• 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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Leveraging Health IT to Strengthen Patient Engagement

Leveraging Health IT to Strengthen Patient Engagement

In the spirit of moving innovation forward, I found relevance in the following article about engendering trust using healthcare technology.  In the crossfire of my own struggles with technology, I can appreciate the very salient points outlined by the author.  Specifically, he asserts that healthcare IT can be the lever for improving the physician-patient relationship through the following means.

In the first instance, he points out that technology can help a physician provide SMARTER care.  With escalating numbers of insured patients attempting to be seen by a shrinking provider pool, new delivery methods must be sought to meet this demand.  While the article addresses wellness and preventative care, it is a natural extension to mention patient’s interest in mobile visits.  Incorporating SMS, video and email into the physician toolbox is tantamount; however, certain touch points require a face to face interaction…and the mobile visit solves this dilemma.  In fact, I would dare say that all mediums should be utilized to ensure that the patient’s particular learning mode is engaged and the provider’s message is reinforced.

Secondly, healthcare IT can optimize physician workflow and remove administrative shackles draining resources and diverting attention from the more complex tasks at hand – treating chronically ill patients.  As noted, “technology can take over for clinicians when it comes to some of the more benign data capture and aggregation roles.”  While this can cover items such as first time visit paperwork, it can also be employed for personal health records, population health management, as well as the patient”s & provider’s modification of the medical record.  And by lightening the physician’s load, they are free to pursue clinical partners and engage them in community health and prevention efforts.  At minimum, in celebration of National Public Health Week, there should be a focus on data exchange for immunization and prevention.

Thirdly, one of the core means of establishing trust occurs through the delivery of personalized messages in a format most conducive to each individual patient’s learning and retention style.  Using technology to engage patients and stay connected during their care demonstrates concern and establishes trust – an integral component to the healing process and a competitive edge for a practice seeking to maximize efficiency and minimize cost.

Last, but not least, the author stresses that technology must be implemented in a safe and secure manner in order to protect and preserve the relationships with one’s patients.  Specifically, “being aware of the security of the larger ecosystem of which an organization is part is a way to quell data loss and enhance the trust of patients.”  Perhaps one of the most difficult things to do today, but arguably should not be forgotten in the quest to do no harm.

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician 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

Designing Healthcare Innovation

Designing Health Care Innovation

By now you know that I have a distinct interest in healthcare innovation, so it should come as no surprise that an article about the recent Healthcare Experience Design Conference caught my eye.   Kicking the day off with a battle cry from Dr. Jacob Reider, chief medical officer at the Office of the National Coordinator for Health IT, he challenged the crowd, “to help this industry do better”.  And by better, he is referring to development of user friendly processes for patients and providers alike.

Albeit, being a do-it-yourself techie hamstrung by programs on a regular basis, I was encouraged to hear that this conference stretched beyond the traditional confines of user-centered design to include workflows, patient engagement and population health.  Having designed a website myself, I can appreciate the tips outlined for engaging individuals in the digital realm; however, what I found most intriguing was Nir Eyal’s discussion about how people choose to engage with habit-forming technology.  According to Eyal, “the key to developing habit-forming technology is to understand end-users’ “internal triggers” – the emotional drives that motivate them – and develop technology that begins as “vitamin” and then “turns into a painkiller.”

Cassie McDaniel, of the Centre for Global eHealth Innovation at Toronto’s University Health Network also pointed out that examining research, usage patterns and prototyping are key elements for user-centered design.  And similar to the role that technology has played in the modernization of healthcare service delivery, McDaniel suggests that user-centered design bears the potential to catalyze the healthcare innovation movement.

One company, breaking down barriers to patient engagement and collaboration, is currently employing user-centered design. Iora Health, an accountable care organization (ACO), maintains its own team of designers and developers that routinely visit member practices to work with clinicians and staff to rethink the relationships between people, processes, IT and health reform. As a result, physicians now project the EHR onto a screen for patients to view/query and provide access to OpenNotes, thereby allowing individuals to access and update their charts.  With the onset of meaningful use stage 2 and the voices of the impatient growing louder, will this impetus be enough?  While I suspect that they have merely scratched the surface, time will only tell how far these right brain thinkers push the needle for transformation.

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician 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

Engaging Specialty Practices in the Patient Centered Medical Neighborhood

Engaging Specialty Practices in the Patient Centered Medical Neighborhood

Building on last week’s post about embracing change for healthcare transofrmation, it was intriguing to learn about the NCQA’s new patient centered medical home program for specialty practices.  Kicking off  March 25, the Patient Centered Specialty Practice (PCSP) recognition highlights specialty practices committed to access, communication and care coordination as “neighbors” that surround and inform the medical home and colleagues in primary care, according to NCQA.  And I regret to say that I missed the informational webinar, including an NCQA advisor and guest speaker from one of the local healthcare systems.

