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December 18, 2015 - "Sepsis: The New CMS Core Measure in 2016”
Speaker: Thomas C. Cesario, M.D., Professor Emeritus, Department of Medicine, UCI College of Health Sciences and School of Medicine

Objectives: Objectives: 1) State the Sepsis Alliance definition of Systematic Inflammatory Response Syndrome (SIRS). 2) List at least two of the four required criteria patients must meet in order to be diagnosed with sepsis. 3) Differentiate the six additional diagnostic criteria that are included but not limited to by the Sepsis Alliance. 4) Examine the role of “positive blood cultures” in diagnosing Sepsis. 5) Identify what the provider must document in order to meet the Sepsis Core Measure requirements, including proper timing of treatment and documentation of diagnosis/treatment, etc. with date/time documented. 6) Define the role coders and clinical documentation improvement (CDI) specialists play in the accurate documentation of a sepsis patient.

Handouts: CME_121815_Cesario_Sepsis_NewCMSCoreMeasure2016

December 11, 2015 - “Pain Overview: Chronic versus Acute Pain, Types of Pain"
Speaker: John D. Loeser, M.D., Professor Emeritus, Neurological Surgery; Professor Emeritus, Anesthesiology & Pain Medicine, University of Washington

Objectives: Objectives: 1) Recognize the differences between acute pain and chronic pain, 2) Understand the many factors that contribute to chronic pain, 3) Describe the appropriate use of opioids for acute pain & for chronic pain, and 4) Understand the role of environmental and psychological factors in the perpetuation of chronic pain.

Handouts: CME_121115_Loeser_What_is_Chronic_Pain_HOs_color

December 04, 2015 - "A Clinical Roadmap for Anti-Obesity Drug Treatment"
Speaker: Donna Ryan, MD, Pennington Biomedical Research Center at Louisiana State University and representative for The Obesity Society

Objectives: Objectives: 1) Understand the specific recommendations for transitioning patients off drugs that cause weight gain, shifting the treatment paradigm from treating weight last, to treating weight first. 2) Learn recommended medications and dosage based on obesity-related comorbidities, including type 2 diabetes and cardiovascular disease. 3) Understand the implications for continuing and discontinuing medication, guidance for prescribing medications that promote weight loss or have no effect on weight, and disclosure of information about medication-related weight gain to patients to promote shared decision making.

Handouts: CME_120415_Ryan_HO_Clinical_Roadmap_AntiObesity_Drug_Treatment

November 20, 2015 - "What Every Provider Should Know about Pulmonary Fungal Infections"
Speaker: Chadi A. Hage, M.D. Assistant Professor of Medicine, Indiana University Health Thoracic Transplantation Program Methodist Professional Center

Objectives: Objectives: 1) Explain the differences between the 2008 and the updated 2011 Clinical Guidelines, 2) Review new methods of diagnosis, 3) Educate on the new medications and treatment approaches to pulmonary fungal infections, and 4) Receive an overview of emerging fungi.

Handouts: CME_112015_Hage_HO_endemicmycosisoverlookedcausesofResped, CME_112015_Hage_HO_WhatEveryProviderShouldKnowAboutPulmonaryFungalInfections

November 13, 2015 - "The Hygiene Hypothesis: Has Our Obsession with Cleanliness Made Younger Generations More Prone to Illness?”
Speaker: Douglas Kuperman, Ph.D., RRT, Assistant Professor of Health Sciences, Director Graduate College Division of Health Sciences, Assoc. Director B.S. in Health Sciences Prg, Rush University College of Health Sciences, Chicago, Illinois

Objectives: Objectives: 1) Review a basic immunologic background for asthma, 2) Discuss the scientific evidence for how the hygiene hypothesis may explain the increased incidence in Western countries, 3) Discuss the important protective impact of exposures to microorganisms, especially during the first 6 months of life. 4) Discuss communications strategies for working with overly cautious parents.

