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Hospital Impact has been ranked one of the top 50 healthcare blogs by Wikio.
Blogs we like:
by Jacqueline O'Doherty
Patient advocacy is a relatively new field, which is gaining traction as patients struggle to navigate the healthcare system. So what exactly does a patient advocate do?
As a patient advocate I support and empower patients, guiding them through today's complex, confusing and changing healthcare landscape. When a patient and his or her family are grappling with the stress of illness, it's easy to get overwhelmed by treatments, medical options, follow up care and insurance issues.
My job is to sort through the confusion, allowing the patient and their family to make educated decisions about their medical options, based on their personal values.
by Gwen Darling
So here we are again, at the end of another year. The holidays will soon come and go, and the New Year will be thrust upon us, forcing some of us to ponder those mystical end-of-the-year-who-am-I-and-what-am-I-doing-in-my-career types of questions.
This results in what I have finally concluded is the greatest time waster of all time wasters--the compilation of yet another list of New Year's resolutions. On second thought, maybe it's not the actual act of compilation that's the greatest waste of time.
by Ron Shinkman, FierceHealthFinance
The iPad has been the year's hottest electronic device. As the days quickly melt toward Christmas, it's high time to discuss some amazing applications for the device that may yet beat the arrival of the fat man in the red suit.
Anyone who works in the healthcare business knows how useful many of the existing iPad apps are. I mean, who hasn't seen that Apple commercial with the EKG rhythms squiggling across the screen? --Read the full article at FierceHealthFinance
by Sandra Yin, FierceHealthcare
If patient-centered care is to get off the ground, health plans and CMS need to make it easier for healthcare leaders to break their addiction to growth.
Until then, healthcare organizations will find it hard to experiment with, or sustain innovative cost-saving practices, because payment models haven't caught up enough to cover the costs of enhanced patient-centered or coordinated care. --Read the full article at FierceHealthcare
Are you looking for more ways to network and share your ideas with other healthcare professionals? If so, we invite you to join us at FierceHealthcare's new LinkedIn group, Healthcare Leader Idea Exchange. This group will give you a place to take part in lively discussions, learn from other members and share your passion and knowledge. Most importantly, you'll be able to connect with peers and leaders in the healthcare industry. See you there!
I'd like to continue the discussion Dr. Jesse Cole sparked with his recent article, "ACOs are based on flawed assumptions."
To add to the discussion, accountable care organizations remind me of the definition of insanity--doing the same thing over and over again and expecting different results.
Raise your hand if you are familiar with the Harvard Pilgrim Health Care receivership of the late 1990's (a step akin to bankruptcy protection, and one that put the insurer under state control).
by Dina Overland, FierceHealthPayer
I recently went to the bank and was greeted by a friendly pregnant manager who, after processing my financial requests, chatted about how she hoped to deliver her second child at the same hospital where her first was born. She couldn't guarantee the delivery location, however, because East Jefferson General Hospital was in a heated contract dispute with Blue Cross Blue Shield of Louisiana.
They have since reached an agreement and I'd like to believe that bank manager was able to labor at her chosen hospital with no complications. But what if the insurer and hospital hadn't resolved their dispute? --Read the full commentary at FierceHealthPayer
by Sandra Yin, FierceHealthcare
Patients still don't know enough about the care they receive.
That's one major finding from a recent survey by the Schwartz Center for Compassionate Healthcare. Less than half of hospitalized patients surveyed (48 percent) said they were always involved in decisions about their treatment.
Hospital patients also aren't getting the care they expect. The survey found a 20 percentage point gap between the compassionate care patients think they should receive vs. the care they actually received in a hospital.
Being kept out of the loop might be part of the problem. Nearly one-third of patients don't even know who handled their case in the hospital. --Read the full article at FierceHealthcare
by Ron Shinkman, FierceHealthFinance
Edgar Allen Poe and Mary Shelley are great sources of Gothic fiction, but recent CMS termination and suspension letters sent to Medicare Advantage and Part D plans gives these masters of horror a run for their money.
The letters spoke of cancer patients goaded into switching coverage by unscrupulous brokers--and missing weeks of chemotherapy or anti-tumor medications. --Read the full article at FierceHealthFinance
by Maria K. Todd, MHA, PhD
In previous posts, I have covered why and how global competition from medical tourism is sure to grow, and then followed up with what U.S. hospitals can do and how they can start to position their competitive response.
Today, I expand the steps you can take and offer additional points to consider as you create an effective strategy for overall revenue integration, marketing, promotional efforts, and creating realistic estimates for volumes and utilization.
I am a bit embarrassed by my home state's healthcare facilities this month. WakeMed Health & Hospitals, as reported in FierceHealthcare on November 30, has filed an open records request with UNC Health Care seeking audited financial statements of UNC Health Care, Rex Healthcare, Rex Physicians and Triangle Physicians Network. WakeMed contends that UNC Health Care is inappropriately using state funds to siphon business from WakeMed.
The past few years have been quite a whirlwind in the communications and marketing field, and the hospital sector is right in the middle of it all. Despite patient privacy and some resistance, social media has taken hold as a vital part of our everyday lives in the world of healthcare and hospital communications.
Its humble beginnings may be traced back to something as simple as a Mayo Clinic video of an adorable couple who played piano in the atrium. I don't think anyone, including Lee Aase, had any idea that this would grow into something as big as it is, with now over 7 million views.
by Dr. Jesse Cole
ACO models offer nothing that other ASOs--alphabet soup organizations--have not offered in the past. HMOs, PPOs, MPOs and more have all been tried and if not failed, at least have never lived up to the hype.
There is no reason to believe ACOs will fare any better. But it's possible the ACO experiment will be more dangerous than its proponents care to admit.
by Brad Wilson
Hard times force difficult choices. That's particularly true in healthcare, where government, businesses and workers already struggle to fund growing healthcare needs. Yet, it is imperative that we invest in reversing certain health trends that will otherwise overwhelm the system.
Obesity is an epidemic that plagues the entire nation, and here in North Carolina, we're particularly affected. Nearly two-thirds of adults are overweight or obese. --Read the full guest commentary by Brad Wilson, who is president and CEO of Blue Cross and Blue Shield of North Carolina, at FierceHealthPayer
by Ron Shinkman, FierceHealthFinance
At a summit about ACOs in Los Angeles last month, there was a lot of discussion of generalities and few specifics. Peter Lee, the Director of Delivery System Reform for the Department of Health and Human Services used the phrase "good question" so many times that it became a nervous joke.
This isn't a surprise: initial regulations on ACOs won't be released by the federal government until 2012. As a result, most healthcare gurus are groping around when it comes to ACO construction, operations and goals. --Read the full article at FierceHealthFinance
by Gwen Darling
With the holiday season officially upon us, many hospital HR departments are going into stand-down mode when it comes to hiring, turning their attention instead to end-of-the-year concerns such as final budget numbers, performance reviews, and employee benefits analysis, to name just a few.
The rationale from many of my hospital HR contacts is pretty much the same--scheduling interviews around the holidays is difficult, particularly with staggered vacation schedules and shortened workdays. I completely understand that line of thinking.
Here's the thing, though.
It is easy to remove oneself from what is important as we trade metaphorical tomatoes about what is wrong with EHR, what may happen to the healthcare reform, and why the nationwide health information network is DOA.
Debating healthcare IT on the Internet is an esoteric and antiseptic conversation, one with few if any catastrophic implications to anyone other than the person trying to sell a used, $100 million EHR on eBay.
We write about the fact that it is supposed to do something to benefit the patient. Is there a more sterile word than patient? Whether we use patient or patients, we keep it faceless, nameless, and ubiquitous. They do not have to be real for us to accomplish our task; in fact, I think we do our best work as long as we keep them at arm's length.
Without a doubt, the biggest information technology challenges in healthcare today are the successful implementation of the electronic medical record (EMR), computerized provider order entry system (CPOE) and all the needed interfaces that support these two massive and incredibly important systems.
During my tenure as chief executive officer for a hospital in Colorado, I had the pleasure of overseeing both of these implementations as we journeyed from paper to fully digital. Here are nine key strategies that leaders should use to ensure a successful CPOE implementation:
Beware...here comes that touchy feely stuff that always shows up around the holidays.
