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News Article | April 17, 2017

ChenMed, a privately owned medical, management and technology company transforming healthcare for seniors, today announced rapid completion of the strategic executive team expansion needed to further optimize growth and performance. “We are pleased to announce several notable additions to the ChenMed executive team,” says Christopher Chen, MD, ChenMed Chief Executive Officer. “George Wheeler and Donald Trexler round-out our six-person Market President team established during the past 12 months. Plus, Jim Whitling and Gaurov Dayal, MD, each bring highly relevant experience to their respective new roles as Chief of Human Resources, and as EVP, Chief of Strategy and Growth.” George Wheeler, Market President for JenCare Senior Medical Center in Virginia, joins ChenMed following years of distinguished service as Vice President, Managed Care and Contracting for the $3.5 billion Bon Secours Health System. He now has full P&L responsibility for the integrated medical practice that presently operates eight Virginia centers serving seniors living with multiple major and chronic health challenges. Donald Trexler, Market President for JenCare Louisiana similarly oversees the operation of four JenCare centers providing best-in-class care to New Orleans seniors. He joins ChenMed after effectively leading five different healthcare companies as CEO during the past two decades (Acadia General Hospital; Cypress Point Surgical Hospital; Baton Rouge Radiology Group; Southern California Orthopaedic Institute; Bienville Orthopaedic Specialists). Both George and Don report directly to ChenMed President Jeffrey Kang, MD.  Like their Market President peers (Jason Barker, South Florida; Frank Mancuso, Chicago; Thomas Davis, Atlanta; Dennis Skrajewski, Kentucky), they are responsible for improving health outcomes and patient satisfaction from the industry-leading levels already being achieved in their markets. George is based in Richmond, and Don is based in New Orleans. “Seniors in Louisiana and Virginia are truly blessed to have Don and George leading exceptional JenCare teams that are fully committed to providing the personalized service that’s vital to helping seniors enjoy more healthy days,” notes Dr. Jeff Kang, ChenMed President. Prior to his tenure at Bon Secours Health System, George distinguished himself as Vice President and General Manager for Universal American; and as Market President, Kansas and Missouri, for Humana Inc.  He also invested 17 years with Coventry Health Care, Inc., starting as Chief Financial Officer and Treasurer for its Southern Health Services company, and rising to serve as President and Chief Executive Officer Coventry Health of Kansas. Each of the hospitals and medical groups that Don led as CEO significantly improved profitability and patient satisfaction levels.  Don also provided expert counsel to multiple regional and national healthcare clients as a principal in an independent consulting agency. Jim Whitling now oversees all HR-related support for ChenMed.  Reporting to Dr. Chen, Jim brings almost two decades of experience as strategic advisor on all organizational and people-related matters to C-suite level executives at Alcon, a $6B division of Novartis, that specializes in eye-care related medical devices and pharmaceuticals (based in Fort Worth, Texas). As VP, Head of HR, Jim most recently supported the $3.5B commercial operations in the U.S. and Canada. In previous roles, he led the HR function for the Europe, Africa & Middle East region and the Global Manufacturing & Quality Assurance groups across all regions for 26 sites and 10,000 associates. “Years of double-digit growth and the absolute priority to effectively nurture our culture of servant leaders, make Jim an excellent choice to oversee Organizational Development, Talent Acquisition, Clinician Talent Acquisition, Learning and Development, Compensation and Benefits, Employment Compliance, and all HR-related support functions for ChenMed,” adds Dr. Chen. Gaurov, Dayal, MD, ChenMed EVP and Chief of Strategic Growth, will help identify and advance fertile business development opportunities enterprise wide for the ChenMed family of companies, and help further enhance the company’s already strong relationships with a variety of health plans. “Gaurov is an innovative and operationally focused leader with experience in population health, physician group operations, health plan operations, hospital operations and pharmacy benefits management operations,” explains Dr. Chen to whom Dr. Dayal also reports directly. “An authority on helping health organizations successfully make the journey from volume to value-based care, Gaurov’s clinic expertise is reinforced by the business and actuarial expertise needed to continually enhance technologies and clinical workflows to manage patient populations effectively.” In his previous role as Senior Vice President, Health Care System Solutions and Strategy for Lumeris, Inc., Gaurov helped large health care systems and provider groups create and sustain meaningful payer-provider partnerships focused on value based care and centered around primary care physician engagement. As President of Health Care Delivery, Finance and Integration for SSM Health Care/Dean Health System, Gaurov was operationally responsible for the $1.86B Dean Health Plan covering 400,000 lives; and for Navitus, a fully owned transparent pass through pharmacy benefit management company operating in 38 states and serving 4.2 million members. Gaurov also served as interim CEO for three Wisconsin hospitals, and was directly responsible for overseeing the post-merger integration for two companies he helped acquire.    About ChenMed ChenMed is a privately owned medical, management and technology company working to positively change American healthcare for the neediest populations.  Led and inspired by ChenMed Chairman and founder James Chen, MD, PhD, the company’s medical practice model has been serving low-to-moderate-income seniors with multiple complex chronic conditions for some 30 years.  ChenMed, which has grown by more than 420% since 2013, operates 39 dedicated medical centers in nine U.S. markets. The innovative company simultaneously provides operational support and risk focused end-to-end technologies to also help many independent medical practices deliver superior outcomes for seniors with Medicare Advantage.

