RISK MANAGEMENT AND THE USE OF HYPERBARIC OXYGEN CHAMBERS

Special Report from the Safety Committee

TOM WORKMAN and JIM BELL, UHMS Safety Committee

Over the past four decades we have seen a geometric growth in the number of clinical hyperbaric medicine facilities. The numbers have grown, from approximately 27 facilities in the early 1970s to now more than 1,350 hospital-based programs. There is no reliable estimate of the number of non-hospital based facilities in operation. For the most part, facilities that are a part of a healthcare system are well regulated; those in non-healthcare rated occupancies, such as health spas, commercial office buildings and homes, much less so.

Areas of concern

A segment of the community that presents the highest level of concern is based on the use of portable, fabric, low-pressure hyperbaric chambers that do not meet existing safety codes such as the National Fire Protection Association (NFPA) 99, Health Care Facilities Code. These types of chambers, while cleared by the FDA as a Class II medical device,
do not comply with American Society of Mechanical Engineers, Pressure Vessels for Human Occupancy -1 (ASME PVHO-1) hyperbaric chamber design and fabrication code (as required by NFPA 99) nor with the installation and operational requirements mandated in NFPA 99.

A confounding problem is that local authorities having jurisdiction (AHJs) are not aware that these devices are being used in their jurisdiction. When a traditional hyperbaric chamber is installed, installation permits, and other paperwork are required, and accordingly, AHJs are appropriately notified. There is no comparable notification process for these low-pressure chambers, as they are delivered by a commercial carrier (such as FedEx) and require no traditional installation. Plus, they can be operational within 15-30 minutes of receipt. Because of this, there is no mechanism to notify the AHJ of their presence, and thus they routinely operate “under the radar” of the established regulatory community. There are estimated to be more than 10,000 such hyperbaric chambers in use throughout the country.

Additional examples of non-compliance . . .

Other examples of non-compliance to NFPA 99 are numerous. For example, NFPA 99 requires that the exhaust from a hyperbaric chamber be piped to the exterior of the building housing the chamber. These low-pressure chambers, however, vent to the ambient space in the room in which they are located.

Perhaps the most concerning risk is that these chambers are frequently used with oxygen concentrators to increase the concentration of oxygen that the patient breathes while in the chamber. When used in this configuration, the concentration of oxygen inside the chamber often exceeds the NFPA 99 limit of 23.5%. Operation of hyperbaric chambers with atmospheres containing more than 23.5% oxygen requires the patient to be grounded. Patients treated in these portable chambers are rarely, if ever, electrically grounded. This is exacerbated by facility operators who encourage or allow patients to take into the chamber with them their tablet, cell phone, laptop, and similar devices. The use of these types of electrical devices in a hyperbaric chamber is strictly prohibited by NAPA 99.

. . . and a recent example

The death of a young autistic boy from North Carolina (June 9, 2011) might have been avoided had these low-pressure chambers been regulated as required. As noted above, they do not comply with the well-established design and fabrication code, ASME PVHO-1, Safety Standard for Pressure Vessels for Human Occupancy. North Carolina mandates compliance to this code. NFPA 99 mandates compliance to this code. The Life Safety Code (NFPA 101) invokes compliance to the hyperbaric requirements noted in NFPA 99, which also mandates compliance through reference. Therefore, if properly regulated, hyperbaric chambers of this type would not have been allowed to operate in North Carolina.

The National Fire Protection Association recently highlighted the importance of this issue in the January/February issue of its magazine, NFPA Journal. The story, entitled “The Air In There,” provides a general overview of the hazards and challenges associated with hyperbaric chambers and informs local authorities having jurisdiction about the magnitude of the problem while offering suggestions on how to deal with it.

“This is an area of health care that a lot of AHJs may not know that much about,” said Scott Sutherland, executive editor of NFPA Journal. “With these types of facilities proliferating, though, it’s important for AHJs to understand the potential hazards. I think our story does a good job of describing those hazards and of explaining why this is an area of concern right now.”

Read the complete NFPA Journal story at http://www.nfpa.org/news-and-research/publications/nfpa-journal/2017/january-february-2017/features/hyperbaric-chambers

The Food and Drug Administration (FDA) has posted a consumer update – “Hyperbaric Oxygen Therapy: Don’t Be Misled” –  for the use hyperbaric oxygen on its website http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm364687.htm

It’s a growing concern

A casual search of the internet demonstrates the prolific use of low- pressure fabric chambers for indications that have not been proven. At the time of the posting the FDA had received 27 complaints from consumers over three years about treatment centers promoting hyperbaric chambers for uses not cleared by the agency.