Having gratitude can be a component of improving your health.
Really?
Researchers have found that giving thanks is good for your health.
But that is (to use the technical term) too woo-woo...isn't it? And something that touchy feely cannot be medicine.
Large hospital chains that have been busy scooping up distressed properties may be indulging in wishful thinking, but it's possible they'll make money off of health reform. Still, the industry is facing a slew of negative forces--such as cuts made to Medicare and Medicaid reimbursements and sick people choosing to forgo care due to lack of health coverage or money--that are pushing demand down.
With all those negative pressures, it's puzzling that anyone would want to acquire a hospital, especially those that are struggling. Yet, that's what happened in the following six deals. To learn more about each, read on.
by Maria K. Todd, MHA, PhD
As announcements are made that physician reimbursement will be cut 24.9 percent, and hospital reimbursements dwindle, healthcare providers in the U.S. must innovate to compete globally. Health travel is one way providers can be more competitive in the international market. In fact, the National Expert Initiative (NEI), announced by President Obama in the June 2010 State of the Union Address orders the doubling of inbound U.S. medical tourism over the next five years.
Inbound medical travelers and their related spends, are statistically tracked by the Office of Travel & Tourism Industries (OTTI), a part of the U.S. Department of Commerce.
by Elizabeth McKay
A supply chain executive in the healthcare field will, in his career, witness numerous ways of acquiring goods and services, running the gamut from the honorable and methodical to the cursory and corrupt. Given that most supply chain managers seek to do the best they can within the time constraints imposed upon them, what criteria should they rely on to determine whether a prospective purchase warrants an RFP?
The first consideration is the monetary value of a product or service. If you expect to spend $50,000, for example, you may not need to undertake the full breadth of an RFP while you would do so if you expect to spend $10 million.
by Maria K. Todd, MHA, PhD
Two weeks ago, I began describing why hospitals need to start worrying about outbound medical tourism. This continues that discussion.
With some new health plan offerings, the employer may designate which services may be covered under the arrangement, per IRS rules. They may offer choices of where (for example, location, provider, narrow network) the money may be spent and provide incentives such as companion travel expense contribution, copay and deductible waivers. This is the first phase, which we anticipate will be followed by full global benefits as an option.
Publicly traded health IT companies have been profitable of late--thanks in no small part to the national push to adopt electronic medical records, the tightening of HIPAA privacy and security rules and the upcoming conversion to HIPAA 5010 transactions and ICD-10 coding. Still, other than McKesson's John Hammergren, who was paid more than $54 million in the most recent fiscal year, health IT executives aren't even in the same league as the heads of health insurance companies when it comes to compensation.
Read on to get a more detailed look into the pay packages for some of the top executives at public health IT companies today. Read more...
A tax benefit boosted Tenet's profits, while fewer births and H1N1 cases cut admissions for Health Management Associates. Those are just some of the forces behind Q3 earnings results. Want to know how top hospital chains fared in the third quarter of 2010? Curious as to how well insurers really did so far this year?
Check out FierceHealthFinance's earnings summaries to see how five of the largest, publicly-traded hospital chains and six of the largest health insurers stack up.
Creating a Facebook fan page for your physician practice is a free, easy and increasingly essential way to leverage the phenomenon of online users turning more and more to the Internet for health information. While there are no hard and fast rules when it comes to social media, experts have identified some clear traits among pages that work. Here, FiercePracticeManagement will present their top five best practices for engaging your patients through Facebook fan pages for business.
by Jenn Riggle
Last week, Twitter was buzzing about a new report from the Healthcare Performance Institute that said social media can help reduce medical expenses while improving the quality of care.
The article focused on electronic health records and the importance of sharing patient data, but neglected to look at what I think is the biggest health trend--mobile health, more commonly known as "mhealth."
by Ron Shinkman, FierceHealthFinance
Aron Ralston is back.
If that name is familiar, it's because he's the outdoorsman who amputated his own right arm seven years ago after getting it lodged in a rock formation during a Utah hiking expedition. A movie based on his experiences was released last week.
I bring Ralston up because it reminds me of a horribly mischievous period in my life when I was editing a spoof of the Wall Street Journal called The Walnut (official motto: "Business News For Yes-Men in the No").
The Walnut once reported that Ralston had nabbed a fat endorsement deal from the National Association of Managed Care Organizations. NAMCO had hired Ralston because it had estimated that Americans would save $12 billion a year if they operated on themselves. Ralston made a perfect spokesman for such a cause.
Of course, that's all fictitious. However, the horrible mischief was not. I fear it has returned with the outcome of last week's mid-term elections, accompanied by far more power and far less of a sense of humor. --Read the full article at FierceHealthFinance
Highmark Inc., a Blue Cross Blue Shield carrier in Pennsylvania, has upped the ante on customer service and enrollee health and wellness with the opening of Highmark Direct retail stores in the Pittsburgh and Harrisburg, Pennsylvania areas.
The company has attracted 20,000 visitors since opening the Pittsburgh operations in March. The stores offer a self-service area with kiosks to take simple health measurements, plus classrooms where people can ask questions and work with staff on coverage or billing problems. In the future, the stores may draw health-plan customers for wellness classes in such subjects as smoking cessation or prenatal yoga. They are even tracking negative comments online and intervening to help improve people's experiences with their health plans.
As carriers prepare to compete for millions of new customers starting in 2014 and are mandated to cover all regardless of preexisting conditions, they are seeking the best of both worlds. They want their share of new customers but they also have a huge stake in keeping people well.
Many of you are heading to the Washington, D.C., Convention Center next week to attend the mHealth Summit, where Bill Gates and Aneesh Chopra are among the impressive roster of keynote speakers. Consider also dropping by FierceMobileHealthcare's executive breakfast discussion on telemedicine, Tuesday morning, Nov. 9.
Sponsored by LifeSize, it takes place just across the street from the Convention Center and is separate from the conference (so you don't need a conference registration to attend).
A physician who doesn't jump to answer help calls on airplanes. An ER nurse who reveals some of her daily frustrations dealing with coworkers. Older physicians who see social media as a way to bring medicine back to its roots to connecting with patients. Those are just some of the people you'll read about who we've included in this year's group of 10 Healthcare Bloggers We're Thankful For, FierceHealthcare's latest compilation of some of most informative and entertaining healthcare writers in the blogosphere.
by Maria K. Todd, MHA, PhD
Should American hospitals worry that patients will stream offshore to more distant destinations for their big-ticket healthcare items?
Yes and here's why and how it will play out:
As more employers and their employees are pushed to the wall financially for the cost of health benefits and out-of-pocket cost shares, their curiosity about other options increases.
Recently a Harvard-trained practitioner shared his philosophy with me. The physician's job is to determine the appropriate healing protocol based on existing evidence-based research, he said, and the patient's job is to obey the physician and follow the prescribed protocol. If the patient does not follow the protocol, he is "non-compliant."
Perhaps it is too early to know the impact of yesterday's elections. After all, the impact of conservative Democrats in the Senate remains to be seen, the Supreme Court has not weighed in on the constitutionality of requiring Americans to purchase healthcare insurance, and the president does not face reelection until 2012.
If healthcare remains a collaborative local effort among nurses, physicians, administrators, and allied healthcare professionals to care for patients and their families, what can we do in the aftermath of the election to show that we are listening to patients' concerns?
From a janitor selling tens of thousands of patient records for the equivalent of beer money to caregivers sharing photos of a nearly decapitated patient on Facebook, employees at hospitals and health centers seem to have figured out every way imaginable to violate patient privacy rights.
FierceHealthcare takes a look at 10 of the most egregious recent patient privacy breaches.
I admit I have been concerned about the Health IT Regional Extension Centers (RECs), because they could become another layer bureaucracy in the adoption of Electronic Healthcare Records. However, it seems that according to Healthcare IT News, CIOs have an opposite concern. They feel that the RECs may create a "Tower of Babel." The CIOs feel that inexperience in Healthcare IT and a lack of coordination by the states are wasting resources.
