Having just written about crowdsourcing for healthcare innovation, I was intrigued by a recent tweet for the TEDMED2012 Conference.  Landing on the TED home page, I found myself selecting a link for Lucien Engelen’s presentation, “Crowdsourcing for Your Health”. As the former Dutch Health 2.0 Ambassador, Engelen is also the founder of REshape, a program of Radboud University Nijmegen Medical Centre dedicated to creating the decade of the self-empowered patient.  Inspirational stuff, indeed.

Originated by Richard Saul Wurman, the first TED Conference was launched in 1984. Building on a fascination with people he met working in the fields of technology, entertainment and design, he seized the opportunity to explore these connections further in conference format.  Independently owned and operated, TEDMED remains true to the TED spirit by gathering a community of passionate leaders and doers from a variety of disciplines to “think out loud” about the challenges and opportunities facing health and medicine today.

In his thought provoking TEDMED2011 delivery, the tech publisher, Ted Reilly, discusses what healthcare can borrow from Silicon Valley titans, from better product development to crowdsourcing implementation, wearable tech and even advantageous hacking.

TEDMED2012 will be convening at the legendary Opera House, located in the John. F. Kennedy Center for the Performing Arts in Washington, DC on April 10-13th.  Exciting to note, each of the 11 Main Hall sessions can be live-streamed FREE to qualified healthcare organization auditoriums in HD from professionally produced, multi-camera, high definition feeds. With the opportunity for your institution’s physicians, medical staff leaders, residents, nursing, allied health and administrative staff to send questions electronically to speakers in real-time, what better way to spark innovation in your own organization?  Extend the invitation to providers across the street, payers around the corner, specialty organizations over the hill etc. and we may very well have the impetus for collaboration at the local level.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

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Crowdsourcing for Healthcare Innovation

In Robert Berenson, MD and Nicole Cafarella’s article, Is the CMS Innovation Center Innovating Too Fast?, the authors note that, “One of the few health policy issues that receives bipartisan support is the need to dramatically alter the way providers are paid, shifting from “paying for volume” to “paying for value” to alter the trajectory of health care spending while improving health care quality.”  One of the cost-cutting and quality enhancing tools created to facilitate this activity is the Center for Medicare and Medicaid Innovation.  While previously focused primarily on policy matters, the Innovation Center has added a new tactic to its strategy: crowdsourcing.  Originally coined by Jeff Howe, crowdsourcing’s open call technique helps solve complex problems by leveraging individuals most fit to perform identified tasks, thereby encouraging development of the most relevant and fresh ideas.

The CMS Innovation Center is deploying this tactic by issuing a number of innovation challenges with the intent to award up to $1 billion in grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest health care needs.  As further stipulated in Berenson and Cafarella’s artice, “Despite relatively broad agreement in the policy community on the Innovation Center’s objectives, some are skeptical about the role of government, as centralized in the Innovation Center, in promoting and adopting true innovation.   Another criticism is that the speed and approach it is using―rolling out over a dozen initiatives in rapid succession―are leaving behind potential innovators that have not been ready to respond to the quick pace of new funding opportunities.”

While proponents will likely fall on both sides of the coin, it is interesting to note that:  a) bipartisan support underscores the fact that the majority grasp the need to develop better care delivery systems and processes and b) the crowdsourcing technique has generated mass response and appeal. Inherent to the crowdsourcing definition, physicians, nurses, allied health and support professionals are conceivably the most fit to address healthcare delivery issues.  And if it is working at the federal and state level, why aren’t healthcare organizations adopting this model at their own institutions?  Penn Medicine is.

Launched on February 7^th, “Your Big Idea: Penn Medicine Innovation Tournament” offers faculty and staff the opportunity to submit patient experience innovations for evaluation and potential funding.  A well defined process will help define the top 10 submissions, followed by contestants pitching their ideas to Penn Medicine’s leadership in a town hall setting. The winning ideas will receive funding and resources for implementation.  While politics and budget concerns will likely determine the fate of federal care delivery improvements, perhaps crowdsourcing can prove to be the stimulant for healthcare innovation at the grassroots level.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

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Collaborative Care for Living Well with Chronic Disease

In observance of National Wear Red Day, Americans will wear red to show their support for women’s heart health.  Poor heart health can lead to congestive heart failure, one of the leading chronic illnesses estimated to represent 75 percent of the $2 trillion in U.S. annual health care spending.  Also noted in the Institute of Medicine Report, Living Well with Chronic Illness, “chronic illnesses are slow in progression and long in duration, and they require medical treatment. All chronic illnesses have the potential to limit the functional status, productivity, and quality of life of people who live with them.”

