Secretary of the Department of Health (DOH)
Director of the Agency for Healthcare Administration (AHCA)
Attorney General (AG)
Secretary of the Department of Business and Professional Regulation (DBPR)
Secretary of the Department of Children and Families (DCF)
Secretary of the Department of Corrections (DC)
Commissioner of Education (DOE)
Secretary of the Department of Elder Affairs (DOEA)
State Treasurer/Insurance Commissioner (DOI)
Secretary of the Department of Juvenile Justice (DJJ)
Executive Director of the Correctional Medical Authority (CMA)
Two Representatives of County Health Departments (CHD)
A Representative of Florida schools of public health chosen by the Board of Regents (BOR)
A Representative of the Florida Association of Counties (FAC)
A Representative of the Florida Healthy Kids Corporation

Council Members in Attendance:
Robert Anderson, representing the Office of the Attorney General
Don Bennett, representing the Correctional Medical Authority
Dr. Michael Graven, representing University of South Florida, College of Public Health
Relda Halbert, representing the Agency for Health Care Administration
Dr. John Heilman, representing Pinellas County Health Department
George Hinchliffe, representing the Department of Juvenile Justice
Cheryll Lesneski, representing Putnam County Health Department
Becky Lyons, representing the Department of Children and Families
Linda Nelson, representing the Department of Health
Rod Westall, representing the Department of Corrections

Council Members Absent:
Jim Bracher, representing State Treasurer/Insurance Commissioner
Lee Cornman, representing the Department of Business and Professional Regulation
Cretta Johnson, representing the Florida Association of Counties
William P. “Bud” Johnston, representing the Department of Elder Affairs
Rose Naff, representing Florida Healthy Kids Corporation
Commissioner of Education

Others in Attendance:
Kim Bahrami, STO
Judy Bentley, DOH
Julia Blankenship, DJJ
Rena Coffield, DOH
Taj Deloney, AHCA
Kit Goodner, DOH
Meade Grigg, DOH
Erica McCall-Hamilton, DOH
Barry Monroe, Senate Health, Aging, & Long-Term Care Committee
Allen Pearman, DOH
Jacki Seabrooks, DOH
Kim Shafer, AHCA
Lorene Wilson, DOH

I. Call to Order and Welcome: Dr. John Heilman called the Florida Health Information Systems Council meeting to order and welcomed participants.

II. Roll Call: In lieu of roll call, attendees identified themselves and the organization they represented. Attendance is reflected above.

III. Approval of Minutes: The minutes of the Florida Health Information Systems Council meeting held December 13, 1999 were adopted as presented.

IV. FHISC Background and Purpose

Ms. Judy Bentley provided a brief overview of the act of the 1997 Legislative Session that created the Florida Health Information Systems Council (FHISC). She explained that Senator Brown-Waite wrote a memorandum to Senate President Toni Jennings expressing concern that health data be shared, standardized and collected in the most efficient manner possible. (A copy of the memorandum is available upon request.) This memorandum provided the stimulated actions ultimately resulting in the creation of the FHISC

Ms. Bentley continued by noting the legislative requirements for the Council “to facilitate the identification, collection, standardization, sharing and coordination of health-related data, including fraud and abuse data and professional and facility licensing data, among federal, state, local and private entities.”

There being no further questions or discussion, the chair moved to the next agenda item.

V. State Chief Information Officer Presentation: Development & Implementation of an Enterprise Wide Information Technology Strategy

Kim Bahrami, representing the State Technology Office (STO), began by indicating that Roy Cales was unable to attend the meeting due to scheduling conflicts. She continued by briefly outlining STO strategic planning initiatives for statewide information technology management. She noted that normally strategic planning efforts would be built upon enterprise business process models. No such models currently exist for state government. One role that the FHISC stakeholders might play would be in the development of business process models for the health and human services (HHS) sector of state government. A draft of the STO strategic plan is tentatively scheduled to be completed sometime in January. She indicated that the strategic planning efforts of the STO and FHISC require close cooperation and coordination to ensure consistency among strategic plans.

In comments related to the FHISC, Ms Bahrami noted that the FHISC strategic plan appeared to do a “good job” addressing critical issues related to the “what” and “where” steps needed to be taken to address health related data issues. However, she suggested that more specific actions need to be (identified and implemented) to outline “how” goals and objectives are to be achieved.

