Christina's Considerations

California's Pre-Existing Condition Insurance Plan

David Sayen is my state's CMS Regional Administrator and we share an interest in social media.  He wrote an editorial for his local paper and is sharing the story through his connections on LinkedIn and Twitter (@davidsayen).

Being a good blogger and always looking for important information to share with my readers, I'm including a link to his comments on the  CA Pre-Existing Condition Insurance Plan, which was created out of the Affordable Care Act.  I ask that you inform anyone who has been turned down for health insurance because of a pre-existing condition or offered coverage only at an unaffordable price of this option.

Please also share this post with those in your networks.  If you are interested in plans for another state visit the PCIP site to find your state.

Hospital Employees Devastated by Recent Disasters

Hospital employees are among those who have been devastated by the recent flooding and tornado disasters in Alabama, Arkansas, Georgia, Louisiana, Mississippi, Tennessee and Missouri.

The Care Fund, created in the aftermath of hurricane Katrina, is there to assist those hospital employees who experienced devastation and suffering. Contributions are tax deductible and funds are distributed by hospitals to those employees who need assistance. The fund is administered by the Alabama Hospital Association.

For information about The Care Fund, e-mail CareFund@alaha.org or call (800) 489-2542. You can also visit their Facebook page.

New Telestroke Initiative Discussion Group Added

The Telestroke Initiative now has just initiated its discussion group for connecting, collaborating and communicating on issues related to telestroke systems and care.  This is a public group and discussions are open to anyone on the Internet.

Hospital Evacuation - it can and does happen!

St. John's Hospital in Joplin, MO had to evacuate last night. I first learned they were hit by the tornado when I received their Twitter feed and then followed their link to the Facebook page.

As I watched the news, I thought I should post a reminder on hospital evacuations and offer my assistance to those who might want an objective review of their all-hazard plan or a template (hospital or public health).

Hospital Evacuation - It can happen!

Update 5/27/11 - for some detials from that evening in the hospital read this Tornado advisory.

Update 5/28/11 - for some finer details that come from the observations of a reporter. Notice his comments about Twitter being the best way to get messages out. And, how the hospital staff didn't seem to mind his tweeting, but might have been more concerned if he had a notebook and pen.

Update 8/22/11 - Joplin Tornado Trip Report_1_1 (1)

HealthLeaders Intelligence

Want to know what healthleaders are thinking? Visit the 2011 HealthLeaders Media Industry Survey findings. The reports are based on surveys sent to healthcare leaders in eight segments across the industry:

• leadership,
• finance,
• technology,
• marketing,
• quality,
• physician,
• nurse, and
• health plan.

In addition, data is combined into an overall cross-sector report and has also been extracted based on community and rural status and service line.

Partnering to Heal: Teaming Up Against Healthcare-Associated Infections

HHS has a new social media tool that relys upon a virtual world and avatars to help users see outcomes of their actions and make better decisions. This along with other examples demonstrate that we are finally starting to see social media being incorporated into healthcare operations and clinical care in a significant way. This is really exciting for me!

The training focuses on prevention of surgical site infections, central lines associated bloodstream infections, ventilator-associated pneumonia, Catheter-associated urinary tract infections, Clostridium difficile and Methicillin-resistant Staphylococcus aureus (MRSA). In addition, it includes information on basic protocols for universal precautions and isolation precautions to protect patients, visitors, and practitioners from the most common disease transmissions. The training promotes these key behaviors:

• Teamwork
• Communication
• Hand washing
• Vaccination against the flu
• Appropriate use of antibiotics
• Proper insertion, use, and removal of catheters and ventilators

Trainees assume the identity of characters in a computer-based video simulation and make decisions as each of those characters. Based upon their decisions, the training branches to different pathways and patient outcomes. The training is designed and developed for use by groups in facilitated training sessions and by individuals as a self-paced learning tool.

What do ACO-Minded Providers Want?

Physician Practice interviewed me about what hospitals with an eye on accountable care organizations want.  I believe it is all about partnerships and the priorities of hospitals, physicians, long-term care, home care and other community-based providers will include:

• identifying partners with good outcomes
• identifying partners who are efficient, but effective, and utilize resources wisely.

