Christina's Considerations

SearchHealthIT Tips

A few weeks ago I was asked by SearchHealthIT to contribute some tips and I chose to focus in on leveraging portal technologies and recognizing some of the more subtle risks.  Links to both articles are below, but I'm also including some of the highlights here for those who ask for "Just the facts, Ma'am."

Enterprise portals improving patient engagement for meaningful use

1.  When patients and their family caregivers are not in front of providers (approximately 95% of the time)
2. Platform for the integration of disparate patient/consumer-facing information systems 
3. Scale to accommodate management of condition-specific or general populations
4. Personalize access to health records, education, self-management tools, social networking and support opportunities 
5. Support more transparent communication with patients and families about care transition and treatment processes.

Patient-facing information systems raise HIPAA concerns

1. Creating barriers to patient and family engagement
2. Lacking identification and assigned roles
3. Tagging sensitive data as "do not disclose"

If you can think of anything to add to either list, please leave your comment.

Care About Your Care

The RWJF is working to bring some attention to improving transitions from the hospital to home environments and reducing readmissions with the Care About Your Care effort.  It highlights the revolving door syndrome with a report on  US hospital readmissions and an interactive map.

Some of the striking bits of data include:

• Poor continuity of care after a patient leaves the hospital–especially for those with chronic conditions–leads to readmissions
• More than a third of patients don’t get the tests, referrals or follow-up care needed after a hospital stay
• Nearly 20% of Medicare patients return to the hospital within a month after discharge, costing $12 billion per year
• Only 50% of patients rehospitalized within 30 days had a doctor visit before readmission
• Poor care coordination was responsible for $25-$45 billion in wasteful health care spending in 2011

A discharge preparation checklist and transition planning tool is a great reference for patients and their family caregivers.  The discharge preparation checklist can help patients and caregivers track all the information they should understand before leaving the hospital, including:

• Overall care plan
• Where the patient is going after discharge
• Who to contact if a problem arises during transfer
• Medication instructions and potential side effects
• What symptoms to watch for
• Necessary follow-up appointments

The care transition plan can help keep patients and caregivers keep track of important information in one place, including:

• What symptoms to watch for and how to respond
• Scheduled follow-up appointments
• Contact information for hospital, primary, and home health providers, as well as pharmacy
• Medications, what each does, and how to take each, and when to take each

 Free continuing education resources for professionals is also available.

Think Before You Sue: Physicians & Negative Online Reviews

iHealthBeat has an article about physicians increasigly suing patients over negative online reviews, ratings and/or comments.  This absolutely floors me...  Why?  Because patients finally have a voice and outlets to share their experience -- what they like and don't like!  More importantly, other consumers and patients have an opportunity to learn from those experiences.  This is the new world of transparancy! And, yes, it is free speech!

Now, I'm a practical person... and a former hospital risk manager.  So, I know when a review can get ugly and cross the line to a true legal cause.  But, this probably won't/shouldn't be a frequent occurrance.  It is also likely that comments may also be emotionally charged, like the example of the husband posting about his deceased wife. 

Patients and family members who have had poor experiences use to spread their dissatisfaction word of mouth, or perhaps via a letter to the editor of the local paper.  Today's online sites do help them reach a broader audience.

But, consider what we already know about lawsuits against healthcare providers -- and that they are most likely the result of communication breakdowns.  In today's social world, my guess is that these same communications breakdowns are also leading to a negative comments online.  As painful as it may be to see these unwelcomed comments, I caution my physician friends to not respond with legal action.  Instead, take an objective look at the case, communications and processes and identify opportunities for improvement.  Can you imagine the power of that same person posting an update extending appreciation to the physician for resolving the complaint?

Another action that can diffuse negative comments  -- and preserve your reputation -- is to encourage those who have had a great experience to share it with others.  Promoting your social channels is a starting point to encouraging these patients to share - and blend the good with the bad.

"Think before you post" is one of my recommendations to audiences.  I think I should also add "don't respond with ugly -- think before you sue"!

 

The Creative Destruction of Medicine: How the Digital Revolution will Create Better Health Care

I heard Dr. Topal speak about digital medicine  once and have been a fan ever since.  He has a new book out, so I'm looking forward to reading it.  Until I'm able to post some of the highlights, watch this video for a sneak peak of his interest in the mHealth revolution. 

