by Nick Jacobs
Cell phones prohibited in our hospitals.

About five years ago, on a visit to MIT, we had a casual discussion with a physician leader, and asked why we hadn't seen signs banning cell phones. His response was fast and simple, "They don't bother anything." Ever since that visit, we lifted the ban on cell phones in our hospital, and nothing has happened to anyone.

In March 2007, Mayo Clinic researchers published the results of a study in which they attempted to deliberately create interference in medical devices through the use of cell phones. They used them near 200 different medical devices in 75 patient rooms at their facility. They also tested BlackBerry models as well. The paper published in March of '07 in the "Mayo Clinic Proceedings" says there are no "clinically imprortant interferences" when cell phones were used in a "normal" way.

According to Mayo Clinic researchers, Jeffrey Tri, Rodney Severson, Linda Hyberger, the long-held notion that they are unsafe to use in health care facilities is not valid. Three hundred tests were performed over a five-month period in 2006, without incurring a single problem.

You can look this up at www.mayoclinicproceedings.com or on Snopes.com.

Makes you wonder if cell phones are safe to use on airplanes? Maybe they're banned because the phone companies can't track you down to bill you? Any studies out there on that one?

by Nick Jacobs

Tony’s original mission statement, business guide and raison d'être is clearly defined at the top of this site: What will it take for our hospitals to be the best run organizations on the face of the planet? Periodically, it is important for us to revisit this question with the same passion and commitment that originally fed this site.

A few weeks ago, a very engaging young woman commented on my writing. Her name is Reut Schwartz-Hebron, and the book that she authored is entitled: Outswim the Sharks: How to Quadruple Your Team's Productivity with Kindness.

Upon further investigation of her work, it became clear to me that Reut’s philosophy is very similar to my own, and it is without a doubt one very well defined path to Tony’s goal.

We have written often about the Planetree Philosophy, about the removal of bullying from the workplace, the concept of patient centered care, and the exploration of various employee considerations and benefits that lead to a successful organization; treating people with kindness, dignity and respect.

When you observe the really functional organizations, you will quickly conclude that their secret is their employees. In the book Leadership Jazz, Max Depree, the former president of the Herman Miller Furniture company, creates a convincing and revealing parallel between jazz and leadership.

In both jazz and leadership, autonomy and performance, creativeness and convention, muse and self-discipline must be expertly combined. This book describes “why beauty and harmony must pervade an organization and all it does; how to reach for the renewal, innovation, and vitality required for truly lasting solutions; and how to understand and evaluate your own gifts and motivations.”

So, if you want to find the secret of “what will it take for our hospitals to be the best run organizations on the face of the planet?” You don’t have to look very far. Reut’s company, KindExcellence is just one more gateway to transformation. It is about treating each other as we would want to be treated; employees, patients and peers.

Start with the most uncommon issue, common sense, and work from there. Just remember that high performance can emanate from kindness.

by Nick Jacobs

How do you stop a speeding freight train? Type 2 diabetes is one of the most poignant ailments of the 21st Century. According to the American Diabetes Society website: If present trends continue, one in three Americans, and 1 in 2 minorities, born in 2000 will develop diabetes in their lifetime. That prediction alone could lead to our children having shorter life spans than their parents. In 2005 1.5 million new cases of diabetes were diagnosed in people age 20 years or older.

Diabetes is the fifth-deadliest disease in the United States. Since 1987 the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke, and cancer have declined.

Sedentary lifestyles and inappropriate diets are at least two of the primary culprits contributing to this situation. It is no secret that diabetes is a disease that can destroy your body in numerous ways including:

* High Blood Pressure
* Blindness
* Kidney Disease
* Nervous System Damage
* Amputations
* Dental Disease
* Pregnancy Complications
* Sexual Dysfunction
* Others

What is the answer? Maybe the answer is to employ the Ad Council? White bread is bad. Broccoli is great. If all else fails, however, there may be one last emergency rip cord to pull for the auxiliary chute.

A few weeks ago, Parade Magazine featured an article that reported the findings of a study from Melbourne, Australia confirming what many of us have known definitively for a number of years now. Type 2 diabetes can, through weight loss attributed to bariatric banding surgery, be reversed.

Bariatric banding surgery involves the careful placing and then inflation of a small silicone type band around the top of the stomach. How is the surgery done? A miniature camera is inserted through a small incision and transmits images back to a video monitor. The band is then inserted through very small incisions that, post surgery, can simply be covered with band aids.

