CEO Toby Cosgrove, MD, shared this video, titled "Empathy," with the Cleveland Clinic staff during his 2013 State of the Clinic address on Feb. 27, 2013. Without words it is really powerful and should inspire all!
I especially like the way this video presents the context of both patients and staff and it reminds me of the project underway at Adventures in Caring titled Oxygen for the Caregiver... which will be out soon! Stay tuned for a release date!
Originally posted at TOWER's Latest Thinking
As of January 1, 2013, the Medicare Physician Fee Schedule includes reimbursement for transitional care management (TCM) services from the hospital to the community setting. The two relevant codes are 99495 and 99496 and apply to physicians and other qualified non-physician professionals. The goal of this investment is to generate savings from a reduction in the number of re-admissions.
While this new approach to reimbursing for care is truly welcome, the inclusion of non-face-to-face care management services is an opportunity to leverage enterprise portals and social technologies to facilitate these processes. The following services are required be provided unless they have been determined to not be medically necessary:
Performed by a qualified professional: obtain and review discharge information; review need for, or follow-up on, pending diagnostic tests and treatments; interact with other providers involved in patient’s care; educate patient, family, guardian, and/or caregiver; arrange for needed community resources.
Performed by clinical staff or case manager under direction of qualified professional: communicate with home health agencies and other community services utilized by patient; educate patient and/or family/caretaker regarding self-management, independent living, and activities of daily living; assess and support treatment regimen adherence and medication management; identify available community and health resources; facilitate access to necessary care and services.
Now is the time for innovative providers to develop new processes and create strategies for leveraging technologies to support delivery of these important and reimbursable services.reimbursement fits with my current work in the post-treatment phase of the continuum of care, I'll discuss question that arise from this change with CMS officials and share what I learn here.
Last year I attended The Beryl Institute's Patient Experience Conference and really enjoyed the opportunity to learn about the organization and their work with healthcare providers.
The 2013 conference will be held April 17 - 19th in Dallas, TX and I will speak on engaging patients across the continuum of care with social media. The learning objectives are to:
The February issue of H&HN has a great article that frames the issue of diabetes. It also makes the case for innovative applications of technology to improve the health of the rapidly growing number diabetics. Drivers for changing how the health delivery system responds include:
Many hospitals are developing diabetes centers and management programs that involve teams of physicians, nurses, dietitians, pharmacists and diabetes educators. But, there is a tremendous opportunity to also leverage technology to help enable diabetic patients and their care teams to exchange data easily, as well as, extending access to professionals for patient questions.
Technologies can facilitate the transmission of patient generated data – blood glucose readings directly from their glucose meters – along with blood pressure, weight, vital signs, caloric intake and exercise – to electronic health records. In addition, these tools can also present data in an organized and understandable manner so patients and providers can see patterns. They can also generate alerts to team members when pre-set triggers are reached, necessitating an intervention. And, social media can also facilitate support networks to help patients learn how to live with diabetes without always having to contact their physician.
All it takes to get started is to have a vision and cross-discipline support. Then the work of creating a strategy and roadmap to guide the implementation process can begin.
The American College of Healthcare Executives is holding its annual Congress on Healthcare Leadership in just over two weeks (March 11 - 14, 2013). I'm attending and will sharing my thoughts on the good, bad and ugly of social media.
There are two session times available (Monday at 4:15 pm and Tuesday at 8:45) In addition, there will be a brief 20 minute "highlight segment" available for those who had planned to attend, but are no longer able. During the session we will explore legitimate and innovative uses of social media and mobile technologies that contribute to improved patient outcomes and enhanced experiences. We will also discuss the threats and strategies to manage risks and miminimize loss.
Yes, tweeting during my sessions will be permitted! Just include @ACHECongress in your tweets so those following highlights of the conference can find them!
If you are attending Congress this year, you may also be interested in coming to visit me at the book signing for the newly released second edition of Social Media in Healthcare: Connect Communicate Collaborate at 3:45 on Tuesday in the Bookstore. It is a big year for social media and healthcare leaders!