Ms. Bahrami also referenced the STO knowledge group employed by to review and rank legislative budget requests for the health and human services sector of state government. This exercise served to identify certain infrastructure issues that potentially could be combined and leveraged for more effective state purchasing of information technology resources. The meetings also served to begin the identification process of common issues and linkages related to the health and human services agencies.

During the following discussion period, Dr. Michael Graven presented background on an attempted data merging effort for an AHCA sponsored planning grant applications involving multiple state agencies which was unsuccessful, at least in part, due to multiple (between 9 and 11) and perhaps duplicative approval requirements for access to confidential patient data. In addition, certain technical requirements presented significant challenges that prohibited timely access to required data. The issue was presented as one that could be addressed as part of the strategic planning and implementation efforts of both the FHISC and STO.

VI. FHISC Strategic Plan: Progress, Process, and Issues

Mr. Pearman noted that the revised FHISC Strategic Plan is now due June 1, 2001 (rather than March 1). Kim Bahrami then summarized suggested modifications and discussion points related to possible revisions of the FHISC Strategic Plan. (A copy of the “Florida Health Information Systems Council Strategic Plan Revision Discussion Points” is attached to these minutes.)

A unanimous vote adopted the recommendation to incorporate language (reflected in the following quote) more directly linking the FHISC strategic plan to the Governor’s enterprise perspective for information technology. Staff was directed to incorporate the following changes into a revised FHISC Strategic Plan:

· Page 7, 1st full paragraph.... 3rd sentence... replace with something along the lines of.... “From the Enterprise perspective, the Governor views health and human service agencies as a single knowledge domain or business area in which core business processes can be readily consolidated and streamlined through more strategic and focused utilization of available information technology and associated assets."

FHISC staff will also undertake steps to contact council members regarding establishment of a workgroup to address FHISIC strategic plan revisions. As part of this effort, staff will continue to monitor and work with the STO to ensure that strategic plans are consistent and support enterprise wide efforts. A report on the status of the strategic planning activities will be presented at the next FHISC meeting.

VII. Health Data Reports

Status Report on Federally Mandated Healthcare Integrity and Protection Data Bank

Allen Pearman presented a summary of the Healthcare Integrity and Protection Data Bank (HIPDB) reporting requirements and summarized status of DOH compliance with the requirements. HIPDB was created to combat fraud and abuse in health insurance and health care delivery. The Healthcare Integrity and Protection Data Bank is a national data collection program for the reporting and disclosure of certain final adverse actions taken against health care providers, suppliers, or practitioners. The reporting requirements (effective in October 1999) apply to licensed and unlicensed health care providers, suppliers, and practitioners.

Within the Department of Health all MQA professions are currently reporting actions directly to HIPDB, with the exception of Nursing which is being reported to the National Council of State Boards of Nursing. The MQA legacy data project is presently underway and being researched for missing data elements and will be forwarded to HIPDB upon completion.

Review of the statistical data on state reporting raised some concerns with the number of reported actions for Florida. The level of reporting appears to be incomplete for the dental, osteopathic and medical professions. MQA staff is working with NPDB and HIPDB to investigate whether or not NPDB transferred data on these particular professions from the National Practitioner Data Bank to HIPDB as planned.

Review of the reporting by Department of Health units did reveal a gap in reporting of adverse actions against paramedics, emergency medical technicians, and ambulance services. The Division of Emergency Medical Services and Community Health Resources is undertaking steps necessary to comply with federal reporting requirements.

The Attorney General’s office (Medicaid Fraud Control unit) indicated that reports related to Medicaid fraud have been forwarded to HIPDB for the past year. Certain technical issues related to the electronic reporting of data are being addressed with federal staff representing the HIPDB.

The extent of reporting by other state agencies is not clear at this time.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996-Current Status

Linda Nelson introduced Meade Grigg who presented a summary on the current status of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and an outline of the initial steps being taken by the Department of Health to address issues raised by implementation of rules resulting from HIPPA. He noted that HIPPA is intended to provide improved efficiency in healthcare delivery by standardizing electronic data interchange, and provide specific protection of confidentiality and security of health data through setting and enforcing standards. Rules are to be developed and implemented for standardization of electronic patient health, administrative and financial data; establishment of unique health identifiers for individuals, employers, health plans and health care providers; and. ensuring establishment of security standards protecting the confidentiality and integrity of individually identifiable health related information. To date, only one rule related to electronic data transmission standards has been formally adopted. The effective date for that rule is 2003.

