Important Clinical Links
Soarian (on campus or on VPN only - for off campus use App Store above)
Columbia Library (for access to journal articles off campus)
Latest News from AIM
Teledermatology Pilot Starts 2/4
Starting on Monday there will be teledermatology services available for our patients most days of the week. The faculty have been trained on the process and equipment (see medicineclinic.org/telederm if you want to review the workflows). If you have a patient that would benefit from real time dermatology consultation in your continuity clinic or in walk in clinic, let your PIC know and he/she can help facilitate. Let me know how the consult goes!
As of December 15, 2018, the Quantiferon TB Gold (Quest) lab order was discontinued and replaced with Quantiferon TB Gold +, 1T (Quest) order. Dr. Scharle is working on updating the AIM common orderset with these changes, but for now, you will need to order the new test from the main menu.
Prior Authorization for Medications
· Dottie and our PA team have streamlined the medication PA process dramatically over the past few years (Did you know the group addressed >2700 requests and obtained almost 900 prior authorizations in 2018?). The process works best when the whole PA team (not just Dottie) is engaged via our call center and the pharmacy.
· Some providers have been astutely anticipating that a medication will need PA and reaching out to Dottie directly which unfortunately complicates the team process. If you know that a medication needs prior authorization, please send an SHM to the GROUP “AIM PA's” and include the name of the medication, indication/ICD10 and the prior medications that have been tried or contraindications. This will streamline the process for the PA team.
Ambulatory Read of the Week
Association Between Sodium-Glucose Cotransporter 2 Inhibitors and Lower Extremity Amputation Among Patients With Type 2 Diabetes
A retrospective cohort examining the hazard ratio for amputation among patients newly prescribed SGLT2 inhibitors vs other classes of oral diabetic medication. Spoiler: even this cohort of 2 million patients didn't generate enough events to find a statistically significant correlation, though the fact that the point estimate gives a hazard ratio of 1.98 for ANY SGLT-2 inhibitor vs older antidiabetic medications is reason enough to continue to avoid these medications in patients at high risk of amputation, especially those with known peripheral arterial disease.