• Principle Healthcare Associates


    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

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Creating the Connected Patient

Creating the Connected Patient

After watching Mitt Romney speak at the Republican National Convention, I was reminded of the importance of connecting with one’s customer.  While the jury is still out regarding the Republican presidential candidate’s ability to do just that, there is still time for healthcare providers to rethink their strategy for patient engagement.  And with the addition of a meaningful use patient engagement core objective slated for 2014, there is no better time than now to dive in.

In order for healthcare providers to draft a successful engagement strategy, Bob Spoerl noted the following trends in consumer healthcare:

  • Legislation is providing health consumers with more options regarding quality and price transparency
  • As patients begin to embrace this new data, providers with a strong brand and customer service orientation will be able to differentiate themselves through digital media
  • With the explosion of mobile, telehealth and social media, healthcare companies become uniquely positioned to deliver prevention and wellness messaging

In addition to noting key trends, the Agency for Healthcare Research and Quality new report on Engaging Patients and Families in the Quality and Safety of Hospital Care, also points to gaps currently existing in many hospital patient engagement strategies:

  • Strategies aren’t attuned to patient and family member experiences of hospitalization; instead they focus on focus on hospital workflow
  • There is a lack of individual tools to support system-level strategies, such as patient and family advisory councils
  • There are too few interactive tools being utilized to incite behavior modification with ‘next steps’ and a concrete plan of action
  • While nursing staff play a pivotal role in patient education, they are not receiving adequate training or tools to leverage their position

Through unique utilization of their electronic medical record’s patient portal, one enterprising healthcare provider, OSU Medical Center, has pushed to the forefront of patient engagement.

While the work that has been accomplished to date is laudable, I can’t help but wonder what OSU Medical Center could achieve if they had the ability to sync glucose or heart monitoring data from mobile devices?  Because, as Jane Sarasohn-Kahn, MA, MHSA, a health economist and blogger admits, “You have to create in connected health systems incentives for patients to connect back,” and “you want to enable patient engagement, which requires interactive tools, carrots, and when appropriate, sticks.”

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 that stand head and shoulders above the competition.

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

Innovating The Nurse Practitioner Role in Chronic Disease Management

Innovating The Nurse Practitioner Role in Chronic Disease Management

In a special Health Affairs report, Rachel Garfield, PhD, of the Kaiser Commission on Medicaid and the Uninsured, and Anthony Damico, PhD, of the Kaiser Family Foundation, determined that Medicaid’s role in covering the population with diabetes will grow in 2014 when additional low-income, uninsured adults gain eligibility for the program under the Medicaid expansion provisions of the Affordable Care Act.  Since the total annual per-capita health spending on adult Medicaid patients with diabetes was more than three times higher than spending on beneficiaries without diabetes ($14,229 versus $4,568), this could be a disturbing statistic for North Texas residents.  Using data from the CDC, the Institute for Alternative Futures Diabetes model estimates that diagnosed and undiagnosed diabetes cases in this region are expected to rise 78 percent between 2010 and 2025, when the total is projected to exceed 1.5 million.  Sobering, indeed.

While Type 1 diabetes involves a malfunctioning pancreas, Type 2 diabetes develops when one’s own insulin becomes less efficient at moving sugar out of the bloodstream.  Both can be associated with obesity, high blood pressure, cholesterol and depression and are often undiagnosed in the presence of other common complications such as eye, kidney, lower extremity and heart damage.  For the good news, both types can be managed with appropriate drug regimens and lifestyle modifications.  As noted in the ISA report, future diabetic reductions depend upon the promotion of targeted screening for asymptomatic adults, improved access to quality medical care and increased patient compliance with therapy.  Halting the “twin epidemics” of diabetes and obesity will also require greater access to opportunities for physical activity in schools, workplaces, and communities and a significant shift in the American diet away from sugar, salt, refined carbohydrates and saturated fats and toward more fruits and vegetables.

With the North Texas regional diabetes societal and medical related costs already set to balloon 87% between the years of 2010 and 2025, one has to wonder how the pending Texas Medicaid changes will affect this?  Expansion or not, creative healthcare providers have the opportunity to improve this frightening situation.  As Suma Health System discovered, nurse practitioners employing the Chronic Care Model, including the use of planned visits, a patient registry, drug intensification protocols, and collaboration with other members of the team, can improve processes of care and clinical outcomes for this population.

