Focus on the Spine. The Future of Spine Care NorthBay Green Valley Conference Center Friday, May 4 th 2018

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1 NorthBay Center for Neuroscience and Mayo Clinic Symposium Focus on the Spine The Future of Spine Care NorthBay Green Valley Conference Center Friday, May 4 th 2018 Co-Directors: Edie Zusman, MD MBA Christopher Rumery, MD

2 NorthBay Center for Neuroscience Mayo Clinic Focus on the Spine Welcome Introduction to Spine Symposium Impact of Back Pain Opioid Epidemic Health Care Economic Models Best Practices for Spine Care Mayo Clinic Model at NorthBay

3 NorthBay Center for Neuroscience Focus on the Spine Welcome Honored Guests John Obegolu Judy Robinson Teri Duarte Richard Riemer

4 NorthBay Neurosurgery Team Kristin Alderisio Corey Beausoleil Kawanaa Carter Jonathan Forbes Patrick Maloney Phillip Parry Atul Patel Sherry Taylor Edie Zusman

5 Dedicate this Program to Dr. Charles Wilson, MD, MHA Neurosurgery Chair - UCSF

6 Focus on the Spine Back pain diagnosis and evaluation Dr. Taylor Occupational Health Dr. Petrofsky Opioid Epidemic Dr. Ford Pain Management Dr. Rumery Band Aid Spine Surgery Dr. Patel Osteopathic Manipulative Medicine Dr. Skates

7 Focus on the Spine Case Based Learning - Patient s own physicians presenting their case to our world class panel Keynote Speakers From Mayo to Military Dr. McClendon and Dr. Parry Q and A -Continue the Conversation Reception with Speakers and Panelists Breaks Hands on learning & developing our community of health

8 Why Are We Focused on the Spine? 100,000,000 people will have back pain at some point in their lives Number one cause of lost work days 20 % of visits to Primary Care Provider Gateway to chronic pain and opioid addiction Increasing with aging population Impacted by social determinants of health 29% increase in need for spine services over 5 yrs Advisory Board 2014

9 Shared Health Care Value Back Pain Operative AND Non Operative Known Risk Factors for Spine Surgery are Obesity Deconditioning Prior Spine Surgery NorthBay Spine Center PREHAB and REHAB Shared Responsibility for Health with our Patients and Employers/Communities Porter 2009 Zusman Neurosurgery 2011 Porter 2016

10 Continuum of Services Required To Treat Spine Problems Neurosurgical Triage rule out tumors, spinal cord compression, neurologic disorders Optimized Non Operative Management Multimodality/Non Narcotic Meds Correct Imaging Value Based Optimized Return to Work PT/Water Therapy/Movement is Medicine

11 Continuum of Services Required To Treat Spine Problems Interventional Pain Procedures Osteopathic Manipulative Medicine (OMM/FDM) Minimally invasive outpatient spine surgery Traditional open surgery nerve decompression Computer guided spine fusion Complex spine reconstruction/tumor/infection Scoliosis surgery

12 NorthBay Cares for Patients in Both Capitated and Fee for Service Models Incentives are uniquely aligned to do what is right for patients

13 NorthBay Spine o Top Talent Spine Team o Admin Director, Dustin Nguyen o Shauna Bishop and Lisa Gonzales-Marin o Clinical o Pain Management Drs. Amster, Jaber, Khan, Pena, Rumery o OMM Dr Lim and Dr. Skates o Neurosurgery/Spine Drs. Maloney, Parry, Patel, Taylor, Zusman Physical Therapy Spine Specialized o HealthSprings Fitness Personalized Training o Neurology Drs. Ali, Almullahassani, Rehman o Nutrition Laura Hitt o Osteoporosis Dr. Allen, Elizabeth Milne and Dr. Feinberg o Neuroradiology Dr. Borg, Gainsler, Lai o Ortho Joint- Dr. Brooks, Elmes, Parkin, Peterson Holistic and Comprehensive Approach

14 NorthBay Hospital Top Technology Wellness Center HealthSprings o State of the art Operating Rooms o NorthBay is completiing 200 million dollar expansion o Zeiss Microscopes and Endoscopes o Minimally Invasive technology o Stealth Computer Navigation o State of the art Health Fitness Center o 50,000 square foot wellness center o 4 swimming pools and jogging track o Mayo Clinic Model One Stop Shop o Patients seen in 5-7 days of referral o Multidisciplinary Spine Conference Holistic and Comprehensive Approach

15 NorthBay Center for Neuroscience Spine Center 5% Urgent OR 15 %? Surgery 30% Non Operative Primary Care Provider Make SPINE Center Referral Spine CenterTeam Referrals Coordinator 50% Chronic Back Pain Neurosurgery Team Does Highest Level Triage Pain Management OMM EMG/NCV Physical Therapy HealthSprings

16 The Future of Spine Care Multidisciplinary - Conferences and Clinics Shared Responsibility for Spine Health Through the Continuum of Care Prehab, Disease Centered, Rehab Minimally Invasive and Outpatient Computer Nagivated Complex Spine Reconstruction Patient Centered NorthBay Model!

17 Thank you to our NorthBay Center for Neuroscience Team Kelly Rhoads-Poston Sarah Jewel Justine Zilliken Elnora Cameron Shauna Bishop Mechelle Levingston Dustin Nguyen Wayne Geitz And our Scribes Kasey, Erica and Ryan

18 Thank You! NorthBay Center for Neuroscience Edie E. Zusman, MD, MBA