Handouts: CME_111315_Kuperman_colorHOs_TheHygieneHypothesis

November 06, 2015 - “The Really Big One: Are We Ready? How The Cascadia Subduction Zone May Impact Central Oregon”
Speaker: Ken Quiner, BS, Emergency Management Coordinator, St. Charles Health System

Objectives: Objectives: 1) To characterize the consequences of disasters on health services and the role of health services in disasters; 2) To describe different strategies for setting up health services in emergency situations; 3) To discuss the key steps for managing a mass casualty incident; 4) To characterize the crucial role of healthcare providers in emergencies.

Handouts: CME_11615_Quiner_HOs_TheReallyBigOneAreweReady

October 30, 2015 - “The Management of Bone and Joint Infections”
Speaker: Pen Barnes, MBBS, MRCP, FRCPath, Ph.D., Assistant Professor, Division of Infectious Diseases OHSU

Objectives: Objectives: Discuss the epidemiology and clinical manifestations of bone and joint infections. 2) Describe laboratory and imaging studies in the initial assessment of bone and joint infections. 3) Discuss the management of bone and joint infections, including antibiotic treatment and surgical management.

Handouts: CME_103015_Barnes_HOs_TheMngmtBoneJointInfections

October 16, 2015 - "Enhancing Care with Health Informatics”
Speaker: William Hersh, MD, F.A.C.P., F.A.C.M.I. , Professor and Chair, Department of Medical Informatics & Clinical Epidemiology (DMICE), Oregon Health & Science University

Objectives: Objectives: 1) Describe the rationale for the HITECH investment 2) Present the beneficial and problematic results of the investment for both the medical staff and patients 3) Discuss how the electronic health record can meet its goal of improving the care of patients.

Handouts: CME_101615_HOs_Hersh_ClinicalInformaticsEssentialCompetency

October 09, 2015 - “Opioid Therapy, Pain and Addiction at the Crossroads”
Speaker: Steven D. Passik, Ph.D., Vice President of Clinical Research and Advocacy

Objectives: Objectives: 1) Discuss the recent history of opioid abuse and understand its connection to pain management 2) Critically evaluate and discuss the concept of hyperalgesia and understand its roots in opiophobia 3) Apply management strategies to accompany opioid therapy in chronic pain management.

Handouts: CME10915HOsOpioidTherapyPainAddictionCrossroadsPassik

October 02, 2015 - “Managing Long-Term, Non Cancer Pain With and Without Opioids”
Speaker: Catriona Buist, Psy.D, Clinical Director of the Pain Management Program Progressive Rehabilitation Assoc.

Objectives: Objectives: 1) Explain methods to teach patients to take a self-management approach to chronic pain treatment 2) Review how psychological conditions impact chronic pain 3) Identify assessment tools and resources to include in an evidence-based, outcomes directed treatment approach 4) Emphasize to focus treatment of chronic pain on improving function and quality of life.

Handouts: CME_100215_Buist, CME_100215_HOsManagingLongTermNonCancerPainOpioids_Buist

September 25, 2015 - “The PSA Controversy”
Speaker: Nina S. Davis, M.D., FACS, Associate Professor of Urology and Urogynecology, Oregon Health and Science University

Objectives: Objectives: 1) Discuss the challenges of prostate cancer screening. 2) Review current guidelines regarding the use of PSA for prostate cancer screening. 3) Discuss newly available and soon to be available tests that may lead to superior prostate cancer screening strategies.

Handouts: CME_092515_HOThePSAContoversyDavisN2015

September 18, 2015 - “Chronic Pain and Depression”
Speaker: Charles DeBattista, DMH, M.D., Director, Depression Clinic, Psychopharmacology Clinic Chief, ECT Service Stanford University School of Medicine

Objectives: Objectives: 1) Discuss the overlap between depression and chronic pain, 2) Review the “Whole Life” Approach, 3) Understand anti-depressants and their effect on both pain and depression, 4) Learn the benefits of physical activity, 5) Learn about the impact of pain school and talk therapy, 6) Review recommended management strategies.