Staff in the Office of Planning, Evaluation and Data Analysis will be responsible for facilitating a DOH HIPAA Team. This team will include representatives from each division of the department (including the CHD's) and will lead implementation activities for each section of the law as the guidelines are finalized. The team will begin meeting in January 2001.

The initial charge for the team will be to (1) determine the impact the final requirements on the department, (2) development implementation plans and teams as appropriate and (3) provide oversight during the implementation process. The team will also be responsible to disseminate information about HIPAA activities to all staff across the department.

The current HCMS staff in HPE and IT will make modifications to that system or provide a standard interface to that system that assures CHD's can transmit electronic billing records consistent with the national standards. Mr. Grigg noted that DOH is currently in compliance with HIPAA content standards most commonly used in the CHDs (HCFA 1500). Initial contact with the Medicaid Program in AHCA has been made and DOH will participate as part of the user community consulted as part of AHCA implementation efforts.

Linda Nelson specifically identified the need for regular HIPPA status updates for the FHISC.

Board of Regents & Department of Health (MQA)

Allen Pearman reported that, as directed, Council staff has taken steps to assist BOR obtaining certain information on licensed physicians and their training background (including specialties). Two major issues were identified as part of the analysis conducted. The first issue was that data on medical schools attended was entered into a “text” field with no specific rules for data entry. This meant that a name of a specific school could be entered in a number of different ways (i.e., “University of Florida”, “U. of Florida”, “U of F”). The second issue was that listing of more than one school per physician are permitted and do occur.

It was concluded that any analysis of the proportion of Florida medical school graduates licensed in Florida requires the specific identification of schools qualifying as a “Florida” medical school. Because the data are entered into a text field, identification must be based upon analyst inspection and judgement. (A copy of the complete response is included as an attachment to these minutes.)

Status Report on Specific Health Data Sharing Efforts Among State Agencies

Rod Westall (Department of Corrections) briefly described a couple of projects involving sharing of medical record information with County Health Departments to ensure continuity of care for inmates upon there release or parole from the state correctional system.

Discussions related to the Department of Juvenile Justice database revealed a possible opportunity for data sharing once the Department of Health’s immunization registry becomes operational.

Allen Pearman briefly outlined the status of an on-going effort between the Agency for Health Care Administration and the Department of Health to consolidate the approval process for sharing confidential data while ensuring required data security.

VIII. Other Business:

Two other issues were raised during the discussion of other business. Cheryll Lesneski emphasized the importance of establishment and maintenance of data sharing mechanisms between the public and private sectors for the purpose of public health surveillance (including bio-terrorism).

Linda Nelson directed the attention of the Council members to the work of the special Task Force on Privacy and Technology. The recommendations of the task force may affect data sharing between public entities.

There being no further business, the meeting was adjourned.

Summary of Action Items:

1. Invite Roy Cales, statewide Chief Information Officer, to next Council meeting in order to seek his insight into the role of the Council in implementing an enterprise-wide information technology policy.
2. Incorporate modified language adopted by the Council on December 6, 2000 into a revised FHISC strategic plan
3. Schedule and present status report on FHISC and STO strategic planning efforts.
4. Schedule staff update on status of the HIPPA rule adoption and implementation for next Council meeting.
5. Schedule staff update on status of the federally mandated health practitioner integrity data bank for next Council meeting.

Florida Health Information Systems Council Strategic Plan Revision
Discussion Points

1. Incorporate language more directly linking FHISC strategic plan to Governor’s Enterprise Perspective for IT

· Page 7, 1st full paragraph.... 3rd sentence... replace with something along the lines of....”From the Enterprise perspective, the Governor views health and human service agencies as a single knowledge domain or business area in which core business processes can be readily consolidated and streamlined through more strategic and focused utilization of available information technology and associated assets."

2. Use or adoption of national standards as starting point for data standardization efforts

· Is there significant value to be gained by utilizing national data collection definitions and elements as the kick-off point for formulating statewide standard health-related data definitions and transmission standards? If health-related data definition standards and transmissions are already in existence, is it cost-effective to utilize these as a basis for facilitation of statewide health-related data standardization?

