To learn more about the specialty of family medicine, the AAFP’s positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit http://www.aafp.org/media-center.html
Governor Ducey Issues Executive Order to Increase Reporting of Opioid-Related Data
24-hour reporting requirement will give real time picture of overdose deaths
PHOENIX – Governor Doug Ducey today issued an executive order to increase the reporting of opioid-related data, allowing state health officials to have information within 24-hours. The order comes one week after the Governor’s emergency declaration to address the growing number of opioid deaths in Arizona.
“Last year alone, 790 Arizonans died from an opioid overdose – we’re in the midst of a public health emergency, and we must do all that we can to develop real, targeted solutions,” said Governor Ducey. “Through this enhanced surveillance, public health officials will be able to collect data in real-time to enhance our laser-like focus to treat addiction and prevent overdoses.”
“The data we receive now can be up to a year old,” said Dr. Cara Christ, director of the Arizona Department of Health Services. “That doesn’t give us a clear picture of what is happening every day. Today’s executive order will help us obtain timely data and get help to the people who need it in an effort to reduce opioid deaths.”
Opioids include heroin as well as prescription medication and are powerful painkillers that are highly addictive. Last year, an average of more than two people per day lost their lives to opioid misuse in Arizona. The trend shows an alarming increase of 74 percent over the past four years.
The Governor’s executive order requires those encountering opioid overdose related events to send their data to Arizona public health within 24-hours of the event. Those required to participate in the enhanced surveillance include:
- Licensed healthcare providers
- Administrator of a health care institution or correctional facility
- EMS/Ambulance to include:
- First response agencies
- Ground and air ambulance services
- Medical Examiners
The executive order directs multiple agencies to share information with the Arizona Department of Health Services to coordinate opioid prevention activities statewide.
The specific health conditions to be reported will include:
- Suspected opioid overdoses
- Suspected opioid deaths
- Naloxone doses administered in response to either condition
- Naloxone doses dispensed
- Neonatal abstinence syndrome
In addition to the 24-hour reporting requirements, the Arizona Department of Health Services’ public health laboratory is preparing to begin testing all blood samples from suspected opioid overdose deaths. The toxicology screening will help to bring more information on the kinds of opioids causing severe outcomes in Arizona. The department will begin work with hospitals and laboratories to develop a submission process and timeline for implementation following today’s executive order.
The Governor’s enhanced surveillance advisory for opioid overdose epidemic is provided in accordance with A.R.S.§36-782.B. This new required reporting will go into effect 48 hours from the issuance of this order. The order expires in 60 days. A copy of today’s executive order will be available on the department’s opioid website http://azhealth.gov/opioid.
MEMBERS IN THE NEWS:
Delivering Health-Care Services to People ‘Where They Need Them’
Two University of Arizona College of Medicine – Tucson programs that bring health care to rural, underserved communities in Arizona are reaching major milestones this year.
Contact: Jane Erikson, 520-334-9464, email@example.com
Aug. 16, 2016
TUCSON, Ariz. – Two University of Arizona College of Medicine – Tucson programs that bring health-care services to people in Arizona’s rural, underserved communities are reaching major milestones this year: the Mobile Health Program, launched in 1976, and the Arizona Telemedicine Program, which got its start in 1996.
Four decades of health care on wheels
The UA Mobile Health Program in the early days.
In October 1976, what was then the UA Rural Health Office launched the Mobile Health Program (MHP) with Augusto Ortiz, MD, a UA family physician, as medical director. Dr. Ortiz and his wife, Martha Ortiz, who managed clinic details, took their clinic on wheels – an RV donated by a Tucson missionary and outfitted with two small exam rooms – to such tiny communities as the Yaqui Pueblo and Picture Rocks northwest of Tucson; Continental and Amado, south of Green Valley; and later into Cochise County. Some families were so poor that their homes lacked electricity and running water. But the MHP payment policy was then what it is today: Pay if you can, and if you can’t, you still will get care.
The Ortizes, with their staff and volunteers, including medical students and resident-physician, as well as trained community health workers, known as promotoras, encouraged communities to establish their own clinics. Clinics thrive today in Picture Rocks, Continental and Amado.
Dr. Ortiz died in 2006, but Martha, now 92, continues to serve on the advisory board that advocates and raises funds for the program.
Martha Ortiz in 2013.
How much of a difference does the program make? Martha Ortiz recalls the experience of a young woman who had four miscarriages, before becoming pregnant a fifth time. A friend told her about the MHP, through which she received appropriate prenatal care for the first time. She carried her fetus full term, then gave birth to a perfectly healthy baby boy.
“For many individuals and families, the Mobile Health Program is the only place where they can get health care that they trust,” said Ravi Grivois-Shah, MD, MHP medical director and associate professor in the UA College of Medicine – Tucson’s Department of Family and Community Medicine, which now oversees the program.
“There always will be the need for this kind of program,” he said, “so our goal is to make our program sustainable into the future.”
Since its grass-roots beginnings, the UA Mobile Health Program has received financial support from the UA, Pima County, non-government organizations and private donors. Recent grants from Delta Dental of Arizona Foundation, Arizona’s First Things First child-development program and the March of Dimes support prenatal care, well baby check-ups and preventive dental care for children and adolescents in Tucson and surrounding communities. Both Banner Health and the UA Department of Family and Community Medicine provide additional funding.