Wong D.T.L.,Monash Medical Center | Wong D.T.L.,University of Adelaide | Ko B.S.,Monash Medical Center | Cameron J.D.,Monash Medical Center | And 9 more authors.
Journal of the American College of Cardiology | Year: 2013

Objective The purpose of this study was to assess the diagnostic accuracy of TAG320 in predicting functional stenosis severity evaluated by fractional flow reserve (FFR). Background: Coronary computed tomography angiography (CCTA) has limited specificity for predicting functionally significant stenoses. Recent studies suggest that contrast gradient attenuation along an arterial lesion, or transluminal attenuation gradient (TAG), may provide assessment of functional significance of coronary stenosis. The use of 320-detector row computed tomography (CT), enabling near isophasic, single-beat imaging of the entire coronary tree, may be ideal for TAG functional assessment of a coronary arterial stenosis. Methods: We assessed the diagnostic accuracy of TAG320 using 320-row CCTA with FFR for the evaluation of functional stenosis severity in consecutive patients undergoing invasive coronary angiography and FFR for stable chest pain. The luminal radiological contrast attenuation (Hounsfield units [HU]) was measured at 5-mm intervals along the artery from ostium to a distal level where the cross-sectional area decreased to <2.0 mm2. TAG320 was defined as the linear regression coefficient between luminal attenuation and axial distance. Functionally significant coronary stenosis was defined as ≤0.8 on FFR. Results: In our cohort of 54 patients (age 62.7 ± 8.7 years, 35 men, 78 vessels), TAG320 in FFR-significant vessels was significantly lower when compared with FFR nonsignificant vessels (-21 [-27; -16] vs. -11 [-16; -3] HU/10 mm, p ≤ 0.001). On receiver-operating characteristic analysis, a retrospectively determined TAG320 cutoff of -15.1 HU/10 mm predicted FFR ≤0.8 with (a bootstrapped resampled) a sensitivity of 77%, specificity of 74%, positive predictive value of 67%, and negative predictive value of 86%. The combined TAG320 and CCTA assessment had an area under the curve of 0.88. There was incremental value of adding TAG320 to CCTA assessment for detection of significant FFR by Wald test (p = 0.0001) and integrated discrimination improvement index (0.11, p = 0.002). Conclusions Assessment of TAG320 with a 320-detector row CT provides acceptable prediction of invasive FFR and may provide a noninvasive modality for detecting functionally significant coronary stenoses. Combined TAG320 and CCTA assessment may have incremental predictive value over CCTA alone for detecting functionally significant coronary arterial stenoses; however, larger studies are required to determine the benefit of combined TAG320 and CCTA assessment. © 2013 by the American College of Cardiology Foundation.

Melbourne Health, Austin Health and Southern Health | Date: 2011-05-11

The present invention relates generally to viral variants exhibiting reduced sensitivity to particular agents and/or reduced interactivity with immunological reagents. More particularly, the present invention is directed to hepatitis B virus (HBV) variants exhibiting complete or partial resistance to nucleoside analogs and/or reduced interactivity with antibodies to viral surface components including reduced sensitivity to these antibodies. The present invention further contemplates assays for detecting such viral variants, which assays are useful in monitoring anti-viral therapeutic regimens and in developing new or modified vaccines directed against viral agents an in particular HBV variants. The present invention also contemplates the use of the viral variants to screen for agents capable of inhibiting infection, replication and/or release of the virus.

