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Fall 2011


Continuing to Reach For Quality and Efficiency in Ways Old and New

Tony Mira
President and CEO

Health information technology has become the colossus of high quality, high- efficiency medical practice. Anesthesia Business Consultants continues to expand our resources in the area of HIT—as do all of you. With the lead article in this issue of the Communique?, we introduce to you a major new resource: Bryan Sullivan, Director, EMR and Clinical Integration. Bryan’s article on cloud computing explains an important direction in which HIT is moving.

Anesthesiology is on its way to becoming a complete perioperative discipline—as it must, in an environment that will be dominated by integrated, accountable healthcare delivery systems. Richard P. Dutton, MD, MBA, Executive Director of the Anesthesia Quality Institute, describes the role of the AQI in pre- and post-anesthesia assessment in his latest article. In the write-up of his interview with Parish Management Consultants’ Al Patin, “Anesthesia Leadership in the Preoperative Clinic,” ABC Vice President of Client Services Bart Edwards shares what he recently learned about launching a preoperative evaluation service.

The role of first-rate preoperative anesthesia assessment assumes even greater importance as more and more surgery moves to the office setting. Fred E. Shapiro, D.O. co-founded the Institute for Safety in Office-Based Surgery (ISOBS) to raise the standard of quality of anesthesia provided in the office setting. Only 23 states regulate office-based anesthesia, so there is certainly a need for voluntary safety efforts like the ISOBS. One of the major contributions made by this new organization to date is the Safety Checklist discussed in Dr. Shapiro’s article. The Safety Checklist is also referenced in “Putting Your Anesthesiology Practice on Wheels,” an account by Shawn Michael DeRemer, MD and Gregg M. White, CRNA, MS of how their company in Portland, OR created a successful mobile anesthesia service.

In the final article of this issue, our legal contributor, Neda Mirafzali, Esq., takes up the controversial matter of the targeting of anesthesia supervision in CMS’ Plan for Retrospective Review of Existing Rules.

As the number of articles contributed by anesthesiologists, lawyers and other independent professionals grows, the range of opinions is more obvious in its width. Perspectives on the autonomy of nurse anesthetists, on the safety of certain procedures or sites of service, and yes, on how the law might apply to a given set of circumstances differ. Our role is to provide you, the reader, with information, and information includes the opinions of others. We do not edit and nor do we necessarily endorse the general tenor or any bias of third-party articles, although we do edit for factual accuracy. You are certainly capable of evaluating the information offered for yourselves. If you agree or disagree with something that you read in these pages strongly enough to write us a letter or perhaps even an article of your own, we will be pleased to consider publishing your response in the next issue of the Communique?, if it adds new information to the topic. For that matter, if you would like to submit an article introducing a new topic, we would be very happy to hear from you.

With Best Wishes,

Tony Mira
President and CEO