By Linda Sinisi
If the proverbial key to success in real estate is location, location, location, in the IT world it's communication, communication, communication. Yet one common complaint across industries is that IT staff aren't responsive or don't communicate enough or in a language that "normal" people can understand.
Keeping leaders in the loop has been of paramount importance for me.
In a fragmented industry like healthcare, one with many entrenched interests that simply don't have a lot of motivation to change, disruption can be a positive thing. What distinguishes truly disruptive individuals from the status quo are a maverick spirit, a willingness to fight for what they believe is right and the ability to motivate others to embrace their fresh ideas.
With that in mind, FierceHealthIT presents 10 disruptive forces in health IT.
Hospitals are not exempt from the economic woes our country is facing. More and more, we hear of hospitals facing layoffs to address budget deficits. This can undoubtedly cause concerns among patients and members of the community. They may worry about whether they will be able to get the care they need if your hospital appears to be downsizing.
Hospitals that use social media for marketing are often inclined to NOT use these tools during difficult times. Take these two instances:
Two things have prompted my post this month. First I read this transcript from public radio about where hospital advertising is really aimed. And then, I was invited to a presentation by the Health Care Advisory Board regarding their take on reform. That put the public radio piece in context. And it further solidified my belief that as health care reforms and hospitals change, marketing has to change as well. Let's start with the radio first.
The radio feature highlights hospitals in my hometown of Philly. It contends that hospital advertising is not aimed at consumers but payers.
by Chris Mohr
Our IT department at PinnacleHealth operates more than 300 servers, ensuring that our applications are continuously available for 5,000 employees.
We previously relied solely on a physical, tape-based solution for all daily and weekly backups for eight terabytes of data.
However, the backup was slow, taking 12 to 15 hours, our tape expenses were increasing, and recovering data was time consuming and not always successful. The process of retrieving and mounting the tapes would take three to four hours, for example. We clearly needed to find a better and easier way to do data backup.
A few weeks ago, I wrote about an article I read about Canada's perception of trust in their physicians. Shortly after returning home, I came across another survey which detailed results of a Rasmussen Report (conducted via telephone with 1,000 adults in mid-August 2010) about patients' attitude toward physicians in the United States.
What a difference in perceptions! While the Canadians seem not to trust their physicians, the U.S. study found
Soliciting prostitution. Bribing state officials. Bribing...homeless people? Yes, healthcare executives have made headlines for some head-scratching decisions over the years. The real question is, what were these guys thinking? FierceHealthcare takes a look at nine executives who, unfortunately, have been in the spotlight at one time or another for all the wrong reasons.
Whether they're going green or going wireless, hospitals are innovating at a rapid clip. In a first-of-its-kind bariatric procedure, surgeons at one California hospital removed a man's stomach through his mouth. And in Pennsylvania, one healthcare organization uses RFID technology to track patients throughout its operating suites.
We culled our 'Top 10' list of Fierce, trailblazing hospitals by identifying the elite organizations that appear on multiple ranking lists, such as HealthGrades or Thomson Reuters and which also appear on Hospital & Health Networks' "Most Wired" or "Most Wireless" lists.
by Gwen Darling
Like it or not, if you work for a hospital you will be involved in an EMR implementation project in one way or another--sooner than later.
This fact has many hospital employees squirming, for it inevitably means change. And on the way to change will be group briefings, mandatory training sessions, more group briefings, and most likely a test or two thrown in for good measure. I know, "ARGH!" right? But here's the thing. Your attitude about this complicated, overwhelming, and let's be frank, pain-in-the-ass change may very well determine your future.
How so?
I recently heard a Yale-trained advanced practice nurse discuss the human connection in healing and how critical cultivating a relationship is to best position a patient to achieve a health goal. She shared best practices and offered strategies to avoid typical pitfalls that lead to what clinicians call "patient non-compliance."
After the conference, her talk generated much discussion. Attendees said that every office should have a practitioner like her.
But not everybody agreed with the speaker.
What will it take to create local health information exchange (HIE) systems that fit in with the federal government's vision of local, regional and national health information exchange networks based on standards defined by the Nationwide Health Information Network (NHIN)? The fragmentation of the efforts of groups involved in the actual HIE implementation at the community, local and regional levels is just one of many challenges and obstacles facing those who are trying to meet the government's meaningful use criteria. Here are some others.
I believe that there are no coincidences in my life. As a guest blogger who took the summer "off" to move to the north shore of MA and write my third book (Getting It Done: Lifelines from the Field), I struggled with getting back into posting something each month that will add value.
Feeling the pressure of too many tasks and too little time, I reluctantly acknowledged the call to worship last weekend and found meaning in Rabbi Jack Riemer's responsive reading, "Turning," in which he noted that for leaves, birds and animals, turning comes instinctively--whether it's leaves turning colors, birds heading south or animals storing food for the winter. Yet change for us does not come so easy. Not only does it mean breaking with old habits and perhaps losing face, "it means starting over again."
By Linda Sinisi
Here are some service expectations and goals I developed for my new IT team at Pennsylvania Hospital as part of a larger drive to create a service-oriented IT culture.
Service excellence starts with listening. When someone takes the time to explain what they need, the first step I take is to repeat what they said to confirm that I understand. Immediately afterward I send a note with next steps and a realistic timeframe for addressing their request.
Service excellence also means anticipating the needs of your clients. At Pennsylvania Hospital we recognize that clinicians don't always have time to call the Help Desk. So we developed two other ways to reach tech support.
by James Blair, DPA, MHA, FACHE
The nation's hospital and healthcare systems have failed to meet their expected roles and responsibilities in the country's evolving 20-year strategy for homeland security. Well before the 9/11 attacks, the industry ignored many calls to prepare for known threats of non-state terrorist groups securing weapons of mass destruction (WMD) from stockpiles left from the Cold War.
Terrorist attacks with or without WMDs are only one of three major threats facing hospitals. Evolving infectious diseases and more frequent and robust natural disasters are the other two.
The clinical scenario is familiar to many doctors.
An elderly man arrives at California Pacific Medical Center's emergency department in San Francisco at 11 p.m. on a Saturday by ambulance, unconscious and severely ill. A neighbor had called 911 after he failed to answer the phone or door. No friends or relatives are available, and the man has never visited this emergency department before.
The treating doctors must start from scratch to diagnose and treat this patient, with no knowledge of his other physicians, past medical history, medications, or previous medical care. This process is expensive and inefficient, because historical information is missing.
by Jenn Riggle
Women have always been considered the healthcare gatekeepers. However, things may be changing.
The popularity of Viagra has proven that men are taking a more active role in their healthcare--or at least they're willing to talk about issues that impact their sex lives. Since sexual performance issues affect approximately 15 to 30 million American men, this is a major issue.
We can give some of the credit to CNN's Dr. Sanjay Gupta and the ever popular Dr. Mehmet Oz for bringing men's health issues out of the locker room and into the living room.
Like most programs, the Health IT Regional Extension Centers (RECs) that are being established across the nation as mandated by the stimulus are a great idea in theory. Their intent was to encourage the adoption of EMRs by providers by disseminating best practices for adoption. But what is the reality on the ground?
How do you define mobile health? Is it still emerging? And how broad is its scope? Does it include wireless sensors?
These questions are part of a debate that has played out on the 3G Doctor blog, according to FierceMobileHealthcare Editor Neil Versel. Several months ago, David Doherty, head of business development at the Ireland-based mobile healthcare software vendor 3G Doctor, took a stab at defining the field.
He took issue with a Wikipedia entry that cites the work of Robert Istepanian, a professor of data communications at Kingston University in London, who defined m-health as "emerging mobile communications and network technologies for healthcare." The entry, at least as it read six months ago, also mentioned "embedded wireless devices that track health-related parameters," Versel writes. FierceMobileHealthcare
Financial institutions suffer more data breaches than healthcare organizations, right?
Wrong. It's healthcare--by a factor of three to one, writes Websense CIO Jim Haskin.
