• 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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Embracing Change for Healthcare Transformation

Embracing Change for Health Care Transformation

With thousands flocking to Chicago for the annual ACHE Congress on Healthcare Leadership, many were interested in learning more about the strategic initiatives, aimed at delivering ‘high value’ healthcare, manifesting here, there…suddenly everywhere.  Speaking to the increased recognition and velocity for change, Sabrina Rodak highlights six key themes that were no doubt ubiquitous at this moment of metamorphosis for healthcare, and more to the point, the hospital industry.

Building on a recent article in Health Affairs, “Decline In Utilization Rates Signals A Change In The Inpatient Business Model”, Rodak notes that keeping patients healthy through preventive and primary care services, and out of acute care facilities whenever possible via population health management is the new mandate. By focusing on care delivery in the right place at the right time with the right quality, cost, and access, leaders in this new era will transform the health of the system, as well as the nation.

In order to succeed, six fundamental requirements have been defined:

1. Culture. Hospital leaders need to focus on delivering value rather than only acute-care services.  Proponents believe that happy, engaged providers and employees have a more positive impact on patient experience, versus those that do not.

2. Physicians and care delivery. Hospitals will need a strong physician platform to reduce utilization and cost and improve value. In concert with local, affiliated physicians and allied health providers, hospitals and health systems are moving closer to this goal through a variety of care coordination innovations.

3. Communication and HIT. Hospitals need to develop health IT systems to communicate with providers across the care continuum and analyze data to increase value. And with the onset of stage 2 meaningful use, having the tools to define and eradicate potential conflict between patient expectations and evidence-based medicine becomes tantamount.

4. Facilities. Hospital leaders should consider investing in outpatient settings instead of building costly hospital facilities.

5. Contracts. Hospital leaders need to encourage payors to participate in value-based initiatives to support providers who are delivering value. Nimble, forward thinking organizations are exploring a variety of collaborative measures in order to jointly address care delivery innovation.

6. Transformation. Hospitals need to start preparing for a value-based care model now by eliminating clinical variation, reorganizing services and reducing costs.  Checking out the ACHE Congress Management Innovations and Circle of Life winners gives you a small sample of the transformations en route and poised to come.

While measured steps are being taken for positive outcomes, critics of the Health Affairs article argue that this is meaningless activity for those lacking health insurance, mired in sub-optimal social health circumstances and facing a dangerous precipice with potential changes in Medicaid funding. Right, wrong or indifferent, there is one consistent theme – the time is ripe for change.  And as the outgoing ACHE Chairman, Gayle Capozzalo, points out – we, as healthcare leaders, are no strangers to change.

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

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Collaborating for Care Management Innovation

Collaborating for Care Management Innovation

With the onset of sequestration, Texas stands to lose funding for Head Start services, children’s vaccines and meals for seniors.  Add to this potential losses in law enforcement and education funding, one can see that programs, once aiding children, seniors and the homeless by keeping them out of the emergency room, might cease to address this critical need.  Compound these losses with the pressure being exerted by value based purchasing, and the dilemma becomes magnified tenfold.  As if accountable care organizations, medical homes, hospitals and healthcare systems did not have enough on their plate, one wonders where they will find the resources to supplement these activities?

One enterprising non-profit has tackled this challenge head-on.   Billed as a nine-year old strategic initiative with a mission to improve the quality, capacity, and accessibility of the healthcare system for vulnerable populations in the City of Camden, the Camden Coalition has analyzed local healthcare system claims data for the purpose of building a repository and sharing data with regards to this typically transient population.  In addition, they operate several health project initiatives that demonstrate a collaborative approach to improving care delivery and patient outcomes in their area.  And by building relationships with executive leadership of the hospitals, social service/public health agencies, state government agencies, leaders at the statewide Medicaid health plans, and policymakers, they have taken a discretely modern approach to healthcare delivery.

Current innovative initiatives garnering attention include the Coalition’s Care Management and Care Transitions programs, aimed at reducing hospital utilization by directing outreach to the ‘high flier’ population whom frequently lack appropriate access to primary and mental health care.  Designed to target high cost, complex patients for improved care transitions and care coordination, the Coalition is steadfastly working to move these patients into a medical home model.  Upon presenting at the emergency room, patients are divided into one of two groups:  a) those with no primary care access and significant mental/social issues and b) patients with more stable primary care and mental health status.