In order to improve individual quality of life for chronic illness sufferers while simultaneously reducing healthcare spending, radical re-engineering of the healthcare delivery system must occur.  One such innovative design can be found in British Columbia’s Expanded Chronic Care Model.  According to this model, healthcare organizations must support chronic disease management (CDM) strategy at all levels.  Attempts at improvement must be aimed at global change and include a defined process for addressing quality issues.  Furthermore, agreements to facilitate care coordination must extend within/across organizations in the continuum of care and incent providers to improve quality of care.

The model further stipulates that health care service delivery should be tailored to assist practitioners in implementing planned interactions to support evidence-based care. Providing culturally sensitive clinical case management services for patients with complex health issues in combination with regular follow-up moves the needle in the right direction.  In order to carry out these tasks, healthcare organizations should harness the potential of their clinical information systems through the use of business intelligence software to identify and target sub-populations that would merit additional focus for care planning, targeted messaging and intervention.

The patient’s role is also crucial to maintaining good health and this model demands that individuals play a central role in managing his or her health. Self-management support strategies include assessment, goal-setting, action planning, problem-solving, follow-up and establishing contact with community resources that provide support.  Mobilization of community resources to support or expand healthcare for chronically ill patients remains additionally critical. The key focus here is to encourage: (a) patient participation in community programs (exercise, seniors and self-help groups) and, (b) partnerships with community organizations to support and develop interventions to bridge gaps in needed services.

Current healthcare delivery systems developed around acute visits and crisis management have not been successful in meeting chronic disease care needs. Based on brief and infrequent patient-provider interactions, these models do not provide the sustained support necessary to maintain the healthy lifestyle changes critical to prevention and management of chronic diseases. To better meet the needs of these individuals, care systems must explore new ways to define collaborative care for living well with chronic disease.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

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* Graphic:   Wagner, E.H.  Chronic Disease Management:  What Will It Take to Improve Care for Chronic Illness?  Effective Clinical Practice 1998; 1:2-4.   Permission to reproduce model image granted from American College of Physicians (ACP), July 7, 2006.

Healthcare Innovation for an Economy Built to Last

According to President Obama’s recent State of the Union speech, “An economy built to last is one where we encourage the talent and ingenuity of every person in this country.  It means we should support everyone who’s willing to work, and every risk-taker and entrepreneur who aspires to become the next Steve Jobs.” Overwhelmed by the increasingly complex, disorganized and costly system of care, healthcare organizations are creating entities to explore non-traditional solutions to a wide variety of healthcare delivery issues.  Taking a cue from private industry, these organizations are embracing innovation as a means for overcoming a number of previously insurmountable obstacles.  According to the California Healthcare Foundation’s brief, Reinventing Health Care Delivery:  Innovation and Improvement Behind the Scenes, the following is a short list of formal programs that currently exist:

• Kaiser Permanente’s Sidney Garfield Healthcare Innovation Center serves as a test bed for workflow improvements, floor design plans and new technologies. In addition, they host comparative analyses and live demonstrations of competing technologies and equipment for consideration.  Two innovative processes emanating from this concept include the Nurse Knowledge Exchange, a comprehensive bedside protocol that facilitates information sharing at the time of shift change and KP MedRite, a systematic process for safe medication administration.

• With three hospitals and 40+ physician practices in predominantly rural Pennsylvania, Geisinger Health System was an early adopter of the patient centered medical home concept.  Rebranded ProvenHealth, this forward thinking entity is focusing on personal care coordination by shifting from episodic acute care to a continuous, comprehensive team-centered approach.

