Christina's Considerations

Hospital Administrators Needed: To help a Ph.D. Candidate

From time-to-time I've been called to assist students, but this time you can help too.  Below is a request for help from Garry Buttermann.

I am a graduate student at the University of Louisville—my official
title is Ph.D. Candidate - Entrepreneurship and Strategy. At this time,
I am writing a dissertation focused on organizational strategy and
knowledge resources and will be using the hospital industry as the
sampling frame. I hope to find an important link between resources,
strategy, and performance.

Hospital knowledge is embedded in employees, business relationships with
suppliers and physicians, and idiosyncratic rules and procedures. In the
academic literature, these resources are known as intellectual capital.
I am interested in ways that intellectual capital and strategy
development (e.g., innovation, supply chain, and customer strategies)
drives performance in the hospital industry.

Is hospital performance driven by its level of intellectual capital?
What role does this knowledge play on the development of hospital
strategies? Can administrators develop knowledge that results in
financial performance? These are the questions that I hope to answer
with my dissertation research—they are consistent with theory
development but should help develop practical solutions for
administrators seeking to improve performance.

To answer these questions, I need data.

Therefore, I am calling on Officers, Vice Presidents, and Directors from
200 U.S. hospitals and to answer a short survey about strategic
processes and hospital resources. The sampling frame includes
non-government system and non-system hospitals.

At completion of the project, I will be providing a summary report of
findings for survey participants. The project follows University and IRB
guidelines in that respondents will be kept anonymous and data will be
reported in aggregate form.

Interested in participating?

Contact Garry Buttermann at 502-523-8163 or at
garry.buttermann@louisville.edu

CalRHIO: Ready for HIE

CalRHIO released a white paper why California is ready for health information exchange and they are announcing the launch of a statewide system to provide physicians with secure electronic access to critical patient information at 23 emergency departments in Orange County.  It will start by providing medical record information on 360,000 patients enrolled in CalOptima, which provides coverage for people in Medi-Cal, Medicare and Healthy Kids Insurance.

I had a small role in this project very early when this was anew goal for CalRHIO, so I'm really happy to see that it has progressed tothe point of implementation and look forward to watching it expand.

Not Your Father's COO

I remember the days of my father's Chief Operating Officer and have a pretty clear idea of how my roles have been different.  So, it was a bit refreshing to read the H&HN Magazine article Not Your Father's COO, which verbalizes the evolution to a much more complicated role requiring a more diverse skill set. 

Today's COO has to be more actively involved in controlling costs because he/she best understands what will be less painful to the organization.  The COO of today is interested in market share and strategy because it translates to revenues to cover costs and needs to maximize the return on investment.  And, the COO is now much more visible and engaged with a broader range of stakeholders because they have to operationalize strategy and policy.

But, most importantly, it is no longer enough to keep the daily operations of a hospital humming along.  It is imperative that today's COO be able to continually find ways to improve performance and operations, reduce costs, eliminate waste and identify value propositions.  I'm not my father's COO and I'm proud of how far we have come during my lifetime.

I can't end without also mentioning the fact that today there are also so many more women who are COO's.  We have come a long way baby and I believe have risen to the challenge along with our male peers.

Map of Hospitals and Nursing Homes

I just came across a document that includes a map of each state marking the location of its hospitals and nursing facilities and population distribution.  There may be some variations in the data, but this information is valuable for disaster preparedness and surge planning purposes.

Since I'm in a big state, I'd really like to get this information for my region and will see what I can find.  Let me know if you have any ideas.

Pay-for-Purchase Incentive Programs

I have to say that since my first TPRA ConferenceI've been impressed by Allscripts and their approach to bringing EHRs to physician offices. 

They just released results from an online survey of physiciansthat concludes that U.S. physician groups are eager to accept a proposed multi-billion dollar package of government loans, grants and incentives designed to promote broader adoption of information technologies such as the Electronic Health Record (EHR). 

This is good news because there is now an option to physicians footing the whole bill or getting one donated from a hospital in order implement an electronic health record.  It partly addresses the thorn of payors helping pick up the tab (since they are likely to realize significant cost savings) because the federal government is a payor.  It also sets the stage for private payors to follow an offer their own incentive programs because they usually keep in step with Medicare.  So lets stay tuned and see how this all turns out!

