to imagine the growing Auburn Community Hospital (ACH) of today filed for bankruptcy just 16 years ago. Since 2007, bolstered by the belief brighter days were ahead and led by the expertise of CEO and President Scott Berlucchi, FACHE, LNHA, Auburn Community Hospital has experienced a financial and operational turnaround. Berlucchi is known for his specialty in managing and growing small rural hospitals and has a proven track record for turning around struggling healthcare systems, as evidenced most recently by his leadership of ACH.

Today, ACH is both a Safety Net and Sole Community Provider Hospital offering a myriad of medical services to its patients. The health care center also encompasses the top-rated Finger Lakes Center for Living skilled nursing facility, three urgent care centers in the surrounding communities, and Auburn Memorial Medical Services, a multi-specialty physician group. Exciting additional services that will soon be offered at ACH include the new Auburn Heart Institute, Comprehensive Cancer Care Center, and Auburn Concussion Clinic, as well as new initiatives focusing on orthopedic care and excellence in nursing.

Reflecting on this exciting phase of expansion, Berlucchi emphasized the hard work of the entire team at ACH.

“The Center will provide needed care for the local community that they would otherwise have to travel long distances for and will also increase employment”

“We are taking care of our business. We could not do this without strong support from our Board of Trustees, led by Anthony Franceschelli, and an exceptional management team that has worked hard to transform our healthcare system. Demand for ACH’s services, utilization and growth continues to increase as we bring acute, post-acute and preventive care to members of our community. What I am most proud of is according to a recent study by The University of Wisconsin Population Health Institute, Cayuga County has experienced remarkable year over year improvements in health outcomes vs. other NYS counties over the last 10 years despite numerous challenging health factors. That means as the only health system in the area we are making a difference in our community when it comes to health outcomes,” he said.

LIFE-SAVING CANCER CARE
A recent partnership with Upstate Medical Center has allowed ACH to bring highly advanced specialty outpatient treatments closer to home for its patients, with the new comprehensive Cancer Center planned to open in January of 2024. The addition of the Cancer Center to ACH is aimed at directly improving the health and well being of the hospital’s patient population, as data indicates that cancer is the leading cause of premature death in Cayuga County. Additionally, according to Truven Health Analytics, 80% of residents in the surrounding area must travel further than 25 miles to receive medical oncology services.

To help alleviate these concerning circumstances, the Cancer Center allows patients to take advantage of “one-stop shopping” for their medical treatments, since the Cancer Center  is connected to the main hospital. Combined with the partnership of excellent SUNY Upstate cancer physicians, this increased convenience for patients will provide for more efficient, cost effective, and quality care right in their own community. Dr. Komal Akhtar, Medical Director for the new Cancer Center, has extensive training in Internal Medicine, Hematology and Medical Oncology, and is a member of the American Society of Clinical Oncology. She expressed her excitement about the impact the new Cancer Center will have on the area served by ACH.

“The Center will provide needed care for the local community that they would otherwise have to travel long distances for and will also increase employment,” she said. “The partnership with SUNY Upstate Cancer will provide world class care and lives will be saved because of the care given locally. This is the hospital’s highest priority and a critical part of our long-term sustainability as the largest employer in the area.”

INVESTMENTS IN CARDIAC CARE
Alongside the addition of the Cancer Center, ACH is enhancing the level of cardiovascular care for its patients with the new Auburn Heart Institute. Located in a newly renovated wing on the third floor of ACH, this multimillion-dollar investment in cardiac care will be led by Dr. Ronald Kirshner, who was recently appointed as its chair and medical director. Dr. Kirshner recently served as the Chief of Cardiac Services and Cardiothoracic Surgery at Rochester Regional Health Sands Constellation Heart Institute for over 30 years, and his clinical interests and expertise include creating systems to drive healthcare efficiency and quality.

After Berlucchi had asked Dr. Kirshner to come to ACH and recommend improvements to its cardiac care offerings, Dr. Kirshner found that for those in Auburn and Cayuga County, the risk of dying from heart disease is significantly higher than other parts of the state. He thus identified the need for a comprehensive cardiac care center at ACH, and the idea for the Auburn Heart Institute was born. The Heart Institute will offer many cardiac care services, from diagnostic testing to a cardiac catheterization laboratory, and the longterm vision is to perform procedures and surgeries at the facility.