The Colbert Report
Get More: Colbert Report Full Episodes,Indecision Political Humor,Video Archive

This takes me back to my Aging in Place days.

A new healthcare quality metrics: Facebook “likes”

Imagine checking Facebook to identify the quality of care provided at your hospital or to assess patient satisfaction with the experience. Researchers looked at New York hospital mortality rates from Hospital Compare and compared them to their number of Facebook “likes” and actually found a statistically significant relationship.  The actual data is that each percentage point drop in mortality, corresponded with nearly 93 more Facebook “likes”.  

It makes sense… if a hospital has truly engaged their community and their patients experience exceptional care, there is a better chance that they will “like” those facilities on Facebook. When I look at what I’ve “liked” on Facebook, it is that which I perceive to be exceptional. I’m not “liking” the ordinary!

The most informed consumers will look at both the hospital's actual mortality rate and their number of Facebook "likes".  In the grand scheme of things it really is today’s “word of mouth” and one more data point for consumes to consider when making decisions about their care. Add it to the list with Yelp, Foursquare, HealthGrades and Hospital Compare!

Read the entire report in the American Journal of Medical Quality.

Digital Access and Patient Experience

FierceHealthIT reported on a study that finds 70% of consumers would be open to a virtual doctor visit.   Another key finding is that almost 50% of consumers and 66% of providers  would be comfortable sharing and receiving health information through social media

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Reaching Women Through Health IT: Introducing Gabby

Last week I wrote about the impact of  evidence-based communication techniques and then the next day was invited to comment on the results of a new study.  It turns out Reaching Women Through Health Information Technology: The Gabby Preconception Care System is a great example of social evidence-based communication and I've been waiting for just this kind of new example.

New, because, I was already familiar with Louise, the virtual discharge advocate, who facilitates educational processes and gets great marks for patient satisfaction and addressing low health literacy levels.  Patients who have been using Louise represent an older and minority population. But, Gabby is targeted at a younger population and she is a risk assessment tool for conception.

Gabby the Virtual Preconception Care Advocate

 There is a disproportionate share of young women of demographic minority status and socioeconomic disadvantage with high rates of poor reproductive health and family planning outcomes in the US.  Gabby, an avatar, is an online preconception risk assessment tool that engages young women at a sixth-grade reading level. 

This type of social media tool doesn't replace physicians, nurses and other clinicians.  Instead it facilitates:

• women having the opportunity to hear the information multiple times in order to aid with comprehension
• culturally relevant, familiar and viable delivery of a health risk assessment and interventions
• the time of interaction and pace driven by participant
• evidence-based, closed-loop communications
• women preparing for appointments with their provider
• reinforcement of  information discussed during a clinical encounter
• women preparing themselves for a pregnancy and knowing what actions they need to take to improve their health and reduce risks to their child

I know we will see more applications of avatars and virtual patient advocates and welcome anyone that has had an experience with one to leave a comment.

The title of the article that I contributed to is "Can Avatars Improve Patient Outcomes?"  I say, of course they can... if there is a clear strategy and they are well planned out and implemented.

Recommendations for Healthier Organizations in 2013: Data Security

It’s time for some New Year’s resolutions; and they have nothing to do with eating right, losing weight or exercising.  Instead, they have everything to do with protecting against the organizational and financial stresses of data breaches—which have become an everyday disaster.

As noted in a post last month, the Third Annual Benchmark Study on Patient Privacy & Data Security, reports that data breaches in healthcare are growing; insider negligence is the root cause; and mobile devices pose threats to patients’ protected health information (PHI). Despite the fact that 94 percent of healthcare organizations surveyed suffered data breaches, data breaches don’t have to be disastrous if organizations take steps to operationalize pre-breach and post-breach processes to better protect patient data and minimize breach impact.

The results of this survey have lead to a few of us bing invited to share our recommendations for a healthier organization in 2013 and beyond:

1. Establish mobile device and Bring Your Own Device (BYOD) policies that include technical controls and employee and management procedures.

Rick Kam, CIPP/US, president and co-founder, ID Experts

2.  Control the cloud or it'll control you. Make it a point to fully understand what cloud service-level agreements mean in practice and then push for meaningful information on failover and disaster recovery practices used.”

