The pathology of diabetes mellitus may play an integral role in the microvascular density of patients with primary open-angle glaucoma (POAG), according to new data presented at the 

American Academy of Ophthalmology (AAO) 2020 Virtual Meeting.

In new data from a cross-sectional study conducted by a team of US-based investigators, findings indicate diabetes mellitus pathology could associate with POAG density within superior and nasal quadrants.

Led by study author John Yu Cheng, BA, investigators sough to evaluate the quantitative characteristics associated with radial peripapillary capillary (RPC) vascular plexus in the eyes of glaucoma patients with or without diabetes. 

Their assessment included optical coherence tomography angiography (OCT-A), correlating observed associated changes with retinal nerve fiber layer (RNFL) thinning as seen on tomography.

Their assessment included 44 eyes from as many patients. Patient eyes were split between primary open-angle glaucoma only (n = 26) and diabetes/POAG eyes (n = 18), and were scanned using OCT-A and OCT RNFL.

Patient diabetes was defined as HbA1c levels greater than 6.5%. Cheng and colleagues conducted their assessment using the two-way ANOVA with post-hoc Tukey honest significant difference (HSD).

Eyes of patients with diabetes and POAG showed a decreased mean microvascular density versus those with lone POAG (

 <.01). An assessment of RPC in 4 quadrants also showed patients with diabetes and POAG have reduced mean density versus lone POAG patients in nasal (34.2% vs 40.3%) and superior (34.1% vs 40.8%) quadrants (

A sub-analysis of RNFL on OCT in 4 quadrants also showed a difference in the thickness of RNFL between both patient groups (

<.01). Investigators observed a “moderate correlation” in RNFL loss among patients with both diabetes and POAG to have a dropout in microvascular density.

“Our results indicate diabetes pathology may act on the microvasculature density of primary open-angle glaucoma patients in a synergistic manner within superior and nasal quadrants,” investigators wrote.

Effects of Type 2 DM and POAG on Peripapillary Microvasculature Density and Nerve Fiber Layer

Articles

Retinal nerve fiber layer density also appears to be influenced by presentation of both conditions.

Diabetes Could Influence Glaucoma Patient Microvascular Density

 features a report on a screening technique designed to assess multiple chronic disease risks in women with just one examination.

The report—sandwiched between findings that candy licorice is associated with hypertension and an advertisement for Sebulex dandruff shampoo&mdash;found risks for high blood pressure, diabetes, and breast cancer among various women.

Screenings such as this 15-minute test should become more commonplace among general practitioners, the reporter opined. After all, chronic disease prevalence, as well as physician workload, were on the rise.

Fifty years have passed, and the healthcare field is still trying to aid the overworked physician. The annual rate of US-trained MD physicians matched into primary care residencies has dropped for nearly a decade. Osteopathic- and foreign-educated physicians have assumed these vacancies, and nurse practitioners and physician assistants have seen their roles shape into something more resembling that of a doctor’s.

“Going to the doctor” no longer necessarily means you’re going to see a doctor. Healthcare teams are multi-faceted, diverse, specific. And as interpretation of disease has become better defined; as the potential of novel therapies have become met; as the networks of cross-specialty collaboration have become strengthened, healthcare has evolved.

 as part of our effort to provide clinical news and insight to every healthcare professional with a role in patient care.

Our embrace of the greater healthcare professional population will coincide with innovations to our offering of content:

A revamped podcast series which will highlight insights from topline clinicians and researchers.

The Peers and Perspectives video series, set in an interview-based expert dialogue format.

Social media-led discussions and projects, including live broadcast interviews from major medical meetings as well as the ‘#DocTalk’ Tweet Chat series.

Our growing, engaged audience can still continue to expect an array of digital content—from video Insight series to breaking FDA news, from Peer Exchange panels to live medical meeting coverage&mdash;featuring broader expert perspective.

, a collaborative system of specialty publications headlined by 

®. Our goal is to provide the best materials on diagnostics and precision medicine for any provider, in any field of care.

will be re-introduced to a field of coverage that better reflects its namesake and intent.

Thank you for reading, watching, and collaborating with 

. It’s time to expand our discussion of healthcare.

Introducing the New HCPLive, and HCPLive Network

As the weather warms and spring turns to summer, the layers of clothing come off. It’s the time of year when people ramp up their diet and exercise regimens to tighten up that beach body.

