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Open Letter to the Patients of William F. Owen, Jr., M.D. and Carl Stein, MHS, PA-C and Q&A

NEW FAQ posted since the Open Letter was mailed are highlghted & posted below, just above the prior Q&A and within the FAQ

URGENT: Your signature is REQUIRED ASAP to remain as a patient of OWEN & STEIN-we are still accepting your signed consents

Dear Patient,

35 years ago I started our medical practice in San Francisco. In 2015 we will be taking a new direction. The last day of our private practice was December 22, 2014. On February 2, 2015, we reopened as an affiliate practice of Sutter Pacific Medical Foundation (SPMF). So, you might be asking, “What does this mean for me?” We hope to answer some of the most frequently asked questions below. As other questions arise, we will post them on our website, www.owenmed.com.

NEW Q: You mentioned that access to my athenahealth Patient Portal disappeared after December 28, 2014. Does that mean my entire athenahealth electronic health record (EHR) is gone forever?

A: No, within a few weeks of closing athenahealth, we received from athenahealth an encrypted key containing PDF files and Continuity of Care Documents (CCDs) of each of our patient's athenahealth EHRs.

NEW Q: I'm still worried that my athenahealth EHR will be lost.

A: No, your athenahealth records won't be "lost". As noted above, we received on an encrypted key a PDF of all of our patients' EHRs from athenahealth within a few weeks after we discontinued athenahealth at the end of 2014. If you have already printed out your Patient Visit Summaries, it might make it easier to reenter some of the historical data when you come for your first visit on Sutter EHR, the new EHR powered by Epic.

NEW Q: So, if you are getting a PDF of my entire athenahealth EHR, why did you ask me to go to the trouble of printing out the contents of my athenahealth Patient Portal by December 28, 2014?

A: We did not know at that time just how "organized" the PDF of your athenahealth EHR would be. We recommended that you print out the Patient Visit Record of your most recent comprehensive physical exam OR preoperative exam OR HIV quarterly visit. We believed we might need those items to facilitate entry of data into your new Sutter EHR. The essential data elements include an updated problem (diagnosis) list, medication list, drug allergy list, list of other providers you consult from time to time, vaccination record, past medical history, surgical history, family history, and social history.

NEW Q: Why are you and Carl Stein having to do all of the work of reentering all of my data manually into SPMF's Epic EHR?

A: There are two parts to this answer. First, I requested that athenahealth provide to us all of the athenahealth patient data in a usable digital format. athenahealth declined, stating that it was their corporate policy not to provide any assistance to their principal EHR competitior (i.e., Epic). However, athenahealth did actually provide to us Continuity of Care Documents (CCDs). The Information Services department at Sutter Health investigated whether these CCDs might be importable into Sutter EHR as usable data. While they are importable, Sutter does not have any experience or policy yet on importing CCDs from an external EHR. Therefore, Sutter IS decided not to allow CCD importation from your athenahealth EHR. Second, SPMF has offered to provide limited abstracting of our patients' athenahealth PDF files that we received on an encrypted data key. However, we have not been informed by SPMF how many patients' athenahealth records will be abstracted by the SPMF abstractors, nor have we been advised for how long this service will be provided, only that the abstracting assistance will be "limited". All of this says that Carl and I might have to reenter data for a significant number of our patients. This is where your organized athenahealth Patient Portal printouts, if you were able to obtain those, may be of some assistance.

NEW Q: Can I receive a copy of the PDF of my entire athenahealth EHR?

A: Every patient is entitled to a copy of his or her own medical record. So the answer is yes. However, please understand that at this moment we are overwhelmed with transition issues. If you would like to receive a copy of your athenahealth PDF on a CD-ROM, please wait until we are back in our renovated Suite 402, after February 2, 2015. At that time, you will need to sign a new consent (different than your SPMF consent), this time requesting a personal copy of the PDF of your athenahealth EHR plus anything we scanned from your previous paper chart. The fee for production of this disc will be $50, payable by money order only, to William F. Owen, Jr., M.D. After February 2, 2015, send your signed request and your $50 money order or drop it by our office in a sealed envelope addressed to Dr. William Owen and marked "Personal & Confidential". The $50 fee includes the cost of transferring your athenahealth PDF and any scanned files from your paper chart to CD-ROM, burning it, placing it in a CD envelope, the media mail postage to send the disc to the address of your choice, as well as my personal time for doing all of the above. As employees of SPMF, our staff will no longer be responsible for fulfilling such requests for medical records from my private practice, so I will need to do all of the work myself. Please understand that I will not have any employees to do this, so it may take time to produce CD-ROM discs for everyone requesting one.

Q: Dr. Owen, will you and Carl Stein continue to practice at 45 Castro in February 2015 upon reopening as an SPMF office?