Melbourne Health, Austin Health and Southern Health | Date: 2012-05-23

The present invention relates to methods for determining the potential of hepatitis B virus, HBV, variants to exhibit reduced sensitivity to Adefovir dipivoxil, ADV, and/or Tenofovir, TFV. The present invention is also directed to isolated HBV variants exhibiting decreased sensitivity to ADV and/or TFV. The present invention further contemplates methods for detecting agents having inhibitory activity to such viral variants, as well as the uses of such viral variants in the rational design of anti-HBV agents and in the manufacture of medicaments for the treatment and/or prophylaxis of HBV infection.

Melbourne Health, Austin Health, Southern Health, St. Vincents Hospital Melbourne Ltd. trading as St. Vincents Hospital Melbourne and Alfred Health | Date: 2012-01-11

The present invention relates generally to viral variants exhibiting reduced sensitivity to particular agents and/or reduced interactivity with immunological reagents. More particularly, the present invention is directed to hepatitis B virus (HBV) variants exhibiting complete or partial resistance to nucleoside or nucleotide analogs and/or reduced interactivity with antibodies to viral surface components including reduced sensitivity to these antibodies. The present invention further contemplates assays for detecting such viral variants, which assays are useful in monitoring anti-viral therapeutic regimens and in developing new or modified vaccines directed against viral agents and in particular HBV variants. The present invention also contemplates the use of the viral variants to screen for and/or develop or design agents capable of inhibiting infection, replication and/or release of the virus.

Goergen S.K.,Southern Health | Rumbold G.,Monash University | Compton G.,Southern Health | Harris C.,Monash University
Radiology | Year: 2010

Purpose: To systematically review evidence about the relationship between metformin administration and the use of iodinated contrast medium and risk of lactic acidosis (LA) and to assess the quality of five current guidelines for use of contrast medium in patients who are taking metformin. Materials and Methods: A search strategy was developed by using search terms related to metformin, contrast media, and LA. Searches were conducted in MEDLINE (Ovid), all Evidence-based Medicine Reviews (Ovid), EMBASE, and Cochrane library databases and were augmented with searches for evidence-based guidelines on radiology and evidence-based medicine Web sites by using the Google Internet search engine. Guidelines were appraised by two independent reviewers by using the Appraisal of Guidelines Research and Evaluation Collaboration Instrument. Other studies were appraised by using structured appraisal checklists. Results: Five guidelines were identified and five empirical studies met inclusion criteria. All guidelines had poor scores on some Appraisal of Guidelines for Research and Evaluation (AGREE) Collaboration criteria; poorer scores tended to occur in relation to objective assessment of rigor of guideline development, editorial independence, and applicability of the guideline to clinical practice. Lack of agreement was observed among guidelines about the need to stop taking metformin after contrast medium is administered, risk of LA in patients with normal renal function before contrast medium injection, recommended method of measuring renal function, and values used to define abnormal function. The evidence that was used as a basis for determining the guidelines for metformin administration, use of contrast medium, and risk of LA consisted of a limited number of observational studies, including case reports, summaries of case reports, and case series (National Health and Medical Research Council of Australia level IV-V evidence). More important, it was not apparent that a systematic search strategy had been used to identify the studies referenced by the guidelines nor that the referenced studies had been appraised. Individual guideline recommendations were not clearly connected to cited references. Conclusion: Substantial inconsistencies exist between the recommendations of the five international guidelines about contrast medium administration in patients who are taking metformin. These are, in part, caused by the low level of evidence underpinning guideline recommendations. © RSNA, 2010.

Sehgal A.,Monash Childrens Hospital | Sehgal A.,Monash University | Doctor T.,Monash Childrens Hospital | Menahem S.,Monash University | Menahem S.,Southern Health
Journal of Pediatrics | Year: 2013