• Massachusetts General Hospital’s John D. Stoeckle Center for Primary Care Innovation develops, tests and implements improvements for their 22+ primary care practices care delivery process.  Included in their arsenal is a patient decision support tool that involves viewing short videos explaining the pros and cons of various treatments.  Additional efforts to increase the utility of the patient-provider interaction include development of the Ambulatory Practice of the Future which relies heavily on virtual doctor-patient visits.

• Northwestern Memorial Hospital’s Szollosi Healthcare Innovation Fund – borne out of a discussion between patient, Peter Szollosi, and Dr. Lyle Berkowitz, contributions to this entity are being used to improve the overall patient experience.  More specifically, this small group is focused on junctures in the care continuum where significant events transpire but friction or inefficiency often undermine the process.

• Vanderbilt University Medical Center for Better Health provides a range of tools and capabilities for developing, testing and implementing new healthcare methodologies, systems and strategies.  While fifty percent of the work is performed for the medical center and medical school, the remaining time is spent consulting for external clients.

• Mayo Clinic Center for Innovation is using a patient-centered focus to transform the experience and delivery of health care for patients everywhere. Laser focused on three platforms, each one is centered on human needs, has a multidisciplinary team, internal and external collaborators and a diverse portfolio of projects supported by a solid business model.  Specifically, they have their sights set on practice redesign, community health transformation and care at a distance.

• Ascension Health Transformational Development Team – as the largest nonprofit health system with 67 hospitals and more than 500 total health care facilities, this group spends a great deal of time scanning a variety of business and industrial sectors to identify ideas, solutions and techniques that may be applicable in extending care beyond the hospital of physician’s office.  Borrowing from the world of high-tech start-ups, Ascension’s “funnel” approach requires a project to progress through a specific set of development, validation and testing stages prior to approval.  In a radical departure from traditional healthcare delivery, this group is also piloting immersion studies aimed at uncovering unique social and cultural barriers to care.

• John Hopkins Center for Innovative Medicine has been creating new models of health care delivery that improve patient safety, quality and efficiency.  Through the development of tools and training programs that engage health care workers—from frontline staff to top leadership—to realize radical, measurable advances in care delivery.  Leveraging these experiences, the center has also helped hundreds of hospitals in the United States and around the world to develop or expand their quality and safety programs.

• Stanford’s Clinical Excellence Research Center organizes research teams from multiple Stanford Schools to design and test new methods of health care delivery that substantially reduce population-wide disability and annual per capita health spending in the near term. Research is led by teams of post-doctoral research fellows and mentored by faculty from multiple Stanford Schools with initial emphasis on Business, Engineering and Medicine.

• Founded in 1995 by Harvard Medical School teaching hospitals, the Center for Connected Health develops new strategies to move health care from the hospital and doctor’s office into the day-to-day lives of patients. Leveraging information technology — cell phones, computers, networked devices and simple remote monitoring tools — the Center helps providers and patients manage chronic conditions, maintain health and wellness, and improve adherence, engagement and clinical outcomes.

• A relative new entrant, Boise, Idaho’s St. Luke’s Center for Healthcare Innovation, has culled expertise from the payer and venture capital industry and will be focused on employing venture philanthropy models for the purpose of accelerating cutting-edge projects.  By employing an approach that leads with the community and individuals, rather than an institution, the goal is to offer an opportunity for technology companies to test their wares in the real world.

• Last but not least, philanthropic pioneers Gary and Mary West launched the West Health Policy Center in Washington D.C. this week.  While heavily weighted towards health policy and reimbursement, two of the five focus areas do include promoting infrastructure independent care and appropriate care utilization. Hoping to act as a fellowship program, the Center intends to:  1) fund research to identify more than $100 billion in cumulative health care cost savings within ten years, 2) serve as a neutral convener between the public and private sectors, and 3) conduct educational activities with government, industry, academia and nonprofit stakeholders.