A year round approach is the best way to maintain long-term health. But the truth is,  as we age, no matter how much someone works out or restricts their  calories, some stubborn fat can remain — and may be nearly impossible to burn off.

 For those who want to shortcut time spent counting calories or sweating at the gym,consider three non-surgical body-contouring options available for men and women. They are effective on some of the most embarrassing spots where fat develops, common problem areas that can turn anyone into a self-conscious wreck.

CoolSculpting is a technique that uses a process called “cryolipolysis” to cool and destroy fat cells in the body without harming the surrounding tissue. CoolSculpting has been FDA approved to be used on abdominal fat, love handles, back and thighs. There is also a related version for neck and chin areas called “CoolMini.”

During the procedure, a gel pad and a specialized applicator is applied to the target area to cool the fat cells. Skin (and fat) is then drawn into the applicator using a vacuum and the area is then treated. Patients can generally expect to reduce fat in the area targeted by 20- to 25-percent for each treatment. Patients report only minimal discomfort while undergoing treatments, which can take between 25  to 90 minutes depending on the size of the area.

Since CoolSculpting is noninvasive, after treatment there is no downtime required and individuals can go about their daily routine. It takes four months to see the results from CoolSculpting, but the process can be repeated in one to four months depending on the area being treated. 

CoolSculpting is not an effective treatment for everyone. One key consideration: the Patient needs to be able to “pinch” the skin and fat between their fingers since CoolSculpting draws this pinch-able fat into the applicator.  

Vanquish appears similar to CoolSculpting since it also targets the same treatment areas, such as the abdomen, love handles and hip areas. Yet Vanquish works very differently, using Selective RF™ technology to heat up the fat cells, which in turn are then destroyed. One of the advantages of Vanquish is that the applicator doesn’t actually touch the patient’s skin, heating it up instead.

Patients can expect to see a reduction of fat in problem areas from between two and four inches in total. Treatments take up to an hour and generally most patients require up to six weekly treatments. Results are typically quite fast and patients should be able to see changes in their body fat as the treatment schedule progresses.

Exilis® is a skin-tightening treatment that uses the same Selective RF™ technology as Vanquish and is made by the same manufacturer, BTL Aesthetics. Exilis is designed to treat different aspects of excess fat and skin and it is also designed to promote collagen reproduction, which helps tighten skin.

Exilis is used to treat mild fat deposits in the same areas as CoolSculpting and Vanquish, but it can also be applied to the face to treat fine lines, turkey necks and jowling in the face. One of the key differences with Exilis is that it is normally recommended treat issues with loose skin, or skin laxity, anywhere on the body. For individuals who have lost a lot of weight, skin laxity can be a problem and Exilis can treat mild cases of this effectively. Generally a number of treatments — four to six, on average, carried out over a series of weeks – will be needed to get best results. Consult with a cosmetic dermatologist such as Dr. Michele Green (

 and choose the option that’s best for you. Then hit the beach!

-       Michele S. Green, MD, attending dermatologist at Lenox Hill Hospital

As the weather warms and spring turns to summer, the layers of clothing come off. Itâ€™s the time of year when people ramp up their diet and exercise regimens to tighten up that beach body.


Beach Body: Consider These Non-Surgical Body Contouring Options for the Summer

  The American Academy of HIV Medicine (AAHIVM) is pleased to announce Dr. Kevin Fiscella, MD, MPH, of Jordan Health in Rochester, NY, as the winner of the sixth annual 

AAHIVM/Institute for Technology in Health Care HIV Practice Award

. Dr. Fiscella will receive $20,000 in recognition of his innovative use of technology in caring for people living with HIV.

“While technology plays a vital role in HIV, often patients are socially disadvantaged and many, particularly the older patients, are on the wrong side of the digital divide,” stated Dr. Fiscella. “I think this award highlights the power of technology, but also the need for technology to be brought to everyone.”

Using a community-based participatory research approach involving persons living with HIV (PLWH), clinicians and AIDS organizations, Dr. Fiscella and his team developed URHealth, an electronic patient health record (ePHR) for PLWH.  It is unique because it uses the patient’s own data to prompt him or her to ask their HIV clinicians about specific gaps in care.

Provided as an app, URHealth, prompts patients to take action when their viral load is not undetectable or when they are missing key preventive steps. It also provides links to high quality HIV related information. Most importantly, peer-facilitated trainings ensure that patients not only understand how to use their smart device and URHealth, but that they also understand the significance of lab results, various medications, and immunizations, and have the skills and confidence to discuss their questions and concerns with their HIV clinicians.