We have seen an increase in transparancy of outcomes as it relates to hospitals and SNFs and believe we will soon see efforts to also publish physician specific outcome metrics.  Ultimately, outcomes will also be available on other long-term care facilities, home health, hospice and other providers.

Use of technology (EHRs, HIE, Telemedicine, Remote Monitoring, Social Media, Mobile, etc) will also play an important role in the efficieny and effectiveness of partners.

Let me know if you think there is something else that should rise to the top of an ACO-minded leaders list.

 

Moms Turning to Facebook with Health Information

This latest Healthcare IT News article really speaks to me...

Oh, if I were a young mom again, I could see my friends and I connecting on Facebook just as we did with our play dates. And, this would have carried through to today during the teen years. But, we didn't really have Facebook 16 years ago.

However, I am connected with family and close friends on Facebook now and do share some of my healthy children and families blog posts with them. I've also posted health information targeted at the many young people that I'm connected with in the hopes that they will watch the video or read the information.

Mom's are probably still the go to person in the family for health issues and the young ones (and most importantly their friends, too) are on Facebook. It is a great tool for them to form groups and to support one another. And, perhaps, learn from those who have gone done the path before.

Hospital Preparedness Program

The Hospital Preparedness Program (HPP) includes participation from about 85% of the nation's hospitals; and approximately 76% met 90% or more of the program measures for all-hazards preparedness. I've been participating in this program for over two years and really see value and encourage them all to participate,take advantage of the resources offered and improve on their measurements.

HHS has released a new report titled From Hospitals to Healthcare Coalitions: Transforming Health Preparedness and Response in Our Communities, which includes state-by-state reports on participating hospitals and their performance measures.

I'm looking forward to reviewing it and seeing how much HIT/HIE and Telehealth are part of the transformation across the country. I've recently learned of a couple of programs and want to see just how widespread this may be. I'll report back when I know more.

What is Meaningful Use?

IT types can be some really creative people.  In this post, I'd like to share Dr. Ross Martin's latest Rap on Meaningful Use.  If your asking "What is Meaningful Use?" this is a fun way to learn.

 

A Good Day...

Our last Borders is closing today, so we took a little trip to see what deals were left. I found a book on managing the mobile workforce and another on surviving my 40s (I hope it isn't too late.)

Then, I scored when my husband brought me Coming Back Stronger and Home Team by Brees and Payton, respectively, and won the game when my daughter showed me the last 4-disk DVD of the Saints Road to XLIV!

I think I'm set with my summer reading.  It is a good day!

Telestroke Initiative

I last wrote about the collabortive Telestroke Initiative when we released our survey results last year. Since then, we have been in transition and earlier this week launched our new Telestroke Initiative site, which is built upon a wiki platform.

Part of our transition has been a new partnership with the Western States Stroke Consortium and this has resulted in us expanding our focus from just the Northwest to the entire Western part of the US.  The site includes a growing library of information and resources to help anyone wanting to establish a telestroke program or to develop their existing services.  We will also soon return to scheduling informative discussions and educational web programs.

Please visit the site or share a link with other in your network who may have an interest.  If you are involved with telestroke and want to get involved, just let me know.

The Mother of All Hospital Administrators

If Florence Nightingale was the Mother of All Hospital Administrators, then I'm proud to be her daughter.  Administrators sometimes get a bad rap.  I'll admit, there have been a few who deserved it because of some really poor choices and/or actions, but most of us really are new-age Florences. We have evolved and grown in response to our environment and have...come a long way since the mid 1800's.

Satisfying Your Customers with Social Media

The May/June 2011 issue of Healthcare Executives includes an article I wrote about using social media to engage patients in their Satisfying Your Customers column.  And, I've been invited to prepare a follow-up article for a later edition on satisfying employee and physician customers.  This is exciting for me since there is so much more to social media than just marketing to consumers.

For example, a HIMSS News article titled Social Media in Healthcare - What's Up Doc? describes how a local support group for alcoholism incorporates social media for ever-present support.  The article also highlights a description of social media from my book:

"Social media are electronic tools that enhance communication, support collaboration, and enable users across the globe to generate and share content."