He cites a recent report from the Identity Theft Resource Center (ITRC) showed that compromised data stores from healthcare organizations outstrip those in other industries. According to the ITRC, healthcare organizations disclosed 119 breaches this year through early August, compared to 39 reported in the financial services industry. Why is this happening? FierceHealthIT
In Canada last month, a newsstand magazine caught my eye. In bold letters on the cover of the August 23 edition of Maclean's Magazine were the words: "Crisis in Confidence: Do You Trust Your Doctor?" According to the article, an increasing number of Canadians don't.
The article detailed some examples of medical errors (for example: misdiagnoses, misread pathology, and incorrect surgery) and the erosion of trust in medical professionals. The article cited surprising results from a recent poll they conducted that suggest trust in physicians has eroded over time:
I'm insulted and you should be too.
I knew when I read this FierceHealthcare blurb that there was a blog lurking. But right after I read it I had to leave my desk for a doctor's appointment. Well that appointment sealed the deal.
When you arrive at your 2 p.m. appointment and are not seen until 3 p.m. that is an insult.
by Gwen Darling
As hospitals continue to focus on demonstrating "meaningful use," one thing has become clear: The hunt for experienced Healthcare IT professionals is on, and the competition is fierce.
Fortunately many excellent educational programs are in full swing, working to produce the workforce of tomorrow. But in the meantime, any hospital employee who has played an integral part in a successful EMR implementation is one hot commodity. And if that employee happens to be certified in one or more key vendors' software modules? That employee isn't just hot, but on fire.
Colleagues across the country tell me that their patient volumes are soft which is driving their expenses out of line with expectations when adjusted for volume.
This is a growing issue as inpatient volumes continue to be flat or down for lower acuity patients while many hospitals are experiencing growth and stronger volumes in some of their more complex patient populations, who need implantable devices such as stents, pacemakers, and total joint replacements.
When the expense of high cost, complex volume is spread across a smaller base of adjusted patient days, the expenses are naturally inflated.
In times like these, supply chain executives and their teams have to be ever more diligent in helping end users right size their purchasing and inventory practices,
It's no secret that Americans are getting fatter and that more Americans can expect to get sick and die from obesity-related complications, such as heart disease, stroke, and diabetes.
But while it is great news that people are universally acknowledging that obesity is a huge health issue, the current healthcare system does not position physicians (and other practitioners) to best leverage their skills, wisdom, heart and energy to help individual patients understand and address the root causes of their obesity.
Back-office automation and process improvements have rarely been a high priority for U.S. hospitals, writes Jim McDowell, senior director for healthcare insight and industry strategy at Oracle Corp. in Phoenix.
Over the past dozen years alone, hospitals and integrated delivery networks (IDNs) have focused on everything from the Y2K problem to primary medical records system overhauls, and now the push for health information exchanges and meaningful use threatens to keep back-office systems squarely on the back burner. FierceHealthFinance
by Brian Lapidus
In the interest of full disclosure, let me note one fact: The title of this piece is a misnomer.
Why?
It's simple: You can't prevent a security breach.
In fact, when it comes to experiencing a data breach, the question is not if, but when. That's why an organization's security plan shouldn't focus on prevention alone.
Your organization must be in the best defensible position to handle a data breach when the inevitable hits.
Like you, I see two distinct groups who do not play well in the same sandbox-clinical and IT.
Sometimes one group will try to quickly learn skills from the other group.
But having members of one group go to the other's summer camp to pick up a few skills will not qualify them to pull a few costly and hairy projects from the bowels of project hell anymore than having an IT executive take an EMT course would qualify that person to perform surgery. Studying anything for a brief period does not mean you're qualified to perform that task.
HIPAA is a common term in hospitals. If your hospital or health system is like ours, you spend a lot of time training, reminding and testing all employees on what is covered by HIPAA laws. For the most part, I believe employees understand the law and what they need to do to protect our patients and their privacy. Hospital employees sign agreements and promise to uphold their end of the deal, realizing there will be consequences if there are violations.
But for some strange reason, when it comes to social networks, employees seem to forget they are bound by those same regulations.
by Neil Versel, FierceMobileHealthcare
Once an upstart, Google's open-source Android operating system has grown into a formidable player in the world of smartphones. And with the growth in its user base has come a flood of apps.
With a little help from Google and an app developer or two, FierceMobileHealthcare has compiled a list of free and interesting healthcare-related apps that help make the lives of healthcare professionals and patients a little easier. Start slideshow
Now that there is scary.
Most people have been assuming that with healthcare reform, everyone will opt to have insurance and therefore seek care routinely.
But little is being said of the option to opt out of insurance or the types of coverage that will be available. Consider that people with high deductible plans, even though insured, are now and will continue to opt to delay or skip care. Healthcare reform has not brought us pricing reform and from all indications health premiums are still rising and will keep rising. And the employer landscape would suggest that high deductible plans are becoming the norm not the exception.
By Cathy Leahy
So the federal government's Department of Health and Human Services (HHS) has decided that their breach notification final rule under the HITECH Act needs further review. Apparently they got an earful from privacy advocates so they decided to scrap it and start over.
Those of us in healthcare rarely see life through the patient's or family's eyes. Yet there is much we can learn from first-hand experience as patients or their families. When we do experience our healthcare system up front and personal, we walk away with an experience that can change us forever.
Readers of my posts are aware of my decision to leave my hospital CEO position in Colorado at the end of 2009 to return to Chicago and help my wife with her ailing father. As I wrote then, it was a very hard decision, but family comes first.
That situation, which has brought us up close and personal with the healthcare system, ended in early July when my father-in-law, after suffering a stroke in June, succumbed to his multiple ailments.
When Lowe's Home Improvement recently announced that all employees who needed cardiac surgery would go to Cleveland Clinic, it made me pause. Living just miles from Lowe's headquarters (near Charlotte, N.C.) and surrounded by very good major medical centers, I would have liked to be a fly on the wall when local hospital officials heard the news. The announcement must have sent shock waves through them.
In any given webinar or lecture on social media, you'll hear that if used correctly, it can be an incredible tool for hospitals that want to build a conversation with our patients and the community, hearing what people want and how we can improve our services, offering health information for the general public, communicating timely information in a crisis, building loyalty for our brand and even supporting fundraising efforts.
For the past year, the hospitals of the Lifespan health system have maintained Twitter and Facebook accounts, as well as a YouTube channel for the system as a whole. Along the way, we've found things that are successful and some things that don't work so well.
by Deb Beaulieu, FiercePracticeManagement
Medical practice revenue isn't just about payer reimbursement anymore. With more uninsured or underinsured patients accessing care, patient responsibilities now account for 20 to 30 percent of a practice's total charges.
To thrive in a still-challenging financial environment, practices must be more aggressive about collecting patient deductibles, coinsurance payments and outstanding balances. FiercePracticeManagement interviewed several revenue cycle experts and practice managers who shared their top advice for collecting money while maintaining positive relations with patients.
Surprisingly, many of their strategies are simple (and effective!). Click here to see their tips
Now that HHS has finally defined "meaningful use," we all can expect a push for adoption.
Or can we?
With both the massive federal incentives and the potential for lower reimbursement rates for failure to adopt, will providers actually adopt Electronic Health Records?
Or will those who have already adopted EHR simply use this as an opportunity to upgrade?
I still have my doubts.
by Gwen Darling
At the time I didn't know it. But in hindsight I'd have to say my most valuable class in high school was Mrs. Alva Johnson's typing class. Not only did she teach me a skill I've counted on virtually every day since then (and there have been quite a few days since then!), but it led me to my first part-time job in the healthcare industry as a medical transcriptionist for a solo practice physician who specialized in geriatrics.
I loved this job, largely due to the doctor's personal approach.
If a patient fell in the woods and nobody heard him, so what?
Most people are comfortable rallying around that approach.
I've spent a lot of time trying to understand what a patient is worth to a hospital. Apparently, no one has had this conversation before. If they have, the answer was sequestered.
Patients are both customers and consumers. Unless the patient is in the back of an ambulance being driven to the nearest hospital, as I was, the patient can choose which hospital to purchase services from.
Choice. If I wish to purchase a healthcare procedure, how might I go about that?
The entire industry is being turned on its head and the only people who do not recognize it are those running the hospitals.