Staff from eight HIV practices in Rochester and New York, NY have engaged in this use of technology.

In its sixth year, the AAHIVM/Institute for Technology HIV Practice Award seeks to acknowledge those who have created, adapted and/or used innovative technology in their HIV practice and to share that technological knowledge with others in the practice of HIV medicine to improve patient care.

As the winner of the AAHIVM/Institute for Technology in Healthcare HIV Practice Award, Dr. Fiscella recently presented URHealth at the ACTHIV conference in Dallas, TX.

“It’s a really powerful tool in bringing patients together all committed to the same goal, which is improving self-management through technology,” stated Dr. Fiscella.

an Academy of HIV Medicine is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV disease.  Our membership of HIV practitioners and credentialed providers give direct care to the majority of HIV patients in the US.

he Institute for Technology in Health Care (ITHC) encourages the use of technology in various fields to benefit health care.  ITHC wishes to stimulate users, researchers, and students to present papers to groups of their peers, or write articles that demonstrate how they have used technology from any field to benefit the practices of medicine to improve health in any community. It is also interested in stimulating innovative projects that use technology from any field to benefit health.

Staff from 8 HIV practices in New York have engaged in this use of the technology.


American Academy of HIV Medicine and the Institute for Technology in Health Care Announce the 2017 HIV Practice Award Winner

photo, right with Archbishop Timothy Dolan, left

)  paraded up Fifth Avenue in Manhattan today as thousands of New Yorkers lined the street and countless more marched behind him in the 256th St. Patrick’s Day Parade. Mr. Dowling served as 

, an honor the County Limerick native received in October as validation of his remarkable Irish-American immigrant story.

From scratch beginnings — a thatched, mud-walled home with no electricity or running water – Mr. Dowling used education to lift himself up one rung at a time. He earned his undergraduate degree from University College Cork (UCC), Ireland, and after working the docks of the New York waterfront, obtained his master’s degree from Fordham University. Today Mr. Dowling leads New York State’s largest private employer and one of the nation’s biggest health systems.

“It just proves what the United States is all about. No matter how you began, the United States gives opportunities that exist no place else in the world,” Mr. Dowling said during his long walk from 44th Street to 79th. “To be in New York, to be in the United States and to be Irish on a beautiful day like this on St. Patrick’s Day — what could be better?”

Mr. Dowling began the day by celebrating mass alongside New York City Mayor Bill de Blasio at St. Patrick’s Cathedral followed by breakfast with His Eminence, Timothy Cardinal Dolan, Archbishop of New York.

Then Mr. Dowling performed his ceremonial duties, leading the parade through a sea of green to Central Park.

“Hard to believe,” said Mr. Dowling. “It’s a long way from a small village in West Limerick.” 

Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals and over 550 outpatient facilities. We care for more than two million people annually in the metro New York area and beyond, thanks to philanthropic support from our communities. Our 61,000 employees — 15,000+ nurses and nearly 3,400 physicians, including nearly 2,700 members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institute. We're training the next generation of medical professionals at the visionary Hofstra Northwell School of Medicine and the School of Graduate Nursing and Physician Assistant Studies. And we offer health insurance through CareConnect. For information on our more than 100 medical specialties, visit 

Michael Dowling, CEO of Nortwell Health, was Grand Marshall of the St. Patrick's Day Parade. 

Northwell CEO Celebrates Immigrant's Dream: Leads St. Patrick's Parade

To better guide clinical activities to improve engagement and retention in care, the International Advisory Panel on HIV Care Continuum Optimization published guidelines for optimizing the HIV care continuum in adults

In these guidelines, “systematic monitoring of retention in HIV care” was recommended with “proactive engagement and reengagement of patients who miss clinic appointments…”

.  Case management and intensive outreach were mentioned as possible interventions. 

In the area of outreach and contact interventions, several have been found to be successful, but there is no consensus as to which should be implemented. Due to the busy schedule of clinic staff and interventions that often are time intensive, the amount of time dedicated to these programs may be restricted within our current funding limitations. 

Given the diversity of the HIV clinics across the country, some of the evidenced-based interventions may be more effective in some settings than others. Thus a succinct, universally applicable, and highly successful intervention is ideal.