3. Need for increased focus/specificity in FHISC strategic plan

· The STO planning process will present each strategic goal in the following format:
a. Strategic Goal X
b. Objective(s) X
c. Outcome(s) X (What, specifically, is to be accomplished and an associated timeline)

· Ideally, each of the strategic goals should be accompanied by an associated timeline depicting major milestones implied by the strategic target. In the FHISC plan, the objective (b) and the outcomes(c) appear to be contained in the statement of objectives. It is suggested that the objectives/outcomes should be taken down to the next level of detail. (i.e. What exactly will be produced as a result of accomplishing a particular objective? Why will it take until 2003 or 2004 to accomplish the objective? What immediate steps/actions are planned?) Briefly stated, this document lays out the "what" and the estimated "when" but fails to document "how" the council will accomplish its goals. The "how" should be produced by the collaborative efforts of this council, not by a consultant hired to formulate the document. Buy-in from the HHS business leaders is critical to success. Shift the focus from "planning for the sake of discussion" to "planning for the sake of execution of objectives."

· In order to accelerate the business-IT fusion; attempt to tie the strategic goals to meaningful action(s) and outcomes. Gleaning from the Knowledge Domain LBR process, include a consolidated, coordinated listing of HHS-domain specific initiatives. Factor these initiatives into each strategic goal (i.e. IHIS, Florida, PRAES, FRAES, HomeSafenet, Telemedicine, Enterprise Architecture, and HIPAA) In other words, how are these investments and projects supporting the strategic goals defined by the FHISC? What changes need to be implemented? What proposed activities offer the greatest potential cost savings?)

4. More general issues

· What is the framework that will be utilized to systematically address the original purpose of the FHISC (“to facilitate the identification, collection, standardization, sharing and coordinating of health related data among federal, state, local and private entities")?
· What are the major tactical components? (i.e. Understanding and Identifying federal health-related data standards, Developing and implementing Florida state government health-related data standards, Providing Florida health-related data standards direction for local governments and private entities.)

February 21, 2000

Linda Rackleff, Specialist for Health Affairs
Florida Board of Regents
325 W. Gaines St.
Suite 1529
Tallahassee, FL 32399-1950

Dear Linda:

Wayne McDaniel, Deputy Secretary, has directed me to respond to your request for information of December 13, 1999. My understanding is that you seek to determine whether or not Department of Health, Medical Quality Insurance (MQA) physician data has sufficient detail to determine the number of licensed physicians in Florida who graduated from Florida medical schools.

In response, staff has taken steps to ascertain the nature and scope of information on licensed physicians and their training background available from the Division of Medical Quality Assurance (MQA). A number of issues related to completeness, accuracy, and integrity of data have been identified.

The physician profiling data (based upon the licensing data gathered by the Division of Medical Quality Assurance) can provide information on physicians that graduate from Florida medical schools who hold current medical licenses (including those initially issued during the “current” year). The database, while not complete, may provide insight into the proportion of licensed physicians who graduated from or attended Florida medical schools.

Data are available for both allopathic and osteopathic physicians. For allopathic physicians, data include those physicians holding both restricted (eight categories) and unrestricted licenses. Residents who “register” with the Board of Medicine (“Unlicensed Medical Doctor) are also included in the comprehensive database.

The database includes a specific data set for all medical schools attended. The fields include school, date attended, date of graduation, and type of degree. The field for the name of the school is a text field which means that a name of a specific school can be entered in a number of different ways (i.e., “University of Florida”, “U. of Florida”, “U of F”). Listing of more than one school per physician is permitted and does occur.

Any analysis of the proportion of Florida medical school graduates licensed in Florida requires the specific identification of schools qualifying as a “Florida” medical school. The problem is that the data are entered into a text field, herefore identification must be based upon analyst inspection. Preliminary analysis of the data was completed and aggregates data generated from an Excel spreadsheet which summarized licensed types by medical school as reported. As a result there are 228 “schools” might be classified as Florida medical schools. Since the entire database was summarized, public and private schools and allopathic and osteopathic schools were included. Other issues arose as to whether or not the Florida State PIMS program should be included as a “Florida” medical school attended. (It was included in the count of 228.)

The data extracted on 12/17/99 into an access database also serves to illustrate a number of issues that would have to be addressed in any analysis based upon the Division of Medical Quality Assurance (MQA) database. A total of 44,499 physicians were identified as holding unrestricted allopathic licenses in “1999.” For these physicians, 48,027 medical schools attended were reported (1.08 schools per licensed physician). Approximate 1,423 “blanks,” non-standard entries, or empty fields were included in the data reported for medical school attended. Non-reporting therefore represented approximately 3% of the data included in the MQA database. [Note: The practitioner profiling data maintained by MQA is required as a condition of license renewal for all Florida physicians. The data incompleteness is partly due to the fact the license renewal cycle has yet to be completed for all Florida physicians.]