In the Care Management program, patients meeting specific criteria receive assistance from a social worker, a health outreach worker/medical assistant and a nurse practitioner with primary/specialty care coordination, applying for government assistance, finding temporary shelter and enrolling in medical day programs.  Through stabilization of their social environment and health conditions, the team’s ultimate goal of finding a primary care medical home for the patient can begin.

Patients participating in the Care Transitions program are enrolled in and receive assistance from embedded care management nurses and health coaches from one of two Camden Federally Qualified Health Centers (FQHC) – CAMcare and Project HOPE.  On the path to becoming patient-centered medical homes, these FQHCs are fostering better care transitions and coordination with their hospital and health system partners.

These bold programs have been facilitated by city-wide use of health information exchange and electronic health record use for this targeted population, thereby allowing providers to share information and analyze data for additional care coordination.  Data analysis also remains integral for the monthly Care Management Committee meeting, held at rotating hospitals, in order to review and refine current processes for these programs. And by bringing together emergency room physicians, hospitalists, specialists, social workers, and nurse discharge planners across the city, more efficient and effective discharge planning and care coordination can help decrease utilization and improve safety, experience and ultimately, quality of care.

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

Cliff Diving for Healthcare Innovation

Cliff Diving for Health Care Innovation

Ringing in the new year brings a time for reflection on the past and preparation for the future.   After looking at the first Recruiting for Healthcare Jobs blog post in 2012, I am reminded that significant strides in healthcare innovation remain.  While the previous year culminated in progress, metrics and transparency for value-based purchasing and consumer sentiment are poised to have a more profound impact on health system operations going forward.  In order to rise to the challenge, hospitals and healthcare systems should embrace healthcare innovation.

While innovation is typically discussed in reference to process or technology development, a more strategic view might encompass the following continuum:

Innovation in Healthcare Collaboration

  1. Develop partnerships with key constituents in the community to help manage high risk patients
  2. Find new ways to collectively address social determinants that negatively impact community health
  3. At the most fundamental level, solicit new avenues for engaging patients in their health care 

Innovation in Health Delivery Process

  1. Focus on eliminating variation, improving safety and quality, while also enhancing the patient experience in the inpatient admission, discharge, transition and outpatient visit processes
  2. Develop new services and care delivery mechanisms to keep patients healthy

Innovation in Technology

  1. Implement technology that supports your collaboration, process improvement and patient engagement efforts while continuing to protect and enhance the quality of the patient experience

Innovation in Environment

  1. Create a modern therapeutic environment with a corporate culture focused on compassion and quality customer service

And, as the President of the Federation of Hospitals aptly put it, since “lawmakers chose to rob hospital Peter to pay for fiscal cliff Paul”…wouldn’t it be better to dive into innovation rather than be pushed?

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

Healthcare Innovation: Moving from Stewardship to Leadership

Healthcare Innovation:  Moving from Stewardship to Leadership

With the close of the subdued Democratic National Convention this week, there was noticeably scant mention of healthcare reform.  In light of the Supreme Court’s landmark ruling in favor of the Patient Protection and Affordable Care Act (PPACA), perhaps President Obama has checked this off his list.  Given the compelling need to drive cost out of the current bloated system, one might argue, however, that now – more than ever – healthcare reform should be a topic for discussion.  And as Alan Zuckerman, President of Health Strategies and Solutions, states, “(in this new era with new imperatives).. like many other industries, the call to action is how do we do more, or even the same, with less? And with the artificial prop of 5 to 10 percent increases in rates and spending no longer guaranteed, how do we maintain the vitality of our organizations?”

Living in a prosperous economy with profitable reimbursement rates, Zuckerman argues, shields healthcare companies, in particular, non-profit entities, from innovation.   In addition, he points out that the traditional terminology reserved for healthcare leadership – administrator – connotates stewardship versus active management.  In order to tackle this challenge head on, Zuckerman suggests, “busting the status quo, challenging long-held assumptions, envisioning the possibilities when uncertainty is converted to action and forging a new path – that’s what true innovation in healthcare could look like.”  While this can be a daunting charge, “healthcare executives must recognize that their organizations’ cultures are at odds with this new posture and work to reshape the cultures to make them more adaptable, flexible, risk-bearing and (centrally focused on innovation).”  Check out this previous post for more examples.