With relatively differing approaches, several common themes do remain.  Innovating and evaluating effectively requires substantial investment.  In addition, unnecessary duplication of efforts and inability to define/document value can derail any program.  And it is only through structure and metrics that the most tenacious programs will prevail – and prosper – the goal of an economy built to last.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

*Graphic courtesy of the Kaiser Permanente’s Sidney Garfield Healthcare Innovation Center

Healthcare Collaboration: A Dream for All

With the recent celebration of Martin Luther King, Jr.’s birthday, we are reminded about his passion for the dignity of life and justice for all Americans.  He would have turned 83 this year; and if this had occurred, it would have defied the average life expectancy of 69.7 years for an African American male.  Revisiting Dr. John Eisenberg’s, former Director for the Agency for Healthcare Research and Quality’s 2000 post, I too wonder what Dr. King would think about parity, but also the manner in which healthcare is delivered today?

While there remains significant work to be done regarding access for the under and uninsured, do we not have a wealth of opportunity to level the playing field by inviting all Americans to engage in their healthcare experience?  By encouraging patients to express their preferences for the type/intensity of health care services they receive and the settings in which they receive them, perhaps we would see more people taking an active role in preventative health and not just responding to an acute episode.

Poised on the cusp of a digital health revolution, there have been significant advances in electronic and personal health records,  mobile phones and wireless technologies, text messaging, tracking sensors and social media.  Despite this gain, a recent hypertension study published by the Journal of American Medical Informatics Association, noted that a mere 26% of patients used personal health records (PHR) frequently.   And it was only the most frequent users of the PHRs that saw reductions in their blood pressure.  So, how do we change this?

In the recent Congressional Budget Office economic and issue brief, Lessons from Medicare’s Demonstration Projects on Disease Management, Care Coordination, and Value-Based Payment, one of the recommendations for delivering high quality low cost services is to apply team-based care that includes face-to-face, as well as, telephonic visits by care managers.  While these individuals by and large have been working with chronic frequent flyers, imagine having a care manager assigned by your insurance company who becomes your point of contact upon entry into the system?  They review your insurance coverage with you to verify that it is appropriate for your needs, aid in your selection of a primary care provider and establish expectations for your role in maintaining your health.  Maintaining your health could very well be the most important job of your life.  Similar to a performance review, the payer care manager would contact you on an annual basis to confirm that you are liaising with your medical home care manager, discussing your care plan and acting on recommendations.  In essence, they become your macro patient relationship manager.

Payer care managers will also be instrumental in maintaining open lines of communication with the care manager, also known as the micro patient relationship manager, assigned to you within your medical home.  The success of such a model would be perpetuated by the secure exchange of vital data via a health information exchange (HIE), thereby allowing both parties to remain up-to-date regarding your current status.  Medical home care managers will work with providers, practitioners and individuals to develop a comprehensive plan of care.  And by ‘working’, these individuals become responsible for educating patients about their outcomes and reinforcing the role that they play in determining them.  With a firm baseline and predictive modeling, patients will receive preventative health reminders, episodic management and transitional follow-up.  Removing the burden of information exchange with pharmacy and lab providers, specialty providers, ambulatory sites and long-term care providers will also facilitate this critical planning process.

A system that provides connected care to patients no doubt can lead to improved care – and therefore improved health –  which is nothing less than a dream for all.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Digital Health Summit:  Should it be Advancing or Aligning Innovation?

The Digital Health Summit at the 2012 Consumer Electronics Show commenced this week, bringing to the forefront a number of new consumer-based health and wellness innovations that sit at the convergence of technology and healthcare.  According to the Summit’s website, “ today’s generation of high-tech healthcare products and services will be the catalyst for better managed healthcare, patient/doctor communication, shorter hospital stays and faster recovery time, lowered costs for health insurance, early prevention and detection, digital patient information records, medical attention over distances, and so much more. A robust industry is developing to serve the healthcare market. The Digital Health Summit and Exhibition is here to serve as its epicenter.”  While consumer gadgets still dominate the CES 2012 platform, global technology giants clearly recognize that mobile and telehealth will continue to diminish barriers to healthcare access, quality and cost reduction.