Dr. Kirshner stated that he’s looking forward to continuing to build a strong team at the Heart Institute. “I’m excited about the opportunity to develop a world‐class heart institute in close collaboration with my colleagues and this community. We’re going to start out with the highest quality and that will be our North Star. Our goal is to make the Auburn Heart Institute a healthcare destination for cardiac care in Upstate New York. I’m committed to recruiting world-class cardiologists and other cardiac professionals to join our multidisciplinary team,” he said.

ENHANCEMENTS IN ORTHOPEDICS, NURSING AND MORE
Exciting new developments at ACH are certainly not limited to cancer and cardiac care. In the realm of orthopedic care, Dr. Daniel Alexander joined Auburn Orthopedic Specialists (AOS) in October of 2022, and he has over 20 years of experience performing more than 20,000 surgeries. He is laser focused on continuing to build a “patient first” orthopedic practice at ACH. “The team at AOS has built a first-class orthopedic practice, and I look forward to helping them grow this practice. All the surgeons in the AOS practice are doing remarkable work, and I’m impressed with the investments Auburn Community Hospital leadership has made in new technology to allow this practice to grow and serve this community. I’m excited, too, about working with our  local physicians and those healthcare professionals who are doing remarkable work in our operating rooms and in the various service areas offered throughout our healthcare system,” he stated.

Another important addition to the team at ACH is Dr. James Syrett, who joined the hospital in May of 2023 as the Chief Medical Officer. Board certified in both Emergency Medicine and EMS Medicine, Dr. Syrett has become only the third physician within a 100 mile radius of Auburn to be certified by ImPACT Applications Inc., a leading provider of concussion management tools, which helps ensure healthcare providers have the necessary skills and knowledge to use the tools effectively. Utilizing his extensive experience in EMS and Emergency Medicine, as well as an interest in the emergency management of concussions. Dr Syrett will serve as the Medical Director of the new Auburn Concussion Clinic, which opened in October and is seeing patients next day when referred from other physicians. This gives patients immediate access to concussion specialists, which is unusual in this region.

The groundbreaking growth of service offerings at ACH, from orthopedics to cancer care, cardiac care, and emergency concussion management, is also bringing about excitement and a new vision for the hospital’s nursing staff. Led by Dr. Emily Brooks, DNP, RN, who joined the leadership team at ACH as the new Chief Nursing Officer in June of 2023, the nursing staff’s goal is to serve the surrounding community with the utmost compassion and highest quality of  evidence-based care.

“We’re creating a culture of nursing excellence at Auburn Community Hospital,” Dr. Brooks explained. “We’re creating the best place for nurses to work in a healthy work environment. This will create a nursing workforce committed to delivering the very best evidence-based care. For every patient that comes into our hospital, the goal is to be able to care for them here, in their community. As such, we have developed the very first Auburn Community Hospital Nursing Strategic Plan. The focus is quality, patient experience, excellence, and nursing performance.”

BUILDING ON CURRENT GROWTH FOR FUTURE SUCCESS
Certainly, the focus on providing highquality health care for patients right in their own community that Dr. Brooks emphasized is already having an immensely positive impact.

Looking to the future, Berlucchi has a vision for ACH to build on this success in the surrounding community and partner with other area hospitals to better serve patients throughout the wider region, as well.

“We want to work with the other central New York hospitals to become more of a regional health care hub that partners to provide care for the growing population, in particular the increased healthcare needs of employees and family members of Micron when that ramps up. I’m also very concerned about the lack of sufficient mental health care in our area and plan on working with NYS, Cayuga County Health Department, and the other hospitals to develop a comprehensive plan to  serve the needs of those suffering from mental health challenges and addiction,” said Berlucchi.

However, for Berlucchi and the rest of the team at ACH, there is no limit
to how far ACH’s reach will extend and how many patients’ lives will be positively affected by the quality care being offered. “What’s happening right here in Auburn is that we are working together with our community, regional partners and our State and Local governments to build the model for rural community hospitals,'” Berlucchi said. “We’ll take care of Auburn. We’ll take care of Cayuga County. But mark my words, you’ll see a region that is growing and we are going to see the whole region coming to Auburn for the level of care that we’re providing.”