Richard Santalesa, senior counsel, InfoLawGroup LLP

3.  Have a current breach response plan that is ready and tested. This will help pave the way for a well-executed response that can mitigate the financial, legal and reputational harm caused by a security incident involving patient information.

Marcy Wilder, partner and director of global privacy and information management practice, Hogan Lovellis

 4.  Conduct small but focused risk assessments rotating control review on a monthly basis to continually understand and measure risk. Most importantly, have a plan to address the risk, through remediation, mitigation or risk transfer activities.

Chad Boeckmann, president and chief strategy officer, Secure Digital Solutions, LLC

5.     Immunize mobile devices against viruses that might steal patient data.

Dr. Larry Ponemon, chairman and founder, Ponemon Institute

 6.       Attack your leadership team with phishing and other social engineering campaigns. Nothing raises awareness like catching people and correcting them on the spot—and it's a lot more interesting than the annual 30-minute online security training.

Michael Boyd, Director of Information Security Management, Providence Health & Service

7.     Use a checklist to evaluate periodically whether covered entities and business associates are in compliance with all privacy and security requirements. Sign and date the checklist to show that your organization is not guilty of "willful neglect" in complying with privacy and security laws.

Jim Pyles, founding partner, Powers, Pyles, Sutter & Verville, P.C.

 8.      Educate all staff to recognize applications, mobile devices and medical equipment that collect, contain or transmit patient information and/or biometric data; and train them to communicate the risk to those responsible for information security management.  

Christina Thielst, FACHE, Vice President, Tower

 9.     Decide how to handle the residual risk of a data breach, how much risk to accept, and how much, if any, risk to transfer through cyber insurance.

Christine Marciano, President, Cyber Data Risk Managers LLC

 10.Boards should ensure their organizations have robust, board-reviewed and approved security policies and procedures.

Larry W. Walker, president, The Walker Company

 11.   "Big data" is a source of both the disease and the cure for privacy and information security symptoms. Currently, we have to deal with data minimization, but in the future, look for applications that may collect broadly, but protect against unauthorized disclosure or misuse very, very well.

Jon Neiditz, partner, Nelson Mullins Riley & Scarborough LLP 

 Rick Kam, president and co-founder of ID Expertis isn't a physician, but he believes  “patient information is at risk for infection” and “organizations need to make a commitment to a healthier organization from top to bottom, otherwise a common cold data breach will turn into tuberculosis.”  I have to agree and in some respects it is just another HAI - hospital acquired infection.

Also, one more recommendation is in order.... be careful with #6.  It could lead to a bit of personal risk -- otherwise known as a CLM or "career limiting move".

Knowledge Capital in the Digital Society: Information-Based Value Creation

I finished reading Peter Waegemann's book on knowledge capital in the digital society not long ago and wanted to share a few key take-aways.  

• the need to learn by memorizing is now replaced by the need to thrive in the digital world... to be creative, to research to connect the dots and to manage information and knowledge.

•  
  • Digital intelligence will mean the ability to smartly navigate the immense world of knowledge and information, not trying to memorize it.

• today... the smartest child is the one who can navigate information resources and connect the dots -- that is the one who understands the meaning and context of information.

•  
  • the new challenge concerns how one 
    • acquires knowledge, 
    • manages information, 
    • distinguishes useful from trivial, 
    • separates truth from spin, 
    • navigates information resources and 
    • identifies belief systems according to established values 
    • while remaining open to alternatives and 
    • how one continues to improve knowledge over a lifetime.

• Advertising is moving from printed media to digital product targeting

• Information fields such as medicine, law, engineering, and even language translation may ultimately be mapped like geography, using software to guide people accordingly

• predictive text, indexing and semantic software, that within seconds, can extract relevant subject matter out of millions of pages will help us manage the wealth of information

This is a book that makes you think and reflect back to look at the future! It is especially relevant to healthcare leaders, human resource professionals ... and parents!

Patient Safety, Team STEPPS & Technology

The life of blogging sometimes requires a confession to get back into the good graces of your readers. So, yes, once again I've been a bit of a delinquent blogger.  It has been almost a whole month since my last post!