Ultrabooks and smart phones with improved processing speeds for better viewing, video and data streaming, remote sensors and hubs, gateways and aggregation software dominated the healthcare presentations.  While these glitzy product launches can be instrumental in introducing new technology, are these companies – established and start-up alike – investing in the right mediums to successfully engage patients and providers for their product use?  As noted in the American Hospital Association’s Care Systems of the Future, the number one priority is to align hospitals, physicians, and other providers across the continuum of care.  Conceivably, one could argue that this should be extended to “hospital-physician-patient alignment,” under which strategies and action plans are implemented to align the interest and needs of the healthcare organization, physician, and the patient.  And when it comes right down to it, healthcare is about relationships – and who do patients trust more than their provider?  More to the point, with trust and respect comes influence.

While insurance companies attempts to engage patients in their healthcare management also remain important, would they not have more success if the patient’s primary care physician were aligned in this critically important mission?  Physicians inherently are analytical individuals, craving data for empirical evidence to validate the utility of new technology.  So goes the endless cycle, begging the question how does one solve it?  In short answer, smart technology vendors are surreptitiously working with residents that are entrenched in the ‘guts’ of healthcare delivery, allowing them to collaborate on future technology applications.  Similar to the Office of the National Coordinator’s (ONC) health video challenge, technology companies should seek opportunities real-time, be it video or state/local society meetings, to solicit feedback from physicians and other healthcare providers regarding best practices for positively influencing patient engagement and technology utilization.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Innovating Healthcare Beyond the Primary Season

As the race for the White House heats up, healthcare will continue to be a focal topic.  According to Representative and House Budget Committee Chairman, Paul Ryan, the debt crisis is, above all, a health care spending crisis. About one-quarter of all federal government spending goes to health care — a percentage that would rise dramatically under the president’s new health care law.  For taxpayers, employers and families alike, health care costs rose about 8 percent in 2011 and are projected to rise by 8.5 percent in 2012.

At the rate health care costs are rising, no one-time tax increase could keep up with spending on health care — taxes would have to rise again and again, devastating the economy. As President Obama recently said, “If you look at the numbers, then Medicare in particular will run out of money, and we will not be able to sustain that program no matter how much taxes go up.”

At its root, the Affordable Care Act is designed mainly to extend healthcare coverage to more than 30 million uninsured Americans by expanding Medicaid for the poor and establishing state exchanges where people with low incomes who do not qualify for Medicaid can buy subsidized private insurance.  In addition, it also calls for innovations that could guide America’s $2.6 trillion healthcare system, the world’s most expensive, toward incentives to contain costs.

In efforts to further this concept, the Centers for Medicare & Medicaid Services (CMS) announced the billion dollar Health Care Innovation Challenge in October 2011.  Moving at a speed more characteristic of private industry, the first set of advisors were announced a mere two months later.  According to Kathleen Sebelius, “Public and private community organizations, including hospital, physicians, churches, and other groups, are developing innovative solutions to help improve our healthcare system. This competition will help them build on their success.”  Combining process improvement, technology and utilization of appropriate labor forces, the potential exists to reduce redundancy and waste prevalent in the current system.

With the primary season in full swing, Republican candidates have one thing in common—they all want to repeal the health reform law, the Affordable Care Act.  While campaign protocol requires a general response to what they would replace it with, few have stated specifically how they would reduce healthcare costs, improve quality and simultaneously provide coverage to the uninsured.   With the labor force participation rate – the percentage of able bodied adults in the workforce – falling in December and 60,000 falling out of the labor force altogether, the debt crisis – aka the healthcare debate – will continue to rage.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Musings on 2012 Health IT

IDC Health Insights is an advisory services and market research firm that closely follows the payer, provider and life science segments of the healthcare industry, with special emphasis on developing and employing strategies that leverage IT investments to maximize organizational performance.

According to research and conversations with health industry executives, IDC has created the following 2012 Health IT predictions. There are five overarching themes impacting the healthcare industry which will affect the future of health IT, according to IDC: health reform, analytics and big data, cloud computing, mobile devices, and social media.

1.  The majority of U.S. providers will use EHRs by the end of 2012. This will advance health information exchange functionality.

2.  Providers will establish successful ACOs, which will emerge from private or public-private initiatives.

3.  Health plans will rebrand in 2012 as the focus turns to consumers. According to IDC, in 2012 at least 70% of health insurance companies and technology resources (beyond ICD-10) will be channeled toward enhancing consumer engagement and care or health management strategies.