In the last 20 years, there have been many attempts at tweaking the physician reimbursement model, with each new idea aiming to avoid making the same mistakes as its predecessor. For example, in the early 1990s, many physicians were reimbursed via a fee-for-service methodology with a withhold. Essentially, payers would hold back a percentage of payment in hopes of seeing improved utilization and decreased medical expenses. Over time, however, physicians seemingly planned to have a certain amount of money withheld, and the leverage opportunity for the payers was lost.
A short time later, quality-based incentive programs became in vogue. Eventually, those were repackaged as pay-for-performance (P4P) programs, which ultimately became a more broad-based offering. Despite all of the aforementioned attempts, as well as ones that came afterward, however, one question remained constant: Did any of those methodologies truly serve to help improve health outcomes?
by Alicia Caramenico, FierceHealthFinance
In the midst of game-changing healthcare reform, many hospitals approved hefty payouts for their top executives last year. Here, FierceHealthFinance presents a review of CEO compensation at the largest publicly traded healthcare systems based on 2009 revenue. Using the Fortune 500 list of the health systems with the largest revenue in 2009, we examined the compensation of executives from the six largest systems. We looked at how (and if) factors like the economic climate, corporate litigation, and stock value affected the way those companies compensated execs. Read the full report
by Jenn Riggle
Hospitals can't be all things to all people.
But hospital marketers often forget this fact. The end result: Your hospital's marketing message is muddy--and forgettable.
Instead of focusing on the one thing that makes the hospital unique, hospital marketers try to promote all of their services and their message ends up becoming: "XYZ Hospital has a number of great clinical programs and scored high on quality measures." While this may be true, it's hard for people to wrap their arms around it because it doesn't speak to the care they need. Besides, quality care isn't a differentiator; it's an expectation.
There's more dismal news on our healthcare system. When compared to six other developed countries on a number of indicators, the U.S. came in last, according to a report released on June 23by the Commonwealth Fund.
We ranked last or next to last on five "dimensions of a high performance health system" compared to Australia, Canada, Germany, Netherlands, New Zealand, and the United Kingdom.
by Sandra Yin, FierceHealthcare
Talk about a wake-up call.
It came too late to keep Gen. Stanley McChrystal from being sacked. But hospital leaders might learn something from what transpired last week after Rolling Stone published the highly publicized story that led to the abrupt end of McChrystal's tenure as commander of all U.S. and NATO forces in Afghanistan.
The blogosphere and mainstream media were all abuzz. In the article, McChrystal and his staff criticized almost every member of the president's national security team and expressed contempt for the president and vice president.
Apparently I wasn't the only one who had questions about the general's conduct.
I attended a conference in Charlotte last month where Terry McGeeney, MD, President and CEO of TransforMED, gave an interesting presentation on how to transform a medical practice into a medical home.
Much of what he said I had heard before, with one exception. He contended that the foundation of any medical home must be built upon sound practice management. I would agree.
My nephew is a registered nurse in a busy cardiac catheterization lab in Columbus, Ga., and on a recent visit, his wife let slip that he's packed on a few pounds since he moved from medical/surgical nursing to the cath lab.
When I asked what she thought was the cause, I was surprised by her response. "Breakfast and lunch is brought in every day by the company representatives for the supplies his department uses," she told me. I was dumbfounded, not because I wasn't aware that supplier reps bringing food into certain hospital departments, but more so because my nephew's wife had associated the practice with her husband's weight gain.
Noted healthcare journalist Shannon Brownlee is not alone in her assessment that more medical tests and treatments do not necessarily lead to better overall outcomes. In her 2007 book "Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer", Brownlee elaborates on that opinion, noting that one of the main motivators behind such behavior is that doctors, oftentimes "are paid for how much care they deliver, not how well they care for their patients."
This is something that I know about all too well.
by Gwen Darling
A recent FierceHealthcare headline read, "Nearly half of surveyed hospital employees 'discontent' in their work." The article cited the results of a study that found that 45 percent of the 235,000 employees surveyed consider themselves "distanced from or discontent with their current work." It went on to outline that the most unhappy employees tend to be younger--"mostly Gen Y and Gen Xers"--while those born before 1945 usually are satisfied with their roles. Part of the reason for that gap, researchers noted, is that Gen X and Gen Y employees want recognition for their work and inclusion in decision making processes.
These findings are actually a bit more sobering when you stop to do the math and figure out that according to the survey, the happy employees are 65-plus and most likely on their way out the door.
I recently read in the New York Times that, in an effort to ensure medication and adherence and prevent hospitalizations, various programs are paying people to take their medicine. One program uses a digital pillbox to monitor compliance.
The article goes on to discuss other innovations, such as insurance companies rewarding doctors for prescribing medications that help prevent hospitalizations. Such preventive and pay-for-performance measures are key components of the new healthcare reform law.
I think the lesson learned here is the true importance of health IT. These payment innovations are made easier by health IT. As a result, we'll save money by preventing future hospitalizations and thereby improve productivity -- and better productivity is exactly what our healthcare system needs.
by Marco Huesch
In the rush toward "meaningful use" and amid the HIT sales pitches, let's pause for a moment to consider strategy.
What, for example, does "interoperability" mean for your strategy? It might mean little now -- even if you're in Boston, and have the planet's best hospital CIO. When Beth Israel Deaconess Hospital gets paid substantially less than Partners HealthCare despite clinical parity or superiority, it's hard to imagine real "interoperability" working out just yet.
But what if "interoperability" does get exploited in all its neat potential? What happens to your strategy when the balance of power in your relationships with other providers, regulators and referrers gets turned?
by Dan Bowman, FierceHealthcare
This week, FiercePracticeManagement reported on a study published in the Annals of Internal Medicine that raised quite a few eyebrows with regards to medical school rankings. The study looked at things from a "social mission" point of view, essentially ranking the nation's 141 medical schools by how well they produced graduates who practiced primary care, worked in areas with a federally designated shortage of health professionals and belonged to underrepresented minority groups. While some relatively unknown schools like Morehouse School of Medicine, Meharry Medical College and Howard University topped the list, traditionally high-ranking med schools like Harvard, Stanford and Johns Hopkins were ranked much lower.
Dr. Candice Chen, one of the authors and an investigator at the George Washington University School of Public Health and Health Services, talked to FierceHealthcare about the study, and why she thinks it's important to also look closely at experience and intangibles when it comes to our doctors, as opposed to just test scores.
FierceHealthcare: In the paper, you specifically discuss medical school rankings (like the one created by U.S. News & World Report) and their flaws. What do you think can be done to address these flaws, especially considering that you constantly see schools like Johns Hopkins and Duke atop most medical school rankings, but on your list they rank near the bottom of the pack?
Candice Chen: The interesting thing about U.S. News & World Report is that they do two different ranking systems right now. They've been doing their primary-care rankings now for a good decade-plus. Prior to adding the primary-care ranking, they really valued research, and in their main ranking they still do that. So there's always a question of "what do we value in our medical schools?" It's not that we shouldn't value research and the research that they've produced, but sometimes I think we value research in the absence of valuing some of the things that are looked at in our paper.
by Debra Beaulieu, FiercePracticeManagement
Last month over at FierceHealthcare, we reported on a study revealing that 90 percent of parents surveyed would welcome email access to their child's doctor. Picture me, a mom of two tough-to-wrangle toddlers, raising my hand emphatically from behind the laptop.
How nice would it be if I could just beam our pediatrician a digital photo of a rash, describe any other symptoms and get a response--even if it's that I'll need to make an appointment--without necessarily having to haul both kids over there and inevitably bring the healthy one back with the germs of some other kid who couldn't resist smooshing his face right up against the giant fish tank? As a parent and as a patient, it would be very nice indeed.
Read more!
It's one thing to discuss anecdotal symptoms of our broken healthcare system. It's something totally different to live with those symptoms, or to witness their impact on a loved one. The cost of a broken healthcare system to a dear individual is significant. The financial cost to us all of having a broken system can be significant, as well.
Today I want to tell a story about a family member "Betty" and her recent experience in our healthcare system.
I'm a huge fan of soccer (or non-American football) and this week kicks off the 2010 World Cup in South Africa.