Coupling the activities above with on-site patient education via tablets and additional patient-centered technology beyond the clinic walls, similar to this Southeast Minnesota Beacon initiative, improves engagement and therapy adherence, strategic elements for stage 2 meaningful use demonstration.  Partnering with other healthcare organizations to create green, sustainable buildings in underserved areas for delivery of primary care, psychosocial and wellness services also presents a tangible opportunity to prevent future diabetes development.   Utilizing roof space to install an urban garden and jogging track for inner city or landlocked destinations represents a creative solution for a commitment to physical fitness.  And working with nutritionists and local farmers markets to educate and deliver healthy food choices takes the community one step closer to improving access to care, preventing re/admissions, and reducing prevalence and associated cost of this potentially dilapidating disease.  With a veteran diabetes provider and acute care nurse practitioner in the role of President, Health Care and Education for the American Diabetes Association, is there no better time to illustrate this innovative role for NPs in managing 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 that stand head and shoulders above the competition.

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

Hospital Evolution: Collaboration in an Era of Change

Hospital Evolution:  Collaboration in an Era of Change

Change is everywhere.  No more evident is this than the presidential election soon to be upon us.  And with the selection of Vice Presidential running mate, Rep. Paul Ryan, healthcare (change) will be a hot topic for debate.  While the Democratic and Republican parties, as well as the voting public, attempt to come to terms with Medicare & Medicaid changes, this recent article puts the focus on a different topic.  Specifically, how will the American hospital evolve in this ever changing landscape?

After speaking with numerous industry experts, Molly Gramble sets forth the following hypotheses:

  • There will be fewer ‘heads in the bed’, with a move towards increased outpatient services and a key focus on prevention and wellness
  • Partnerships will abound as these institutions seek to deliver high quality care in a transparent environment that demands safety and efficiency
  • Utilizing innovation to find new niches will be the key to adding value and sustaining the hospital’s role in the healthcare ecosystem

And, in order to drive this adaption, Jeanette Clough, CEO of Mount Auburn Hospital, outlined the American Hospital Association’s (AHA) Performance Improvement Committee’s must-do strategies:

  • Physician alignment — getting in sync with doctors whose current incentives and view of the world may be very different from that of hospitals — is considered essential
  • Information systems that are intuitive, adaptable, and connect doctors to patients, colleagues and hospitals are viewed as fundamental to the hospital’s future
  • Quality and safety programs that grow in depth and strength to benefit the patient as well as the bottom line are a fundamental strategic priority
  • Improving efficiency through productivity and financial management will require greater creativity than ever before as reimbursement shifts from a fee-based to a value-based system.

While I sense that it is intuitive, one strategy that I do not see outlined is collaboration. Certainly a necessary ingredient to physician alignment, I am also speaking to collaboration with patients, caregivers, specialty, community/public health, post-acute, home health, nursing home, retail providers, payers…any and everybody in the continuum.  In the most rudimentary sense, are we not currently connected?  So perhaps, we instead need to focus on collaborative engagement in order to find innovative ways to deliver high quality, safe, efficient patient-centered care of the future – similar to Dr. Peter Margolis’, M.D., Ph.D., Co-Director, Cincinnati Children’s Center for Health Care Quality, strategy for the past twenty years.

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 that stand head and shoulders above the competition.

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

Community Health Centers and Healthcare Systems Partnering for Healthcare of the Future

Community Health Centers and Healthcare Systems Partnering for Health Care of the Future

In a recent passionate plea, Dr. Mark Smith with the California Healthcare Foundation, inquires, “can Medicaid still succeed in a post-ACA world after absorbing millions of new enrollees (and) rely on its existing networks of clinicians and institutions—despite evidence that many enrollees have more difficulty than other insured individuals in getting an appointment when they need one?”  And with the proclamation of National Community Health Center Week, it seems only fitting to consider how these institutions will play an important role in the ensuing Medicaid debate.