Had I attended the webinar, I would have been better prepared to query the CEO of a hospital within the same healthcare system at a recent American College of Healthcare Executives (ACHE) function.  Interestingly, we had a lengthy conversation regarding the system’s desire to exchange data within the area; however, the CEO noted that current system architecture made it challenging enough to simply share information amongst health system participants.  With one of the key tenets for the PCSP recognition being timely exchange of data, this is a bit of a conundrum.  While the Direct project offers a simple solution, the ultimate goal will be to facilitate and encourage physicians to search for records in efforts to keep all parties abreast of the care plan.  And while this is a tremendous step, we also noted that retail & urgent care clinics, solo primary care practices and free-standing care centers need to get in on the game too.

I also see a need for ancillary providers to be included as well.  Not only would individuals benefit from the opportunity to view x-rays but, more to the point, visualizations, similar to the one here.  While Physical Therapists do an excellent job engaging patients in discussion, they would have far greater impact with the ability to illustrate their points on an interactive tablet app.  And thinking out loud, wouldn’t it be great for individuals to be able to reference the same app at home – to review the information and implement “their’ steps in the care plan?

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician 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

Dreaming of Healthcare Collaboration

Dreaming of Healthcare Collaboration

In preparation for the celebration of Martin Luther King Jr.’s birthday, we are once again reminded about the inequities lurking in healthcare service delivery.  Numerous studies from Health Affairs to Forbes cite the lack of parity between services rendered and outcomes for individuals of different racial, ethnic and socioeconomic status.  In other words, while so much has changed…so many things remain the same.

For the good news, we have the ability to change this phenomenon.  And, it’s in plain sight, at the tip of our fingertips.  Collaboration – amongst payers, providers, employers, third party vendors and most importantly, patients – is the key.

Engagements are under way to redesign personal and electronic health records for improved interoperability and increased utilization.  Major advances are being made with respect to the development of apps and gadgets for personal data capture, analysis and sharing.  And while these are positive steps in a long journey, what value does this information have in silo?  Definitely not as much, so it is encouraging to learn about the steps that Dr. Dirk Stanley has taken to do something about it.  Though his approach does not engage patients directly, he is employing low tech – a wiki – to share order sets with other providers – in order to deliver high quality, safe, affordable care.

And as individual provider collaboration continues to advance, so too does the flow of communication between providers and payers.  As noted by the announcement of 100+ new ACOs, these groups are finding new ways to manage cohorts of patients successfully.  While creativity and innovation have spurred change across provider, payer, vendor and government processes and technology, the commencement of a second inauguration will prove telling in the continuing healthcare evolution.

With growing success in management of chronic disease for the Medicare population, is it not time to stretch collaboration to our communities in order to address true population health management for the uninsured and Medicaid enrollees?  By enlarging the scope of determinants from a medical home to a medical neighborhood, two separate projects have recently been announced by the Department of Health & Human services.  While the American Academy of Family Physicians subsidiary, TransforMED, will work with VHA hospitals and affiliated primary care & specialty practice physician groups, Rutgers University will be working with low income individuals to help them navigate social assistance and identify a medical home.

As mentioned previously, keeping healthy is the most important job of one’s life.  And with access to a connected system of care, individuals can experience not only improved care, but better health – which is nothing less than a dream for all.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician 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

Driving Down the Real Cost of Healthcare: Pediatric and Teen Medical Homes

Driving Down the Real Cost of Health Care:  Pediatric and Teen Medical Homes

At last, the presidential race has concluded and, as a nation, we can prepare to move forward.  With President Obama’s election to a second term, implementation of the Accountable Care Act (ACA) moves full steam ahead.  In light of the fiscal cliff – perpetuated by the expiration of the Bush tax cuts, the 2009 Economic Stimulus provisions, the payroll tax holiday and 67 other tax provisions – the question still remains, how do we make a significant impact on cost reduction in healthcare?

While much has been written about the spiraling cost of chronic care, I found it surprising to learn that spending on healthcare for commercially insured children under age 18 grew faster than spending for adults from 2007 to 2010. After examining more than three billion insurance claims from three major carriers, the Healthcare Cost Institute reported that consumer spending on pediatric and teen healthcare increased 12% to nearly $88 billion dollars from 2007-2010, while spending on adults increased at a slower rate of 8%.  Even more intriguing, it seems that spending for children’s healthcare increased despite decreasing numbers of children covered and a utilization of expensive healthcare services, such as hospital stays and brand-name drugs.

If utilization is not driving this increase in healthcare cost, then what is?  According to the report, a number of activities are contributing to this trend, including increased use of consults, procedures and testing facilities. Digging deeper into the data, the study also revealed that two groups are incurring the highest cost:  infants, three years and younger and teenagers, aged 14-18.  While the increasing expense associated with pre/peri/post-natal births and associated outcomes is comprehensible for the infant cohort, what makes les sense is the skyrocketing expense for prescription drugs for central nervous disorders, such as anti-depressants, anti-anxiety disorders and drugs used to treat ADD or ADHD in the teenage population.