A: Yes, Carl and I and our two staff members will continue to practice at 45 Castro Medical Office Building, Suite 402, when it reopens on February 2, 2015. Some time after we return in February, we will be adding a third medical assistant/patient care representative in February to assist us in the transition to SPMF.

Q: Will you continue to accept my health care insurance?

A: For the most part, yes. On our website you will find a table showing the insurance plans SPMF and our practice accept. The plans accepted by both our practice and SPMF are highlighted in green. The plans Sutter and our practice do not accept are highlighted in red. If you have a PPO plan or a traditional Medicare plan, you should be able to remain with our practice. The major exceptions would be HMO plans and a few Medicare Advantage plans. You may contact Patient Services at (888) 637-2762 to verify whether SPMF accepts your insurance if you have a plan that is not listed on the table.

NEW Q: I heard from Blue Shield of California that they were unable to reach a contract agreement with Sutter Health. Does this mean I will need to find a new primary care provider?

A: The contract dispute between Blue Shield of California and Sutter Health was settled on January 30, 2015 following the negotiation of a two year contract. For additional information from Sutter Health's perspective, here are Sutter Health's FAQs about the settlement with Blue Shield of California.

Q: OK, Dr. Owen. So I have an insurance that you and SPMF accept. What do I need to do now to remain a patient of you and Carl Stein under SPMF?

A: You must sign the release of records to remain a patient of William F. Owen, Jr., M.D. and Carl Stein, MHS, PA-C, under SPMF. During the hectic final days of our private practice, when we had to remove everything from our office to prepare for demolition and reconstruction, we believe that several of the forms were shredded or sent off to long term storage without having been marked as received. Even if you did sign the SPMF consent form in December 2014, but you received a US Postal letter from us in January 2015, containing a cover letter, a consent form and a stamped return envelope, please accept our apologies and complete, sign and return the new form. The records release, in PDF format, may also be found on our website. The form states that “…the facility listed above (our practice) will receive compensation for the use or disclosure of my health information” and that “There may be fees incurred for this service.” Both of these statements are not applicable to what SPMF is requesting here: your signature to allow you to remain as our patient. Be sure to check off and initial all 4 of the boxes on the top of page 2 and sign the form on the bottom of page 2.

Q: Why do I need to sign a release of my medical records if I’m staying as a patient with you and Carl?

A: SPMF considers this to be a transfer of care, even though you are staying with the same providers. So, basically, you are transferring from the private practice of William F. Owen, Jr., M.D. and Carl Stein, PA-C, to the care of Owen and Stein under the auspices of SPMF.

Q: May I use a virtual and secure e-signature service (e.g., DocuSign)?

A: Yes, you may use either your actual signature or an e-signature service for which you have registered.

NEW Q: How can I get the release back to you?

A: We have extended our orginal deadline and are still accepting signed consent forms from our patients but please submit those forms to us ASAP so that we can import your data into SPMF's EHR, Epic, or abstract your data for entry direcly into Epic. Our preference for returning the form is in the order listed below:
1. If you received our second request by mail, which included a postage paid addressed envelope, kindly complete, sign and mail your release in that stamped envelope to William F. Owen, Jr., M.D., 45 Castro Street, Suite 402, San Francisco, CA 94114.
2. You may complete, sign and fax the release to (415) 369-1314.
You may complete, sign (either by hand or using an e-signature service), scan and email the release to SPMFConsent@owenmed.com
You may complete, sign and drop off your release to our office, 45 Castro Street, Suite 402 San Francisco, CA 94114.

Q: Why did you close from December 23, 2014 through February 1, 2015?

A: We were at the 45 Castro Suite 402 location for 25 years of our 35 years in practice and our office was in need of renovation. Some of the construction was prompted by Americans with Disabilities (ADA) and privacy (HIPAA) statutes that did not even exist when we opened this office in 1989. We packed up our supplies and equipment during the final five work days in 2014. Demolition began on Saturday, January 3, 2015 and our office suite became one giant construction zone starting on Monday, January 5, 2015, and continuing through the end of January. We were NOT present in Suite 402 during the construction. As of February 1, 2015, the construction project was only partially completed. We returned to our SPMF Care Center at Suite 402 on February 2, 2015 but please understand that our resources are limited until the construction project is complete.

Q: Dr. Owen, during the reconstruction of your office, were you, Carl Stein, and your staff on vacation for five weeks?

A: We wish! (LOL) Actually, all of us were offsite in training as new employees of SPMF. We were also learning how to use the Sutter electronic health record (EHR) powered by Epic. This change in EHR will still take us a few months to get up to speed. Please bear with us if you have an appointment with us over the next few months and we are running late. There are still quite a few "bells and whistles" to the Sutter EHR that we are learning about as we are trying to provide care to all of our patients.