Preliminary results of the analysis conducted are summarized as follows:

· Florida schools represented approximately 12% of schools attended by allopathic physicians licensed in Florida in “1999”

· Florida schools represented approximately 8% of schools attended by new/initial allopathic physicians licensed in Florida in “1999”

The results presented here are only for illustrative purposes. Any formal release of the results of this type should be subject to formal review by MQA and any other agency conducting or using an analysis based upon the MQA database.

The information previously outline should aid you establishing the parameters for use of MQA data in answering the questions you have posed concerning physicians licensed in Florida.

Please contact me at 413-8501 if you have questions or comments.

Sincerely,

Allen L. Pearman
Senior Management Analyst II
ALP/alp
Enclosure

Copy: Wayne McDaniel
Gloria Henderson
Diane Orcutt
Tanya Williams
Judy Bentley

Florida “Medical Schools”
(As reported in the MQA profiling data base)

UNIVERSITY OF SOUTH FLORIDA
FLORIDA INTERNATIONAL UNIVERSI
FLORIDA SATE UNIVERSITY
FLORIDA ST UNIV PIMS PROGRAM
FLORIDA STATE UNIV (PIMS)
FLORIDA STATE UNIV PROG MED SC
FLORIDA STATE UNIV. PIMS PROG.
FLORIDA STATE UNIV.-MEDICAL
FLORIDA STATE UNIVERSITY
FLORIDA STATE UNIVERSITY (PIMS
FLORIDA STATE UNIVERSITY(PIMS
FLORIDA STATE UNIVERSTIY
SOUTHEASTERN CO OF OSTEOPATHIC
SOUTHEASTERN COLL OF OSTEO MED
SOUTHEASTERN COLL OF OSTEOPATH
SOUTHEASTERN COLLEG OF OSTEO
SOUTHEASTERN COLLEGE
SOUTHEASTERN COLLEGE OF OSTEO
SOUTHEASTERN COLLEGE OF OSTEOP
SOUTHEASTERN OSTEOPATHIC MEDIC
UNI OF FL COLL OF MED GAINES
UNI OF FL SCHOOL OF MED GAINES
UNI OF MIAMI
UNI OF MIAMI SCH OF MED, MIAMI
UNIV MIAMI
UNIV OF FL
UNIV OF FL COL OF MED
UNIV OF FL COL OF MEDICINE
UNIV OF FL COLL MED OF GAINES
UNIV OF FL COLL OF MED
UNIV OF FL COLL OF MED GAINES
UNIV OF FL COLL OF MED, GAINES
UNIV OF FL COLL OF MED, GAINS
UNIV OF FL COLL OF MED,GAINES
UNIV OF FL COLL OF MED,GAINSVI
UNIV OF FL COLL OF MEDICINE
UNIV OF FL COLL OFMED, GAINES
UNIV OF FL COLL OR MED
UNIV OF FL COLL OV MED, GAINES
UNIV OF FL COLLEGE OF MEDICINE
UNIV OF FL COLLGEG OF MED
UNIV OF FL OF MED GAINES
UNIV OF FLORIDA
UNIV OF FLORIDA COLL OF MED
UNIV OF FLORIDA COLL OF MED, G
UNIV OF FLORIDA COLLE OF MED
UNIV OF FLORIDA COLLEGE OF MED
UNIV OF FLORIDA PIMS TALLAHASS
UNIV OF MIAIM
UNIV OF MIAMI
UNIV OF MIAMI MEDICAL SCH