Objective To investigate the differences in cardiac function and arterial biophysical properties between term-born appropriate for gestational age (AGA) infants and small for gestational age (SGA) infants. Our hypothesis was that adaptation to intrauterine growth restriction induces changes in cardiac and arterial indices. Study design This was a prospective observational echocardiographic evaluation of cardiac and arterial indices in SGA infants and AGA infants. Demographic and echocardiographic data were compared between 20 inborn term SGA infants with birth weight <3rd percentile for gestational age and 20 AGA infants. Results The Ponderal index was significantly lower and blood pressure was significantly higher in the SGA infants compared with the AGA infants. Left ventricular output was lower in the SGA infants (170 ± 31 mL/kg/min vs 197 ± 39 mL/kg/min). Diastolic dysfunction was greater in the SGA infants (ie, reduced E and A wave velocities, higher E/A ratio [1.08 ± 0.16 vs 0.85 ± 0.07], and prolonged isovolumic relaxation time [73 ± 6.2 ms vs 62.6 ± 3.6 ms]). Aortic intima-media thickness was significantly greater in the SGA infants (822 ± 105 μm vs 694 ± 52 μm), as were arterial wall stiffness index and input impedance. Conclusion Cardiac function and arterial biophysical properties were altered in the SGA infants. The findings complement the information on the association between in utero growth and cardiovascular morbidity in later life. © 2013 Mosby Inc. All rights reserved.

Nguyen E.V.,Southern Health | Heggie A.A.C.,Epworth Hospital
International Journal of Oral and Maxillofacial Surgery | Year: 2015

To the authors' knowledge, avascular necrosis of the midface secondary to disseminated intravascular coagulation has yet to be described following a hypoxic syncopal episode secondary to 'heat stroke'. A slow, progressive loss of anterior maxillary bone and the collapse of the nasal dorsum in a healthy young man with no other known medical co-morbidities led to the diagnosis. Following debridement, a staged reconstruction of the maxilla-nasal complex was successfully performed. © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Yamin S.,Southern Health | Vaddadi K.,Monash Medical Center
International Review of Psychiatry | Year: 2010

Pharmacological intervention using antipsychotic agents is the cornerstone of treatment in schizophrenia. Polypharmacy and the use of higher doses is often practised in the hope of getting better symptom control in multi-episode, chronically unwell, people with schizophrenia. However, these regimes often pose unacceptable and at times dangerous risks. The current review examines the factors that influence dosing and argues that optimization is transient and needs ongoing consideration throughout the course of the illness. What is defined as 'the optimal dose' changes over the course of the illness and this should be reflected in treatment. The evidence presented in the current paper suggests that given the negative symptoms associated with neuroleptic medication, dosage should be discussed as part of the case review process and dosage should be systematically reduced as part of the standard treatment protocol. A case-study is presented of a patient who had her dosage of clozapine reduced and the subsequent health and lifestyle benefits from this reduction. We argue that the focus needs to be shifted away from the specific aim of treatment of psychotic symptoms to a more holistic view of treatment that incorporates function and psychosocial function as a measure of improvement. © 2010 Institute of Psychiatry.

Joseph S.J.,Southern Health | Harvey J.N.,Southern Health
Journal of Hand Surgery | Year: 2011

Purpose: Extensor tendon injury after osteosynthesis of distal radius fractures is a well-documented complication. It has been shown to be associated with screw protrusion through the dorsal cortex, or plunging of the drill bit into the overlying tendon. It is difficult to determine screw length and protrusion using the standard anteroposterior and lateral intraoperative fluoroscopic images because of the triangular configuration of the distal radius and Lister tubercle. In fractures with a coronal split, it may be necessary to lag the dorsal fragment, necessitating longer screws and risking screw protrusion beyond the dorsal cortex. For these fractures, we use a radiographic view aimed along the long axis of the radius to detect screw protrusion. Methods: This was a retrospective case series involving 15 distal radius fractures. To obtain the dorsal horizon view, the wrist is hyperflexed and the beam of the image intensifier is aimed along the long axis of the radius. We evaluated 15 distal radius fractures with a coronal split component, where the dorsal horizon view was used to detect dorsal cortex screw protrusion. This view was used intraoperatively following the use of the standard views. We evaluated records and imaging to ascertain whether the use of this radiograph led to a change in intraoperative screw selection. Results: Of the 15 cases, we changed screw selection as a result of the additional view in 4 patients. In 3 of these cases, the screw length was long, which was not apparent on standard intraoperative fluoroscopic views. Conclusions: The use of the dorsal horizon view is a useful adjunct to prevent screw protrusion beyond the dorsal cortex when performing osteosynthesis of the distal radius. © 2011 American Society for Surgery of the Hand. All rights reserved.

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