JamesLHollyMD.com

	James L. Holly, M.D.

About SETMA Joint Commission Contact Information History Mission Statement Medical Home Scope of Services I-CARE Initiative Infusion Center The SETMA Way - What is it? SETMA's Model of Care Patient-Centered Medical Home The SETMA Approach to Patient Care	In The News Letters Vital Signs - Examiner Publication SETMA's Providers as of January, 2015 SETMA Knows - Abraham Lincoln and Healthcare Analytics SETMA – 1999 – Four Seminal Events PC-PCC Award January, 2015 Vital Signs Spring 2015 Vital Signs Q&A for PC-PCC Award Links to SETMA 2012 eHealth Innovator Award for LESS initiative Handout for Attendees eHealth Conference January 12, 2012 eHealth Initiative 2012 Award Program Application The eHealth Initiative's 2012 Award Letter 2012 National Quality Forum National Healthcare Improvement Award Effective prioritization of performance improvement goals Dashboard to Measure and Manage Whole System Performance Commitment to transparency Date-driven improvement of NQS priorities Demonstration of readiness to assume responsibilities of an ACO Demonstrated results on publicly reported performance measures Public Reporting Quality Metrics for 2009, 2010, 2011 Internally Tracked Reporting Quality Metrics for 2009, 2010, 2011 Complete Application in PDF Format SETMA's Medical Home Pilgrimage 2009 Medical Home Series I 2010 Medical Home Series II 2011 Medical Home Series Two 2009, 2010, 2011 Medical Home Miscellaneous Articles The Dr. and Mrs. James L. Holly Distinguished Professorship Universal American Letter of Transmittal for Support Dr. Holly's Acceptance Address for the 2012 Distinguished Alumnus Award CMS Medical Home Feedback Report Qualify & Cost SETMA questions Influenza Data SETMA I - October 2011 SETMA II - October 2011 Mark A. Wilson Clinic SETMA West - October 2011 SETMA and Fox 4 News - Healthy Living Videos SETMA Advertisements - Display and Video SETMA Announcements Featured Content Archive	Syllabus PC-MH Externship SETMA's MS4 Patient-Center Medical Home Selective Syllabus Introduction to SETMA's Senior Externship and Syllabus An Introduction to the Origins and Beginnings of Southeast Texas Medical Associates, LLP Patient-Centered Communication PC-MH Health Affairs August 15, 2013 Policy Brief -- Health Gap SETMA 8.20.13 Provider Training -- Health Affairs 2.14.13 -- Patient Engagement SETMA Provider Training 8.20.13 during First Senior Medical Student PC-MH Externship Medical Home Coordination Review Tutorial 2011 Medical Home Series Two Teaching Tool for PC-MH Course - Patient Care Activation, Engagement, Shared-Decision Making	Patient Information What Does Patient-Centered Medical Home Mean to You? What Does Patient-Centered Medical Home Mean to You? Health information exchange Patient Rights and Responsibilities Patient Directions Contact SETMA – Secure Texting What is HIPAA? Authorization To Release or Obtain Medical Records Complete Privacy Policy Website Privacy Policy	Presentations Invited Presentations SETMA Provider Training
Governance Board Governance Board Responsibilities Governance Board Leadership Training The SETMA Team and The SETMA Culture SETMA's Mission, Vision and Goals: Patient Safety and Quality Care Harassment, Neglect, Abuse, Exploitation - Role of HCAHPS & CAHPS Healthcare Provider Standards Providers Responsibility Medication Refills, Reconciliation and Maintenance Provider and Leadership Use of Data and Analytics Commitment To All Patients -- Ethnic Disparities Kaizen - Board Creates Culture of Safety and Quality SETMA's Policy and Practice for Advanced Directives SETMA's Policy on Completion of Medical Records Care Guidelines : Improve processes to evaluate and treat Integrated patient safety program (Sentinel Events) Effectively Manages all programs, services or sites Provides Patients with information about Primary-care Medical Home Organization-wide Planning to Maintain Focus on safety and quality Organization-wide Planning to Maintain Focus on safety and quality SETMA's Performance Quality & Safety Judged by CMS SETMA's Performance Quality & Safety Judged by CMS SETMA Awarded by HIMSS for Quality and Safety 2011 John M. Eisenberg Patient Safety and Quality Awards Application Healthcare Quality Award 2012 Principles of Quality and Metrics Principles Contacting SETMA & Secure Texting PC-MH Mission, Vision, Goal, Access, End-of-Life Communications and Public Reporting Change Existing Processes