Latest News 


  • October 11, 2016 11:01 AM | Sally Winkelman (Administrator)

    September 2016, WISHIN Connections

    Medicaid prescription-fill data for Wisconsin Medicaid members is now included in WISHIN Pulse, the statewide community health record. Medicaid prescription-fill history dating back to May 1, 2015, has been loaded into WISHIN Pulse and the data is being refreshed twice daily from the Medicaid pharmacy claims system, thus providing near-real-time prescription information to support better informed patient care and safety for Medicaid patients.

    "We are constantly adding new participants and data sources to WISHIN Pulse to provide value to our participants and the patients they serve," says Joe Kachelski, CEO of WISHIN. The addition of Medicaid prescription-fill data substantially enhances the clinical data available through WISHIN Pulse.

    "With hundreds of thousands of Wisconsinites covered by Medicaid, the addition of up-to-date prescription information is going to add substantially to the value of WISHIN Pulse."

    Providers using the WISHIN Pulse system will be able to view Medicaid prescriptions in a tab under the "medications" section. WISHIN Pulse also includes information such as diagnoses, immunizations, lab results, care plans, and visit summaries.  In addition, WISHIN Pulse has integrated with the state's Prescription Drug Monitoring Program (PDMP) to allow clinicians to see a patient's history of controlled-substance prescriptions without having to log on to the state's system and separately search for a patient.

    WISHIN Pulse users should be aware that the data displayed represents the vast majority of drugs paid for by Medicaid. However, it possible that in the transmission process a small number of records may fail to immediately load.  It is also possible that prescription-drug claims may be reversed after appearing in WISHIN Pulse. 
  • October 11, 2016 10:59 AM | Sally Winkelman (Administrator)

    Join WHN on October 18 when insurance leaders will discuss exchanges, narrow networks and more during a roundtable discussion moderated by Wisconsin Health News Editor Tim Stumm. Panelists include: 

    • Julie Brussow, CEO, Security Health Plan 
    • Dustin Hinton, CEO, UnitedHealthcare Wisconsin
    • Sherry Husa, CEO, MHS Health Wisconsin
    • Paul Nobile, President, Anthem Blue Cross and Blue Shield in Wisconsin 


    Tuesday, Oct. 18, 2016
    11:30 am to 1 pm - discussion begins at noon
    Madison Club; 5 E Wilson St.; Madison, WI 53703
    Register now

  • October 11, 2016 10:57 AM | Sally Winkelman (Administrator)

    The Wisconsin Council on Medical Education & Workforce (WCMEW) and the Wisconsin Area Health Education Center (AHEC) System invite you to register for Interprofessional Collaborations: Advancing Wisconsin’s Healthcare and Education, an interprofessional conference.

    This Thursday-Friday conference is designed to bring together educational institutions and health care facilities from across Wisconsin. The event is being presented through a partnership of AHEC and WCMEW. The conference will take place on Thursday, Nov. 10 and Friday, Nov. 11, 2016, at the Marriott West in Madison.

    Register here for the conference and access more information including the agenda, event details and learning objectives. The conference room rate of $139 has been negotiated for a block of hotel rooms at the Marriott. The room block will be held until October 12.

  • October 10, 2016 4:02 PM | Sally Winkelman (Administrator)

    September 2016, WISHIN Connections

    In many cases, Medicaid health plans and other payers are not aware of their members' Emergency Department (ED) or other hospital admits or discharges unless they make arrangements individually with each hospital to get notifications or until the claim resulting from the visit is received, which may take up to 30 days. 

    The Patient Activity Report for Payers (PAR-P) provides daily notifications of patient hospital or ED visits to payers. The report, which includes admission, discharge and transfer (ADT) information, was created to help payers follow up proactively and timely with members who have visited a hospital or ED. The PAR-P can help to assure compliance with care plans, avoid preventable re-admissions, prevent duplicative testing and procedures and connect targeted Medicaid ED visitors with medical homes or appropriate follow-up care.

    Working in Partnership for Improved Care Coordination

    The PAR-P project was developed by the WISHIN team with input from payers and completed in partnership with and supported by funding from the Wisconsin Department of Health Services (DHS). The first sites, Medicaid health plans serving certain members in Milwaukee, went live in April 2015. Many of the health plans chose to include members beyond those in the pilot population.

    In September 2015 a survey was distributed to the pilot sites to gather feedback on the organizations' experiences with PAR-P and what they would like to see in Phase 2.

    More than 80% of respondents indicated that they found the PAR report useful and timely. When asked how the patient care coordination process changed with information from the report one respondent commented that the follow-up process has been made easier by having the most recent demographic information on a patient. The respondent continued,

    "It also allows us better access to patients that have been floundering in the system without access to a [primary care physician (PCP)] due to their own lack of knowledge. The hospital inpatient notification has allowed us to share this information with their PCP and obtain referrals to our care coordination team for temporary or permanent placement into a care coordination or disease management program. These patients in the past were typically lost until they presented to an office and at that point their disease may have progressed needlessly."