Low-pressure fabric chambers are designed and have an FDA 510(K) premarket notification to be pressurized with air to treat acute mountain sickness. They are not built to ASME PVHO or NFPA 99 codes. However, they are routinely being operated outside of the FDA approval and NFPA codes and standards. The use of these chambers is sometimes referred to as mild hyperbaric oxygen therapy (mHBOT).

From a position of risk management we do not support the use of low-pressure portable fabric chambers for anything other than acute mountain sickness. Clinical hyperbaric oxygen therapy as defined by the Undersea and Hyperbaric Medical Society, Hyperbaric Oxygen Therapy Indications, 13th edition, requires that the patient breathe near 100% oxygen while inside a chamber pressurized to at least 1.5 atmospheres absolute. The low-pressure fabric chambers are not designed to provide this clinical dose of oxygen and pressure. Clinical hyperbaric oxygen chambers need to be designed, manufactured, housed and operated according to the FDA, NFPA and ASME-PVHO codes.

Jim Bell CHT/EMT/CFPS is Chair of the UHMS HBO2 Safety Committee; Tom Workman MS, CAsp, CHT, FAsM is UHMS Director of Quality Assurance and Regulatory Affairs and a dedicated committee member.

 

From the First Quarter 2017 issue of Pressure, the UHMS member newsletter. See the entire open-access document at:

https://www.uhms.org/publications/pressure-online.html

TAKE A NEW ROUTE: UHMS PROGRAM FOR ADVANCED TRAINING IN HYPERBARICS (PATH)

ENOCH HUANG MD, FUHM  •  E: enoch.huang@mac.com  •  Twitter: @POTUHMS

Let’s talk education.

There is currently a low bar to practice undersea and hyperbaric medicine (UHM). Most hospitals only require completion of a 40-hour introductory course in hyperbaric medicine (ICHM) to get hospital privileges, and some organizations are offering portions of the ICHM online, circumventing the UHMS requirement that those 40 hours be conducted in person with live, face-to-face encounters with course faculty.

On the other end of the spectrum, the UHMS considers UHM fellowship training and American Board of Medical Specialties (ABMS) UHM board certification to be the gold standard when considering education in hyperbaric medicine, and we recommend this pathway for all new graduates and anyone who has the means to do so.

However, we recognize that not every current practitioner can take a year off from work to complete this process. This is where the Program for Advanced Training in Hyperbarics (PATH) comes into play. This extensive online program allows individuals to earn recognition for the extra effort that they have put into obtaining advanced education in hyperbaric medicine. Physicians (MDs/DOs) will be able to earn a Certificate of Added Qualification (CAQ), and Advanced Practice Clinicians (NPs/PAs) will be able to earn a Certificate of Advanced Education (CAE), demonstrating that they have gone above and beyond the minimum 40-hour ICHM.

While other organizations offer a CAQ in hyperbaric medicine, the UHMS CAQ is different: The requirements are much more stringent and involve both didactic material as well as a peer-reviewed clinical management component as part of the PATH. Additionally, the UHMS PATH will be the first program to include Advanced Practice Clinicians (APCs), who will be able to earn a Certificate of Advanced Education. While the issue of whether APCs should be allowed to supervise hyperbaric oxygen (HBO2) treatment or not is still actively debated, this is an issue that is outside the control of the UHMS and is regulated by the laws of individual states. The UHMS Board of Directors voted to embrace our mission of education and raise the level of education for all providers of HBO2.

Students in PATH will be able to earn more than 100 hours of CME reviewing a carefully curated syllabus of pertinent hyperbaric literature and video lectures. They will also have to submit cases that they have seen and personally managed for peer review and feedback. There will be live online case conferences where nuances of management decisions and documentation pearls will be discussed. Finally, students will have to complete an in-person hands-on skills lab to demonstrate familiarity with chamber systems and treatment algorithms. This program is far and above what is available through other certification programs, which usually include only a written examination and a self-reported “log” of supervised treatments. Completion of the UHMS PATH will prepare the student to be a safer, smarter and superior hyperbaric practitioner.