to Improve Performance Team Members Focused on Safety and Quality	Your Life Your Health View Articles by Subject Aging Well Behavioral Health Cardiovascular Disease Risk Care Coordination Care Transitions Children's Health COGNOS Project Diabetes Exercise Healthcare Reform:Public Policy HIPAA & Security Labor Day Less Initiative Medical Home Medical Records Men's Health Mental Health Nutraceuticals Nutrition Smoking Cessation Thanksgiving Weight Management Women's Health All Articles	Public Reporting Public Reports by Year (2009-2017) Public Reports by Type Fall Risk, Pain, Functional, Wellness, Stress Assessment Fall Risk, Pain, Functional, Wellness, Stress Assessment for 2011 AND 2012 Core Measures: SETMA & Baptist Hospital Core Measures for January to December 2011 PQRS Diabetes Measures - Blood Pressure Diabetes Measures - Glyco and LDL Diabetes Measures - Nephropathy Screening, Foot Exam, and Eye Exam Preventive Measures - Screening (BMI, Colorectal Cancer, Mammography, Osteoporosis) Preventive Measures - Influenza, Pneumococcal, Urinary Incontinence Preventive Measures - Tobacco Use NQF Care for Older Adults Comprehensive CHF Care Diabetes Measures Diabetes Measures - Blood Pressure Control Diabetes Measures - Glyco and LDL Diabetes Measures - Smoking Cessation Female Measures General Health Measures Medication Measures Persistent Medications Medication Measures Pediatric Measures HEDIS (NCQA) Effectiveness of Acute Care Effectiveness of Chronic Care - Clinic/Hospital Effectiveness of Chronic Care - Clinic Only Effectiveness of Chronic Care - Diabetes (Smoking Cessation) Effectiveness of Chronic Care - Diabetes (Glyco and LDL) Effectiveness of Chronic Care - Diabetes (Blood Pressure Control) Effectiveness of Preventive Care Effectiveness of Preventive Care - Older Adults Effectiveness of Chronic Care - Diabetes Measures Effectiveness of Chronic Care - Persistent Medications (MPM) NCQA Diabetes Recognition Program Audit LESS Initiative PCPI PCPI Hypertension PCPI Diabetes PCPI Chronic Stable Angina PCPI Care Transitions PCPI CHF PCPI Weight Management PCPI CKD Stages IV V SETMA Lipid Audit Lipids Treatment Audit Tutorial Lipids Tutorial AQA COGNOS Project SETMA Audit for CKD Stages I III Patient Satisfaction Survey	Accreditations/Awards Achievements which have Advanced SETMA: The Time-line, Philosophy and Principles which Underlie that Advancement Awards	Diabetes Center of Excellence Education Diabetes Order Referral Form Seven Stations 2011 Advances in Diabetes Diabetes Tutorial Diabetes Prevention
EPM Tools Association of Medication and Diagnosis Automated Team Function Behavioral Health Adult Weight Management Tutorial Annual Questionnaires: Fall, Functional, Pain, Stress, Wellness Behavioral Health in SETMA's Patient-Centered Medical Home Model of Care Depression Tutorial Fall Risk Tutorial Health Insurance Portability and Accountability Act (HIPAA) Privacy Tutorial Intensive Behavioral Therapy (IBT) Obesity and Cardiovascular Disease Medicare Preventive LESS Initiative Tutorial Medical Home Transtheoretical Model Assessment Stages of Change Tutorial Pain Management Tutorial Reduction of Antipsychotic Medications Toolkit Smoking Cessation Tutorial Stratifying End-of-Life Risk for Hospice Services Tutorial Chronic Conditions Tutorial Chronic Renal Disease Management Tool Tutorial Calculating the Stages of Renal Disease Proteinuria Disease Management Tools Acute Coronary Syndrome Tutorial Adult Weight Management Tutorial Angina Tutorial Cardiometabolic Risk Syndrome Tutorial Chronic Renal Disease Tutorial Congestive Heart Failure Tutorial Diabetes Tutorial Hypertension Tutorial Lipids Tutorial Lipid Quality Audit Tutorial Primary Pulmonary Hypertension Tutorial Framingham Cardiovascular Risk Cardiometabolic Risk Assessment Framingham Heart Study Risk Calculators Tutorial Frederickson Classification of Dyslipidemia LDL Level Lipid Disease Management Risk Assessment General principles about ICD-9 Codes and HCC/RxHCC Codes Charge Posting Tutorial Coding to Ensure Accurate Health Risk Scoring E & M Codes Tutorial HCC & RxHCC Risk HCC/RxHCC Risk Tutorial ICD-9 Code Training Manual Hepatitis Screening Hospital Based Tools Hospital Care Summary and Post Hospital Plan of Care and Treatment Plan Tutorial Admission Orders Tutorial Daily Progress Notes Tutorial Care Transition Data Set from PCPI Tutorial Using The Clinic and Hospital Follow-up Call Templates Respiratory