For organizations having ‘played between the lines’ in the past, how do they adopt this new mindset?  According to Zuckerman, “Peter Drucker’s Harvard Business Review article, “The Discipline of Innovation,” identifies seven sources of innovation, four that are internal — unexpected occurrences, incongruities, process needs, and industry and market changes — and three sources that are external — demographic changes, changes in perception and new knowledge. He suggests that “an innovation has to be simple, and it has to be focused. It should only do one thing…Above all, innovation is work rather than genius.”

Furthermore, he lays out the following five actions to launch the innovation journey:

  • Rally senior leaders
  • Reexamine and begin to modify your organization’s culture to be more risk-bearing by encouraging experiments and pilots and create a non-punitive environment
  • Make innovation a theme of day-to-day operations
  • Consider structural changes in the form of a Chief Innovation Officer or committee to support innovation
  • Last but not least and my favorite – JUST DO IT!

A leader in the innovation movement, Kaiser Permanente has created a formal consultancy aimed at deploying design thinking to improve the care experience for both the patient and healthcare provider.  Listen in to find out more…

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

Moving mHealth to the Next Frontier: Aligning Patients, Physicians, Healthcare Providers & Payers

Moving mHealth to the Next Frontier:  Aligning Patients, Physicians, Healthcare Providers & Payers

“Health data is no longer a government initiative. It is an American initiative.”  Such were the words spoken by U.S. Chief Technology Officer, Todd Park, at this week’s Health Datapalooza.  Organized by the Robert Wood Johnson Foundation, the California Healthcare Foundation and HHS, more than one hundred applications and websites, all powered by open data, took center stage at the exposition.

As Derek Newell,  CEO of Jiff,  illustrated in a recent Forbes article, mHealth has the ability to revolutionize healthcare delivery by providing the following:

  • Improved access to care
  • Improved patient engagement
  • New provider of business models
  • Reduced medicare fraud
  • Improved patient safety

Absent Medicare fraud, I daresay that without patient engagement…the other four will likely fail in this business model. And while I applaud the pioneering  efforts of this growing movement, I also wonder what will it take for patients to truly embrace these applications?

One innovative solution, mRx, has been developed by Happtique, the first mobile health store for healthcare professionals by healthcare professionals.  Utilizing the mRx technology, physicians can ‘prescribe’ apps and send them directly to the patients’ mobile devices, thereby increasing the likelihood of download and implementation.

While drawing a causal relationship between patient and provider is critical, is it not equally important for the patient to be incentivized to adhere to the ‘prescribed therapy’?  According to Joanne Wu, MD, MPH, the answer is a resounding yes.  In her article, Rewarding Healthy Behaviors—Pay Patients for Performance, Dr. Wu asserts that rewarding clinicians in the form of pay-for-performance (P4P) has produced lackluster results due to the challenge of patient behavior modification.  Instead, she proposes that patients be rewarded for achieving evidence-based health goals.  Rewards would be issued in the form of discounts towards co-payments for doctor’s visits, procedures, and medications, thereby potentially reducing cost and compliance issues.

There is no denying that the efforts of the Healthcare Data Initiative Forum III, aka Healthcare Datapalooza, are  truly innovative.  And now that the data has been liberated, shouldn’t we be turning our attention to how it is being utilized?  While the definition of the provider role is changing, it remains the fulcrum for healthcare service delivery.  With  the development of certification and standardized processes, these tools could one day be required CME training for physicians, allied health and nursing personnel.  And only when the federal government and payers take an active role in the design of a payment system bearing incentives will we move mobile health to the next frontier by aligning patients, physicians, healthcare providers and payers.

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

Implementing Kaizen for a Lean Health Care Transformation

Implementing Kaizen for a Lean Healthcare Transformation

Having recently attended a meeting for the American College of Healthcare Executives, I had the chance to query a hospital CEO, who coincidentally happened to be a Toyota engineer in a former life, about healthcare Kaizen.  After mentioning that his team was currently engaged in a lean project, he, much to my surprise, confessed that he was not very familiar with the concept either.  Given my interest in continuous quality improvement, I decided to investigate further.