    Phase 2 Improvements

    By the request of the pilot sites, the PAR is now delivered to an sFTP folder rather than via secure email. The sFTP folder process can simplify health plans' workflows so that their systems can automatically retrieve the file from the folder rather than taking multiple steps to open secure emails and download the files.

    Additional Phase 2 improvements were made to provide more details to payers receiving the report to clearly indicate what event triggered the PAR. For example, event identifiers were added to encounters including whether the notification is being sent because of an admission, discharge or change in demographics, or change in diagnoses. Furthermore, five new data elements have been added to PAR-P: event type, discharge date & time, discharge disposition, internal visit/account numbers and the primary-care physician. With the addition of these details, case managers can quickly move through their workflow rather than spending time identifying why the report was generated or tracking down contact and other information critical to a swift follow-up.

    WISHIN is pleased about the potential of the PAR-P report to connect health plans and their members to accelerate and improve care. The addition of the PAR-P to WISHIN's services builds on its mission to promote and improve the health of all communities and patients in Wisconsin. 

    If you have questions about the PAR-P's capabilities and uses or would like to find out if your organization could use the report, contact WISHIN at wishin@wishin.org or (608)274-1820.
  • October 07, 2016 11:24 AM | Sally Winkelman (Administrator)

    September 29, WMS Medigram

    Six “Town Hall Meetings” are scheduled during the next two weeks to provide Wisconsin Medical Society members and their health care teams more information about the Society’s new Association Health Plan (Plan).

    The Plan was created to continue to serve Society members in the changing health insurance market. It provides a range of options, allowing groups to offer as many as six of eight plan designs to their employees. Wisconsin Medical Society Insurance and Financial Services, Inc. is the Plan’s sole broker and WPS is the insurance carrier.

    During each meeting, Insurance Advisor Chris Noffke will present the Plan’s benefit options and underwriting requirements. The presentation is designed to help human resources staff, office managers and administrative personnel guide their employees through the online application process. The meetings are:

    • Monday, Oct. 3 at NeuroSpine Center of Wisconsin, 5320 W. Michaels Drive, Appleton, WI 54913. Presentations will be at 10 am and 3 pm
    • Wednesday, Oct. 5 at OakLeaf Surgical Hospital—River Prairie Conference Room, 1000 OakLeaf Way, Altoona, WI, 54720. Enter through door #2 and follow the signs to the conference room. Presentations will be at 10 am and 12 pm
    • Wednesday, Oct. 12 at Wisconsin Medical Society—Milwaukee Office, 6737 W. Washington Street, Suite 1120, West Allis, WI 53214. Presentations will be at 10 am and 3 pm

    There is no cost to participate but seating is limited. To register or for more information, please e-mail ​Chris Noffke.

  • October 07, 2016 11:15 AM | Sally Winkelman (Administrator)

    September 29, WMS Medigram

    The Wisconsin Medical Society has been named to a new Task Force on Opioid Abuse announced by Governor Scott Walker last Friday. The announcement came after Gov. Walker issued ​Executive Order #214, which also appoints several agency secretaries, or their designees, to the task force.

    “We’ve recently seen opioid use and abuse escalate throughout Wisconsin,” said Gov. Walker. “The bottom line is this has become an epidemic and every year we see more people dying from opioid overdose. We’ve taken serious steps in the past to combat opioid abuse in Wisconsin, including signing Heroin Opiate Prevention and Education, or H.O.P.E., legislation into law last spring, and issuing a standing order allowing naloxone to be dispensed without individual prescriptions. These efforts are saving lives and helping people get the support they need to recover. Our announcement today about the creation of the Governor’s Task Force on Opioid Abuse demonstrates our unified efforts and brings us closer to our goal of ending opioid abuse and overdose in Wisconsin.”

    The task force will meet in the coming weeks and months to advance work already being done to combat opioid abuse, and to make additional recommendations to end the opioid crisis in Wisconsin. Lieutenant Governor Rebecca Kleefisch and Rep. John Nygren will serve as co-chairs. Other participants include Attorney General Brad Schimmel, representatives from law enforcement and public health, the Wisconsin Hospital Association, the Pharmacy Society of Wisconsin and the Wisconsin Coalition for Prescription Drug Abuse Reduction, and legislators and members of the public.

    “One of the strengths of Wisconsin’s strategy in fighting the opioid abuse epidemic is the collaboration among elected officials, law enforcement, physicians and other health care groups. We all bring different perspectives and experiences about this crisis and we all learn from one another,” said Society Chief Medical Officer Donn Dexter, MD. “Governor Walker’s action this morning will enhance these efforts even further. Coordinating government agencies’ statewide reach with health professionals’ knowledge will maximize our ability to make progress by saving lives.”