Failure Tutorial Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): Tutorial for SETMA's Internal HCAHPS Survey Master GP Suite of Templates Master GP Suite of Templates Tutorial Medical Home Support Materials Department of Care Coordination, Director of Care Coordination and Care Coordination Referral Template Electronic Tickler File Electronic Tickler File Tutorial Follow-up Calls Intensive Behavioral Therapy (IBT) Obesity and Cardiovascular Disease Medicare Preventive Services Medical Home Coordination Review Tutorial Medical Home Plan of Care and Treatment Plan Medical Home Transtheoretical Model Assessment Stages of Change Tutorial Patient-Centered Medical Home Annual Questionnaires Patient-Centered Medical Home: SETMA's Medical Home Coordination Review (MHCR) Tutorial Patient Document for Coordination of Care Transitions of Care Management Coding (TCM Code) Tutorial Merit-Based Incentive Payment System (MIPS) Quality Metric Tool Tutorial Nursing Home Depression Tutorial Fall Risk Tutorial Hydration Assessment Tutorial Nursing Home Guidelines for Care Tutorial Nursing Home Principal Suite of Templates Nutrition Assessment Tutorial Reduction of Antipsychotic Medications Toolkit Skin Care Tutorial Outpatient Infusion Center for Intravenous Antibiotic Therapy and Other Meds Preventive Health Tools Adult Weight Management Tutorial CHF Exercise Tutorial Diabetic Exercise Tutorial Diabetes Prevention Tutorial Exercise Prescription Tutorial Hypertension Prevention Tutorial Intensive Behavioral Therapy (IBT) Obesity and Cardiovascular Disease Medicare Preventive Initial Preventive Physical Exam & Annual Wellness Visit Tutorial LESS Initiative Tutorial Progression to Type 2 Diabetes Smoking Cessation Tutorial Progression to Type 2 Diabetes Quality Metrics ACO and Medicare Advantage Stars HEDIS: NCQA, History, Quality, Safety, STARS, ACO ACO Quality Measures Performance Tool ACO Quality Measures Performance Tool Tutorial STARs - A Tutorial for Utilizing SETMA's Deployment of the STARS MA Program Specialized Tools Annual Questionnaires: Fall, Functional, Pain, Stress, Wellness Association of Medication & Diagnosis Chronic Conditions Tutorial Chronic Care Management Code (CCM) Tutorial Depression Tutorial Drug Interactions Tutorial Electronic Tickler File Tutorial Evaluation Lower Urinary Tract Symptoms in the Male Fall Risk Tutorial Future Labs Tutorial Hydration Assessment Tutorial HCC Risk Training Tool Hypertension: Fulfilling Quality Metrics for the PCPI Program Laboratory Results - Signing Off: Why and How Medication Module Tutorial Medication Reconciliation Tutorial Nutrition Tutorial Pain Management Tutorial Problem List Reconciliation Tutorial Progression to Type 2 Diabetes Referral Skin Care Tutorial SOAAP Opioid Risk Assessment Stratifying End-of-Life Risk for Hospice Services Tutorial Texas State Reportable Infectious Diseases Tutorial Transitions of Care Management Coding (TCM Code) Tutorial	Transforming Your Practice Library Introduction to SETMA's TCPI Library Transforming Your Practice (TCPI) Summary Document of TCPI CMS Quality 12.2015 TCPI Leadership and Governance Care Coordination HIPPA and Security Data Analytics Care Transitions LESS Initiative Medical Records Clinical Decision Support Hospital Care Tools Disease Management Tools Preventive Health Tools Behavioral Health Transformation Tools New Transformation Tools Patient-Centric Care Nursing Home Medical Home Display and Explanation of SETMA's Patient-Centered Medical Home Tools	Medical Home The Story and the Ideals Introduction to Preventive Health Tools PC-MH Patient Engagement & Alternative Payment Models Preventive Care: The Best Way to Treat Illness is Don’t Get it Coordination of Care Patient-Centric Care Population Health Transition of Care - One form of Care Coordination HCAHPS - Hospital Consumer Assessment Of Healthcare Providers and Systems CAHPS - Consumer Assessment of Health Care Provider and Systems Teaching Tool for PC-MH Course – Patient Care Activation, Engagement, Shared-Decision Making Display & Explanation of PC-MH Tools SETMA's Medical Home Pilgrimage Concierge Medicine not Medical Home Medical Neighborhood Security & HIPPA Referrals Patient Web Portal Health Information Exchange Medication Reconciliation The Automated Team Coordination of Care Medical Home Description & Standards AAAHC Joint Commission NCQA Planetree URAC NCQA Interview February 14, 2014	Facebook	Letters