The good news is that this post may provide some really good considerations for my readers who are involved with patient safety.  

Not long ago, I got to think back on my roles as hospital safety officer and incorporate some of the challenges I faced with my current work leveraging technologies to improve the patient engagement.  The result was a iHealthBeat Perspectives article.

In the article I present how techniques of TeamSTEPPS and other safety initiatives ( SpeakUP, Ask Me 3, etc) can leverage technologies to improve patient safety -- especially for the estimated 77 million people in the US with a poor understanding of basic medical vocabulary and health care concepts.  These are the individuals who are most at risk for re-admissions or poor outcomes.

Just after the article was published, an AHRQ representative provided me with information on another initiative - designed to improve communication between patients and clinicians to help make health care safer and lead to improved outcomes.  Questions are the Answer offers free tools for patients and their clinicians, including:

•  A 7-minute video featuring patients and clinicians who discuss the importance of asking questions and sharing information – this tool is ideal for a patient waiting room area and can be set to run on a continuous loop.
• A brochure, titled "Be More Involved in Your Health Care: Tips for Patients," that offers helpful suggestions to follow before, during and after a medical visit.
• Notepads to help patients prioritize the top three questions they wish to ask during their medical appointment.

A broad mix of medical group practices, hospitals, local health departments, health promotion and disease prevention centers, and insurers are using these materials and have reported their usefulness in helping patients and family caregivers have more effective two-way communication with their clinicians.

Taking a lead from my article, I'd like to see the:

• notepad in a format that can easily be completed and referenced on a mobile device; rather than a pdf
• the brochure converted to a widget to take the reader through the learnings and then quiz them on their understanding ... and perhaps offer a checklist.
  • if I could really have what I wanted, each checklist (for each of a patient's appointments) could be uploaded to their health record for easy reference and ...perhaps review by the physician before they walk into the room to greet the patient.

 

Health Literacy Resources

I recently looked for some reference materials on health literacy and came across the documents listed below.  Each had some valueable information or insight into health literacy and the impact on patient safety and outcomes.  Hopefully, a few of my readers will also find value in these resources.

The Health Literacy Environment of Hospitals and Health Centers: Making Your Healthcare Facility Literacy-Friendly, (2006)

What_Did_the_Doctor_Say?  Improving Health Literacy to Protect Patient Safety, Joint Commission, 2007

Health Literacy Universal Precautions Toolkit, AHRQ 2012 

Is Our Pharmacy Meeting Patients' Needs? Pharmacy Health Literacy Assessment Tool User's Guide, AHRQ, 2007 (prior post with interesting data)

Medication Labeling Project ACP

A while back I also shared a video from the Am College of Physicians about the impact that literacy has on health costs.  I believe today's emerging technologies offer opportunities to overcome the challenges of health literacy and can help us improve outcomes and manage costs.

New Tools for Emergencies: Social Media

Sometimes graphics really can say it all...

To view the full survey and infographic:

• Full Survey PowerPoint
• Infographic as jpeg
• Infographic as PDF

By the way, I saw this in action here in California during the last hurricane to roll through New Orleans. Family and friends gave updates, especially on flooding, loss of power, safety, etc.  Sometimes, more importantly, those with power shared the news and offered to assist those without.  It was faster than the traditional sources of information and more personalized!

Hospitals: Take down those walls!

A new article in HealthcareITNews highlights the hospitals of the future and their need to become more virtual.  I love the five key design elements for hospitals of the future -- without walls:

1. The ability to design a digital profile of each individual  -  i.e. healthcare CRM
2. The ability to see and engage virtually via high-definition video, anytime, anywhere and on any device
3. The ability to create centers of collaboration excellence both inside and outside of our communities
4. The ability to access massive amounts of data without putting it in one container
5. The ability to leverage social media as a care coordination platform, not merely a collaboration platform 

I, like Ash Shehata, have envisioned this and am so happy to see I'm not alone.

ShakeOut: Drill in your community or from your computer!

Ever been in an earthquake? It can be pretty scary. On October 18th, Shakeout.org is hosting the largest ever earthquake drill. In as little as 90 seconds you can learn and practice what steps to take to protect yourself and those around you right from your computer! Join the 14 million other participants and get educated.