Over a year in the making, the UHMS PATH represents an evolution of the Stellenbosch University CAQ program from several years ago. While that curriculum is still available directly through Stellenbosch University, this program was designed to meet the needs of UHMS members based on feedback received from enrollees and graduates of that program. We are continually refining the elements of PATH and will be rolling out additional modules as they are ready. As an overview, PATH will have the following components:

SELF-DIRECTED LEARNING

(9 blocks of material covering 70-plus assignments):

  • Reading assignments – Students will read selected textbook chapters, seminal articles and other publications.
  • Video presentations – Students will view selected PowerPoint presentations that have been selected from previous UHMS educational events or prepared especially for PATH.
  • Pre-test/Post-test – For each block of material, students will be given a pre-test and post-test. The pre-test will be “closed book” to assess baseline knowledge of the material prior to reading the assignments. The post-test will be “open book” and will be administered after all of the reading has been completed. Students will be given feedback on which questions were answered incorrectly on the post-test in order to research the content.
  • Final examination – After completion of all of the blocks, a final examination will be administered. Students must get 70% of answers correct on the final examination to be eligible for completion of the program. Students will be given three opportunities to pass the examination.
  • Case presentations – Students will submit case write-ups from the initial consultation to the end-of-treatment summary for peer review by a board-certified UHM faculty member. Students will have to receive a passing review of 10 cases (covering at least four distinct HBO2 indications) to be eligible for completion of the program.
  • Case conferences – Students will participate in regularly scheduled web-hosted case conferences led by board-certified UHM faculty members to discuss interesting cases and provide feedback on case workups. Students will be expected to attend six conferences to be eligible for completion of the program.
  • Skills lab – Students will have to complete the UHMS Hyperbaric Skills and Emergency Management course that will be offered periodically in a live setting. The tuition for the skills lab will be independent of PATH tuition.

IN SUMMARY

  • PATH is not a substitute for ABMS board certification in UHM, and its curriculum is certainly not a substitute for fellowship training, which is considered the gold standard for physician education in UHM.
  • There is a large knowledge gap between completion of a 40-hour ICHM and fellowship training.
  • The knowledge gained in a 40-hour ICHM is insufficient to fully prepare a clinician to practice the full breadth of undersea and hyperbaric medicine.
  • There is no formal training program other than the 40-hour ICHM available to APCs.
  • There is no means for clinicians who have undertaken additional continuing medical education in UHM to show that they possess training/education above the most basic attendee of a 40-hour ICHM.
  • There is no means for foreign medical graduates to obtain ABMS board certification, and limited opportunities for them to receive an advanced certification in UHM.
  • Hospitals have no means other than board certification to identify more highly trained providers of UHM.
  • The UHMS feels that raising the level of knowledge for all providers of UHM falls within its mission to develop and promote educational activities, symposia and workshops that improve the scientific knowledge of matters related to undersea exposures and hyperbaric oxygen therapy.
  • While this CAQ and CAE will be provided and recognized by the UHMS, it will ultimately be up to hospitals and other regulatory agencies to determine whether they will require any minimum training requirements for practice.

We have been working hard on the foundation of this program, and will continue to refine and improve it based on your feedback. I look forward to seeing you all on the UHMS PATH.

QUESTIONS/ANSWERS ABOUT PATH

Here are several questions that have already been asked about the program:

Do I need to be a member of the UHMS to enroll in PATH?
Yes. You need to be a UHMS member in good standing to enroll in PATH and to maintain your CAQ / CAE.

Why is there a difference between the CAQ (for physicians) and the CAE (for APCs)?
Distinction. While both groups of providers will complete an identical curriculum, the committee felt that we needed to maintain the distinction between provider types.

Will there be CME credits for this program?
Yes. We will provide more than 100 hours of CME for the program. This is in distinction to the previous Stellenbosch program that did not award any CME credits. You will be awarded CME credits after each post-test is completed for the self-directed learning, after each case presentation that has been passed, and after each case conference attended.

If I completed the Stellenbosch CAQ program, do I have to take the UHMS PATH?
No. The UHMS CAQ awarded through the Stellenbosch program remains a recognized CAQ.

If I deferred completion of the Stellenbosch CAQ program, do I have to register for the UHMS PATH?
No. Students who deferred completion of the Stellenbosch program are automatically registered for the UHMS PATH.

Do I have to complete the blocks in order?
No. You can complete the blocks in any order you wish. As a matter of fact, we will be releasing blocks when the review committee has completed writing and reviewing the test questions, so they may not be released in the order that they are listed.