Consumer HIE/HIT Materials

I came across an inventory of HIT and HIE materials for consumers and want to share this listing with my readers who may want to learn more about this subject which is being discussed as part of the current economic stimulus package.  Beyond knowing where your tax dollars will go, readers also should understand how information technology (applied correctly) will improve the quality, safety, cost and access of their healthcare.

The inventory was created by State of Georgia and is available on their Georgia Health Info website, which was designed to provide healthcare quality, cost and health education information.   I was flattered to find my weblog listed as one of the resources and look forward to consumers taking a more active role in their local efforts to build health information exchanages.

Amazing Stories of Polio!

I've been a member or the Santa Paula Rotary Club for the last year and a half and am really impressed by a cartoon titled Amazing Stories of Polio  in the February 2009 issue of The Rotarian.  It is truly a wonderful history lesson on this virus that still haunts parts of the world.  Unfortunately, you can only see 1/2 of the polio stories online, but I'm sure if you ask around you will find a Rotarian friend who will be more than happy to share a copy of his/her issue.  (Oh, and don't be surprised if you get invited to a meeting as a guest.)

The Rotary Club is truly a group a people with big hearts who work tirelessly to eradicate polio and improve communities!

Peanut-containing Product Recall: Public Health Threat Continues

There continues to be a risk of Salmonella infection due to peanuts or peanut products including meal, oil, granules, paste, and other items used to manufacture human and pet food items.  The recall list now includes hundreds of items that were manufactured or include peanut products provided by Peanut Corporation of America in GA. 

Over 550 people (including many children) have gotten sick from Salmonella, but many others may not realize they have been infected.  If you think you may have had Salmonella, contact your healthcare provider.

Recall List:

The list is being updated as new products are identified and can be found at http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm  Anyone who does not have access to a computer can call 800 232-4636 (English or Spanish).

  

Clinical Features/Signs & Symptoms

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12-72 hours after infection.  Infection is usually diagnosed by culture of a stool sample.  The illness usually lasts  4 to 7 days.  Although most people recover without treatment, severe infections may occur.  Infants, elderly persons and those with impaired immune systems are more likely than others to develop severe illness.  When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sides and cause death unless the person is treated promptly with antibiotics.

  

Discarding Recalled Products

Affected products may have a long shelf or freezer life, so public health officials are encouraging the public to continue their awareness of the risk.  If you have re-called products or are unsure, discard it in a tied plastic bag to prevent exposure to others and then wash your hands.  Do not feed recalled peanut products to pets.  Some pet products, such as dog biscuits and bird food, may also be involved and should also be discarded.

  

Preventing Exposure in Children:

The recall does not include jarred peanut butter sold in grocery stores, but does include many packaged products that are enjoyed by children.  Talk to your principal and school food service staff about steps being taken to ensure that snacks brought into the school (for parties) or served in the cafeteria are not on the recall list.  Talk to your children about the recall and have them listen to the CDC's podcast for young children at:  http://www2a.cdc.gov/podcasts/player.asp?f=10779.

  

The most current advice is to:

• discard recalled product,

• avoid eating products if unsure,

• contact your healthcare provider if you think you may be infected with Salmonella

for more information visit http://www.cdc.gov/salmonella/typhimurium/

 

 

Electronic Exchange of Health Information: Cost of Doing Business

In a couple of my presentations where I address the return on investment (ROI) and most recently in a December post,I've talked about health information exchange ultimately becoming a cost of doing business.  Sooner, rather than later,the application of widespread health information technology will become a cost of being in healthcare industry, just as ATMs and other banking information technologies are a cost of doing business for banks wanting to competitively compete.

Well, this week I saw a new sign supporting that movement may be underway.  According to a Modern Healthcare article,  terms included in one piece of legislation provide millions of dollars in incentive payments to hospitals that become fully wired facilities.  It goes further and also stipulates that providers that choose "not to adopt health IT or do not use it effectively will face payment penalties starting in 2016." 

Now, I was just thinking about the requirement to submit all and more data electronically continually, not penalties.  Ooohhh!  Not that is a motivator!  I'm not going to be a big supporter of the fines unless something happens to help address the upfront funding issues that remain (ie most of the current benefits accrue to others, not the provider investing in the technology.)

I like the wake-up call, but lets keep working on this to make it right!