As I've been chatting with friends internationally and reading up on preparations, there has been interesting news about some of the challenges the host country is facing from a healthcare perspective. Apparently the Federation Internationale de Football Association (FIFA) has very specific requirements of the host country and cities where the matches are played.
by Neil Versel, FierceHealthIT
If you think this whole "meaningful use" thing is a challenge, get a load of what they're trying to do in Europe.
Last week, the European Commission--think of it as the executive branch of the European Union--published its "Digital Agenda," a 10-year plan for IT advancement across the continent. Healthcare figures prominently in the agenda, including the goal of providing secure, online, patient-controlled medical records for many Europeans in the second half of this decade. There are some interim steps in the near term, though.
One aim, according to E-Health Europe, is to "increase safety and medical assistance to Europeans, for instance in an emergency abroad, by defining a minimum set of health information to be included on patient records that can be accessed electronically anywhere in the EU." This is to be done by 2012.
As you may have read this week in FierceHealthcare, two new studies suggest that nurses working in hospitals are much more susceptible to depression than their counterparts in clinics, schools or other locations, especially if their hospital is high-volume.
A study in the May 4 Journal of Clinical Psychiatry looked at the relationship between bed occupancy rates and absenteeism and found that those working in units that were 10 percent more crowded than the optimal rate had twice the rate of depressive illness than their counterparts in less crowded units.
The second study, appearing in the May 19 issue of Health Policy, is based on data from the 2005 National Survey of the Work and Health of Nurses in Canada. While looking at absenteeism in general, the report notes that depression is a "significant determinant" for missed work among RNs and LPNs, and that those who work in a hospital are more likely than those working in other settings to miss work.
If you've ever been lucky enough to stay at the Ritz, you've experienced their first-rate customer service, attention to detail, inviting atmosphere, unique gift shops and scrumptious food. Could such luxurious pampering and quality translate over to the hospital environment?
It could, and it does. Bill Taylor, cofounder of Fast Company magazine, blogs for the Harvard Business Review about Henry Ford West Bloomfield, a suburban Detroit hospital that's run by former Ritz-Carlton executive Gerard van Grinsven.
What is your healthcare organization's Vision Statement?
What is your specific role in ensuring that your organization achieves this vision? How often do you assess the impact you are having on this achievement?
In my last post on Hospital Impact, I discussed events that are taking place now to change the way care is delivered to U.S. citizens with pre-existing conditions and to retirees who are not yet eligible for Medicare. I would be remiss not to mention another development on the horizon that is affecting hospitals and physicians: Accountable Care Organizations (ACOs).
OK, did you read where people's dissatisfaction with hospitals dragged the American Customer Satisfaction Index down by five points? In response to the survey's results, a spokesperson for the American Hospital Association said hospitals have made and continue to make "tremendous improvements" in the quality of care.
I don't know about you, but I completely disagree with the notion that a hospital association--or any association for that matter--can determine whether or not they've made "tremendous improvements" in quality of care. Isn't that something for patients to decide?
Apparently I'm not alone in my thinking.
by Caralyn Davis
How much do hospital CFOs really know about the technological nuts and bolts of protecting patient health information? How much should they know?
That's the question I posed recently to Dr. Barry Chaiken, chair of the Healthcare Information and Management Systems Society (better known as HIMSS). He echoed what many CIOs have been saying for some time; while some of the more tactical IT issues are better left to IT geeks, CFOs should consider privacy and security "a strategic issue," Chaiken says.
"We can no longer in healthcare work in silos," Chaiken told me. "Everybody is interconnected, so clinical and nonclinical people have an obligation to work closely together to address all the issues in healthcare, particularly privacy and security."
Chaiken outlined three critical steps that healthcare financial leaders should take...
by Dan Bowman
Since it's one of our most popular special reports, we wanted to let you know that FierceHealthPayer just published our annual review of health plan CEO compensation.
Each year, we comb through the proxy statements of the largest health insurance companies to determine how much their leaders earn. As you might imagine, it always garners lots of interest. If you're curious, check out the full report, hosted on the website of our newest publication, FierceHealthPayer. Enjoy!
So when's the last time you asked your operations VP--or even your front-line maintenance and facilities staff--for their money- and energy-saving ideas? These guys, and gals, know the innards of your facility better than anyone, and are perfectly positioned to know where you're wasting money.
Back when I was a reporter covering the hospital environment of care beat, I interviewed one facilities operations director who described how his Texas hospital saved more than $1 million by implementing some of the common-sense, low-cost ideas that bubbled up from his crew. One tip alone helped save nearly $500,000 in energy costs--simply by making minor adjustments to the chilled water flow rates and the steam temperature.
I've worked in hierarchical organizations for most of my career, where decisions are top-down and based on what's already known; where individuals provide input based solely on their role and responsibility (no stepping outside); where process and outcomes are based on historical expectations and where patterns are the strict definers of success.
Then I joined an organization in 2005 where the collaborative leadership "Circle Process" was the heart and soul of its culture. The prevailing culture emphasized heart-centeredness, authenticity, trust, honesty, shared leadership, and speaking and listening from the heart. It was quite an adjustment for someone coming from the typical corporate structure.
When Health Grades announced its 50 Best Hospitals Report a few months back, it marked the beginning of that silly season of health care ratings.
Step right up ladies and gentlemen. I present you the best of the best from: US News and World Report, CMS, The Joint Commission and yes, even Angie's List. What did you say Mr. and Mrs. Consumer? You don't understand these ratings? Every list ranks hospitals differently, you say? You're confused? I get it!
Doctors are confused too.
I'm a big proponent of taking responsibility for your actions. It is a practice I try to live by, and I expect the same from friends and colleagues, as well as companies. I think this is especially important in a crisis, and I truly believe it can make or break a company's brand management.
Social media provides us with incredibly useful tools for doing just that. While some hospitals are still reluctant to break into this medium for a host of reasons, recent headlines are providing lessons in how these tools can help you through a crisis, and are providing some important lessons for us all.
For example, right now there's a brand in big trouble--BP.
Process improvement experts use root-cause analysis (RCA) to evaluate and identify the reason for the cause of a defect in an effort to isolate the one major area adversely impacting and contributing to a defect and the defect's recurrence.
Identifying the root cause of a chronic illness is one critical process improvement that will positively impact the lives and health of both individuals and communities (and bend the healthcare cost curve down).
by Gwen Darling
Earlier this month, the Department of Health and Human Services announced awards totaling $84 million to help universities and junior colleges train and develop more than 50,000 new health IT professionals. The program targets six key health IT roles:
* Clinicians/Public health leaders
* HIM specialists
* Health information privacy and security specialists
* Research and development scientists
* Programmers and software engineers
* Health IT sub-specialists
I was wrong. I wrote that Scott Brown's victory in the Senate election in Massachusetts meant that we needed to pursue other areas of healthcare reform while Congress was embroiled in partisan gridlock. I did not expect passage of the Patient Protection and Affordable Care Act (HR 3590) and Health Care and Education Affordability Reconciliation Act (HR 4872), but admit that their passage just before the Annual Congress of the American College of Healthcare Executives made for exciting discussions. Participants felt like we were part of the present.
by Paul Roemer
Now that spring is in full bloom, I've been doing a little gardening. My dogs are the anti-gardeners. No sooner do I turn my back after planting something, there they are, happily digging away and ceremoniously digging it up. I don't know if that's because they don't like the particular plant, or just happen to disagree with where I planted it.
Today I discovered the youngest dog uprooted a plant and replaced it with a Reece's Peanut Butter Cup. Perhaps she wanted to grow a candy tree.
One thing that always confuses me about gardening is this: When I plant a one-gallon shrub, I dig a two-gallon hole. I place the gallon shrub in the two-gallon hole and proceed to fill the remaining one gallon hole with the two gallons of dirt lying next to it. Without fail, there is never enough dirt to fill the hole. Perhaps you can tell me what I am doing wrong.