Your Life Your Health - Celebration of Religious Freedom

James L. Holly,M.D.

June 29, 2006

Your Life Your Health - The Examiner

No freedom is more fundamental to the liberty of the mind, soul and body than religious freedom. And, whether addressing mental health or physical well being, few issues in human experience have been so fraught with health consequences as the right to believe, or not to believe, and the right to express that belief. As we celebrate the founding of the United States of America and as we interface with other nations struggling with the issues resolved by this nation 232 years ago, it a worthwhile to think about the foundations of our independence.

Arguments fly back and forth concerning the rightful place of religion in public affairs. One side argues that religion and even dogmatic religion should be a part of public dialogue. Another side desires to eliminate religion completely from public affairs. To this dialogue, Jon Meacham's book, American Gospel: God, the Founding Fathers, and the Making of a Nation, brings reason to bear by exploring the history of "faith and freedom" in the United States of America.

The truth is that there are two propositions which define the boundaries of this debate. The first is that every man, woman and child has the liberty to practice his/her faith in public worship and has the liberty to express that faith in teaching others. The second is that no man, woman or child can propagate their faith with coercion, intimidation, violence, or manipulation. Within these two boundaries, the practice and expression of religion are the foundation for a stable and healthy society.

Meachum argues, and rightly so, that while the foundation of this nation is religious, it is non-sectarian religion. This means that while reverence toward God and respect of the faith of others are at the foundation of our nation's liberty, public adherence to or political support of any particular faith, or particular expression of a faith, is not only non-essential to the success of our democratic republic, it is lethal to it. Any attempt to impose the tenets of a particular faith upon the laws, or people of a land, is antithetical to the very freedom which allows the promotion of that faith.

The complexity of a multicultural society is that religious freedom is the way to success. Any attempt or desire on the part of one group to impose their beliefs upon another or any desire on the part of one group to discredit, as an act of public policy, the faith of another group or faith in general, will stifle democracy. This complexity is compounded when some come to the United States of America, and while enjoying our liberties, support, advocate or approve either the elimination of religious freedom, or the imposing of religious hegemony in their countries of origin.

Meachum makes the follow statements which are worthy of our attention.

"The Founders…found a way to honor religion's place in the life of the nation while giving people the freedom to believe as they wish, and not merely to tolerate someone else's faith, but to respect it." (page 6)

"Tolerance" is a condescending attitude, particularly toward faith. The only public disposition which sustains true religious freedom is the "respecting" of the faiths of others. This does not require ecumenism whereby the common faith is diluted to the point that it is objectionable to no one and acceptable to everyone, but it does suggest that an act of worship, freely practiced in peace, is celebrated even when it is different from your own.

"If totalitarianism was the great problem of the twentieth century, then extremism is, so far, the great problem of the twenty-first…Extremism is a powerful alliance of fear and certitude; complexity and humility are its natural foes." (p. 17)

Here is one of the greatest problems in practical politics. It has often been said, "While I can't define pornography; I recognize it when I see it." In the context of religious freedom, the roots of extremism begin with the thought, "I can recognize extremism when I see others practice it." While we often ascribe extremist religious views to others, we seldom recognize it in ourselves. Nevertheless, it is easy to see the extremism of those who are willing to attack, maim, and kill others because their faith has been offended, or because they wish to have their faith established as "The faith" in the land.