4.  There will be greater integration of payment systems with clinical performance and outcomes. Twenty percent of health plans will leverage investment strategies started in 2010 and 2011 to integrate care, network, and payment strategies. Integrating these systems will help differentiate health plans and will allow for an increase in analytics software investments to support outcomes-based payment programs.

5.  Pharmaceutical companies will add software that provides real-time alerts, data integration, and analytics to create actionable information that will drive operational efficiencies.

6.  ACOs will need to develop an enterprise analytic framework that includes clinical analytics. 2012 will see ACOs battling to find significant IT and human resources to meet analytic requirements. These resources will be needed to support an integrated model that will make data available for all stakeholders, anywhere and anytime.  According to Dr. Westby Fisher, the use of data to improve clinical efficiencies while simultaneously using the data to market services will become 2012’s data-driven mantra. Like the fortune-teller’s crystal ball, those centers with the foresight and wherewithal to process and puree the large volume of clinical data spewed forth by today’s caregivers data entry personnel will be richly rewarded as new pressures to the cost curve surface. There will be a distinct competitive advantage to those who can simultaneously compare treatment, demographic, and socioeconomic trends in near real-time with an eye for more financially efficient care.

7.  The relationships between pharmaceutical companies and outsourcing firms will shift from what historically has been one-off relationships with siloed systems of processes being outsourced, to broader and deeper partnering relationships across entire functional areas.

8.  As physicians, nurses, and mid-level practitioners increasingly use their personal mobile devices to conduct work-related tasks, hospital CIOs will have to deal with increased security risks.  Further commentary by Dr. Fisher, “One only has to realize the extent of the mobile-medical movement and the innovations in hand-held devices capable of fully managing patients at a distance to appreciate the futile nature of the government’s ability to enforce the HIPAA/HiTECH acts. After all, despite the government’s heavy-handed wrist-slapping in this regard, I have yet to see a story of how the government recovered any of the data lost or how they rectified damages to those whose medical information has already been compromised. Shouldn’t that be the focus?”

9.  Health plans will deploy second-generation communication strategies, developed with the aid of analytics software, to support consumer communications throughout 2012.

10. The second generation of consumer communications will leverage consumers’ social networks, including family, friends, and co-workers, to encourage healthy habits. For example, through mobile devices and social networking sites like Facebook, social connections can encourage (or prod) people to follow medical, diet, or exercise regimens, such as monitoring glucose or blood pressure readings on home health monitoring devices.

While is it exciting to see the proliferation of predictions for innovative technology with regards to patient engagement, it begs the question – how will the healthcare industry insure that pertinent messaging is not duplicated by multiple parties? Sounding strangely familiar, it would be nice to see payers, providers and vendors engage in a collaborative effort to make this 2012 New Year’s resolution come true.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Walmart‘s Greatest Gift

According to Walmart’s newest promotion, The Christmas Price Guarantee, “the greatest gift we can give our customers this holiday is great low prices on the things they want most.”  In light of their recent announcement regarding expansion beyond primary care services, one wonders if this indeed is their greatest gift?  Walmart was one of the first national companies to invest in retail clinics but has since dropped to third place with about 140 of them, well behind CVS Caremark’s nearly 550 Minute Clinics and Walgreens‘ 355 Take Care clinics, according to data tracked by Tom Charland, CEO of Merchant Medicine, a Minnesota-based research and consulting firm. About 1,300 store-based clinics are open nationwide, he says.

With more than 3,500 stores in the U.S., Walmart leases space to independent clinic vendors, while CVS owns and staffs its Minute Clinics. Few centers operated by retailers have doctors on site and most hire nurse practitioners or physician assistants to deliver care. Failing to reach their proposed target of 400 new centers by 2010, Walmart revised its strategy to include partnering with hospital and healthcare systems.

According to Jonathan Linkous, CEO of the American Telemedicine Association, pharmacies and large retail chains with in-store pharmacies continue to look for a retail health clinic business model that offers an acceptable return on investment. Early services included relatively simple diagnostic services provided by an in-store physician, nurse practitioner or physician’s assistant. And several years ago, Walmart experimented with telemedicine services in some of its retail clinics in Texas.