“What’s happening right here in Auburn is that we are working together with our community, regional partners and our State and Local governments to build the model for rural community hospitals,’” Berlucchi said. “We’ll take care of Auburn. We’ll take care of Cayuga County. But mark my words, you’ll see a region that is growing and we are going to see the whole region coming to Auburn for the level of care that we’re providing.”

 

Artificial Intellegence

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BY KATHRYN RUSCITTO, ADVISOR

We are planning a Heritage trip and have spent hours doing research. My daughter pulled up Chat GPT, gave it a few directions and in 30 seconds it listed an itinerary, things to visit, and lots of other info for consideration.

In a moment it became clear to me how Artificial Intelligence can augment my work. I still had to decide who, what, where, and when, but AI took the data that exists, boiled it down and gave me options to start with. It saved time, and while not perfect, gave me info I had not looked at prior.

Can AI do the same thing in health care? From chronic illness , to assisting in the development of new devices and drugs, can AI supplement clinicians work flow? Can it review charts and data, predict at risk patients, and match patients to treatments?

The current use of AI in some phone processes, has proven to be a barrier when a question did not fit the algorithms. In time, those early designs will be improved. For AI to work in health care, it needs to be integrated into clinician workflows, not added as yet another step. The debate about AI replacing human decisions is concerning and deserves consideration. But more likely it will free the workforce from analytical tasks and move to higher level thinking. In addition, other concerns relate to the bias of the data. But the advancement of AI will likely be similar to the integration of computers, smart phones and laptops into our daily lives. They didn’t replace humans, but a human without a smart phone or laptop does not have the advantages in easily accessing info and education. If AI can improve care for patients, by adding to the analytical knowledge of clinicians in an era of accelerated information and inventions, it will advance care.

I looked for some examples where AI is integrated in health care and found specialists are using AI in nephrology and cancer treatments. “Penny” at UPenn is helping clinicians with complex patients between visits, “The technology has the potential to improve patient health by guiding them through complex medication schedules, keeping clinicians routinely updated about a patient’s condition, and enabling clinicians to step in at early signs of trouble.” h t t p s : / / w w w. a a m c . o r g / n e w s / how-ai-helping-doctors communicate- patients.

Additionally there are many applications already in use for detecting disease through programs that analyze bacteria, and other disease criteria to lead to diagnosis and treatment in radiology, pathology and cancer treatments.

For clinicians to be comfortable with machine learning, or language learning that reads patient records and integrates info to recommend treatment, they will want a clear understanding of the quality of the ap’s learning. Also, it’s track record in making accurate diagnosis, and their ability to integrate their own clinical history and knowledge. The AMA cautions clinicians about bias and inaccuracy in todays AI algorithms, but notes it will continue to improve and tomorrows physicians will see a reduction in paperwork burden and back room operations from chart reviews to billing. https://www.ama assn.org/practice management/ digital/why generative-ai-chatgpt cannot- replace-physicians

In the past 100 years we have moved from an agrarian society, to an industrial society, to an age of information. We have now entered what is being called the age of knowledge, or the creative age. Understanding AI’s potential is our best advantage to adapting it in applications for health care.

Resources: https://www.jnj.com/inno ation/artificial-intelligence- in-healthcare &utm_source=goog

AI Won’t Replace Humans https://hbr.org/2023/08/a -wont-replace-humans- but-humans-with-ai-will replace-humans- without-ai

The Current State of AI in Healthcare: https://healthtechmagazin .net/article/2022/12/ ai-healthcare-2023-ml-nlp more-perfco

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynru citto or at krusct@gmail.com

 

Corporate Transparency Act

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On January 1, 2024, a new federal law, the Corporate Transparency Act (“CTA”), will go into effect. The main purpose of the CTA is to crack down on the proliferation of shell companies used as shields in money laundering, tax avoidance, and similar activities. However, the new reporting requirements will also compel most businesses created by filing documents with the Secretary of State to provide the information outlined in the CTA. Any business entity that must report to FinCEN is called a “reporting company” in the language of the CTA. The information will have to be reported to the Financial Crime Enforcement Network (“FinCEN”), which is part of the Department of Treasury.