Globally, there has been a focus on targeted interventions and strategies to improve each step in the HIV treatment cascade, knowing that improvements in testing, linkage, and retention will improve clinical outcomes for individuals with HIV as well as decrease HIV transmission

A recent study using mathematical modeling predicted that 61% of all new infections with HIV were transmitted from HIV patients who were not retained in care

. There are evidence-based services known to improve engagement and retention in care, including case management, mental health services, substance abuse treatment, drug assistance programs, and food, housing, and transportation assistance

At the Medical University of South Carolina Ryan White HIV clinic, we have HRSA funding to provide care to more than 1,200 patients annually without regard to pay, primarily in the greater Charleston area, with extension into the three surrounding counties.

The Ryan White clinic offers the above mentioned evidence-based services along with access to dedicated board-certified infectious disease providers, women’s healthcare, and nephrology as well as multidisciplinary care with social workers, pharmacist, nurses, and support staff.

Despite these evidence-based strategies to improve retention in care having already been implemented, there are still poorly retained patients in need of intervention and reengagement. In South Carolina, in 2012, only 53% of patients in the state were retained in care

. Studies focusing on retention in care have indicated there are a multitude of reasons for loss to follow-up and poor retention

, many of which could be addressed by available services if we could bring the patient back into care. 

               To that end, we piloted an intervention using an outreach coordinator who was a licensed professional counselor with experience working with people living with HIV

. Initially, we piloted a phone, letter, and home visit intervention to patients lost to care in the previous five years, but found low response rates, possibly due to out-of-date contact information and longer times since last appointment

We suspected that outreach interventions may be more successful with patients at risk of falling out of care, with timely intervention close to the last visit to ensure we could find the patient. To target these patients, we defined “at risk of falling out of care,” as missing a clinic visit in 2015 and having intervention from the outreach coordinator.  She used phone call and letter interventions to contact patients for outreach, visit reminders, and missed visits to engage and reengage patients. She recorded the amount of time used for interventions in 15-minute intervals.

The main outcomes were reengagement (having a visit in 2015) as well as retention in care (HRSA definition of two visits divided by 90 days in 2015). Of more than 1,200 patients cared for at our clinic in 2015, 61(5%) met the definition of at risk of falling out of care. The mean intervention time was an hour, the median 45 minutes. Fifty patients (82%)of the patients were reengaged and 22 (36%) were retained in 2015

. As phone calls and letters are simple interventions and the mean intervention per patient was only an hour, this intervention was both succinct and successful.

Several studies have looked at interventions in patients with a recent history of missed clinic visits or those without evidence of retention in care, a population similar to our study on those at risk of falling out of care.

For example, Gardner and colleagues presented a randomized trial that included both newly diagnosed patients and “at risk” patients, with either missed clinic visits or gaps in care, to receive standard-of-care appointment reminders, enhanced contact (EC) with a dedicated person, or EC plus a one-hour skills session

They demonstrated improvements in visit constancy, another measure of retention in care, for those patients with EC (56% vs 46%) but not with the additional skills session (Gardner 2014). These authors also published evidence of cost-effectiveness as the average cost per patient retained over the standard of care was $3,834

Additionally, Bradford and colleagues presented analysis of four programs enrolling patients at risk of falling out of care to receive navigation interventions from peers or paraprofessionals (Bradford 2007). They demonstrated improvements in undetectable HIV viral load (35% to 53%) as well as increased attendance of two or more visits in six months (64% to 79%)

In addition to these studies focusing specifically on those at risk for falling out of care, there is also literature that supports intervention beyond the initial at-risk period.

For example, Udeagu and colleagues reported results of a loss to follow-up intervention utilizing case management to reengage patients who had fallen out of care (Udeagu 2013). They describe a city-wide effort from the public health department with a similar outreach intervention to that reported in our study. They used case-workers in a step-wise process with a phone call, letter, and home visit intervention and were able to reengage 57% of those lost to follow-up over an almost three-year period

The inclusion criteria for this study was absence of care over the previous nine months using a lab surrogate for care, a CD4 count or HIV viral load

.  As a result of this definition 33% of the patients initially identified were currently in care and they excluded patients they were unable to contact

Our study had comparatively good results using an LPC  with a total reengagement of 82%, with 36% retention in care in 2015 -- although the patients were not necessarily out of care for the same duration as that presented by Udeagu and colleagues.