If I do not see patients in consultation, can I enroll in the program just for the didactic portion (self-directed learning)?
That depends. This will depend on the number of people who express interest in this option.

If I do not pass the examination or do not complete the course, can I get a refund?
Unfortunately, we will not be granting refunds if you do not complete the course. You will still receive the CME credits for any modules that you do complete.

Who was involved in the creation of the UHMS PATH?
I want to thank the following contributors who have provided advice, didactic content, examination questions, and/or feedback used for the creation of the UHMS PATH.

Robert Barnes MD
Richard Baynosa MD
Michael Bennett MD
Fred Bove MD
Walter Chin RN
Paul Cianci MD
Richard Clark, CHT
Paul Claus MD*
Bruce Derrick MD
John Feldmeier DO
Jake Freiberger MD*
Lisa Gould MD*
Neil Hampson MD
Sean Hardy MD
Harriet Hopf MD
James Holm MD*
Enoch Huang MD*
Folke Lind MD
Simon Mitchell MD
Hassan Murad MD
Heather Murphy-Lavoie MD*
Neal Pollock PhD
Michael Strauss MD
Bill Tettelbach MD
Richard Vann PhD
Lindell Weaver MD
Gene Worth MD

*PATH Committee Member

From the First Quarter 2017 issue of Pressure, the UHMS member newsletter. See the entire open-access document at:

https://www.uhms.org/publications/pressure-online.html

UHMS makes medicare reimbursement paper available to the public

The Hyperbaric Oxygen Therapy Registry (HBOTR) has released an important paper detailing its work in Medicare reimbursement issues, and it is now available to the public.

Go to: https://www.uhms.org/publications/uhm-journal/uhm-journal-ahead-of-print-public.html

“Rapid analysis of hyperbaric oxygen therapy registry data for reimbursement purposes,” a technical paper by Caroline E. Fife, Helen Gelly, David Walker and Kristen Allison Eckert is available as an epub-ahead-of-print download from the Undersea and Hyperbaric Medical Society.

Jointly sponsored by the UHMS and the US Wound Registry (USWR), the HBOTR recently provided national data quickly to the RUC on thousands of patients who underwent HBO2 in order to help establish a fair analysis of the physician work of hyperbaric chamber supervision.

The process is detailed in the paper and will be published in the September-October 2016 issue of Undersea and Hyperbaric Medicine, the journal of the UHMS.

DON’T FORGET THE UHMS LABOR DAY SALE!

Get 20% off all registrations August 29-September 5, 2016, on any educational programs at the UHMS Online Continuing Educational Portal.

Currently, there are more than 14 programs to choose from that include Fast-Tracks, Journal-Based CME and longer Symposiums on hyperbaric medicine, diving medicine and wound care.

Create a free account today!  

Already have an account?  Login any time to register for any of our educational programs.

WWW.COURSES-UHMS.ORG 

For more detailed info, just scroll down to the original release.

Enjoy a thoughtful and educational Labor Day!

UHMS and the US Wound Registry discuss Medicare reimbursement issues

The Hyperbaric Oxygen Therapy Registry (HBOTR) has released an important paper detailing its work in Medicare reimbursement issues.

“Rapid analysis of hyperbaric oxygen therapy registry data for reimbursement purposes,” a technical paper by Caroline E. Fife, Helen Gelly, David Walker and Kristen Allison Eckert is available as an epub-ahead-of-print download to members of the Undersea and Hyperbaric Medical Society. Just log in and go to:

https://www.uhms.org/publications/uhm-journal/uhm-journal-ahead-of-print.html

Jointly sponsored by the UHMS and the US Wound Registry (USWR), the HBOTR recently provided national data quickly to the RUC on thousands of patients who underwent HBO2 in order to help establish a fair analysis of the physician work of hyperbaric chamber supervision.

Medicare reimbursement rates for all physician services are established via a complex methodology utilizing data provided by the American Medical Association (AMA)/Specialty Society Relative Value Scale Update Committee (RUC), which values the “relative work” and practice expense of CPT codes and makes recommendations regarding valuations to the Centers for Medicare and Medicaid Services (CMS).

The authors note: “It is vital that hyperbaric practitioners engage in registry submission if they are to survive the titanic shift in healthcare payment reform under MACRA (Medicare Access & Chip Reauthorization Act of 2015).”