Handouts: CME_091815_DeBattista_HOs_ChronicPainDepression

September 11, 2015 - “Managing Asthma in the ED”
Speaker: Emily A. Carpenter Rose, M.D., FAAP, FAAEM, FACEP Director, Pediatric Emergency Medicine MSIV Clerkship, Assistant Professor of Clinical Emergency Medicine Keck School of Medicine of USC

Objectives: Objectives: 1) Discuss the National Asthma Education and Prevention Program (NAEPP) Recommendations 2) Review National Heart Lung Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma (EPR-3) 3) Discuss Lung Function Testing: Spirometry vs. Peak Flow Meters, 4) Review medication options for acute asthma, 5) Case Study, and 6) the Asthma Action Plan: Strategies for asthma management.

Handouts: CME_091115_CarpenterRose_HOs_ManagingAsthma_in_ED

July 31, 2015 - “The Fundamentals of Biosimilars: What Every Physician and Pharmacist Will Need To Know”
Speaker: Michael S. Reilly, Esq. Executive Director Alliance for Safe Biologic Medicines, Arlington, VA

Objectives: Objectives: 1) Discuss what biologics and biosimilars are, how they are manufactured and regulatory challenges associated with them. 2) Review the basic science and manufacturing of biologic medicines; 3) Discuss the clinical implications of the key features of biologics size, complexity, sensitivity/propensity for change that distinguish biologic medicines from chemical drugs 4) Understand their difference from generic drugs for purposes of patient care, 5) Discuss the critical importance of communication and the need for physicians and pharmacists to work together.

Handouts: CME_073115_Reilly_HOs_FundamentalsBiosimilars

July 24, 2015 - No Grand Rounds – Medical Staff Meeting

July 17, 2015 - “Appropriate Medical Uses of Cannabinoids”
Speaker: Craig D. Blinderman, MD, MA, Director of the Adult Palliative Medicine Service; Co-director, Center for Supportive Care and Clinical Ethics, Dept of Medicine, Columbia University Medical Center; New York, NY

Objectives: Objectives: 1) Discuss attitudes toward therapeutic use of cannabinoids. 2) Discuss the indications for existing cannabinoid therapeutic agents. 3) Review issues in cannabinoid trials, including efficacy and safety.

Handouts: CME_071715_Blinderman_HOs

July 10, 2015 - “The Role of Social Media in Improving Medical Care: A primer for doctors”
Speaker: John Mandrola MD, Clinical Electrophysiologist, Baptist Medical Associates, Louisville, Kentucky

Objectives: Objectives: 1) Discuss the trend toward use of social media in medical care and which types of social networking are appropriate in the practice setting. 2) Understand how to engage patients using social media while protecting privacy and minimizing online security risks.

Handouts: CME_071015_Mandrola_HOs

June 26, 2015 - "Update of ACC/AHA Blood Cholesterol Guidelines"
Speaker: Michael Shapiro, DO, Assistant Professor of Medicine, Cardiovascular Medicine, Oregon Health & Science University

Objectives: Objectives: 1) Apply current ACC/AHA blood cholesterol. 2) Appropriately identify the patients for whom blood tests will no longer be indicated.

Handouts: CME_062615_ShapiroM_HOs

June 19, 2015 - “Next Generation Molecular Diagnostics: Application in Cancer Genotyping”
Speaker: Christopher Corless, MD, PhD – Executive Director, Chief Medical Officer, Knight Diagnostic Laboratories; Professor of Pathology, Dept of Pathology, Oregon Health & Science University

Objectives: Objectives: 1) Discuss the appropriate us of molecular diagnostic testing. 2) Discuss molecular pathways and how mutations in these pathways may have an effect on specific treatment protocols. 3) Discuss the role of molecular diagnostics and specifically designed clinical trials. 4) Using actual de-identified cases, discuss specific patient outcomes that have been influenced by molecular diagnostic testing.

Handouts: CME_061915_Corless_HOs

June 12, 2015 - “Epigenetics and Child Neurodevelopment Disorder”
Speaker: Joel Nigg, PhD, Professor, Departments of Psychiatry and Behavioral Neuroscience; Director, Division of Psychology in Psychiatry, Oregon Health & Science University

Objectives: Objectives: 1) Be familiar with example studies that relate environmental exposures to child developmental disorders. 2) Understand at a general level why epigenetic data may be important in child developmental disorders. 3) Appreciate new data pointing to the possibility that developmental disorders are epigenetic disorders, as well as limitations of this theory.