Here is another area of confusion for me: When you walk or are wheeled into a hospital, neither you nor anyone else knows the answer to anything.
by Jenn Riggle
Social media is all the rage with hospitals and healthcare systems. Everyone from the Mayo Clinic to Providence Alaska Medical Center have embraced blogging, Facebook, Twitter, YouTube and even LinkedIn, with great success. At last count, some 600 hospitals are actively using social media to connect with patients and create a dialogue with their surrounding communities.
But before you jump on the social media bandwagon, it's wise to take a step back to assess whether your organization is ready. Keep in mind: The call to action for social media typically is to drive people to your website for more information. That's why, now more than ever, a hospital's first interaction with patients is through its website. And as you know, first impressions can make or break a relationship.
Often we hear that collaboration and collaborative leadership is crucial to bringing adaptive change to our profoundly broken health care system.
And yet, to truly be successful in improving our health care system, a health care organization must first create a foundation for such change.
When each voice is heard and accountability is shared, the Mission, Vision, Values and Guiding Principles of a successful health care organization are not only words on paper, but principals that are lived and honored.
by Wendy Johnson
Dr. Larry Nathanson loves his iPad, even if patients and other staff do stop to fawn over it from time to time. The Boston-based ER physician took a break from his duties as Beth Israel Deaconess Medical Center's Emergency Medicine Informatics honcho to blog about his iPad use in the ER.
So far, so good.
The device interfaces well with the hospital's clinical applications, and Nathanson loves how great EKGs look on the device's screen. "The only problem was that the increase in efficiency was offset by the patients and family who wanted to gawk at it."
Anyone who has ever handled an iPhone, or an iPad, however, knows how slippery the sleek devices are. "I am a little concerned about how well it will hold up in a clinical environment," Nathanson writes, "particularly the abuse it will get in the ER." You can read his full commentary on the blog Life as a Healthcare CIO.
Sometimes what is not heard is even more important than what is heard. This is especially true in the case of reforming healthcare, from the most basic of levels all the way to a national overhaul.
For example, a short time ago, while waiting in line to listen to President Obama discuss health reform, I overheard someone talking about the nation's broken healthcare system.
Question: Should we be spending our health care dollar on what is typically considered innovative and sexy and fundable--essentially, on more technology? Or would we be better off focusing more of our attention on lifestyle, nutrition and exercise, creating models that allow for relationship and trust between a patient and physician to be developed, in turn creating a system that promotes ample time for engagement and true learning to occur specific to lifestyle changes, improving nutrition and exercising appropriately?
So I was thinking about health care reform. I have avoided writing about it somewhat because I view it less as reform and more as providing insurance to the uninsured. That said, CEOs should consider the following while thinking about how their organizations and how their marketing may need to change:
by Wendy Johnson
Today's wired healthcare era is exploding in knowledge. Too bad so many healthcare systems are so "fragmented and disorganized" that they're unable to absorb it.
"The result is chaos," says Thomas H. Lee, network president of Partners HealthCare System, in Boston and professor at Harvard Medical School, in a thought-provoking article that appears in the Harvard Business Review magazine.
Now that health reform has passed I was reflecting again on the question:
"Is healthcare a right or a privilege?"
In line with President Kennedy's famous inaugural address from 1961 there is a third option: "Healthcare is an obligation."
We as individuals are obligated to take care of our own health. To eat right, to exercise right, to get enough sleep, to find healthy options to relieve stress, to stop smoking, to drink alcohol in moderation, to develop healthy relationships, to maintain an optimal weight, to ensure optimal conditioning prior to engaging in sports, to wear a bike helmet when riding a bike, to wear a safety belt when in a car, to follow scientific-based prevention guidelines best suited to you as an individual, to make one's health a priority, to develop and manage a healthcare-related budget and so much more.
Invariably, as the time draws near for me to post my monthly blog, someone helps me find the inspiration and make the time. This month, credit goes to Thomas Dahlborg, whose most recent entry recounted the difficult tradeoffs of a primary care physician who feels more like a production worker than healer.
I trained at a time when medicine was a calling and enjoy working as a locum tenens surgeon in New England. I empathize with the physicians Mr. Dahlborg describes, who fit Morrison's definition of hamster healthcare, running faster just to stay in the same place.
In an article about workplace burnout, I recounted the story of a cardiothoracic surgeon who wrote:
By Thomas Dahlborg
Lack of access to primary care is an issue throughout the country and especially so in rural areas. In 2008-2009, the Daniel Hanley Center for Health Leadership brought together leaders from across the state of Maine to understand the key motivators and incentives that will improve primary care physician recruitment and retention in rural areas.
This collaborative group of leaders reviewed the strengths and limitations of historical data obtained through focus groups, survey tools, and interviews. They then sought an innovative way to hear a fresh perspective and selected the Voice of the Customer (VOC) as the tool to explore this challenge in depth.
by Wendy Johnson
Now that you're all back to the weekly grind following a jam-packed HIMSS10 week of networking, learning and checking out the latest health IT products, I wanted thank the many Hospital Impact readers who attended our HIMSS events, including our first-ever HIMSS executive breakfast panel discussion March 2, jointly sponsored by FierceMobileHealthcare, FierceWireless and Meru Networks.
Our panel of hospital CIOs and wireless experts shared their 'been there, done that' lessons learned, and discussed the many misconceptions regarding mobile technology deployment. Although this technology has yet to reach its full potential in the healthcare setting--"we'll see tremendous explosion" predicts said Geoffrey Brown, Senior VP and CIO at Inova Health System in Falls Church, Va.--our panelists agreed that many hospitals have learned the hard way how not to deploy this technology.
by Thomas Dahlborg
A physician friend of mine from a well-known, local health care system recently confided in me that he's so tired and burned-out that he's thinking of leaving the practice of medicine.
As a primary care physician, he feels his role has moved further away from that of a healer and more into that of a "production worker."
by Joseph Ingemi
I must admit I am disappointed in the Meaningful Use Regulations (45 CFR Part 170) because of the high cost of compliance. The regulators themselves admit to the favoritism showed to larger software developers. So I went to Regulations.gov and submitted the following feedback.
The irony is that we hear a lot from Washington, DC about growing small businesses. Yet here we have developed a regulation that strikes a blow to those very small businesses that need help.
Readers know of my passionate interest in international health, and I was very excited to read recently of a collaborative that has been underway for a few years ... especially when I realized that I know some colleagues whom I know are involved in it.
by Thomas Dahlborg
Having once worked for a Medicaid HMO, I witnessed first-hand the impact that charity "free care" (in which individuals receive without having the opportunity to give back) had on an individual's self-esteem, not to mention their health. This Medicaid program did well at supporting individuals through health crises, but lacked any real focus on improving the overall health status of an individual and a community. The key missing ingredient: Supporting the patient's self-esteem.
by Jenn Riggle
When people go to a hospital, they assume they'll receive quality care--and that nurses will answer the call bell and fill up their water pitcher when it's empty. But while hospitals across the country are hoping to differentiate themselves by talking about how they provide quality care, is quality care really a differentiator when "hospitals exceed 90 percent compliance on most of the Joint Commission's 31 quality measures?"
Perhaps a better differentiator would be how well hospitals put meaning behind their quality scores.
by John Cunningham
Like most businesses, healthcare has been deeply impacted by the economy from both a volume and revenue/expense perspective. It appears that there is a "perfect storm" brewing that has created an environment more conducive than ever for providers to lower their supply and services costs in collaboration with their physicians through negotiation, standardization, and right sizing utilization.
But the economy is not the sole element creating the storm. It's also being stirred up by increased scrutiny on physicians and device makers regarding conflict of interest and relationships; the potential for national healthcare reform; changes in reimbursement methodologies to bundle payments for hospitals and physicians; and the increasing focus on evidence based and comparative effectiveness.
After reading Christopher Cornue's Hospital Impact post last week on creating collaborative environments for success, I was inspired to write my own post on how to best breed success. I agree with Mr. Cornue's assessment that "safe environments where everyone's ideas are respected and encouraged" are essential for sustainable leadership, and ultimately believe that culture reflects a shared view of the world and of methods for effective problem solving. A strong physician-hospital culture allows people to feel empowered, knowing that outcomes will remain consistently beneficial and that their efforts will be appreciated
Overall, active listening makes people feel affirmed that their opinions matter even when they do not get their way. Here is what I offer as a three-step strategy for creating a culture of collaboration:
by Anthony Cirillo
I had an "a-ha" moment after reading a recent New York Times article about Apple CEO Steve Jobs: He should lead healthcare reform!