Participation in a Qualified Clinical Data Registry (QCDR) can satisfy the requirement for specialty registry participation under “Meaningful Use” of an Electronic Health Record and counts as 15% of the provider’s total score in MACRA’s Merit Based Incentive Payment System (MIPS). Hyperbaric practitioners who report quality measures through the HBOTR can earn bonus points for the Quality Reporting portion of MIPS (50% of the total score), particularly if they report safety, appropriate use, or outcome quality measures. While no such hyperbaric measures are available in the Physician Quality Reporting System, the UHMS developed hyperbaric safety, outcome, and appropriate use measures in partnership with the USWR, which can be reported through that QCDR and whose data become part of the HBOTR.

To read the paper in its entirety, go to: https://www.uhms.org/publications/uhm-journal/uhm-journal-ahead-of-print.html

Enjoy the fruits of your LABOR with 20% off registration on all UHMS online educational programs August 29-September 5, 2016

Work hard. Save now.

You work hard, and the UHMS would like to reward you with 20% off all registrations August 29-September 5, 2016, on any educational programs at the UHMS Online Continuing Educational Portal.  Currently, there are more than 14 programs to choose from that include Fast-Tracks, Journal-Based CME and longer Symposiums on hyperbaric medicine, diving medicine and wound care.

Benefits of fulfilling your CME/CEU requirements with UHMS Online Education:

  • Work at your own pace and start and stop as you like
  • Receive CME/CEU credit immediately upon completion of the program
  • Access the program anywhere there is an internet connect and supported browser
  • All programs are accredited by UHMS for Physician CME, NBDHMT Category A/B, Nursing/RRT contact hours and MOC for ABPM Physicians
  • Up-to-date content from internationally recognized expert faculty
  • UHMS Members receive significant discounts up to 40%
  • Receive your “12 for 12” recommended hours for less than $150!

Create a free account today!  

Already have an account?  Login any time to register for any of our educational programs!

WWW.COURSES-UHMS.ORG 

Symposium on Hyperbaric Medicine and Wound Management (20 CME/CEU Hours)
Click here to access and purchase the course now

Mayo Clinic Hyperbaric Medicine 2015 (15.50 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 42, Issue 1 (2 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 42, Issue 2  (2 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 42, Issue 3  (2 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 42, Issue 4  (2 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 42, Issue 5  (2 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 42, Issue 6  (2 CME/CEU hours)
Click here to access and purchase the course now

UHM Journal-Based CME Volume 43, Issue 1  (2 CME/CEU hours)
Click here to access and purchase the course now

Fast Track 1: Best Practices in Hyperbaric Medicine and Wound Care: GRADE, CPG’s, Future Research (4 CME/CEU hours)
Click here to access and purchase the course now

Fast Track 2: Wound Care: NPWT, Surgical Treatment of Wounds, Case Studies (4.5 CME/CEU hours)
Click here to access and purchase the course now

Fast Track 3: Diver Fatalities, Fitness to Dive, Stresses in Diving and Case Studies (4.5 CME/CEU hours)
Click here to access and purchase the course now

Fast Track 4: Hyperbaric Facility Operations (Staffing roles, UHMS Accreditation, Practice Models and NFPA Update) (4.5 CME/CEU hours)
Click here to access and purchase the course now

Fast Track 5: Diabetic Foot Ulcers (DFU), Venous Ulcers and Fluorescence Vascular Angiography (FVA) in Hyperbaric Medicine and Wound Care (5.5 CME/CEU hours)
Click here to access and purchase the course now

Accreditation Statement:
The Undersea and Hyperbaric Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

*Hours may vary depending on accrediting organization.  Please see table of contents for full designation statements.  Registration costs vary for Associate Members, Regular Members and Non-Members.

Be safe and enjoy this Labor Day!

CUHMA registration is open

Important Notice from CUHMA regarding online meeting registration

It has come to our attention over the past few days that a glitch recently developed in the registration page on our website for the 7th CUHMA Annual Scientific Meeting.  Several people who were trying to register either received a terminal ‘error’ message when they tried to pay, or believe that they have registered and paid, but nothing came through on the website.