 

For more information and how to register for the drill, check out this summary or visit www.Shakeout.org. 

Age of the Healthcare Consumer

A recent Harris Poll had some great data, but one point struck me as particularily funny.  Well, it really isn't funny, but it is ironic.  The data point is that of 84% of Americans who visited a doctor's office within the past year, nearly half (47%) reported being very satisfied with their last medical visit.  What is funny (ok, ironic) is that it is the same rate as consumers who were very satisfied with their last car purchase.

Really??  Are our patients just as satisfied with their last medical visit as they are with car purchases? Of all the data that I see, this by far has to be one that starts us over the tipping point.  At least I hope so!

Other findings of particular interest to me were:

• Online access to medical records is available to 17% of patients
• 32% of patients consider online access to medical records as very important and 33% see it as important; however, it is not available to these consumers.
• Email access to doctors -- 12% of patients have it; 23% consider it very important and 30% consider it important
• Online appointment setting -- 11% have it, 21% consider it very important, 30% feel it is important
• Online billing and payments -- 10% have it, 21% consider it very important and 29% feel it is important
• Online cost estimator -- 6% have been offered this service and just over three of five patients are without the services, but describe it as either very important (26%) or important (36%)

What do you think?  Is this really ironic?  Or is it funny, or perhaps even sad?

Health IT Promotion - for Patients and Families

The Office of National Coordinator released a video to help promote health IT.  It is the newest resource on their patients and families page.  

Engaging patients and families in their healthcare is also about educating them on the changes in the delivery system, technology and resouces and I like that their outreach includes social media.

Tower's Latest Thinking

I'm starting to post on the Tower Strategies blog about patient engagement, their experience and leveraging emerging technologies.  My first posts are on:

Best Care at Lower Cost: Continuously Learning Health Care

The Truth About Patient Engagement

Patient Experience – The #1 Priority Among Health Leaders in 2012

Please visit the site to see all of our posts, but know I'll also include a few here on this blog.  The one I've set for Monday is on what patients want... online access to data!

National Strategy for Suicide Prevention

My first COO role was at a large acute psychiatric hospital and it taught me a great deal about suicide and the people who attempt or complete this self destructive act.  Since that time I've learned of a few examples where social and mobile was being applied in behavioral health environments.  One was the military's use of text messaging to help reduce the risk of suicide with special populations.

Now I hear that their efforts have expanded into a National Strategy for Suicide Prevention. The strategy leverages:

• Facebook and other social networking sites
• email outreach
• blogs
• mobile apps and devices
• texting

They are also exploring opportunities with virtual worlds, gaming and text analysis.  For specifics on their goals and objectives review the program overview.  To learn how you can help prevent suicide watch the video below.

 

Get Ready with Captain Laz

One of my Santa Paula fire-fighting friends has a new blog and I'm hoping some of my readers will go visit his writings on being prepared for a disaster!  His first post was about the People Like You video, which is truly a great educational and motivational tool!

  

As I often say, the best prepared hospitals are those whose employees are prepared at home!

First EHRs... Now Social Engagement of Patients

West County Health Centers, a Northern California private, non-profit health organization, has deployed what may be the nation’s first social platform designed to engage patients in their own healthcare. The Health Center has rolled out a private, cloud-based social healthcare platform, within its patient population. Extending care and patient engagement outside provider visits is proven to improve healthcare outcomes and reduce costs. 

The platform, WellFX, is a private, secure, HIPAA compliant social platform for providers to deploy in their patient, staff and agency communities.  Because it is provider directed, both patient and provider have confidence in the efficacy of the information, education and motivation being given.  Providers can create managed and unmanaged communities for patients to meet and share experiences while accessing provider created education and healthcare content.  It works to provide complete patient confidentiality, anonymity and data protection. 

The social platform deployed at West County Health Centers will create an extension of the health center by connecting patients with one another, augmented by educational content that is germane to their condition, ensuring that patients are connected with the right people and the right information at the right time. The success of the initiative will be measured in the short term by patient adoption and feedback, in the mid-term by the level of patient activity on the platform, and in the long term on measurable healthcare outcomes such as improved hemoglobin levels in diabetes patients, and reduced recidivism in addiction patients.   It will also be deployed in staff-only community groups where staff can participate and share best practices and success stories across teams and agencies.