UNIV OF MIAMI OF MED
UNIV OF MIAMI SCH OF MED
UNIV OF MIAMI SCH OF MED MAIMI
UNIV OF MIAMI SCH OF MED MIAM
UNIV OF MIAMI SCH OF MED MIAMI
UNIV OF MIAMI SCH OF MED,
UNIV OF MIAMI SCH OF MED, MIA
UNIV OF MIAMI SCH OF MED, MIAM
UNIV OF MIAMI SCH OF MED,MIAMI
UNIV OF MIAMI SCH OF MED. MI
UNIV OF MIAMI SCH OF MEDICINE
UNIV OF MIAMI SCH. OF MED,
UNIV OF MIAMI SCHOOL OF MED
UNIV OF MIAMI SCHOOL OF MEDICN
UNIV OF OF FL COLL MED, GAINES
UNIV OF S FL
UNIV OF S FLORIDA COL OF MED
UNIV OF S FLORIDA COLL OF MEDI
UNIV OF S. FL
UNIV OF S. FL COLL OF MED,
UNIV OF S. FL COLL OF MED.
UNIV OF S. FLORIDA, TAMPA FL
UNIV OF SO FL COLL OF MED
UNIV OF SOUTH FL
UNIV OF SOUTH FL COLL OF MED
UNIV OF SOUTH FL COLL OF MED,
UNIV OF SOUTH FL COLLEGE OF ME
UNIV OF SOUTH FLORIDA
UNIV OF SOUTH OF FL COLL OF ME
UNIV SOUTH FL
UNIV. OF FL COLLEGE OF MED
UNIV. OF MIAMI
UNIV. OF MIAMI SCH OF MED.
UNIV. OF MIAMI SCH. OF MEDICIN
UNIV. OF MIAMI SCHOOL MED.
UNIV. OF MIAMI SCHOOL OF MED.
UNIV. OF MIAMI SCHOOL OF MEDIC
UNIV. OF S. FLORIDA
UNIV. OF SOUTH FL
UNIV. OF SOUTH FL COLLEGE
UNIV. OF SOUTH FL COLLEGE OF
UNIV.OF FL.COLL.OF MED.GAINES
UNIV.OF FL.COLL.OF MED.GAINESV
UNIV.OF MIAMI SCH.OF MED.MIAMI
UNIVER OF SOUTH FL COLL OF MED
UNIVERISITY OF FLORIDA GAINESV
UNIVERISTY OF MIAMI SCHOOL OF
UNIVERISTY OF SOUTH FLORIDA
UNIVERSITY OF SOUTH FLORIDA
UNIVERSITY MIAMI
UNIVERSITY MIAMI SCHOOL OF MED
UNIVERSITY MIAMI/JACKSON
UNIVERSITY OF FL COLLEGE OF ME
UNIVERSITY OF FLOIRIDA COLLEGE
UNIVERSITY OF FLORIDA
UNIVERSITY OF FLORIDA COL MED
UNIVERSITY OF FLORIDA COLL MED
UNIVERSITY OF FLORIDA COLLEGE
UNIVERSITY OF FLORIDA MED.
UNIVERSITY OF FLORIDA SCHOOL O
UNIVERSITY OF FLORIDA,COLLEGE
UNIVERSITY OF MIAMI
UNIVERSITY OF MIAMI MED SCH
UNIVERSITY OF MIAMI MED SCHL
UNIVERSITY OF MIAMI MEDICAL SC
UNIVERSITY OF MIAMI SCH OF MED
UNIVERSITY OF MIAMI SCHOOL MED
UNIVERSITY OF MIAMI SCHOOL OF
UNIVERSITY OF MIAMI/ JACKSON
UNIVERSITY OF MIAMI/JACKSON
UNIVERSITY OF S FLORIDA MEDICA
UNIVERSITY OF SOUTH FLORIDA
UNIVERSITY OF SOUTH FL
UNIVERSITY OF SOUTH FL COLLEGE
UNIVERSITY OF SOUTH FLOIRDA
UNIVERSITY OF SOUTH FLORDIA
UNIVERSITY OF SOUTH FLORIDA
UNIVERSITY OF SOUTH FLORIDA CO
UNIVERSITY OF WEST FLORIDA
UNIVERSTITY OF MIAMI
UNIVESITY OF MIAMI
UNVI OF MIAMI
UVIV OF FLORIDA
NOVA SE UNIV HLTH PROF DIV FT
NOVA
NOVA INSTITUTE OF HEALTH TECHN
NOVA S.E. UNIVERSITY
NOVA SE COLLEGE OF OSTEO
NOVA SE COLLEGE OF OSTEO MED
NOVA SE HEALTH PROFESSIONAL DI
NOVA SE UNIV