Our IT Manager has now corrected the glitch. Although it appears to have affected mainly American registrants, we are uncertain how widespread the problem was. We are therefore, asking anyone who either received the error message, OR did not receive an e-mail confirming their registration for the CUHMA conference, to please contact me at: drdeb1@ns.sympatico.ca. As a result of this glitch, the ASM Planning Committee has decided to extend the 10% early-bird discount on registration for this year’s conference until 27 Aug 2016.

This year’s conference will be held in Vancouver, BC, from 9-11 Sept 2016 at Simon Fraser University’s Segal Building, Harbour Centre.  Please go to our new website: www.cuhma.ca for registration.  Additional information includes:

Conference – This year’s conference will include both a Hyperbaric Medicine Day on Sat, 10 Sept 2016 and a Diving Medicine Day on Sun, 11 Sept 2016.  Morning and afternoon refreshment breaks and lunch are included with registration for the conference.  The final Scientific Program is now available on-line.  Block-bookings for discounted hotels in the area have now expired, however a list of hotels within 10 min walking distance of the conference venue are still listed on our website. In addition to the early-bird discount, current members of CUHMA receive an additional 10% discount on registration.  If you decide to join CUHMA at the time of registration, you will be entitled to this additional discount; membership can be applied for on-line at the same time as registration for the conference.

HETS (Hyperbaric Emergency Team Simulation) Pre-course – Scheduled for Fri, 9 Sept 2016, ‘early-bird’ registration has also been extended to 27 Aug 2016.  This intensive course is designed to meet the demands for certification and Continuing Professional Development in Hyperbaric Medicine. The new Diploma in Hyperbaric Medicine available shortly from the Royal College of Physicians and Surgeons of Canada requires the use of simulation in training.  The HETS course has now been approved for 22.5 MOC Section 3 (FRCPC) and 7.5 Mainpro+ (CCFP) study credits.  The course involves hands-on participation, decision-making skills and expert debriefing for multiple complex scenarios that cover key areas of expertise for both multi-place and mono-place hyperbaric chambers.  Watch an exciting teaser-trailer video of what to expect at:  https://cuhma.ca/events/hets-teaser-trailer. For more information and registration, click: https://cuhma.ca/events/hyperbaric-emergency-team-simulation. The course will be conducted at CESEI, Vancouver General Hospital (not the SFU Harbour Centre conference site).

Tour of Shearwater Research – A unique opportunity to learn more about the development and manufacturing of dive computers, Shearwater Research is offering a tour of their new facility in Richmond, BC on Fri, 9 Sept 2016 from 13.00 – 15.30h. There is no charge for this tour, and transportation will be provided to and from the Segal Building.

Welcome Reception – Hosted by Simon Fraser University at the beautiful Simon Fraser Observatory on Fri, 9 Sept 2016; a full buffet dinner is included courtesy of our hosts. Transportation to and from the Observatory will be provided from the Segal Building Harbour Centre conference site, departing at 18.30h.  The Welcome Reception is included with conference registration, but please indicate during registration whether or not you plan to attend so that we can plan for transportation accordingly.

Dinner & Awards Banquet – Always a highlight of each year’s scientific conference, this event will be held at the Segal Building conference site on Sat, 10 Sept 2016 from 19.00 – 22.00h.  The cost will be $65.00 per person for a unique buffet-style dinner, including wine and door prizes.  A wide variety of starters, entrees and desserts will be available.

Hope to see all of you in Vancouver!

Best regards,

Debbie L. Pestell, MD
Planning Committee, CUHMA 2016 Vancouver
Board of Directors, 2016 President-elect

UHMS Seeks Grant Funding for Scientific Writer

Undersea and Hyperbaric Medical Society grant proposal request for part-time scientific writer 

I. PROPOSAL SUMMARY

The Undersea and Hyperbaric Medical Society (UHMS) is seeking funding to contract with a scientific writer to work with the various UHMS committees for the purpose to assist them in authoring works in the fields of undersea and hyperbaric medicine such as: position letters and statements, creating commentary on published works, gathering and creating metadata, etc. This resource is expected to have a positive material effect for the membership.

II. ORGANIZATION DESCRIPTION and HISTORY 

The Undersea and Hyperbaric Medical Society (UHMS) is an international scientific organization which was founded in 1967 to foster exchange of data on the physiology and medicine of commercial and military diving. Over the intervening years, the interests of the Society have enlarged to include clinical hyperbaric oxygen therapy. The society has grown to over 2,000 members and has established the largest repository of diving and hyperbaric research collected in one place. Clinical information, an extensive bibliographic database of thousands of scientific papers, as well as books, and technical reports which represent the results of over 100 years of research by military and university laborato­ries around the world are contained in the UHMS Schilling Library, holdings are now part of the Duke University Library, Durham, NC. The results of ongoing research and clinical aspects of undersea and hyperbaric medicine are reported annually at scientific meetings and in Undersea and Hyperbaric Medicine published bi-monthly.