Over the weekend while at my place with no cell or Internet service in rural American, I read a real paper book about the social media #revolution. It was produce by the Mayo Clinic Center for Social Media and their truly fearless leader, Lee Aase.
The book is a collection of essays from a variety of social healthcare leaders and it includes provider, patient, marcomm and other perspectives. I found reading about each contributors spark for entering the blogosphere or leveraging social media to be the most interesting. I also really, really appreciate several contributors putting blogging into perspective. For many of us, it is our "home page".
Below, I include a few of really special quotes or thoughts from the book. But, read the entire book yourself for more perspective and the great stories.
Forward by Dr. Noseworthy, Mayo President and CEO:
Speaking of embedded content, you may also be interested in the video:
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:
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.
Collection of data is worthless unless that data is used. As it relates to consumers and their health, presenting the data in a way that is useful and actionable is the goal.
The simple act of presenting the data to create awareness only takes us half of the way. As discussed on the chealth blog the real power comes from presenting the information along with varied, contextual messaging. The graphic below demonstrates the power of feedback along with the contextual messaging in a study they conducted on use of text messaging to promote sunscreen use.
This reminds me of my work with evidence-based communications and those TeamSTEPPS techniques that are closed-loop, such as, Check-back, Feedback, and SBAR. The real key is taking the next step and then engaging the patient and using technology to deliver the varied, contextual messaging. In TeamSTEPPS, the relevant engagement techniques include STEP, Task Assistance and/or Feedback.
The beauty of technologies like microblogs or text messaging is the need to keep the content short and simple; which is also important for communications to those with low health literacy levels. In addition, these "mobile" technologies travel with the patient as they live their life or go on to their next point in care. They facilitate an ongoing connection and support of patients, even when they aren't physically located in front of the provider - at least 95% of the time.
I've been seeing a convergence and the data from the Center for Connected Health really takes it home!
Fred Lee blended his experiences with Disney and hospitals and wrote a very thought provoking book. In it, he questions some longstanding beliefs and misguided approaches. Anyone with an interest in the patient experience really should read the entire book.
In this post, I'd like to focus in on some of the ideas that really struck me. Some have been my long term beliefs and at times I did feel a bit lonely. Others prompted me to shift my thinking.
Submit updated chapters with new graphics...... ✓
Check edits & revise...... ✓
Approve new cover & back.... ✓
Wait for 2nd Edition of book to be printed.... Due March
Update the online companion... In Process
As I near the end of this process, I'm really looking forward to seeing the results of my effort to update Social Media in Healthcare: Connect Communicate Collaborate. It has been a time consuming process, but I've truly enjoyed seeing just how far we have come with social media since the 1st edition was written in 2009. I especially enjoyed seeing that many of my projections have become realities in healthcare.
The official release of the book will be at ACHE's annual Congress on Healthcare Leadership. I'll conduct two breakout sessions on the subject and there will be a book signing. If you are attending, come by and see me.
One unintended consequence of this effort is that my blogging has sufferred a bit. It has been a challenge to keep up with posts while I work/travel, take care of a family, relax at my piece of rural America (without Internet access) and re-research and edit the book. But soon, I hope to have a bit more free time for this pursuit. So, stay tuned!
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".
Several state laws, including California's AB1844, went into effect this week and prevent employers from requiring employees or applications from providing their social media user names or passwords. I had heard of this practice by companies and some hospitals and could only wonder if the human resource leaders or executives truly understood the risk. In this post, I thought I'd just pose a few questions.
1. Shouldn't my personal Facebook page or other social media channels be private? Yes, if I manage the company/hospital's account, I would expect you to have the user name and password in case something happens to me (unexpected illness or leave, death, termination, etc.) But, do you really want to peer into my personal life -- would you peer into my home?
2. Who exactly will be looking at my social media channels - the hiring manager?
3. What would you do if you found any of the following by looking at my social media accounts?
4. What social media channels will you ask me to access? Twitter, Facebook, LinkedIn? What if I also (or instead) have accounts with Google+, Friendster, Pinterest, Squidoo, Instagram, FourSquare, SecondLife and many others?