NEW Q: Does this mean that I don’t have access to the athenahealth Patient Portal?

A: That is correct. Although athenahealth sent us an encrypted data key containing a PDF of each patient's entire EHR, you did not have personal access to the records in your Patient Portal after December 28, 2014. If you followed our recommendation to print out important data elements from your athenahealth EHR, you should organize any data you printed by category and bring this with you to your next visit with us in 2015. Depending on how much of your athenahealth EHR, if any, SPMF abstractors have been able to enter into the Epic EHR, or how much data we have been able to import into SPMF's Epic EHR from your athenahealth EHR, you and we may need to reenter some or all of that data into our new Epic EHR ourselves, so having all of the details of your history at your fingertips will be essential.

NEW Q: I really [choose one] like / dislike the athenahealth Patient Portal. Will Sutter Health's Epic EHR have its own Patient Portal?

A: Yes, Epic is the premier EHR in the U.S. right now, used by 22% of practices with an active EHR. It is the EHR used by all of Sutter Health, UCSF, Kaiser-Permanente, and Stanford, among many other institutions. Sutter EHR, powered by Epic, has a well-regarded Patient Portal, known as "My Health Online". Here is the online link to activating your My Health Online account. You will need an access code in order to do an online activation of your My Health Online account, which our office staff can provide at the time of your first visit with us under SPMF. Alternatively, you may do a paper enrollment in My Health Online by completing this form and mailing or faxing it to the Patient Services Contact Center in Sacramento. Paper enrollment will take approximately one week for processing. This might be the best way for our existing patients to sign up for My Health Online so that you already have patient portal access before your next visit with us.

NEW Q: I would like to sign up for My Health Online and have a few questions. Where should I go for additional information?

A: Sutter Health has an FAQ page with several questions and answers about My Health Online. Navigate to the My Health Online FAQ site for additional information.

NEW Q: Suppose I need an appointment during the transition period: what will I do?

A: As always, if you have a medical emergency, dial 911 or go to the nearest emergency department. For minor issues (e.g., sore throats, sexually transmitted infections, backache, etc.) we have posted on our website a list of urgent care centers inSan Francisco and surrounding counties, including clinics specializing exclusively in sexually transmitted infections. If you need to seek any medical attention during the transition period, please be sure to ask the provider to send us a report of your encounter. Our preference would be that you visit either (1) a Sutter Health affiliated urgent care center or, in the absence of a Sutter Health urgent care center, (2) an urgent care facility where they also use the Epic EHR (e.g., that of UCSF in San Francisco). With "Epic Anywhere", we will be able to import your urgent care visit data directly into your new Sutter EHR the next time we see you.

Q: Is there any chance we can see you or Carl Stein during the transition?

A: We have been doing our best to approve prescriptions that have run out of refills and to field basic phone calls and document them within the Sutter EHR. Please check out our website, www.owenmed.com, for the latest announcements about any changes in our schedule. However, we will not be able to make future appointments or to schedule urgent visits until we are fully comfortable with the Sutter EHR. So it’s best to use the urgent care centers we’ve posted—or emergency departments if necessary—if you have a condition that must be checked out in a timely fashion. And our staff and we would be most appreciative if you could hold any routine care questions until your next regularly scheduled appointment, assuming those questions are minor enough that you can wait until then to discuss those concerns with us.

NEW Q: Suppose my refills run out during the transition period. What should I do to prevent that?

A: You should call your pharmacist ASAP and ask them to send us an electronic request for a refill. If you have been keeping regular interval appointments with us and doing the laboratory tests we have asked you to do, we will try to approve all reasonable prescription requests.

Q: I have an electronic order in athenahealth for laboratory tests I must do in 2015. Will those orders be available to me when I go to the lab?

A: No, our ability to access athenahealth online, to make any new entries in athenahealth, or to print out specific functions like laboratory orders or prescriptions, disappeared after December 28, 2014. This means that any future lab test orders we previously ordered for you electronically for 2015 from within athenahealth, our previous EHR, will not be accessible. If you do not already have a printed LabCorp or Sutter Health/CPMC order to be done prior to an already scheduled upcoming visit, you should call our new office number, (415) 600-4750, during normal business hours to determine how to proceed.

Q: Which laboratory may I use now that your practice is part of Sutter Health?

A: You may take your already printed laboratory order form either to any Sutter Health facility laboratory (including the CPMC-Davies lab, right across the driveway from us) or to any LabCorp (including the station two blocks from our office at Noe & Henry Streets). You may NOT use Quest Diagnostics laboratory.

NEW Q: Why do I have to use LabCorp or Sutter/CPMC? I like using Quest Diagnostics laboratory.