The key in this description is the word "users" which applies to consumers/patients, just as much as it applies to employees, physicians, board members, volunteers, vendors, strategic partners, donors, residents/students, and other healthcare stakeholders and customers!

By the way, if you have a great example of how your healthcare organization is satisfying your physician and employee customers using social media, get in touch with me or leave a comment and perhaps I'll include it in the article.

Finding Solutions to Healthcare Challenges with Telehealth Technologies

The following is a commentary I was invited to submit for the ATA Daily News.

In 2008, while working in a small rural hospital, I watched as some of our patients had to be transferred to a larger facility in our system to receive needed specialty consults. At the time, the hospitalist, emergency director and I wished we had telemedicine capabilities, but the funds for equipment were not available in our budget.

Then in 2010, I learned about the telehealth resource centers, attended my first ATA Annual Meeting and had the opportunity to experience telehealth technology in action across the Northwest, California and the Pacific Basin. I soon learned that the most effective implementations applied the technologies to solve specific challenges and problems.

These include:

• A rural hospital in Wyoming with excess pharmacy capacity assisting a critical access hospital in the region after the retirement of their pharmacist by providing remote order entry verification and support to physicians and other providers when local staffing was no longer an option.

• A system of community clinics turning to telehealth after losing access to specialists in psychiatry, endocrinology, neurology, hepatology and dermatology for their hard-to-reach migrant population.

• A community clinic being able to perform digital retinal eye exams for its diabetic patients, to be read by an ophthalmologist in another state.

• A hospital turning to an intensivist located two counties away to augment their existing physician staff and fill coverage gaps with remote care to patients in the intensive care unit.

• Multiple physicians and psychologists experiencing shifting demands on their time that no longer allow them to drive hours out to remote communities to hold monthly or weekly specialty clinics. Not wanting to disrupt access for these patients in already underserved communities, they turn to telehealth to facilitate the connections needed to continue care.

• California hospitals employing real time remote triage, diagnosis and monitoring as their fastest growing strategy to address increasing emergency department specialty coverage needs.

• Several physicians conveying their stroke outcome success stories – one reducing the first-contact neurology response time to less than 22 minutes at one hospital, and another increasing use of tPA by ten times despite only having two neurologists.

• The telehealth network in Montana that recognized the opportunity to leverage their existing infrastructure to facilitate community-wide health information exchange.

• A pilot study involving remote monitoring of blood glucose in an underserved Native Hawaiian population using Bluetooth-enabled smart phones and the development of plans to expand to monitoring blood pressure, weight and activity levels.

• And, in my own county of Santa Barbara (Calif.), I've been fortunate to facilitate the establishment of videoconferencing network between the five hospitals and public health department to enhance disaster preparedness and event communications and reduce non-productive travel time and costs.

Why does this matter? The rural stroke patient who shared his confidence in his local critical access hospital had it right when he told his neighbors:

"The telestroke program and similar programs mean that right here in Moab we have access to a major medical center. I urge you to support our hospital in any way you can. …"

Over this last year we have witnessed some movement toward elimination of traditional barriers to more widespread adoption of telehealth technologies. We will continue to realize success as value is demonstrated more broadly – improved access to needed care, patients having better outcomes and reduced costs.

We will face some new challenges, such as data breaches from malicious attacks, and growing pains with the highly complex ecosystem that includes wireless devices and mobile technologies. The merger of infrastructure and data in electronic health records, telemedicine and remote monitoring will continue – bringing us closer to realizing longitudinal health.

As I prepare for my second ATA Annual Meeting, I am grateful for the progress and recognize the opportunities for continued improvement. I believe the forecast is good and we will continue to see telehealth technologies applied to solve challenges – today, and in the future.

http://destinationata.com/content/finding-solutions-healthcare-challenges-telehealth-technologies

Improved Availability and Guideline Compliance with a Remote Presence Neurointensivist Program

A physician friend of mine recently leveraged the power of social media and released a YouTube video about his virtual medical group. It is an ideal vehicle for him, given his use of videoconferencing to provide telemedicine care.

He also recently shared results of a  Remote Presence Neurointensivist Program at the American Telemedicine Association Conference.  The findings related to improving access to specialist care, compliance with guidelines and performance on quality metrics are impressive.