The UHMS is a nonprofit 501(c)3 corporation. The board of directors (board), elected by the membership oversees the organization’s mission and adherence to its bylaws. The president of the board is responsible for choosing the UHMS committees’ chairs. There are numerous standing committees and a few ad hoc ones as well. The board hires the executive director who oversees the organization and executes the policy of the board.

The Society shall be international in scope. Its primary purposes shall be:

  1. to provide a forum for professional scientific communication among individuals and groups involved in basic and applied studies concerned with life sciences and human factors aspects of the undersea environment and hyperbaric medicine.
  2. to promote cooperation between the life sciences and other disciplines concerned with undersea activity and hyperbaric medicine.
  3. to develop and promote educational activities and other programs, which improve the scientific knowledge of matters related to undersea and hyperbaric environments and the accepted applications of hyperbaric oxygen therapy for the membership, as well as physicians and allied health professionals, divers, diver technicians and the public at large.
  4. to provide a source of information and support in the clinical practice of hyperbaric medicine and to stay abreast of legislative, legal, and regulatory changes in the field.
  5. to provide a means by which hyperbaric facility directors/owners will have an opportunity to request an accreditation survey of their facility for safety, staffing and verifying the adequacy of the professional medical application of hyperbaric therapy.

The UHMS has long been regarded as the pre-eminent scientific organization in the fields of undersea and hyperbaric medicine. The UHMS continues to shoulder the burden of producing the scientific rationale that allows the field to progress. However, over the past few years, globally the fields and medicine in general have been beleaguered with regulatory changes and the UHMS is underfunded to be able to adequately respond with the scientific information needed for each issue being presented.

The UHMS can be a central force, as it has in the past for positive change but needs additional and external funding to accomplish this goal.

III. BACKGROUND

The UHMS has historically been the organization regulatory bodies have referenced including the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA), particularly with regard to the scientifically backed indications for hyperbaric oxygen therapy (HBO2).

This goes back to the need for meticulous scrutiny of emerging clinical applications of HBO2, the UHMS established the Hyperbaric Oxygen Therapy Committee in 1976. The committee was charged with the responsibility of continuously reviewing the research and clinical data and rendering recommendations regarding clinical efficacy and safety of HBO2. To achieve this goal, the multidisciplinary committee is comprised of practitioners and scientific investigators.

Since, 1976, the committee has met annually to review research and clinical data. From the twenty-eight indications for which third party reimbursement was recommended in the 1976 and 1979 reports, the number of approved indications has been refined to fourteen in the 2014 report. These indications are those for which in vitro and in vivo pre-clinical research data as well as extensive positive clinical experience and study have become convincing.

Evidence considered by the committee includes sound physiologic rationale; in vivo or in vitro studies that demonstrate effectiveness; controlled animal studies; prospective controlled clinical studies; and extensive clinical experience from multiple, recognized hyperbaric medicine centers.

The committee also reviews cost effectiveness and has established guidelines for each entity. Results show that, in addition to its clinical efficacy, HBO2 therapy yields direct cost savings by successfully resolving a high percentage of difficult and expensive disorders, thereby minimizing prolonged healthcare interventions.

The committee recommends third party reimbursement of HBO2 for the disorders included in the accepted conditions category. Currently, most insurance carriers have established HBO2 reimbursement policies.

The need to support the field with scientific literature is unprecedented at this point in the fields’ existence.

Specifically, the major issues being experienced at this point are third party payor challenges to the UHMS approved indications including these listed below.

  • Misinterpretation of UHMS diagnoses which do not meet the intent of the author(s)
  • Deletion of indications potentially without proper analysis
  • Deletion of indications as a result of a poorly defined crosswalk between ICD-9 and ICD-10

IV. PROJECT

To address the challenges the UHMS is seeking to fund a scientific writer to assist the UHMS committee chairs in authoring scientific works, i.e. position statements, letters, etc. that will have a positive and meaningful impact on individuals participating in the fields of undersea and hyperbaric medicine.