A: Unfortunately, Quest Diagnostics and Sutter Health have not yet built an interface between Quest and Sutter EHR. However, we understand that Quest is working with Sutter to have this interface available some time during 2015. Therefore, until this Sutter EHR interface has been programmed and tested, if you were to do your lab tests at Quest, the data would not flow into your Sutter EHR. At best, it will be very difficult to track down your Quest lab data. At worst, your test results done at Quest might get permanently lost. We are confident this situation is a temporary one and that you will be able to use any Quest Diagnostics lab facility (in addition to any LabCorp or Sutter Health facility) later in 2015.

Q: When should I do my lab tests in 2015?

A: As before, it’s always best to do your lab tests two weeks prior to your next office visit. If your order includes a basic or comprehensive chemistry panel, blood glucose (sugar), or lipid (cholesterol/triglyceride) panel, please remember to fast for 12 hours. That means no food with any caloric content but we strongly urge you to drink lots of water before you have your tests drawn. The exception to the two week rule is for lab tests done in conjunction with a Medicare annual well patient visit. Starting in 2013, Medicare began denying payment for tests we have always considered to be “preventive tests”. Now Medicare only pays for tests when there is a specific diagnosis or medical indication to do the lab tests. So if you are having a Medicare physical exam, we will decide which tests are medically justified at the time of the annual exam and you may do the lab tests after the annual exam has concluded. You may then view your test results via your Sutter EHR patient portal, "My Health Online"., once you have enrolled.

Q: How can I communicate with you or your staff during the transition period?

A: As already mentioned, we were offsite during the transition, training as employees of SPMF and learning how to operate the Sutter EHR. Our old telephone and fax numbers were replaced by new numbers (see below). Because we are still not up to speed with all of the new SPMF systems, our lines may be forwarded at times to another office or to our answering service. Because of HIPAA privacy law restrictions, we are not permitted to communicate about health issues via standard email, so please do NOT send us standard email requests about your medical problems. We had previously outlined the importance of preparing for our absence starting in mid-December 2014, making sure that you had enough refills to carry you through the transition and that you had a paper Sutter/CPMC or LabCorp lab order for any lab tests to be done in 2015. You should also review the list of urgent care centers to select a location near you, should you need to use it during this next phase of the transition, with preference given to urgent care centers that are either affiliated with Sutter Health or that use the Epic EHR (e.g., the UCSF urgent care center in San Francisco). We strongly recommend that you enroll NOW in the Sutter EHR patient portal, My Health Online, so that you will have yet another way to communicate with us now that we have returned to our office as of 2/2/2015.

NEW Q: Has your office changed its phone numbers now that your practice has joined SPMF?

A: Yes, as of January 5, 2015 our new phone number is (415) 600-4750. Our new clinical fax number is (415) 369-1314. Please use our clinical fax number only for consultations, urgent care visit reports, ER reports, hospital admission and discharge summaries, lab reports, X ray reports and other medical documents and forms that relate to you as a new or existing patient.

Q: Dr. Owen, your appointment schedule is booked so far in advance. Is there any chance that you might be adding another physician to your practice under SPMF?

A: Unfortunately, because of the winter holidays and the fact that we were unable to attend any patients in January 2015, we have had to push out appointments several months. When we were in private practice, the cost of adding another physician would have been prohibitive. However, SPMF has committed to start recruiting for another M.D. later in 2015. As a sign of that commitment, during the next phase of the remodel of our 45 Castro Suite 402 Care Center, SPMF is bringing our exam room capacity from the current four up to six exam rooms. SPMF has assured me that I will have an opportunity to interview prospective candidates, to make certain that they are compatible with our providers, staff, and patient population and that they are knowledgeable about the variety of medical conditions we commonly encounter in this practice.

Q: Dr. Owen, does all of this really mean that you will be retiring soon?

A: When I made the decision to join forces with SPMF, I also made the commitment to work within this new structure for at least two years. Starting in 2015, I have reduced my hours from 4 days per week to 3 days per week, two full days (Monday and Tuesday) and two half days (Wednesday afternoons and Thursday mornings). I anticipate that extra day off will give me an opportunity to “charge my batteries” and to renew my commitment to my patients. At the end of two years, I will reevaluate whether I would like to continue as an SPMF physician or choose another option. Among several alternative options that I would have available to me at the end of 2016, one of those is retirement. Please note that the reduction in office hours only affects my own hours. Carl Stein, MHS, PA-C, will still be available for both AM and PM appointments 5 days per week, Monday through Friday.

On behalf of everyone in my practice, I wish to thank you for your loyalty during these many years of service by my staff and me to our community. We apologize for any inconvenience you might experience during our transition to SPMF. We are looking forward to seeing you in our bright, newly remodeled Suite 402 and to working with you in 2015 and beyond.

Best regards,

Last modified: May 24, 2015