“Family and Community Medicine is extremely proud of the Mobile Health Program’s service to our communities over the past 40 years,” said department head Myra Muramoto, MD, MPH. It also has enabled generations of medical students and other health professions students to experience the satisfaction of providing care to rural and underserved people. The Mobile Health Program truly brings together our department’s missions of service, teaching and community outreach.”
Two decades of long-distance health care
The Arizona Telemedicine Program is an international leader in the “virtual” delivery of health care and long-distance learning opportunities for patients, physicians and other health-care professionals.
But in 1993, the program was only an idea. Former state legislator Bob Burns, now a member of the Arizona Corporation Commission, learned about the benefits of telemedicine at a conference in Scottsdale that year. He presented the idea for a telemedicine pilot program to fellow legislators and then-UA College of Medicine Dean James E. Dalen, MD, MPH.
Dr. Ronald S. Weinstein
Dr. Dalen embraced the concept and appointed Ronald S. Weinstein, MD, as director, a title Dr. Weinstein still holds. The Arizona Legislature authorized funding for the Arizona Telemedicine Program (ATP) in June 1996. In July 1997, the program went live with its first two sites, Mariposa Clinic in Nogales, Ariz., and the state prison in Yuma.
One of the early cases at the Nogales clinic, now known as Mariposa Community Health Center, was that of a little girl with a serious viral infection. Her doctor was consulting with UA professor of pediatrics Ziad Shehab, MD, an infectious disease specialist. The little girl and her mother – who did not have a car – were in the room, and at the end of the consult, Dr. Shehab said to the child, “I’m so sorry I can’t give you a hug.”
The girl walked over to the monitor and gave it the biggest hug she could.
The child now is an adult – a tribute to the advances in viral disease care, to which Dr. Shehab is a widely recognized contributor, and the convenience of telemedicine, which made it possible for the girl to be seen by an expert.
In 2003, the ATP established the T-Health Institute in downtown Phoenix, to offer training programs and videoconferences on innovations in education and health-care delivery.
The Arizona Telemedicine Program is connected to 170 sites throughout Arizona.
ATP now is connected to 170 sites throughout Arizona. Specialists in a wide range of fields – trauma surgery, newborn intensive care, stroke diagnosis and care, ophthalmology, cancer treatment, burn care, behavioral health care and other specialties, as well as primary care – consult with their colleagues in almost every rural community in the state.
Outside the United States, ATP has helped establish telemedicine programs in Albania, Kosovo, Africa and Panama, and is exploring opportunities in other countries.
ATP has been recognized with numerous honors. In May, the U.S. Distance Learning Association honored the ATP for its “distance learning” sessions that physicians and other health-care professionals can log onto from around the state. The association’s highest individual award went to Bob Burns.
Asked if he had any idea 20 years ago what telemedicine would look like today, Dr. Weinstein said, “We would have recognized that in a decade the world would be very different. We just wouldn’t have been able to say precisely how that would be.”
Over the last 20 years, the Arizona Telemedicine Program and the Mobile Health Program have collaborated to provide eye care, prenatal care and other services to residents of Southern Arizona.
In 2004, the Arizona Department of Health Services and other funders awarded grants to ADVICE – the Arizona Diabetes Virtual Center of Excellence. The grants enabled the Mobile Health and Telemedicine programs to provide diabetes care, risk assessments, nutrition counseling and classes led by a certified diabetes educator to underserved communities ranging from Tuba City on the Navajo Nation, to Nogales, Ariz., where the Mariposa Community Health Center is located.
Mariposa’s team of promotoras helped diabetes patients understand their disease, made sure they got to their appointments, and helped patients connect with food banks and other services.
ATP’s distance-learning program made it possible for individuals around the state to learn from experts how best to live with diabetes – or prevent it from happening to them.
“I want to congratulate both the Mobile Health Program and the Arizona Telemedicine Program, which fulfill one of the highest priorities of the UA College of Medicine – Tucson: to provide all Arizonans with the preventive care and treatment they need to live healthy, productive lives – regardless of their economic status or where they live, said Charles “Chuck” Cairns, MD, dean of the UA College of Medicine – Tucson.
“These programs meet the critical health-care needs of diverse populations throughout Pima County and all of Arizona. They prove that we can efficiently bring medical resources to people where they need them.”
About the UA College of Medicine – Tucson
The University of Arizona College of Medicine – Tucson is advancing health and wellness through state-of-the-art medical education programs, groundbreaking research, and advancements in patient care in Arizona and across the United States. Founded in 1967, the College ranks among the top medical schools in the nation for research and primary care and is leading the way in academic medicine through its partnership with Banner – University Medicine, a new division of one of the largest nonprofit health-care systems in the country. For more information: http://medicine.arizona.edu
About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. The UA Health Sciences includes the UA Colleges of Medicine (Phoenix and Tucson), Nursing, Pharmacy and Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the growing Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, the UA Health Sciences reaches across the state of Arizona and the greater Southwest to provide cutting-edge health education, research, patient care and community outreach services. A major economic engine, the UA Health Sciences employs almost 5,000 people, has nearly 1,000 faculty members and garners more than $126 million in research grants and contracts annually. For more information: http://uahs.arizona.edu