This procedure limits the amount of food a patient eats and thus begins the weight reduction process. That is what contributes to the reversal of diabetes. The study found that, “after two years, 73% of those treated surgically went into remission from diabetes. That was in comparison to the other 15% who underwent the conventional therapy of diet and exercise. The surgically treated patients lose over 20% of their weight during that amount of time. The researchers did observe that the magic number leading toward reversal seemed to have been a weight loss of about 10%.

Of course the reversal itself is directly attributable to weight loss, and is only recommended and paid for by most insurance companies after everything else has been tried.

The pitfalls of the various solutions available including any surgical procedure must be fully understood, but bariatric banding surgery is: 1.) Less risky than traditional gastric bypass surgery 2.) It is minimally invasive, and 3.)Finally, it is reversible. Although this procedure as compared to the complete bypass procedure may result in a little slower weight loss, it is, according to the study, very effective.

Regardless of the type of procedure chosen, the patient must make a commitment for several months to attempt to reduce the weight through conventional diet and exercise, and in a quality, comprehensive program, numerous professionals including: a physician, dietitians, exercise physiologists, a psychologist and nurses are provided to give the patient the support needed to enable them to stay on the program.

Post surgery, that same team of professionals must be available to monitor you so as to ensure that your progress is appropriate, that appropriate nutrients are consumed, and that no complications are permitted to go unchecked.

If the train won’t stop, maybe banding is the solution.

by Tony Chen

We posted a while back on the concept of a "wellness phone." Now Adidas and Samsung have partnered up to create a Fitness phone called "miCoach". Read this journalist's first experience with miCoach. Billed as a "total coaching system," it can measure your current fitness level (run a mile w/ it strapped on your arm & the chip in your shoe) and your pulse. It talks to you. And its coupled with programs on the web to track progress.

More accurately, I wonder if this is more accurately billed as a "runner's phone", but nonetheless, continue to expect more healthcare applications/programs showing up on our phones. Convergence is the name of game. These healthcare applications/technologies won't work as separate one-off programs - they've got the be integrated into daily life (e.g. facebook, cell phone, google?).

by Tony Chen

Recently, I've been thinking about this: what are the most critical societal and healthcare trends that most significantly impacts hospital strategists and innovators? What is going on in our world that will most impact how hospitals are run/defined/positioned 15 years from now? Please share your thoughts in the comments area.

Here's a few trends that come to mind:

- Everyone talks about Baby Boomers, but have any hospitals really designed a new program specifically for Boomers?

- Global warming and the green movement has been huge. But will a patient actually choose one hospital over another simply because they're more green? Not here in the midwest, but maybe in CA?

- Everyone also talks about prevention and wellness, but hospitals face 2 big problems in this arena: warped incentives (you know what I'm talking about) and no compelling business models. How do you get someone to pay you for something they don't want to do (i.e. change their lifestyle)? Maybe the folks at Virgin will figure this out.

- Everyone is also talking about how healthcare is going retail. If you think the recent surge of retail clinics is a big deal, you ain't seen nothing yet. Hospitals may need to develop a "retail strategy" sooner rather than later.

- What about globalization? telemedicine?

- What about the prospect of logging onto your patient record from google.com (not from your hospital's website, your employer's website, or your insurance company's website)? Won't this make EMR late adopters want to wait even longer?

Your thoughts?

by Tony Chen

Of all places, Hospital Impact has been quoted in Southwest Airlines' In-Flight Magazine, SPIRIT. Go figure.

by Tony Chen

Check out this interesting interview (free reg req) on Toby Cosgrove, CEO of Cleveland Clinic. He touches upon a variety of topics, such as:
- how CC gets the most out of its money (metrics and more metrics)
- CC's take on patient charts (they belong to the patient, not the hospital)
- patient "experience" (and why you won't find those behind-revealing hospital gowns at CC)
- Partnership strategy (very clear about what they want and don't want)
- CC's core value proposition - technology leadership
- how CC finds new ideas (they unleash their 1,800 physicians all over the world!)
- His greatest challenge - bringing in the right people.
- what Cleveland Clinic is doing in prevention (it's not just the no-smoking employment policy)

One question I want to bring up to the community - what else should a hospital be doing in the area of prevention/wellness?