NOVA SE UNIV HLTH PROF DIV
NOVA SE UNIV COLL OF OSTEO
NOVA SE UNIV COLL OF OSTEO MED
NOVA SE UNIV HEALTH PROF DIV
NOVA SE UNIV HEALTH PROF DIV F
NOVA SE UNIV HEALTH PROV DIV F
NOVA SE UNIV HLTH
NOVA SE UNIV HLTH PRO FIV FT
NOVA SE UNIV HLTH PROF
NOVA SE UNIV HLTH PROF DDIV FT
NOVA SE UNIV HLTH PROF DIV
NOVA SE UNIV HLTH PROF DIV FT
NOVA SE UNIV HLTH PROF DIV,
NOVA SE UNIV HLTH PROF DIV, FT
NOVA SE UNIV HLTH PROF DIV,FT
NOVA SE UNIV HLTH PROF DIV.
NOVA SE UNIV HLTH PROF DIV. FT
NOVA SE UNIV HLTH PROF, DIV FT
NOVA SE UNIV HLTH PROV DIV, FT
NOVA SE UNIV HLTH-PROF DIV, FT
NOVA SE UNIV PROF DIV.FT
NOVA SE UNIV. COLL OSTEOPATHIC
NOVA SE UNIV.HLTH.PROF.DIV.FT
NOVA SE UNIVER HLTH PROF DIV,
NOVA SE UNIVERSITY
NOVA SE UNIVERSITY HEALTH
NOVA SE UNIVERSITY HEALTH PROF
NOVA SE UNIVERSITY HLTH PRO DI
NOVA SE UNIVERSITY HLTH PROF
NOVA SE UNIVERSITY HLTH PROF D
NOVA SE UNIVERSITY OF HEALTH
NOVA SE UNIVERSTIY COLLEGE OF
NOVA SE UNIVESITY
NOVA SE UNIVESITY Y
NOVA SE UNVERSITY HLTH PROF DI
NOVA SEUHS
NOVA SOUTH EAST UNIVERSITY
NOVA SOUTH EASTERN
NOVA SOUTH EASTERN HEALTH
NOVA SOUTH EASTERN UNIVERSITY
NOVA SOUTHEAST UNIV HEALTH
NOVA SOUTHEAST UNIVERSITY
NOVA SOUTHEAST UNIVERSITY HEAL
NOVA SOUTHEASTER COLLE OF OSTE
NOVA SOUTHEASTER UNIVERSITY
NOVA SOUTHEASTERN
NOVA SOUTHEASTERN O
NOVA SOUTHEASTERN COLL OF OSTE
NOVA SOUTHEASTERN COLL OSTEO
NOVA SOUTHEASTERN COLLEGE
NOVA SOUTHEASTERN COLLEGE OF
NOVA SOUTHEASTERN COLLEGE OSTE
NOVA SOUTHEASTERN COM
NOVA SOUTHEASTERN HEALTH
NOVA SOUTHEASTERN MEDICAL SCHO
NOVA SOUTHEASTERN SCHOOL OF OS
NOVA SOUTHEASTERN UIV.
NOVA SOUTHEASTERN UNIV
NOVA SOUTHEASTERN UNIV- COLL O
NOVA SOUTHEASTERN UNIV COLL OF
NOVA SOUTHEASTERN UNIV COLLEGE
NOVA SOUTHEASTERN UNIV OSTEO
NOVA SOUTHEASTERN UNIVERSI
NOVA SOUTHEASTERN UNIVERSITY
NOVA SOUTHEASTERN UNIVERSITY O
NOVA SOUTHEASTERN UNIVSERSITY
NOVA SOUTHEASTERN UNVERSITY
NOVA SOUTHERN UNIVERSITY
NOVA UNIVERSITY
NOVAE UNIV HTH PROF DIV FT
NOVAL SOUTHEASTERN UNIVERSITY
NOVA-SE UNIV, HEALTH PROF DIV
NOVA-SOUTHEAST UNIV HEALTH SCI
NOVA-SOUTHEASTERN COLLEGE
NOVA-SOUTHEASTERN UNIV,OSTEOP
NOVA-SOUTHEASTERN UNIVERSITY
SOUTHEASTERN U OF HEALTH SCI.
SOUTHEASTERN UNIV (NOVA)
SOUTHEASTERN UNIV MED SCHL
SOUTHEASTERN UNIV OF ALLIED
SOUTHEASTERN UNIV OF HEALTH
SOUTHEASTERN UNIV OF HEALTH SC
SOUTHEASTERN UNIV OSTEO MED
SOUTHEASTERN UNIVERSITY
SOUTHEASTERN UNIVERSITY OF HEA
SOUTHEASTERN UNIVERSITY OF THE

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