Another study, reported by Giordano and colleagues, tested an intervention for peer mentoring to out-of-care patients with HIV during hospitalization which did not show an effect on retention in care and viral load outcomes

Finally, a report from Wohl and colleagues focused on 1,100 out-of-care patients and found 78 were lost to care. They demonstrated interventions by trained navigators resulted in 82% retention in care following the series of extensive reengagement services and interventions

While there is clearly evidence for contact based interventions to reengage out-of-care patients and maintain engagement for at risk patients, retention in care remains a large problem nationally.

One of the key findings in the published data is that contact interventions using trained staff or peers can effectively engage or reengage patients. Moreover, early intervention and high intensity intervention may result in improvement of the ultimate outcome. 

As each clinic may have a different approach to contact interventions for engagement in care, it is important that the information is shared with other HIV providers so we can provide the most cost-effective and universally acceptable interventions to our patients in this era of funding limitations and uncertainty.  

		International Advisory Panel on HIV Care Continuum Optimization.  IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents. J Int Assoc Provid AIDS Care. 2015;14 Suppl 1:S3-S34.

		Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy. NEJM. 2011;365:493-505.

		Skarbinski J, Rosenberg E, Paz-Bailey G, et al.  Human Immunodeficiency Virus Transmission at Each Step of the Care Continuum in the United States. JAMA Intern Med. 2015;175(4):588-596.   

4.      Horstmann E, Brown J, Islam F, et al. Retaining HIV-infected patients in care: Where are we? Where do we go from here? Clin Infect Dis. 2010;50:752-61.

		Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ.  The Spectrum of Engagement in HIV Care and its Relevance to Test-and Treat Strategies for Prevention of HIV Infection.  Clin Inf Dis

6.      Edun B, Iyer M, Albrecht H, Weissman S. The South Carolina HIV cascade of Care. South Medical Journal 2015;108:670—674.

7.      Bean M, Scott L, Richey LE.  Use of an Outreach Coordinator to Reengage and Retain Patients at Risk of Falling Out of HIV Care, Does the Amount of Time Matter? Poster Presentation at the Infectious Diseases Society of America Annual Meeting in New Orleans. October 2016.

8.      Bean M, Scott L, Richey LE. Use of an Outreach Coordinator to Reengage and Retain Patients with HIV in Care. International Physicians in AIDS Care (IAPAC) 

11th International Conference on HIV Treatment and Prevention Adherence

9.      Gardner LI, Giordano TP, Marks G et al.  Enhanced personal contact with HIV patients improves retention in primary care: a randomized trial in 6 US HIV clinics.  Clin Infect Dis 2014;59:725—734.

10.   Shrestha RK, Gardner L, Marks G, et al. Estimating the cost of increasing retention in care for HIV-infected patients: results of the CDC/HRSA retention in care trial. J Acquir Immune Defic Syndr 2015;68:345—350

11.   Bradford JB, Coleman S, Cunningham W. HIV system navigation: an emerging model to improve HIV care access. AIDS Patient Care STDS 2007;21:S49—S58

12.   Udeagu CC, Webster TR, Bocour A, Michael P, Shepard CW. Lost or just not following up: public health effort to re-engage HIV-infected persons lost to follow-up into HIV medical care. AIDS 2013;27:2271—2279    

13.   Wohl AR, Dierst-Davies R, Victoroff A, et al. The navigation program: an intervention to reengage lost patients at 7 HIV clinics in Los Angeles county, 2012-2014. J Acquir Immune Defic Syndr 2016;71:e44—e55

14.   Giordano TP, Cully J, Amico KR, et al. A randomized trial to test a peer mentor intervention to improve outcomes in persons hospitalized with HIV infection. Clin Infect Dis 2016;63(5):678-86.

Keeping some patients with HIV in care can be a challenge. 

Targeted Interventions : Reengagement in Care of People Living with HIV

            MANHASSET, NY — Doctors at Northwell Health’s 

 have begun enrolling patients in the Stereotactic Laser Ablation for Temporal Lobe Epilepsy (SLATE) clinical trial designed to further expand the use of Medtronic’s Visualase® MRI-Guided Laser Ablation System.

	            The Visualase system has already been cleared by the U.S. Food and Drug Administration (FDA) for use in neurosurgery, but is considered an investigational device for people with drug-resistant mesial temporal lobe epilepsy (MTLE), the most common form of epilepsy. The purpose of this multi-centered clinical trial is to test the safety and efficacy of the Visualase System for treatment of people with MTLE.