“Engaging and motivating patients to change behaviors that result in improved healthcare outcomes is the holy grail of primary care,” said Dr. Jason Cunningham, Agency Medical Director at West County Health Centers. “It is a brutal truth that primary care doesn’t do behavioral change well.   It demands that we think and act differently; and we need new tools and technology to make this happen.  The potential we see in WellFX is enormous – it is a tool to effect profound change whereby the provider can act as both educator and facilitator of improved patient behaviors beyond the boundaries of the healthcare visit.”

West County Health Centers was one of the first community health centers in Northern California to deploy Electronic Health Records.  Now it is trail-blazing by using an innovative social platform to disrupt the status quo of patient engagement.  By getting patients to engage with each other outside of on-site visits they are setting the stage for achieving better outcomes for patients.

Social Media: The Good, The Bad & The Ugly

I came across something new for my presentation that I call the good, bad and ugly of social media. Fortunately, it didn't seem to originate as a social media blunder, but it does highlight the care needed when selecting document names for any items being uploaded (pictures, video, voice, documents, etc) onto social media channels, websites or portals.  These document names are tags that can be used in searching.

The issue involved a surgeon who placed on her website, with permission, before and after pictures of women who had breast augmentation surgery.  While there were no faces shown or names visible on the website, the file names used were the actual patient names. Now, the surgeon is facing a HIPAA violation and lawsuit from the 10 women involved.

Once again, this blunder also highlights why everyone should be googling their name to see what pops up.  I bet these ladies were certainly surprised when their before/after breast surgery pictures popped up.  Just as I was surprised to find a picture of my husband and I from a meeting we had with a mortgage company representative.  They had taken our picture and placed it their company's file on a photosharing site.  Unfortunately, it wasn't secure and was labeled with our name.  I found it and asked that it be immediately removed.

Meaningful Use: Transforming Patient Engagement

This morning sent out a press release for Tower and also want to also share it with my blogosphere readers.  As always, I'm interested in your thoughts and hope you will consider leaving a comment. (PDF Version of Press Release)

The Office of the National Coordinator for Health IT (ONC) and The Centers for Medicare & Medicaid Services (CMS) has released the long awaited final requirements for State 2 Electronic Health Records Incentive programs.  Included in the rules is an emphasis on patient engagement.

 New rules specific to patient engagement include:

•  The “provide patients with an electronic copy of their health information” objective is being replaced with an “electronic/online access” core objective.
•  A new core objective for eligible providers is “use secure electronic messaging to communicate with patients on relevant health information“
•  CMS proposed two new core objectives related to patient engagement with measures that require patients to take specific actions in order for a provider to achieve meaningful use and receive an EHR incentive payment.  For both, the threshold was lowered from the proposed 10% of patients to 5% in the final rule.  CMS also recognizes broadband availability limitations in some provider practice areas and introduced an exclusion.
•  Patient and Family Engagement is one of the six key health care policy domains of which all providers must selection at least three for clinical quality measures (CQM) and reporting.  These are the CQMs that reflect the potential to improve patient-centered care and the quality of care delivered to patients. They emphasize the importance of collecting patient-reported data and the ability to impact care at the individual patient level as well as the population level through greater involvement of patients and families in decision making, self care, activation, and understanding of their health condition and its effective management.
•  More than 50% of all unique patients seen by the eligible provider are provided timely (within 4 business days) online access to their health information.  More than 50% of all patients who are discharged from the inpatient or emergency department of an eligible hospital or Critical Access Hospital have their information available online within 36 hours of discharge.

The ONC final rule complements the newly released CMS final rule and reflects their commitment to promote patient engagement and safety.

 As hospitals and other providers prepare to comply, they must first acknowledge that this isn’t just an issue for their IT departments to address.  Instead, attaining meaningful use of one’s electronic health records/systems for patient engagement will require the collective involvement and collaboration of disciplines from across the organization… clinical, operations, information services and communications/marketing.

“Healthcare leaders will need to be strategic and put every decision in the context of the patient experience.  Having an effective patient strategy will lead to happy customers, staff and a healthcare organization exceeding their business objectives” said Dr. Sue Sutton, CEO at Tower, a patient experience consulting group based in Los Angeles, California.