    More information about the task force is included in this ​press release.

  • October 07, 2016 11:08 AM | Sally Winkelman (Administrator)

    September 26, Wisconsin Health News

    The chair of the state's Medical Examining Board said last week that he expects doctors should be able to obtain a license under the interstate licensure compact in January.

    "We want to be issuing the first licenses by Jan. 1," said Dr. Kenneth Simons, who called it a conservative timeline. Simons serves as one of the state's commissioners for the group developing the compact. 

  • October 06, 2016 10:12 AM | Sally Winkelman (Administrator)

    Warning to all first responders, including Law Enforcement and canine officers - Dermal and mucosal exposure is significant.  Carfentanil has not been found in WI yet. When large vet anesthesiologists handle this, always in small quantities, they have emergency providers standing by with a box of Narcan.  Any accidental exposure requires presumptive treatment, even without any symptoms, of 2mg IM every 3 minutes until an IV can be established and they get to the ED. Read more on the recent DEA warning. 

  • October 01, 2016 11:42 AM | Sally Winkelman (Administrator)

    New Epinephrine Labeling:
    There has been a change to the labeling of epinephrine. Epi 1:1000 used for anaphylaxis and asthma is now labeled 1.0mg/ml. Epi 1:10,000 used for cardiac arrests is now labeled 0.1 mg/ml. There has been concern that the current labeling caused confusion and inappropriate dosing. 

    New Crowding Solutions Resource: 
    A new information paper on the causes, impacts and solutions to the crowding and boarding problem has been approved by the Board of Directors.  Members are encouraged to distribute this reader-friendly paper to their hospital administrators or local policymakers who may benefit from a better understanding of why they must, and how they can, address this vexing and dangerous problem. A link to the new paper entitled “Emergency Department Crowding: High Impact Solutions” is available at: https://www.acep.org/Clinical---Practice-Management/Emergency-Medicine-Crowding-and-Boarding/

    Blood Clot Information for Patients Developed:

    ACEP (through an educational grant from Bristol Myers Squibb) is providing UNBRANDED resources to patients with newly diagnosed VTE/PE. The program provides text messages to connect patients to video based education which discusses the importance of taking medication and getting follow up. No product name is mentioned or implied. The program is called Know Blood Clots, and is explained on the website www.knowbloodclots.com. Patients can also text CLOTWEB to 412-652-3744 to sign up for the Know Blood Clots program. If you have questions, feel free to email sschneider@acep.org and I will try to supply further details.

    New Sections at ACEP:
    A sufficient number of members have come together to officially form three new Sections in the College. The Pain Management Section was formed earlier this year and is now being followed by the creation of the Medical Directors Section and the Event Medicine Section. The new Sections will meet at ACEP16 for the first time. Members interested in any of these topics are invited to attend the Section meetings and/or join the new Sections. 

  • September 21, 2016 11:54 AM | Sally Winkelman (Administrator)

    Bobby Redwood, M.D., M.P.H.
    President
    Wisconsin Chapter, American College of Emergency Physicians


    For the past two years, national ACEP has released five practice changing recommendations each October under their Choosing Wisely Campaign. These recommendations (see below) represent ways that the emergency physician can contribute to the triple aim of efficient, equitable, and patient-centered care. Inspired by ACEP's campaign, my group began to practice these ten recommendations routinely in our rural emergency department with a consensus that we feel more career fulfillment after agreeing to follow these evidence-based, patient-centered practices.

    The current Choosing Wisely recommendations are written for a national audience. Given that regional practice patterns vary widely, my question for our membership this October is this: What would Wisconsin-specific choosing wisely recommendations look-like? Are there evidence-based, best EM practices being implemented in your ED that exemplify the triple aim? Are you willing to share? Send your recommendations to WACEP@badgerbay.co. With you help, we at Wisconsin ACEP can publish our own local edition of the Choosing Wisely Campaign for the Badger State! 

    For your reference, ACEP's Choosing Wisely to date: 

    1. Avoid computed tomography (CT) scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.
    2. Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can void, or for patient or staff convenience.
    3. Don't delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit. 
    4. Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up.*
    5. Avoid instituting intravenous (IV) fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration in children.
    6. Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma and a normal neurological evaluation.
    7. Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria (PERC) or a negative D-dimer.
    8. Avoid lumbar spine imaging in the emergency department for adults with non-traumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition (such as vertebral infection, cauda equina syndrome, or cancer with bony metastasis).
    9. Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis.
    10. Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department (ED) patients (age <50) with known histories of kidney stones, or ureterolithiasis, presenting with symptoms consistent with uncomplicated renal colic. 
    *a recent NEJM study by Talan et al has revived this as a topic of discussion