	             “Laser ablation technology is useful in patients with MTLE, where there is a loss of neurons and scarring of the deepest portion of the temporal lobe,” 

 Northwell Health’s director, epilepsy surgery and principal investigator of the study at 

 in Manhasset, a member of Northwell Health. “This scarring is often the cause for seizures that cannot be controlled by medications alone. Laser ablation allows the neurosurgeon to simultaneously deliver and monitor the thermal energy while the patient undergoes MRI imaging.”

	            In this minimally invasive procedure, the laser probe is inserted into the brain through a one-quarter inch incision and delivers energy produced by the laser to heat and destroy the diseased, seizure-producing tissue deep within the brain. The treatment is focused and MRI temperature maps provide the neurosurgeon with a real-time view of the diseased tissue being destroyed, without damaging healthy tissue. The laser probe is then removed and the incision is closed.

	            Participants in the SLATE trial will be followed for one year after their laser ablation procedure and evaluated for seizures, other adverse events, neuropsychological outcomes and quality of life.

	            For more information about the SLATE trial at Northwell Health’s Comprehensive Epilepsy Center, call 516-325-7061.

Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals and over 550 outpatient facilities. We care for more than two million people annually in the metro New York area and beyond, thanks to philanthropic support from our communities. Our 61,000 employees — 15,000+ nurses and nearly 3,400 physicians, including nearly 2,700 members of Northwell Health Physician Partners -- are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institute. We're training the next generation of medical professionals at the visionary Hofstra Northwell School of Medicine and the School of Graduate Nursing and Physician Assistant Studies. And we offer health insurance through CareConnect. For information on our more than 100 medical specialties, visit 

Northwell Health is testing laser ablation for temporal lobe epilepsy. 

Northwell Health's Comprehensive Epilepsy Center  Enrolling Patients in MRI-Guided Laser Ablation Clinical Trial

Dr. Raju will serve as community health investment officer for New York’s largest health provider

NEW HYDE PARK, NY — Ram Raju, MD, the former head of the nation’s largest public health system, has been appointed to a key leadership position at 

As senior vice president and community health investment officer, Dr. Raju will evaluate the needs of the most-vulnerable communities Northwell Health serves, assess programs that enhance the health system’s ability to respond to those needs and collaborate with community-based organizations to create problem-solving solutions.

Dr. Raju served as president and CEO of NYC Health + Hospitals from January 2014 until stepping down in November 2016. 

 includes 42,000 employees, 11 acute-care hospitals, five nursing homes, six diagnostic and treatment centers, more than 70 community-based health centers, a large home care agency and one of the region's largest providers of government-sponsored health insurance, MetroPlus Health Plan.

“Ram’s vast experience, deep commitment to caring for vulnerable communities and keen understanding of New York's health care delivery system make him the ideal individual to lead our efforts,” said 

, Northwell Health’s president and CEO. “His most-recent work with NYC Health + Hospitals certainly enhances his ability to respond to this challenge.”

Dr. Raju has extensive leadership experience. Prior to NYC Health + Hospitals, he served as CEO for the Cook County Health & Hospitals System in Chicago, the nation’s third-largest public health system, where he improved cash flow by more than $100 million and changed the system’s financial health during his tenure from 2011-14. He began his medical career at Lutheran Medical Center in Brooklyn and went on to serve as chief operating officer and medical director at NYC Health + Hospitals’ Coney Island Hospital. In 2006, he became the HHC chief medical officer, corporate chief operating officer and executive vice president. Under his leadership, HHC continued to reach great heights in quality, patient safety and health care data transparency.

“Northwell Health created a position that enables me to pursue my passionate interest in improving population health and addressing the social determinants of health,” said Dr. Raju. “I thoroughly enjoyed the many years I spent at NYC Health + Hospitals, which gave me valuable insight into the needs of our most-vulnerable communities and how health policies can positively influence the delivery of care and improve outcomes. My new role with Northwell will enable me to promote, sustain and advance an environment that supports equity and diversity, and help eliminate health disparities within the communities served by Northwell throughout the city, Long Island and Westchester County.”

Dr. Raju earned his medical diploma and Master of Surgery degree from Madras Medical College in India. He underwent further training in England, where he was elected as a Fellow of the Royal College of Surgeons and later received an MBA from the University of Tennessee and CPE from the American College of Physician Executives.

He served as vice-chair of the Greater New York Hospital Association and currently sits on the boards of numerous city, state and national health care organizations, including the American Hospital Association, the New York Academy of Medicine and the Asian Health Care Leaders Association.