"Jefferson said, ‘Truth can stand by itself.' Franklin agreed: ‘When a religion is good, I conceive that it will support itself; and, when it cannot support itself, and God does not take care to support [it], so that its professors are obliged to call for help of the civil power, it is a sign, I apprehend, of its being a bad one.'" (page 60)

Whether passing laws to under gird a tenet of dogma, or establishing one faith as "the faith of the land," both are anathema to true faith. While the latter is offensive to our civil liberty sensibilities, we are not so quick to appreciate the strangeness of our desire for a constitutional amendment to define the nature of marriage, when people and politicians of faith discard the obligations of marriage as quickly and as easily as those who profess no faith.

"…America was not a ‘Christian nation' except in the sense that it was a nation populated by people who identified themselves as Christians. Words have consequences, and there is a distinction - an essential one - between being a ‘Christian nation ‘and being one who public religion allows religious values, Christian or otherwise, to shape its manners and morals." (p. 144)

This is not unlike my answer when I am asked if I am a "Christian doctor." My answer is, "No. I treat Muslims, Jews, Hindus, Buddhists, atheists and others. I am however personally a committed Christian." There is a profound difference in respecting the person of others which allows for the sharing of principles and precepts of faith when desired but preserving the rights of others not to hear about my faith.

"In securing freedom of religion - which is really freedom of thought—and freedom of speech, the Founding Fathers created a national milieu in which those who saw the right when others did not had the liberty to bear witness to the truth as they understood I, in the hope that the rest of us might come to glimpse it, too." (p. 158)

The advancement of liberty does not result from condescension on the part of one group who recognizes truth toward another who does not. Liberty marches to the cadence of each person esteeming another valuable regardless and in spite of their beliefs. The Establishment Clause of the Constitution never envisioned public discourse without religious content, but simply that public decrees would never demand compliance with religious precepts.

"…'the content of official religion is bound to be thin; the commitment to it also apt, now and then, to be hollow…'…it is a price the country was willing to pay in order to enjoy the benefits of public religion…rather than go down the darker path of Puritan excesses of the seventeenth century in New England, which may be more orthodox but which belongs in the private, not the public, sphere. Serious believers will always find public religion wanting - lighter on substance, perhaps, than they would like or vague to the point of meaninglessness. But part of the American gospel is that such lamentations should take place in churches or home, not in the public arena….'freedom is like oxygen to religion. Without liberty for all, some one sect or creed might crush all the others, and history tells us that no earthly victory is ever final - so he who crushes may one day be crushed. Religious liberty frees a society from the treat of such strife." (pp. 178-179)

If we are to avoid forms of extremism which are objectionable to us, those of us who hold religious ideals and beliefs which are considered extreme by others must be willing and able to dialogue with those who disagree without "shouting" and without acrimony. It is also important not to attribute evil motives to others until or unless their actions reveal such. Public discourse over religion and politics ought to be held with civility and respect.

Earlier, the word "stifle" was used to describe the effects upon religious freedom of publicly imposed religious views - even, and especially, my (be sure and read your name here) religious views. "Stifle" means "to kill by depriving of oxygen." As Meachum reminds us "freedom is the oxygen of religion," thus the elimination of religious freedom with its effort to establish religion, kills any chance of true freedom of religion.

The effect of strongly held private convictions voiced through the language and principles of public faith ought to be the forming of a body politic which is unified by freedom of religion and caring for one another. Thus, Meacham states,

""…we are the strongest nation in human history - and the most religiously, ethnically, and racially diverse. And so the Founders were, as usual, right when they chose the nation's first motto in the summer of 1776: E. Pluribus Unum - ‘out of many, one.'" (p. 246)

The forming of "one" out of "many" requires no compromise; it does require patience, politeness and esteem of another's person. The river of liberty is fed by the streams which form it and which pour their waters into it:

Where there is no freedom of speech, even speech that would offend me,
Where there is no freedom of the press, even where materials are published which would offend me,
Where there is no freedom of assembly, even when others congregate for purposes anathema to me,
Where there is no freedom of worship and religion, even to practice a religion, which is strange and foreign to me,

there is no freedom, only the appearance of liberty. For your life and your health, liberty is required, for it is the oxygen of our public life.

About SETMA	In The News	Syllabus PC-MH Externship	Patient Information	Presentations
Governance Board	Your Life Your Health	Public Reporting	Accreditations/Awards	Diabetes Center of Excellence
EPM Tools	Transforming Your Practice Library	Medical Home	I-CARE Initiative	NextMD