The program will begin immediately as funding comes into the program for the scientific writer and will end when the funding runs out. This position is viewed as being one that could and should go into perpetuity and therefore the UHMS will be seeking to fund the need into the future.

When funded, the scientific writer will be assigned to the highest priority items which at this point are:

  • Assist in authoring a position on the elimination of radiation codes and compromised flap in the process of the ICD-9 to ICD-10 transition
  • Compiling scientific literature and performing analysis on the indications most at risk for challenge by third-party payors

V. BUDGET

The cost of the position is estimated to be eighty thousand dollars – US ($80,000.00) annually for approximately 1000 hours.

100% of the contributions going to this restricted grant request will be used for the project as it is described.

VI. RESPONSES

Individuals or organizations wanting to contribute to this specific grant, please mail funds to the UHMS office specifically as described below. Checks will be made out to the UHMS and in the Memo line please write Scientific Writer Fund.

Undersea and Hyperbaric Medical Society
Scientific Writer Grant
631 US Highway 1
Suite 307
North Palm Beach, FL 33408
+561-776-6110

If you have any questions, please contact John S. Peters, Executive Director UHMS.

Contributions to the Undersea and Hyperbaric Medical Society—a 501(c)(3) charitable organization—are tax-deductible for federal income tax purposes as provided under the Internal Revenue Code.

Donors should consult their own tax advisor regarding the specific deductibility of their charitable contributions.

Spring Pressure 2016 is posted

It’s all good. It’s all new. 

It’s ready for you at:

https://www.uhms.org/publications/pressure.html
Note: Pressure is now open access (now listed under ‘Publications’ on the home page). This means you can invite your colleagues who may be considering membership in the UHMS to read it, too. We hope that getting a sampling of UHMS news will encourage them to join up.

Check it out today at

https://www.uhms.org/publications/pressure.html

Update: 2016​ ASM | 9-11 June | Las Vegas, Nevada | USA

The Preliminary Program Schedule has been updated with the accepted abstracts and their presentation times (schedule is still subject to change). The Non-Physician Track will be posted within the next week.  Also, look for the full Abstract Program Book to be posted shortly.

Continuing Education Credits are currently in the approval process and will be posted soon.

EARLY BIRD MEETING REGISTRATION ENDS MIDNIGHT TONIGHT: MAY 1

Preliminary program: https://www.uhms.org/index.php?option=com_content&view=article&id=89&Itemid=236

Register now: https://www.uhms.org/index.php?option=com_civicrm&task=civicrm/event/register&Itemid=233&id=62&reset=1

Location & Accommodations
HOTEL RESERVATION CUT-OFF DATE IS FAST APPROACHING…
MAKE YOUR RESERVATIONS 
BEFORE MAY 13
Las Vegas, Nevada: A desert metropolis built on gambling, vice and other forms of entertainment, Las Vegas has drawn millions of visitors and trillions of dollars in wealth to southern Nevada in just a century of existence. The city was founded by ranchers and railroad workers but quickly found that its greatest asset was not its springs but its casinos. Visitors came to partake in what the casinos offered: low-cost luxury and the thrill of fantasies fulfilled.

Tropicana Las Vegas Casino Hotel Resort: Prepare to be surprised. Located on the south end of the Las Vegas Strip, the Tropicana Las Vegas is redefining the expectations of today’s global travelers, with a recently completed $200 million transformation that provides a casually elegant resort experience. In addition to a South Beach rhythm and vibe, the transformation of the resort includes a fresh redesign of its best-in-class hotel rooms and suites, the 50,000-square-foot casino, more than 72,000 square feet of meeting and exhibition space, several new restaurants and bars, a new race and sports bar, and Glow®, a Mandara Spa and fitness center. First-class entertainment includes the Laugh Factory comedy club and live music in the Tropicana Lounge.

Please support the Society by booking at our host hotel!  Thank you! 

Tropicana Las Vegas Casino Hotel Resort
3801 Las Vegas Blvd. South
Las Vegas, NV 89109

Room rate:  Sun—Thurs: $85 / Fri-Sat: $145

ONLINE RESERVATIONS: CLICK HERE
Reservations: 1.800.GO2.TROP (1.800.462.8767) or 1.800.634.4000
In order for you to get the group rate you must give the reservations department our 
unique group code: SUHM16.

ROOM RESERVATION CUT-OFF DATE: MAY 13, 2016