The approach required is one of re-defining patient engagement across all touchpoints, both physical and virtual, to positively transform the patient’s experience – as perceived by the patient. “The research tells us where the patients are going, but institutions aren’t paying attention. If the approach taken doesn’t actually engage patients, the organization won’t meet the meaningful use criteria and they may actually lose some patients to healthcare providers who have implemented more patient-centered engagement strategies“, added Dr. Sutton.

Enterprise portals can facilitate electronic access by making information within existing systems available in a more patient-friendly manner.  The portal helps accomplish the goal of compliance with the MU criteria, but it does so at the same time it can accommodate additional features and personalization for enhanced engagement and a better patient experience.  Ultimately, this is what will lead to improved outcomes – the ultimate goal of meaningful use.  

CMS will audit healthcare providers who are participating in the meaningful use program and will focus in on those who show substantial noncompliance.  For detailed information, see

 CMS Final Rule Regulations                   ONC Final Rule Regulations

CMS Final Rule Fact Sheet                    ONC Standards and Certification Final Rule Fact Sheet

Getting Personal: My Patient Experience - #4

I've heard from a few of my readers who had similar experiences as to my #1, so I hope OB professionals are listening.  I debated on whether to share this last one, but here it is.....

At the time when insurance companines in California were having new moms kicked out of the hospital within 24 hours, I was fortunate enough to deliver my first child.  After being in labor all day and then a 12:45 am delivery I woke up at 8:30 and saw a nurse when I opened my eyes.  Her first comment was "what time are you planning to leave today?"  "Uh, I don't know," was my response. I then asked to see my baby.

I didn't see much of the nurses that Saturday morning.  At one point, I did see one and asked her about breastfeeding, because it wasn't seeming to work like the books had said.  She told me to put the baby on each side for five minutes.  Ok, so I did, and thought she will be back to see how it is going. No such luck.

Finally, given the lack of attention (on the completely new unit) and my concern about being asked what time I was leaving; my husband and I decided we should just go home.  He could take better care of me there.  We informed the nurses, but there was one problem.  The baby had not urinated yet, and that was a requirement before she could be discharged.  Not wanting to leave without my baby, here we were, finally ready to leave and we had to wait a few hours before we could.

If I could go back in time, I would expect that the hospital staff could have communicated with me a little more:

• compassionately about the issue with the insurance,
• effectively about breastfeeding, and 
• completely on when I could really expect to leave.  

I think a video or avatar, who stops to make sure I understand or to check back on progress, might have been a great resource for the breastfeeding.  Information upon admission, on the website, or a visit a little later that morning about the insurance issue would have been welcome.

As for the first thing a patient hears when they open their eyes after such an experience... I would hope no other mom ever has to hear "when are you planning to leave".  Good morning,  hello,  my name is ____, I am your nurse, or something else might be a much better first impression of the OB unit (post natal care).

I sometimes hear that the reason OB patients don't choose a hospital is because of the "old" facilities. In this particular case, I think we can agree that the larger issue would have been something completely different --- how we communicate with our patients.

Handwashing and Social Media

Here is a nice video of hospital employees having a little fun with education and setting a culture that values handwashing and other infection control measures to keep patients safe.  I think I'd enjoy working there, too!

 

Also, did you see how they highlighted the role of the pink ladies?

Getting Personal: My patient experience - #3

When I moved to town several years ago, I needed to select a new physician.  My brother-in-law was the CEO of a local clinic, so I thought I'd choose one of his physicians.  I called, was first asked a series of questions and then given an appointment to meet one of the physicians several weeks later.  The many questions focused on my demographics and insurance.

After a couple of weeks I found that I needed to change the appointment and called to get a new one. Unfortunately, when I called they did not have any record of an appointment for me with the doctor at the time and on the date originally specified.  In addition, they had no record of all of the information I had provided during the initial call. 

So, what did I do?  I politely explained that I believed it would be a huge mistake for me to see one of the clinic physicians.  I explained that this situation had given me a poor first impression and that I didn't want to risk repeating this again.  I hung up and called a physician in private practice... whom I still see today.  

Now, if I could just get her onto secure messaging!!!!  :)