Handouts: CME_061215_Nigg_HOs

June 05, 2015 - "Behavioral Health Concerns in Military Veterans: An Overview for Civilian Health Care Providers"
Speaker: David W. Greaves, Ph.D. Chief of Psychology and Administrative Director Mental Health & Clinical Neurosciences Division VA Portland Health Care System

Objectives: Objectives: 1) Review basics regarding military culture and military-specific factors that may impact behavioral health and functioning. 2) Review common deployment-related conditions such as PTSD, TBI, insomnia and depression 3) Identify useful screening and treatment resources and referral options. 4) Discuss strategies for treating patients from the military community who may be concerned about asking for behavioral health care.

Handouts: CME_6515_Greaves_addlHO_BasicScreenforTBI, CME_6515_Greaves_pptHOs, CME_6515_Greavesaddlhandout_Storzbach

May 29, 2015 - “Medical Malpractice Lawsuits 101: A Panel Discussion”
Speaker: Steven P. Jones, Defense Attorney, Keating Jones Hughes, P.C.; Larry Veltman, MD, CPHRM; Virginia Sandau, Manager of Clinical Risk, St. Charles Health System

Objectives: Objectives: 1) At the end of this activity, learners will have a better understanding of the “anatomy” of a medical malpractice lawsuit (from initial filing to trial), and the role of risk management.

Handouts: 052915_HOs_JonesVeltmanSandau_MedicalMalpracticeLawsuits101, CME_052915_JonesVeltmanSandau

May 22, 2015 - No Grand Rounds - Memorial Day Observance

May 15, 2015 - “The Conversation Project”
Speaker: Laura K. Mavity, MD Clinical Director, Advanced Illness Management Center of Care Medical Director, Home Health

Objectives: Objectives: 1) Review current state of advance care planning in the U.S. 2) Discuss the intention of the Conversation Project to improve engagement of the American public and medical system to improve advanced care planning.

Handouts: CME_051515_Mavity_AdvanceCarePlanning_ConversationProject

May 08, 2015 - “Cultural Competence and Mutual Respect: Communication of Intention”
Speaker: Edward Junkins, Jr., MD, MPH, FAAP, Associate Dean of Academic Affairs and Medical Education, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific NW (COMP-NW)

Objectives: Objectives: 1) Discuss cultural competence and communication from an institutional and clinician viewpoint. 2) Discuss the relevance of cultural competency in national initiatives and its impact on providers, clinics, and healthcare organizations. 3) Discuss the inclusion of cultural competence in medical school and residency curriculum.

Handouts: CME_50815_Junkins HOs_CulturalCompetency

May 01, 2015 - “Acute Respiratory Distress Syndrome (ARDS) in Trauma”
Speaker: Eric Seeley, MD, Assistant Professor of Medicine, Pulmonary & Critical Care MedicineUCSF School of Medicine

Objectives: Objectives: 1) Discuss the clinical predictors of ARDS, and early management of ARDS prior to admission to the ICU. 2) Discuss how to minimize risk or prevent ARDS through early identification of risk factors. 3) Review types of trauma that are prone to the onset of ARDS (eg, rib fracture, pulmonary contusions, penetrating trauma).

Handouts: CME_50115_Seeley HOs_ARDS_Trauma

April 24, 2015 - "Antiobiotic Stewardship in the Healthcare Setting"
Speaker: Tom Ward, MD, Assoc. Professor, Division of Infectious Disease, Oregon Health & Science University

Objectives: Objectives: 1) Identify patients at risk for bloodstream infections and multi-drug resistant organisms. 2) Describe features of interventions that have been successful in reducing inappropriate use of antibiotics, including outpatient management.