5. What does your social media policy say? Is it overly broad, include prohibit organizing communications, or address a publicly-available sensitive issue for the employer?
There are several appropriate things that employers can do to minimize risks around employee social media use and to assess applicants for signs of poor communication or judgement. Prohibiting access to social media channels, or inspecting an applicant/employee's social media channels is short-sighted and a sign that the employer is out of touch with the reality of social media. Unfortunately, it took legislation --- in several states -- to keep these employers from self destructing.
Late last year, I presented on social media at the annual AAHAM conference . I was also invited to submit an article for their Journal of Healthcare Administrative Management and chose to explore opportunities to leverage a variety of emerging technologies for improved revenue cycle processes across the entire care continuum.
In the article, I review the role of social media, mobile, remote monitoring and portals and list some specific opportunities for healthcare organizations. Read the article and leave a comment if you can think of anything I've forgotten or haven't yet envisioned!
The Federation of State Medical Boards has produced an overview of telemedicine licensure across the US. Highlights include:
I had created a document outlining licensure across the northwest, but it is even better to have something covering the variations across all states. Licensure that extends across state lines and private insurance coverage are huge issues, especially as we look forward to a new health delivery system, so I'm really happy to see increasing attention by state medical boards.
iHealthBeat's Data Points latest shows how far along healthcare organizations are in instituting policies on mobile echnology.
After finishing my second book by Dr. David Gelber, my first thought was "I want to sit next to this guy at the next Medical Staff dinner". I thoroughly enjoyed his first book, Behind the Mask , and Under the Drapes was no certainly no dissappointment. What did I learn?
Hopefully, you now realize why I want to sit next to Dr. Gelber at the next Medical Staff dinner. He is thoughtful, compassionate, real ... and wildly funny!
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.
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!
The Third Annual Benchmark Study on Patient Privacy & Data Security by Ponemon Institute and ID Experts, has been released and reports that healthcare organizations face a huge challenge in stopping data breaches.
Most organizations surveyed say they have insufficient resources to prevent and detect data breaches, but consider the alternatives. Patients are at increased risk for medical identity theft and their PHI and privacy could be violated as mobile and cloud technology becomes pervasive.
Change is needed and recommendations include:
Now that I have an headache, I think I'll stop here.
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 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:
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.
What_Did_the_Doctor_Say? Improving Health Literacy to Protect Patient Safety, Joint Commission, 2007
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.
Sometimes graphics really can say it all...
To view the full survey and infographic:
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!
I, like Ash Shehata, have envisioned this and am so happy to see I'm not alone.
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 the last two years I've been presenting a six-week online seminar exploring health information technologies for the American College of Healthcare Executives. This followed an invitation from them to write a column on technology for the 2007 issues of Journal of Healthcare Management and their willingness to publish my book on social media in 2010.
My journey into health information technology began in 2004 and at one time a blogger buddy referred to me as the "RHIO queen." Given my passion for hospital leadership and administration I still think it is funny that I developed expertise in this area and a title. However, back in 2004 I could see the importance of healthcare leaders understanding technology applications and was a bit frustrated that some of my peers weren't willing to learn.
I worked hard to catch up and keep up with my own learning, knocked on a few doors and maintained some patience. Today, I'm so pleased to see that healthcare leaders have taken a much more active role in developing their own understanding of the technologies and the importance of implementing the right tool for the right purpose and right auidence. More and more, they also recognize the importance of having a clear strategy and clean workflows before any applying technology tools.
Healthcare leaders play a crucial role and their decisions can instantly impact the spark of innovation and success of an implementation. That is why it is so important that they develop at least a baseline understanding of the technologies, risks and rewards.
Today we start the second six week seminar of 2012 and I look forward to working with a new group of healthcare leaders to envision innovative applications in their organizations for the benefit of our patients!
There is still time to register, so consider joining us! For more information Click Here!