Dr. Raju is the recipient of numerous national recognitions, including 

 list of the nation’s “100 Most-Influential People in Healthcare.” 

 also named him one of the “Top 25 Minority Executives in Healthcare” and one of the “50 Most-Influential Physician Executives in Healthcare.” In 2013, he was named a Business Leader of Color by Chicago United.

The information contained in this electronic e-mail transmission and any attachments are intended only for the use of the individual or entity to whom or to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering this communication to the intended recipient, you are hereby notified that any dissemination, distribution, copying or disclosure of this communication and any attachment is strictly prohibited. If you have received this transmission in error, please notify the sender immediately by telephone and electronic mail, and delete the original communication and any attachment from any computer, server or other electronic recording or storage device or medium. Receipt by anyone other than the intended recipient is not a waiver of any attorney-client, physician-patient or other privilege. 

 
Dr. Raju will serve as community health investment officer for New Yorkâ€™s largest health provider

Former NYC Health + Hospitals CEO Ram Raju, MD, Joins Northwell Health

 Hahnemann University Hospital has launched the Gender Reassignment Surgical Program — a new gender affirmation program for transgender patients. Hahnemann will offer both female-to-male and male-to-female gender confirming surgeries. The launch of the program is the first for an academic medical center in the Philadelphia region.

Under the direction of board-certified plastic surgeon Kathy L. Rumer, DO, FACOS, patients interested in gender confirmation surgery at Hahnemann University Hospital have access to face, breast, chest, body contouring, gender reassignment and other related surgeries. Dr. Rumer is a private practice physician who leads an aesthetic and reconstructive plastic surgery office on the Main Line.

“We’re extremely proud to offer gender confirming surgery at Hahnemann University Hospital because it is in line with our focus on providing all patients with leading-edge, high-quality care,” said Michael P. Halter, CEO of Hahnemann University Hospital.

Patients interested in gender confirming surgery must meet certain requirements, depending on specific procedures, as specified by their insurance company or the World Professional Association for Transgender Health (WPATH) Standards of Care.

For more information about gender confirmation surgery at Hahnemann University Hospital, please call Dr. Rumer’s office at 1-855-782-5665.

Hahnemann University Hospital is a 496-bed academic medical center at Broad and Vine Streets in Philadelphia.  The hospital is a tertiary care institution that specializes in cardiac services, heart failure, OB/GYN, orthopedics, medical, surgical and radiation oncology, bone marrow transplantation, renal dialysis, and kidney/liver transplantation. In 2009, Hahnemann earned Magnet® designation by the American Nurses Credentialing Center (ANCC) Magnet Recognition Program® and received redesignation in 2015. Hahnemann is recognized by the American Heart Association as a leader in stroke and heart failure treatments. U.S. News and World Report’s 2016-17 “Best Hospital’s” report recognized Hahnemann as High Performing in nephrology, chronic obstructive pulmonary disease (COPD) and heart failure. Hahnemann has been recognized as a Top Performer on Key Quality Measures by The Joint Commission for attaining and sustaining excellence in Heart Attack, Heart Failure, Pneumonia, Surgical Care, Stroke and Perinatal measure sets. The hospital performed one of the city’s first kidney transplants in 1963 and one of the first bone marrow transplants in 1976.  Hahnemann became Philadelphia’s first Level I Regional Resource Trauma Center for adults in 1986. Hahnemann is fully accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nation’s oldest and largest hospital accreditation agency. An affiliate of Drexel University College of Medicine, Hahnemann University Hospital is part of Tenet Pennsylvania, which also includes St. Christopher’s Hospital for Children. 

Hahnemann University Hospital has launched the Gender Reassignment Surgical Program â€“ a new gender affirmation program for transgender patients. Hahnemann will offer both female-to-male and male-to-female gender confirming surgeries. 

Hahnemann University Hospital to Offer Gender Affirmation Surgery to Transgender Patients

The HIV Medicine Association, the American Academy of HIV Medicine, The Association of Nurses in AIDS Care and the Ryan White Medical Providers Coalition have written to US Senators urging them not to repeal the Affordable Care Act. The letter has 950 signatures. 

	We write as physicians, pharmacists, advanced practice nurses, physician assistants, nurses and other medical professionals working on the frontlines of the HIV epidemic in the United States who are concerned about our patients’ access to health care coverage and lifesaving care and treatment.   