There are three main parts to the new reporting requirements: beneficial ownership information (“BOI”), company applicants, and information about the reporting company itself. Reporting companies must submit the information of everyone possessing beneficial ownership. A beneficial owner is defined in the CTA as an “individual who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, exercises substantial control over the entity, or owns or controls 25 percent or more of the ownership interests of the entity or receives substantial economic benefits from the assets of the entity.1” While owning or controlling over 25 percent of the business entity is fairly straightforward, the definition of “substantial control” is less obvious. Within the CTA, the definition of substantial control is expansive. It includes, but is not limited to, any senior officers of the company, persons having authority over the appointment or removal of any senior officer or a majority of board members, persons who direct or have substantial influence over important decisions made by the entity or have control over an intermediary entity that exercises substantial control over a reporting company. Since the definition of a beneficial owner is expansive, careful consideration will have to be given to make sure everyone who meets the definition of a beneficial owner has their BOI entered into the FinCEN site.

A “company applicant” is the individual who files the application with the Secretary of State and, in addition, the person who directs or controls the filing if more than one individual is involved. However, at least at this point in time, there can only be two company applicants. The company applicants might not be anyone who works  for or controls the reporting company in question. The company applicant could, for instance, be the lawyer and paralegal hired to help bring the entity into existence. The company applicant information will only have to be submitted once.

The reporting company will need to disclose its 1) legal name, 2) DBA names, 3) business address, 4) state of formation, and 5) Taxpayer Identification Number. The beneficial owners of the reporting company will have to disclose their 1) legal name, 2) date of birth, 3) residential address, 4) unique number from an acceptable document such as a U.S. passport, state ID, or driver’s license, and 5) an image of that document.

The company applicants will need to disclose the same information as the beneficial owners with one potential difference: if the company applicant is registering the company in the course of the applicant’s business, such as lawyers, paralegals, or others, then the business address of the law firm will be substituted for the residential address. Also, the company applicant information will be required only for business entities that are formed on or after Jan. 1, 2024. The BOI will be required of all entities that are reporting companies regardless of their date of formation.

Businesses already in existence on Jan. 1, 2024, will have one year to file an initial report. For Businesses formed on or after Jan. 1, 2024, and before Jan. 1, 2025, an initial report must be provided to FinCEN within ninety days of formation. On and after Jan. 1, 2025, businesses will have to submit the required information within thirty days of formation. Another thing to note is that changes in beneficial ownership will need to be filed. Any changes in ownership or changes in organizational structure will require subsequent filings to keep the BOI up-to-date. Certain businesses are exempt from the reporting requirement, but most of these businesses are those in heavily regulated areas of finance. Otherwise, the important exemption to note is the “large operating company.” To qualify as such, a company needs 1) more than 20 full-time employees, 2) more than 5 million dollars in gross receipts/sales in the US, and 3) a commercial, physical street address in the US. All three of these elements must be met. For example, a business that]  operates online with no commercial, physical street address will not qualify for the exemption even if it has more than 20 employees and over 5 million dollars in gross receipts or sales. The other exemptions will be listed at the end of this post. While this legislation has mostly flown under the radar and might come as a surprise to many business owners, there is still time to prepare the necessary information. CCBLaw is here to help answer any questions and assist your business to ensure compliance with the CTA. In the meantime, to avoid potential civil and criminal penalties, entities that will qualify as reporting companies should make determinations as to who will be considered a beneficial owner under the CTA and gather the necessary information to submit to the FinCEN portal once it is active. Importantly, reporting companies will also want to consider who will have the responsibility of updating any changes in BOI to FinCEN because, as addressed above, as beneficial ownership changes, BOI is required to be updated within 30 days of any such change.

More links:
FinCEN website Small Entity Compliance Guide FinCEN contact page

Benjamin Goldberg is an associate at CCB Law, a boutique law firm focused on providing counsel to physicians and healthcare professionals. He can be reached at 315-477-6214 or bgoldberg@ccblaw.com.