Kaizen is an ancient Japanese philosophy that strives to continually improve all aspects of a person’s life.  Recognizing the need for significant change in the late eighties, Dr. Don Berwick, former Administrator for CMS (Centers for Medicare & Medicaid Services) and Harvard Community Health Plan physician, illuminated the concept of Kaizen in an article in the New England Journal of Medicine.  As a potentially crucial concept for improving health care in the United States, Dr. Berwick writes that, “..in the discovery of imperfection lies the chance for processes to improve”.

With a variety of approaches available for organizational improvement, one may wonder, why choose Kaisen?  While Six Sigma is a mathematical process focused on eliminating statistically relevant defects, Kaizen seeks to improve all aspects of a business through process standardization, increased efficiency and waste elimination by focusing on seven core areas – overproduction, defects, unnecessary motion, inventory, space, transportation and waiting time.   Incremental and frequent improvements emanate from ‘Kaizen events’, which involve members from multiple functions and levels in the organization working together to address a problem or improve a particular process in a short time-frame.  By tackling process redesign, positive and immediate impacts can be found in the quality, cost and speed of service with corresponding results in improved customer satisfaction and patient experience.  And if you are still on the fence about the merits for your organization – be it inpatient or outpatient – you must see how the leaders at Salem Health felt about their journey to Japan to witness the Kaizen process first-hand.

Suspended in free fall – with another dismal jobs report sending the Dow careening, healthcare spending slowing, more Americans grappling with healthcare coverage/choices and the onset of value-based purchasing, the time seems ripe for the healthcare industry to usher Kaizen into their organizations.  With experts predicting that 10% of the workforce should be solely focused on working ON the business rather than IN the business, identifying the typical 30-60% of organizational effort that is waste, how will your organization bring this concept to reality for your own healthcare transformation?

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

Innovation: Aligning Physicians and Hospitals to Create Sustainable Health Care Delivery

Innovation:  Aligning Physicians and Hospitals to Create Sustainable Healthcare Delivery

According to a recent HealthLeaders Media Industry CEO report, the biggest strategic challenge facing hospital, health system, and physician group practice chief executives is care coordination and the continuum of care.  While 30% of respondents selected this answer, 17% of CEO’s felt that improving patient flow and patient experience were equally important.   I, dare say, the two go hand in hand.

The Mayo Clinic, a distinguished leader in health service delivery, recognized the need for patient experience transformation and forged ahead with the development of the Center for Innovation (CFI).  With goals of understanding human needs, innovating care delivery, fostering open collaboration and generating economic value, the CFI’s approach is to work with a ‘think big, start small and move fast’ philosophy focused on connection, design and enablement.

During their tenure as Chair and Associate Chair of the Medicine Department in the early 2000’s, Drs. Nicholas LaRusso and Michael Brennan founded a small laboratory, SPARC, standing for See, Plan, Act, Refine, Communicate, with the goal of delivering more efficient care for improved patient experience.  Within six years, their experiment in medical practice innovation blossomed into a full-fledged enterprise- wide strategy, culminating in the creation of the CFI.  Recognizing the benefit of outside counsel, Dr. Larusso tapped designers from across the country to come to the campus to describe the discipline of innovation in service provision. In 2007, these educational efforts were featured in a conference sponsored by the Department of Medicine called the “Transform Symposium”, which continues on an annual basis today.

Strategically focused on five platforms consisting of a) the Mayo Clinic Connection, b) Prediction & Prevention, c) Wellness, d) Destination Mayo (outpatient experience) and d) Innovation Culture & Competency, it is intriguing to note the focus on factors beyond the traditional clinic walls.  Utilizing the experience of physicians, scientists, nurses, administrators, designers, analysts, software programmers, engineers, legal and HR liaisons, the CFI provides a platform to advance strategic efficiency and patient experience initiatives, further the Mayo brand and test drive captivating technology.

And, not only is this forward thinking institution demonstrating an effective recruitment strategy for drawing providers and clinicians to a pioneer in the use of architecture and design for promotion of healing the whole person, it is also successfully engaging staff creativity and enhancing employee loyalty & productivity.  While no denying the results, the CFI creates a compelling business case for using innovation to align physicians, scientists, nurses, allied professionals, administrators and associated healthcare staff to create sustainable health care delivery.

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