	Two decades ago the development of antiretroviral therapy transformed HIV/AIDS from a deadly condition to a chronic condition for many. With reliable access to care and treatment that effectively suppresses the virus, patients can now be healthy and live near normal life expectancies, and when they are healthy and virally suppressed their risk of transmitting the virus drops to near zero.  The key to this prevention and treatment success is consistent access to medical care and needed medications.  

	Prior to the Affordable Care Act, a majority of our patients were either denied health insurance coverage because of their condition or were unable to afford the extraordinary high cost of the coverage available to them. In most states, Medicaid coverage was available to patients only after they became sick and disabled by AIDS. 

	The ACA leveled the health care playing field by barring plans from denying coverage or charging higher premiums based on health status, setting minimum health coverage standards, and providing premium and cost sharing assistance. Importantly, it modernized the Medicaid program by expanding coverage to families and childless adults up to 138% of the federal poverty level regardless of disability status. As medical professionals committed to our patients with HIV, we strongly urge that any changes to the ACA be based on the key principles below.

	Do no harm.  Prior to making changes to the ACA, a plan must be in place that takes into account the medical needs of low income individuals with complex conditions, like HIV, to avoid dangerous disruptions in health care coverage for our patients with HIV and millions of others. Meaningful health insurance coverage options must offer uninterrupted, affordable coverage for a range of necessary medical services, including prescription drugs, preventive services, laboratory testing, and substance use and mental health treatment.

	Sustain the federal commitment to the Medicaid program. Maintaining the current funding structure, including the federal entitlement, to the Medicaid program is critical so that states can respond to fluctuations in the demand for Medicaid coverage due to economic downturns, public health outbreaks such as the HIV and hepatitis C outbreaks in Scott County, Indiana and medical advances, such as the recent development of curative hepatitis C treatment.

	Continue Medicaid expansion. In the 32 states (including the District of Columbia) that have expanded Medicaid, our poorest patients were offered access to comprehensive, affordable coverage with consumer protections tailored to their socioeconomic and medical needs. Withdrawing this coverage will threaten the health of millions of Americans and be a significant set back to our nation’s public health, including to our efforts to end AIDS. 

	Please consider the needs of individuals with HIV as you evaluate changes to the ACA.  Their lives and our ability to make significant headway against the HIV epidemic in the U.S. depend on it.

	Submitted by the undersigned more than 950 HIV medical professionals:

	Jane Cooper, RN BSN, Univ of Alabama at Birmingham  

	C. Ann Gakumo, PhD, RN, Univ of Alabama at Birmingham  

	Wickliffe Many, MD, Univ of Alabama at Birmingham  

	Jeanne Marrazzo, MD, MPH, Univ of Alabama at Birmingham  

	James Raper, PhD, CRNP, Univ of Alabama at Birmingham  

	Robert  Myers, MD, Maricopa Medical Center

	Sudha Nagalingam, MD, El Rio Community Health Centre

	John Post, MD, Maricopa Integrated Health

	Sandra Brown, MPH, MSN, RN, Jefferson Comp Care

	   Univ. of Arkansas for Medical Sciences

	Marvin Belzer, MD, Children's Hospital Los Angeles and USC

	Constance Benson, MD, Univ of California San Diego

	Steven Bromer, MD, Univ of California, San Francisco

	Ruben Celiz, Registered Nurse, Kaiser Permanente

	Heidi Cevallos, PharmD and AAHIVP, Hillcrest Pharmacy

	Jesse Clark, MD, MSc, David Geffen School of Medicine at UCLA

	Phyllis Cohen, MD, Tarzana Treatment Center

	Summer Collier, MSN, FNP-BC, Family Health Centers of San Diego

	Eric Daar, M.D., David Geffen School of Medicine

	Michelle Davey, D.O., West County Health Centers, Inc.

	Maura Devereux, MMS, PA-C, Sutter Health/

	Mandeep Dhindsa, M.D, Community Medical Centers

	Jake Donaldson, MD, Ventura County Health Care Association

	Jose Eguia, MD, MPH, St. Mary's Medical Center

	William Flores, PA-C, The Doctor Health Center

	Robert Fontanilla, MSPAS, MPH, PA-C, AAHIVS  

	Daniel Gluckstein, MD, Inland Valley ID Medical Group, Inc

	Denise Gomez, MD, North County Health Services

The HIV Medicine Association, the American Academy of HIV Medicine, The Association of Nurses in AIDS Care and the Ryan White Medical Providers Coalition have written to US Senators urging them not to repeal the Affordable Care Act. 

Press Release