Handouts: CME_42415_Ward_AntibioticStewardship

April 17, 2015 - "Optimal Antiplatelet Therapy"
Speaker: Thomas DeLoughery, MD, FACP, Professor of Medicine, Pathology,& Pediatrics, Divisions of Hematology/Medical Oncology and Laboratory Medicine, OHSU

Objectives: Objectives: 1) Describe the current role of aspirin in prevention and treatment of arterial and venous thrombosis as well as its other indications. 2) Discuss current guidelines for perioperative aspirin. 3) Discuss when to use the other antiplatelet drugs such as clopidogrel, presugral, and ticagrelor. 4) Discuss when it is proper to combine antiplatelet and anticoagulants.

Handouts: CME_041715_DeLoughery_HOs_Bendantiplatelets

April 10, 2015 - "Understanding Scleroderma"
Speaker: Leslie Kahl, MD, Dept of Medicine, Division of Arthritis and Rheumatic Diseases; Associate Dean, School of Medicine, OHSU

Objectives: Objectives: 1) Discuss the etiology of scleroderma and differentiate between localized and systemic forms of scleroderma. 2) List treatment strategies for scleroderma

Handouts: CME_41015_Kahl_HOs

April 03, 2015 - TRAUMA CME "The Gut in Trauma and Critical Illness: the source of cure for multiple organ failure"
Speaker: Robert Martindale, MD, PhD, Prof. of Surgery; Chief of Gastrointestinal and General Surgery; Medical Director for Hospital Nutrition Services, OHSU

Objectives: Objectives:1) Discuss major research discoveries supporting the hypothesis of gut as the “motor” for multiple organ failure. 2) Discuss approaches to maximizing gut function in critical illness. 3) Discuss the potential role of probiotics on the clinical outcomes of trauma patients as measured by incidence of nosocomial infections, ventilator associated pneumonia, length of stay, and mortality.

Handouts: CMS_4315_Martindale_HOs

March 27, 2015 - No Grand Rounds Due to Spring Break

March 20, 2015 - "Lymphedema: Early Recognition and Treatment to Facilitate Reversal of Disease Progression"
Speaker: John Beckwith, PT, CLT-LANA, Certified Lymphedema Therapist; Primary Instructor, Norton School Of Lymphatic Studies; Board of Directors, Lymphology Association of North America

Objectives: Objectives: 1) Recognize full continuum of lymphedema as a disease process – from latency/mild to advanced/severe. 2) Recognize value of skilled intervention early in disease progression rather than later stages. 3) Based on etiology, recognize areas of the body affected by lymphedema besides limbs including: head/neck, trunk, genitals. 4) Recognize treatment standards for lymphedema in order to refer to optimal care.

Handouts: CME_032015_Beckwith_HOs

March 13, 2015 - "Top Ten Trauma Papers 2014-2015"
Speaker: Richard Mullins, MD, Professor of Surgery; Chief, Trauma/Critical Care Section, OHSU

Objectives: Objectives: 1) Discuss management of patients with multi-system trauma. 2) Review critically new ideas on trauma care.

Handouts: 31315_HOs_Mullins_TopTenTraumaPapers

March 06, 2015 - "Update in Outpatient Medicine"
Speaker: Robert A Gluckman, MD, FACP, Internal Medicine Specialist; Chief Medical Officer, Providence Health Plans

Objectives: Objectives: 1) Understand new guidelines for management of hypertension 2) Understand how to apply individual patient characteristic to determine appropriateness for cancer screening 3) Understand different approaches to colon cancer screening depending on patient risk 4) Understand the effectiveness of spinal injections.

Handouts: 30615_HOs_Gluckman_UpdateOutpatientMedicine

February 27, 2015 - "Algorithm-Based Deep Vein Thrombosis Management"
Speaker: Andrew Jones, MD and Ed Boyle, MD, Inovia Vein Specialty Center

Objectives: Objectives: 1) Understand the symptoms, evaluation and treatment options to diagnose and treat deep vein thrombosis in the outpatient setting. 2) Understand the use of evidence-based medicine incorporated into an algorithm, and how to use this approach in clinical practice for DVT. 3) Discuss new oral anticoagulants options compared to traditional anticoagulation including how this impacts healthcare economics.