Consider:
Jobs creates "edited products that cut through complexity, by consciously leaving things out." Who better to simplify patient and family experiences? Instead of an accountable care organization, Jobs could create "Your Accountable Care Organization," with just what you need when you need it.
by Emily Paulsen
Part II of a two-part series
Since taking over as chief risk officer at the University of Michigan in 2002, Richard Boothman has gained national recognition for transforming how the institution responds to medical errors and malpractice claims. Two simple words are at the heart of the shift: "I'm sorry."
By apologizing to patients when a medical error takes place, the organization has cut its malpractice insurance cash reserves by a whopping 81 percent--down to $13 million from more than $70 million. Now, instead of engaging in a courtroom battle, physicians and hospital leaders discuss errors promptly after they occur, engaging in a constructive conversation with patients that identifies and compensates errors and ultimately leads to improvements in patient care, he says.
by Maria K. Todd, MHA, PhD
As an interim contract negotiator for several hospitals throughout the country (none of which compete with one another in the same market), I often receive assertions from PPOs, TPAs and others that the hospital's discount is not competitive with so-and-so up the street, in the nearby community or (fill in the blank).
Speaking from first-hand experience, I strongly suggest: the next time someone claims that your discount isn't competitive, first determine if what they say is true, and then determine what you want. Don't just react. Respond with a critical evaluation of the deal. It's time for reform; one contract at a time, if necessary.
Case in point: Consider one of my own recent experiences.
I've often written about (and will most likely continue to write about) the importance for leaders to be collaborative, seek counsel from many disparate individuals, and to recognize there are varying opinions and views to consider when making decisions. Essentially...to be open to debate. This, coupled with other leadership characteristics (e.g., being decisive), will make one an incredibly effective and impactful leader. I've come across some readings recently that help to reinforce this.
by Wendy Johnson
We've had a dialogue on Hospital Impact about the pros and cons of using social media to promote your organization and connect with your community. Turns out that although nine in ten hospitals and health systems use Social Media to some degree, few are going about it in an organized way to really harness its power.
Only about one-third of hospitals have some kind of formal social media plan in place, let alone a budget for "social media employees."
These results come, perhaps not surprisingly, from a web marketing firm that specializes in healthcare. Still, those who are interested in using Twitter, Facebook and other avenues as a means of outreach may be interested in the results, including that hospitals have found it difficult to turn their social media efforts into new patient revenue.
How about you? Has your hospital figured out a way to turn your Twitter feed into revenue? How do you measure your return on the time you've invested in it?
Wendy Johnson is the publisher of Hospital Impact and FierceHealthcare, which delivers five healthcare management and IT newsletters for healthcare industry executives.
by Emily Paulsen
Part I of a two-part series
Since taking over as chief risk officer at the University of Michigan in 2002, Richard Boothman has gained national recognition for transforming how the institution responds to medical errors and malpractice claims. Two simple words are at the heart of the shift: "I'm sorry."
By apologizing to patients when a medical error takes place, the organization has cut its malpractice insurance cash reserves by a whopping 81 percent--down to $13 million from more than $70 million. Now, instead of engaging in a courtroom battle, physicians and hospital leaders discuss errors promptly after they occur, engaging in a constructive conversation with patients that identifies and compensates errors and ultimately leads to improvements in patient care, he says.
"If we make a mistake, we'll move quickly to apologize and compensate that patient," Boothman recently told CNN. "But if we didn't make a mistake, we talk to the patient and explain."
Of course, the hospital's physicians are well-insured.
"I've the luxury of saying to our physicians, no matter how big a case is, how bad a case is, 'You're completely insured and your personal assets are not at stake,'" he told CNN. You can't ask them to be totally honest when they have such things at stake."
Hospital Impact recently talked with Boothman about his program. Here's an excerpt of our conversation:
by Robert B. Teague, M.D.
As we progress through yet another cycle of sound and fury of EMR hype--not to mention billions of dollars of public largesse--the question remains: Why doesn't anyone use these things?
For those of you with a dim view of human nature, pure petulance and willful obstruction seem to be the easy answer. I don't think so, though. The truth is, for clinical purposes, they don't work.
by Maria K. Todd, MHA, PhD
It's been said that "no good deed goes unpunished." This is certainly true when it comes to negotiating with managed care companies, as I've learned the hard way. Little did I know; a contract that is never signed can still become binding if one party can prove that what actually happens in the relationship between the two parties demonstrates a meeting of the minds.
Many payer agreements have passed my desk during my career in managed care and healthcare administration. As a beginner, I thought that if we didn't sign the contract, we weren't bound by its terms. In one case, more than 15 years ago, a physician with whom I worked decided that he would refuse to sign the contract draft agreement.
by Pam McNutt
Healthcare CIOs are understandably concerned about the scope of the work they'll be facing in implementing electronic health records. The promise of stimulus funding for healthcare organizations that "meaningfully use" electronic health records has definitely raised the profile of these clinical systems.
My peers' concern was apparent in a recently completed survey by the College of Healthcare Information Management Executives (CHIME), which showed that CIOs are concerned about their ability to implement applications that are based on standards under consideration by the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services.
by Nancy Cawley Jean
A crisis. Most hospitals have one at some point. If your organization hasn't faced one yet, it will. Whether a local disaster fills your ED to overflowing or a sentinel event occurs and makes the headlines, your staff and your board will need to know what happened, and the media will probably be camped outside your front door. For the communications team, it's all hands on deck.
While every situation is unique, when it comes to communication surrounding a crisis, there are general rules that apply to all. I believe that being visible, honest and timely are the most important.
In a crisis, the last thing you should do is assume it will all blow over, or that word will not get out. Definitely not true, particularly in the age of Twitter, Facebook and other forms of social media. Playing possum will not make the situation go away. To use an old advertising tagline, "inquiring minds want to know."
I enjoyed reading Anthony Cirillo's post last week about how his views of healthcare changed once his mother became a patient--so much so that it inspired me to share my own experience.
Like the people whose sudden illness he describes in his post, I was cruising along in life until my third year of surgical residency, when I noticed a lump in my neck. It was later was diagnosed Stage 1A non-Hodgkin lymphoma. I received eight courses of chemotherapy, complicated by a Vincristine-related seizure that caused three compression fractures of my thoracic spine.
by John Cunningham
Group purchasing in healthcare continues to be under scrutiny from lawmakers in Washington, but as a senior supply chain officer, I don't understand what the noise is all about.
Lawmakers have become convinced that GPOs restrict the provider's choice and ultimately dictate what providers can select and use. This could not be further from the truth.
Yes, GPO members are encouraged to purchase on the GPOs contracts in order to get the best value. But providers will still make choices outside of the GPO contract portfolio when it is in the provider's best interest to do so.
If anything, the value that GPOs provide to their members has been diluted over the past decade, due to pressures from manufacturers, suppliers, and their related industry associations.
by Anthony Cirillo
Until you experience the healthcare system as a patient or a caregiver, you will truly never know how to fix it. A few cases in point: A year ago on Christmas Eve my mother took a tumble that fractured her neck. She ended up in the hospital for a week as a result.
Experiencing the hospital up close and personal as a concerned son, I came to realize that I could serve a much bigger role as an outsider talking about healthcare issues than as a chief marketing officer in a hospital--a position I spent many years at and would probably never do again.
by Jeff Brown, MD
Health care is in great ferment. The organizational side is particularly not much fun right now, but upheaval is too often the only way that we can get to a future of better possibilities. Congress' current meddling is rattling everyone's cage to get used to the idea of change in our business-as-usual thinking, which might in the end be the most lasting benefit of it. Just like the shift to managed care did.
And the key to that change is that we have to rethink how physicians and hospitals work together to manage what we do to help people. To do this, we need to realize that hiding behind the burgeoning problems of spiraling cost and inefficiency and blocking optimum solutions to those problems are the differing basic assumptions from our training that physicians and administrators bring to the table.