Christina's Considerations

Impact of Telehealth Technology

A recent survey sponsored by Intel revealed that 89% of healthcare executives believe telehealth technology will have a significant impact on patient care and the industry.  They agree that it will help cut costs and lead to better outcomes.

An article in iHealthBeat also explores whether the time has come to embrace telehealth as a system solution and it expands upon the data presented in the NRTRC's recent whitepaper.

Additionally, an article on TeleICU in For the Record Magazine explores the broader view that is required when evaluating value.

And, finally, CMS has released its proposed rules for credentialing and priviliging and comments are due by July 26.  The proposed language changes to the Conditions of participation codifies the  existing Joint Commission process and extends it to all Medicare certified hospitals.  This is a huge step forward by CMS and demonstrates to me that they will seriously address the barriers to more widespread use of telehealth technologies.

What is next, you ask?  I suspect that CMS will submit their proposed rules for reimbursement and join with the movement we are currently seeing by private payors and State Medicaid offices.

Remote Monitoring: Diabetes

The upcoming mHealth Conference (September 8 & 9 in San Diego) will include a presentation by one of my NRTRC board members on the topic of remote monitoring with the Native Hawaiian Health System.  It focuses on transforming the care for patients with diabetes from an episodic office based model to longitudnal care using blue tooth technology, a web based intelligent application that is integrated with the EHR and a smart phone to provide a continuum of care for primarily type 2 diabetes patients.

If you are attending the conference, I look forward to meeting you there!  Conference Brochure

Telehealth Gets Connected

I picked up a copy of CMIO Magazineat ATA this past week and the cover story was on telehealth and its role in increasing access and lowering the cost of healthcare.  It also highlighted the pioneering work of AFHCAN, one of our NRTRC charter members, which saves Alaska Medicaid $8.80 to $12 in travel costs for every $1 spent on care using telehealth technologies.

Savings like this are especially important for those states that anticipate a significant increase in the number of Medicaid beneficiaries.  United Health Group estimates the US average growth to be 32%, but the following nine states can expect growth above 50%:

• Montana --  84%
• Nevada  -- 72%
• Utah -- 66%
• North Dakota -- 60%
• Kansas -- 57%
• Colorado -- 57%
• Wyoming  --52%
• Oregon -- 52%
• Virginia -- 51%

Opportunites to improve efficiency and reduce costs for some aspects of care exist, but it will require changes in policy and reimbursement related to telemedicine including; store and forward, home telehealth, remote patient monitoring, telerehab, non-physician providers.

National Stroke Awareness Month: Telestroke

It is National Stroke Awareness Month and I'd like to share a Telestroke Factsheet that I prepared for this week's American Telemedicine Association Conference. 

I encourage you to learn about the symptoms of stoke and find the stroke center near you.   Also, let me know if you have an interest in learning more about telestroke programs.  The NRTRC works closely with the Northwest Regional Telestroke Initiative to promote our common interest in telestroke technologies.

The Crossroads of Telehealth, EHRs & HIE

The NRTRC has released a new white paper on the subject of the intersection between telehealth, EHRs & HIE.  The paper reviews some of the recent disruptors that will require a new approach to the healthcare delivery system.  It also describes how the telehealth infrastructures can be leveraged to facilitate health information exchange, especially in rural areas.

Your response to the paper is welcome.  Just leave a comment to join the conversation.

Health Reform: Is that all there is?

I like Nick's Jacobs in Wonderland postand a reference he made to us trying to figure out health reform.  In some respects I agree with him -- no that isn't all there is.  But, as we move forward and address what at first seems like something complicated and huge, I agree with Peggy Lee.

I agree with Peggy, because too often we get too caught up in what's unruly with it, instead of putting our energy into finding our way through the issue.  Once we break it down into manageable pieces and set into action, we may soon feel like Peggy -- is that all there is?

This health reform package will certainly require us to work a little harder and to "keep dancing".  But, that is what great healthcare leaders do best!

LSU Alumni Crawfish Boil - Southern California Chapter

The LSU Alumni Crawfish Boil is next weekend, but I'll miss it because I'll be in San Antonio for ATA.  So, the family announced, "no problem, we can go without you."  They are all really excited and I'm hoping I might still get some crawfish since I'm only one state over.

In all the pre-boil hype, I've learned about Flippy and his Friends.  As cute as the books and tee shirts are, my babies are just a little too big (teens and tween).  But, I'm sharing Flippy with my readers who may still have little ones.  "Who's your Crawdaddy?" is certainly my favorite for a young child, but I also like "Make roux, not war!"

Social Media Best Practices: Healthcare

This week marked the official release of my book on use of social media in healthcare.  It is now available through Health Administration Press and Amazon.com. 

The book is a high-level overview (targeted at busy administrators) of the various social media tools and their application in healthcare environments.  But, what I am most proud of is the companion site that highlights the best practices of some pioneering healthcare organizations.  It also includes links to additional resources and references.

I invite you to let me know what you this of this book and how social media is likely to impact healthcare.  Please feel free to leave a comment.

Oil In Louisiana

I've been reading the Wall Street Journal coverage of the oil spill and the response to clean it up and also heard some of the coverage on TV.  I have my own thoughts on the subject and since this blog is a place for me to use my voice, I'll do so on Louisiana once again.

Having grown up in Louisiana, traveled down to the gulf shoreline (from Holly Beach to the panhandle of Florida) and married a man who for 17 years repaired, inspected and maintained the oil rigs deep underwater I may have a unique perspective.

Thinking back I am a bit surprised that I only saw a significant amount of oil/tar on the beach once and that was at Holly Beach when I was still really a child.  For all of the oil that is drilled out in the Gulf, I think that is a fairly significant accomplishment.  I also don't remember hearing about too many spills.  As a comparison, I get tar stuck to my feet just about every time I go to the beach here in Santa Barbara, because the pressure pushes it up and it bubbles out then flows to shore.

Oil and the fisheries have been big drivers of the Louisiana economy for many years.  Before the early 80's the oilfield was full of cowboys and safety wasn't always job one.  However, the oil companies did change this culture and safety became really important.  I certainly can't speak for BP, but overall it seems the industry has had good outcomes.  Just as in healthcare there are risks and great leaders manage those risks and take action to minimize errors and loss.  However, it isn't perfect.

Now, the fisherman and oil field workers have co-existed for a long time.  And, I think every oilfield worker knows how big of a challenge it would be for them to get to Venice (and work) if the local fishing communities had lost confidence in their industry and its ability to protect the environment and fisheries.  I suspect that oil knows they can't screw this up.

So, my perspective is that this was a truly unfortunate accident and a root cause analysis to determine what really happened needs to occur.  The lessons learned need to result in corrective action and perhaps, a new regulation might be warranted.  However, I caution government from jumping to regulation before this process has been completed.  I expect BP to fulfill their responsibilities and to learn from this experience and to ensure that they actions are taken to minimize/eliminate the risk of this type of event from reoccurring.

One last thing.  I'd like to make a personal observation, because it reflects on a largely unknown aspect of the south Louisiana culture.  When I still lived in Louisiana, the fisherman had a certain look and it was largely cajunish.  However, I saw a picture of a group of boat captains in the WSJ and it was different -- there were many Asians.  My guess is that they are from the Vietnamese immigrants who fled Communism in the 1970s and settled in Louisiana -- especially in New Orleans East.  I'm often asked why I don't have a southern accent and this is an example of why.  New Orleans is really a big melting pot city.  I'm sure in a few years, the picture will also include post-Katrina Mexican immigrants.

 Getty Image