Handouts: CME_22715_BoyleJones_AlgorithmBased_Deep_Vein_Thrombosis_Management

February 20, 2015 - "Musical Therapy Across the Life Span"
Speaker: Schandler Steven PHD, Senior Professor of Psychology, Director, Addiction Research and Cognitive Psychophysiology Laboratories Crean School of Health and Behavioral Sciences Chapman University, Orange, CA

Objectives: Objectives: 1) Cite evidence-based outcomes of music therapy in children with ADHD, anxiety, depression, etc. 2) Identify candidates for music therapy and prescribe appropriately. 3) Consider culture in the use of music therapy for pediatric patients.

Handouts: 220Schandler_MusicTherapyAcrosstheLifeSpan

February 13, 2015 - "Life Threatening Skin Lesions: A Primer"
Speaker: Roy Colven, MD, Director, Dermatology Residency Program, John E. Olerud Professor of Dermatology Training, Professor of Medicine, University of Washington School of Medicine

Objectives: Objectives: 1) Discuss the drugs that most commonly cause SJS/TENS (Stevens Johnson Syndrome & Toxic Epidermal Necrolysis). 2) Review the etiology, management and emerging therapies for life threatening skin legions such as SJS/TENS, melanoma, and pemphigus (autoimmune bullous disease).

Handouts: 213Colven_Handoutsapproved_LifethreateningskinlesionsBendHandout

February 06, 2015 - "Integrative East-West Medicine for Chronic Conditions"
Speaker: Dawn Upchurch, Ph.D., L.A.c, Licensed Acupuncturist, Professor of Public Health, Dept of Health Sciences, UCLA Fielding School of Public Health

Objectives: Objectives: 1) Discuss the prevalence of complementary and alternative medicine (CAM) therapies for chronic symptoms/conditions. 2) Learn about how traditional Chinese medicine (TCM) can be used to supplement standardized care. 3) Learn the indications, benefits, side effects, of and practical applications of (TCM) therapies i.e. toxicity risks relative to Chinese herbal interactions, including acupuncture in clinical practice. 4) Counsel patients & their families about the benefits of patient empowerment and utilizing the holistic approach to maximize self-care.

Handouts: 26Upchurch_IntergrativeEastWestMedicineforChronicConditions

January 30, 2015 - "ADHD Across the Lifespan: Diagnostic & Treatment Considerations"
Speaker: Sam Goldstein, Ph.D, Adjunct Assistant Professor, Dept of Psychiatry, University of Utah School of Medicine; Clinical Director, Neurology, Learning and Behavior Center, Salt Lake City, UT

Objectives: Objectives: 1) Understand current theory concerning cause, identification and long term prognosis for individuals with ADHD. 2) Review the role that efficiency executive functions plays in contributing to impairments of both youth and adults with ADHD. 3) Develop a better connection between assessment and diagnosis, treatment and prognosis for populations of youth with ADHD.

Handouts: 130NewviewADHDBend2015

January 16, 2015 - "Treatment of Pediatric Marijuana Overdoses"
Speaker: George Sam Wang MD FAAP, Assistant Professor of Pediatrics, Section of Emergency Medicine, Medical Toxicology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado

Objectives: Objectives: 1) Discuss marijuana pathophysiology and pharmacokinetics. 2) List the various forms of marijuana. 3) Discuss unintentional pediatric ingestions in Colorado, and unintentional pediatric exposures in the US. 4) Discuss preventative measures and current safety legislation in Colorado.

Handouts: 116Wang, 116Wang HOs color

January 09, 2015 - "Ebola"
Speaker: Rebecca Sherer, MD,Medical Director, Infection Prevention and Control, Infectious Diseases, St. Charles Health System

Objectives: Objectives: 1) Discuss current statistics in the 2014 Zaire Ebola outbreak. 2) Describe Ebola infection control measures, personal protective equipment and the use of bio containment units. 3) Discuss challenges with the current State of Oregon Ebola Plan. 4) Discuss Ebola virology, pathogenesis, and clinical course, including laboratory features, disease progression and routine medications used. 4) Discuss vaccine trials starting December 2014.

Handouts: 19Sherer, 19ShererEBOLAgrandrounds HOs

January 02, 2015 - No Grand Rounds due to New Year holiday weekend