November 2015 - Vol. 34, No. 10

Academy Advantage Partner: ENT-Cloud offers unique benefits and savings
ENT-Cloud, an Academy Advantage Partner, has associated with the AAO-HNS to provide Members an integrated EHR and practice management platform with unique benefits and savings. Lawrence Gordon, MD, and KJ Lee, MD, both noted and accomplished otolaryngologists, technologists, and visionaries, founded ENT-Cloud. ENT-Cloud answers the need of otolaryngologists asking for specific content and functionality. The software platform is backed up by otolaryngology-specific practice management experts and back-office personnel available to serve in a “virtual back office” role for the ENT office. ENT-Cloud software is not just “designed by ENTs for ENTs.” It includes a complete enterprise level practice management platform built on the latest technologies and flexibly designed to help otolaryngologists meet the demands of running a modern day practice while adapting to continued change. ENT-Cloud clients have access to teams of clinical and business consultants dedicated to helping otolaryngologists and their practice managers realize and achieve their critical needs and objectives. ENT-Cloud experts look at essential elements of the practice such as billing, marketing, clinical, and administrative functions in an effort to improve overall efficiency and profitability. Since it is the lifeblood of a practice, our billing services professionals provide oversight, monthly reporting, current relevant coding, and claims management expertise. It is their job to make sure you get paid correctly the first time, every time. If billing is the lifeblood, marketing is the nutrient that feeds the practice. Without a steady well-balanced diet, a practice will never grow properly or ever reach its full potential. With a focus on your practice goals and online reputation, our professionally managed marketing services will ensure your ENT practice has a professional website, strong online presence, and positive reputation in your surrounding community. ENT-Cloud’s clinical compliance and Meaningful Use service teams monitor your practice’s compliance in relation to the criteria set by CMS through professional clinical oversight and regular reporting. Our teams are focused on achieving the maximum stimulus payment and avoiding fees related to non-compliance. More than just an EHR provider, ENT-Cloud is an organization comprised of ENT practice consultants who are industry leaders in medical, regulatory, financial, and practice management. Let us help take your practice to the next level. Phone: 1-866.495.4002 Email: Web:
AAO-HNSF publishes methodology for developing clinical consensus statements
Since 2010, the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) has published five clinical consensus statements (CCSs) in Otolaryngology–Head and Neck Surgery, including: Diagnosis and Management of Nasal Valve Compromise (2010); CT Imaging Indications for Paranasal Sinus Disease (2012); Tracheostomy Care (2012); Pediatric Chronic Rhinosinusitis (2014); and this month Septoplasty with or without Inferior Turbinoplasty (2015). The CCS development manual supplement also appears in this month’s issue. The manual describes the methodology used by the AAO-HNSF to promote rapid and consistent development of CCSs when the evidence is lacking for development of a clinical practice guideline (CPG). A CCS integrates structured expert opinions with the existing literature to try and provide some clarification on points that are quality improvement opportunities related to a particular topic. In contrast to CPGs, which are based primarily on high-level evidence, clinical consensus statements are more applicable to situations where evidence is limited or lacking, yet there are still opportunities to reduce uncertainty and improve quality of care. Much like the AAO-HNSF Clinical Practice Guideline Development Manual, Third Edition: A Quality-Driven Approach for Translating Evidence into Action, which has now been cited 119 times, the goal of the Clinical Consensus Statement Development Manual is to provide readers with the detailed methodology used by the AAO-HNSF to develop its clinical consensus statements. Publication of the manual facilitates transparency of the AAO-HNSF process and also provides a tool for other organizations to replicate our process. In summary, the AAO-HNSF utilizes a modified Delphi Survey Method to develop its CCSs. The Delphi Method involves using multiple anonymous surveys to assess for objective consensus within an expert panel. This rigorous and standardized approach minimized bias and facilitated content expert consensus. While the CCS development manual contains specific practices relevant to the AAO-HNSF, we believe that the principles explained therein will be a valuable tool for our Members, the subspecialty societies, and to external organizations as well. Comparison of key characteristics of consensus statements vs. guidelines* Characteristic Clinical consensus statement Clinical practice guideline Primary output Statements of fact based on best evidence and expert consensus Recommendations for action based on best evidence and explicit consideration of benefits, harms, values, and preferences Level of evidence Observational studies and expert consensus; higher levels of evidence when available Systematic reviews and randomized controlled trials; lower level evidence as needed for research gaps Size of development group 8 to 10; possibly more 15 to 20 Composition of development group Otolaryngologists; content experts a majority; may include other disciplines as needed Multidisciplinary, including consumers; content experts a minority; includes all stakeholders in the target audience Perspective of development group member Member serves as a content expert based on individual knowledge and experience Member advocates for the discipline or constituency they were appointed to represent Time frame 6 to 8 months 12 to 18 months Meeting venues Conference calls and electronic mail In-person meetings, conference calls, and electronic mail External review Limited review by relevant stakeholders Extensive review by all stakeholders, including open public comment *From the AAO-HNSF Clinical Consensus Statement Development Manual (2015). (In press)