Now, Linkous said, some retailers are looking at using remote patient monitoring technologies to track people with chronic diseases and disorders. Offering blood pressure, weight or other vital sign measurements and storing them for future tracking via an electronic database can help keep a customer loyal to the store where they buy their prescriptions, he noted.  While loyalty is certainly one significant advantage, retail operators also have a compelling opportunity to engage patients in managing their healthcare.

With the sheer volume of stores, Walmart has the ability to draw customers for prevention and wellness activities, as well as, acute episodic management.  Similar to the Mayo Clinic Healthy Living at Mall of the America, a diabetic patient could be assessed for proper foot care and transitioned to a nurse educator to learn more about preventive measures, wellness products and technology that could assist the individual living with this disease.  Taking it one step further, personal health records could be introduced and demonstrated since they are being offered by a growing number of hospital and healthcare systems.  And while capturing key vital sign measurements in a customer relationship management database represents an important first step, finding ways to link this information to a patient’s electronic health record would be even better.  Armed with data from multiple points in the continuum of care, a patient’s multi-disciplinary care team then becomes better prepared to determine the most efficient next steps.

According to Forbes contributor, Tim Worstall, six Walton family members account for more than 30% of the nation’s wealth.  Given their negotiating power on Pennsylvania Avenue, Wall Street – and hopefully – Main Street, Walmart’s greatest gift is to help patients acknowledge, engage and gain control of their healthcare.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Personal Health Record rEvolution

As hospitals and healthcare systems move toward establishing “meaningful use” of electronic health records (EHR), one of their primary objectives remains engaging patients and families in their health care.  Personal Health Records (PHR) and related technologies can further this objective.  While an EHR is maintained by an institution, a PHR contains health data that is curated by an individual patient.  The intention of a PHR is to provide a complete and accurate summary of an individual’s medical history which is accessible online. PHR data can be accessed via a free standing vehicle, as in the soon to be defunct Google Health, or in a format that is linked to an existing EHR.

 According to the National Committee on Vital and Health Statistics, key potential benefits of PHRs include:

• Support wellness and preventative care
• Strengthen communication with providers and improve understanding of health issues
• Increase sense of control over health and access to personal health information
• Support healthcare decisions and responsibility for care
• Verify accuracy of information in provider records
• Support home monitoring for chronic diseases
• Support understanding/appropriate use of medications and reduce adverse drug interactions and allergic reactions
• Support continuity of care across time and providers
• Manage insurance benefits and claims
• Avoid duplicate tests
• Provide convenience via online appointment scheduling and prescription refills
• Increase access to providers through e-visits

Despite these tremendous benefits, a recent survey found that only seven percent of Americans had used online personal health records, and less than 3.5 percent used them with any frequency.  So what can be done to boost the use of personal health records? According to Ross Koppel, Chair of the Evaluation Working Group for the American Informatics Association:

• Instead of requiring patients to be data entry clerks, we should encourage (require?) healthcare technology vendors to agree to common data formats and use rules that would allow information to automatically flow from doctors’ offices, labs, and hospitals into patient’s personal health records. At the same time, we must recognize that some information is best conveyed in person by experienced medical professionals. Just because we can send information instantly doesn’t mean it’s always a good idea to do so.

• The automatic flow of data would make these systems far more user friendly, especially to the elderly and sick. Freed from data entry duty, the health records software could focus on presentation of information with better graphics. We need to make visualizing healthcare information easier and therefore easier to understand.

• We need to alter privacy rules so physicians can safely respond to patients’ email questions while protecting sensitive information. Telephone use norms emerged slowly, eventually encompassing even cell-phones. Emails via healthcare-system websites are considered safe, but all other emails travel on legal quicksand.

• Insurance companies will have to figure out how to reimburse doctors for reviewing and responding to patients’ emails. When patients view their information via the internet, they are going to have questions; and not every question requires an office visit. The same process that provides instant information can facilitate fast responses.

Assuming that these road bumps can be overcome and patients seize the opportunity to access their personal health record, how does the information become actionable and not a lifeless repository?  Perhaps, the time for a true revolution…not just evolution, has arrived.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

*graphic courtesy of the National Committee on Vital and Health Statistics