With their community oriented team centered approach, focusing on patient engagement and social determinants beyond traditional primary care concerns, many feel that community health centers present a viable solution for the onslaught of Medicaid enrollees that will exist in the near future.  Operating in 8500 locations, these entities serve more than 20 million patients and provide a substantial share of the nation’s primary care infrastructure.  And with the help of ACA funding, new health center service delivery sites will expand access to care to more than 1.25 million additional patients and create approximately 5,640 jobs in 2012.

As a strong advocate of the advance practice nurse led medical home, I do agree that the community health center model lends itself to a population centered health management approach.  Providing access to much needed services in one succinct spot can be very appealing to those, not only with Medicaid, but private insurance as well.  And for those organizations benefiting from the participation of Community Health Corps members, there is no doubt that the truest sense of ‘community’ permeates their mode of service delivery. But despite the additional funds and workforce assistance, I can’t help but wonder about Dr. Smith’s query, “will those who have historically served as the health care safety net have the capacity to care for an influx of some 12 million Medicaid patients, and, why are many so quick to excuse high-performing healthcare systems from the responsibility of providing care that low-income individuals can afford?

For the good news, there are a number of providers that envision a role in delivering care to those falling in the ‘safety net’.  As noted in a recent Health Affairs article, hospitals and healthcare systems recognize the need for access to subspecialty care for this vulnerable population and are developing various relationships with their community health centers in order to close the loop.  Noted for their ability to create healthier communities, reduce emergency room visits and further the local economy, will these enterprising minds couple patient-centered technology with community oriented healthcare to model healthcare delivery of the future?

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 that stand head and shoulders above the competition.

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

Advance Practice Nurse Solution: Making Healthcare Affordable for All

Advance Practice Nurse Solution: Making Health Care Affordable for All

Despite adding roughly 160k jobs to the economy in July, today’s jobs report points out that the unemployment rate actually increased to 8.3%.  How can this happen?  According to Morgan Stanley economists David Greenlaw and Ted Wieseman, “…(While) a sizeable portion of the 25,000 rise in the manufacturing sector seems to be related to seasonal adjustment issues, (the) 29,000 rise in the restaurant category is probably reflective of seasonal noise.” Joseph Brusuelas, senior economist at Bloomberg LP, also noted, “The U-6, or what I consider to be the real unemployment rate, increased to 15 percent. This is likely to be a harbinger of things to come, as the unemployment rate inches toward 8.5 percent (when) individuals that have exhausted their unemployment benefits trickle back into the labor market. Consequently, firms (will be) more likely to shed workers due to a slowing economy and to hedge against future risk associated with the coming domestic tax hike and the extended game of policy brinksmanship in Europe over the probable necessity of a Spanish sovereign bailout.”  Not much good news there.

While the national employment outlook appears bleak, there is good news regarding hiring on the healthcare front. The Department of Health and Human Services recently announced that it has awarded five hospitals $200M to help train additional advanced practice registered nurses (APRN). Specifically, the Graduate Nurse Education Demonstration Project will help place nurse practitioners, clinical nurse specialists, certified nurse anesthetists, and certified nurse midwives in critical healthcare delivery roles.  Part and parcel to receiving the grant money, The Hospital of the University of Pennsylvania (Philadelphia), Duke University Hospital Durham, (NC), Scottsdale Healthcare Medical Center (Arizona), Rush University Medical Center (Chicago), and Memorial Hermann-Texas Medical Center Hospital (Houston) have all pledged to support advanced practice nurse training in non-hospital settings such as community health centers and rural health clinics.

While I applaud this historic move to counter the growing primary care physician shortage, I also wonder if this strategy will be successful?  As noted in this timely article in the New England Journal of Medicine, “restrictive state scope-of-practice laws prevent non-physician providers from practicing to the full extent of their training (in 34 of the nation’s 50 states).  Making greater use of these providers would expand the workforce supply, which would increase competition and thereby lower prices.”  A controversial statement at a crucial moment – one has to wonder, will the Advance Practice Nurse Solution – with extended scope of practice – be one of the many innovations necessary to make healthcare once, and again, affordable 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 that stand head and shoulders above the competition.

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