By and large, families were spending the greatest amount on primary care visits, immunizations, and preventive medicines (40.3%), followed in short order by outpatient procedures (24%), inpatient procedures (22%) and prescription drugs (14%).  Sufficed to say, this study did not include children participating in the Medicaid or CHIP programs, so it is difficult to discern if similar trends occurred in this population.  As the author points out, regardless of payer, children with exponential healthcare costs grow into adults with unsustainable expense.  Recognizing the benefit of medical homes for low risk pregnant women and children, it would be a fascinating case study to enroll willing participants currently attending a MindUp program that were committed to learning how to cook healthy food options using locally grown fruits and vegetables and engage in healthy exercise regimens.  Last but not least, reaching this critical and vulnerable population will be key.  Incorporating text messaging, voice, email, video and animation in efforts to successfully communicate important healthcare messages, similar to the program below, will ensure that mothers, infants and teens seek wellness and prevention, in efforts to reverse this frightening trend.

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 Medicaid with the Medical Home Model

Innovating Medicaid with the Medical Home Model

After reading Cheryl Clark’s interview with Dr. Bruce Siegel, President & CEO of the National Association of Public Hospitals and Health Systems, she points out that if the entities existing in one of the 30 states now threatening to refuse to expand their Medicaid eligibility rules to 138% of the federal poverty leveldon’t receive assistance, they’ll continue to provide uncompensated care for many of their sickest patients.  For organizations already stretching to deliver care to the most vulnerable populations, it was encouraging to learn that seven more states have joined the Medicaid ACO project, which targets low-income populations for care improvements and cost reduction via the medical home.

Will a move away from managed care to care coordination payments provide enough incentive for chronically ill Medicaid patients to obtain necessary primary care versus waiting for an urgent or emergent situation to send them to the emergency department?  Dr. Lisa Letourneau, executive director of Maine Quality Counts, a regional healthcare improvement collaborative and  physician champion for the Maine Patient-Centered Medical Home pilot, thinks so.  In order for the 108 practices that have applied for the Medicaid health home pilot, they must have NCQA medical home recognition or have applied for it, maintain an EHR and commit to 10 core expectations of medical home that go beyond National Committee for Quality Assurance (NCQA) conditions.

Although there are already more than 100 ACOs that serve Medicare populations, the Medicaid population is notably sicker, poorer and requires more resources – a complex and challenging equation to say the least.  In efforts to utilize the most efficient resources, advanced nurse led medical homes with patient engagement technology provide an alternative worth considering for those rural locations struggling to meet budgetary requirements. With the brightest minds recently convening at the World Congress 2nd Annual Leadership Summit on Medicaid, one can only hope that they were discussing medical homes similar to Piedmont Health, North Carolina’s first community health center focused on delivering comprehensive primary care services and health education to its members.

With millions of dollars at stake and community health on the line, innovating Medicaid with the medical home model should be a priority today, and not tomorrow.

Patient Protection and Affordable Care Act (PPACA) Impact on the Future Healthcare Workforce

Patient Protection and Affordable Care Act (PPACA) Impact on the Future Health Care Workforce

With the landmark ruling upholding the Patient Protection and Affordable Care Act, it is not surprising to see the wide variety of reaction.  As noted in this local piece, healthcare systems see it as a step in a direction that they were already taking and nurse leaders are happy with the ruling since it elevates the profile of RNs in the new models of care that are evolving.  The one comment that caught my eye was the physician who wonders how the influx of new patients will be incorporated into an already overburdened health system.

In response to the physician – who is likely already overwhelmed with meaningful use, ICD-10/11 requirements and general management of a small business – there are a number of provisions that impact primary care, being the first stop in the food chain.  Specifically, the provisions address:

  • Free preventative care
  • Funds to community health centers
  • Community care transitions programs
  • Value-based purchasing
  • New models of primary care delivery – ACO, PCMH

While it is important to note these initiatives, the better question is what type of workforce provisions exist to execute them in these five states that are projected to have the highest healthcare job growth rate?  Through several additional actions, the law recognizes the importance of primary care physicians, nurse practitioners, physician assistants and other healthcare personnel via the following:

  • Creation of new primary care residency slots
  • Expansion of the National Health Service Corp
  • Tax benefits for working in rural areas
  • PA training in primary care
  • NP training
  • Nurse Practitioner led clinics
  • Funding for healthcare IT and other health profession training

Having just enough time to provide a brief snapshot, it is well worth your time to listen to Joanne Spetz, labor economist and professor at the UCSF Center for the Health Professions, discuss the Patient Protection and Affordable Care Act (PPACA) impact on the future healthcare workforce in the video below.

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