• 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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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

HIMSS 2013: Mayhem or Magic?

HIMSS 2013:  Mayhem or Magic?

With the closing of the HIMSS13 annual conference, I am reminded of the question posed previously – can health ITs newest ideas reduce cost, improve quality and facilitate patient engagement?  In lieu of the recent sequestration events, continued emphasis on value-based purchasing and a still troubled economy, the battle will likely wage uphill.   On a positive note, providers continue to join the ranks of the digital world in terms of medical records and care coordination…but at an alarmingly slow pace.  And while patients are becoming more interested in accessing and sharing their healthcare data, numerous obstacles plague their efforts.

So, how do we find trifecta – where cost reduction, quality improvement and patient engagement peacefully co-exist?  After stumbling on a conversation with SETMA’s Larry Holly, I am reminded of a key overarching principle – perhaps the fulcrum – being the distinct need for both provider and patient behavior change.  As Dr. Holly shares, while healthcare data and technology have evolved at lightning speed, many of the processes associated with utilization have not.  In order to facilitate population management and patient engagement, systems must promote data exchange, add value to clinicians’ diagnostic/therapeutic processes and strengthen relationships with their patients.  Without these capabilities, even the highly customized EMR and mobile applications currently in existence will fail; instead igniting the angst and ire of their users.

Dr. Holly goes on to point out that organizations need to look internally to find the creativity and energy for change while continuing to leverage external experts in this field and others.  And according to Warner Thomas, Oschner Health System CEO, one such field to explore is the airline industry.  With costs spiraling out of control, the airline industry has been forced to automate and reengineer their processes in order to stay competitive – all in the midst of improving customer satisfaction.  A slippery slope, to say the least.  Healthcare, an inherently conservative and compassionate industry, has enabled  patients and providers seeking to maintain status quo.  And while there a select number of healthcare systems that have partnered with vendors to disrupt this mentality, it will be interesting to see how this theme carries over to the annual meeting of the American College of Healthcare Executives, premiering shortly at Chicago’s Palmer House Hilton.

Reading a quote by Arthur C. Clarke, “Technology, properly applied, is indistinguishable from magic.”, I am reminded that healthcare IT is one part art, one part science.  With the opportunity to realize Warner Thomas’ goals – better quality, lower cost and happier providers – the question is, do you believe in magic?

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

Transforming Medicaid via the Medical Home Model

Transforming Medicaid via the Medical Home Model

With the March 1st sequestration deadline looming, the budget battle continues. Facing potential cuts to public health and reduced federal relief, ignoring Medicaid expansion could be hazardous to a state’s health.  At least, some states have come to this conclusion.

Despite this, the state with the largest number of uninsured seeking medically necessary healthcare chooses to stand tall.  With emergency relief in mind, House Bill 10 was introduced in the Texas legislature this past week to address a shortfall in Medicaid and the Children’s Health Insurance Programs.

As one reporter for the Texas Tribune pointed out, “the federal government is offering to pay all of the costs of expanding the Medicaid program to some of the state’s uninsured population for three years, then to pay 90 percent of the costs for several years after that. Texas could, according to a report commissioned by Texas Impact, an interfaith public policy group, spend $15 billion over the next 10 years and pull down $100 billion in federal funds as a result. (So), here’s the business question: Why leave that kind of money on the table, especially if it’s going to be spent elsewhere if Texas opts out?”

While the article goes on to point out that federal monies would provide relief to local taxpayers currently subsidizing uncompensated care and potentially turbocharge the state’s medical economy, what I found most intriguing was the statement about running healthcare like a business.  Having just had a similar conversation with a colleague from the finance industry, I lamented that healthcare is a unique industry, dangerously siloed with imminent challenges to data access and ultimately, provider alignment – U.S. healthcare’s primary economic engine.

Now, some might argue that alignment becomes null and void in the absence of an adequate number of providers to address the incoming flux of under and uninsured persons.  Imagine instead, the opportunity to increase the number of providers by establishing advance practice nurse led clinics for participation in medical homes.  Equipped with patient registries, data analytics and health information exchange, physicians become liberated to focus on chronically ill patients and specialist provider coordination.  And perhaps the most galvanizing of all, instead of penalizing patients for visiting the emergency room, engage them in their care by developing a personal contract with specific achievable goals, provide a personal health record (PHR), mobile apps and texting to help monitor their health while keeping them incentivized via a loyalty program that offers redemption for health related items.

Not only is it the right thing to do, but by embracing this transformational change… perhaps savings similar to Chemung county’s Medicaid Medical Home could be achieved.

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

Innovating with Patient-Centered Medical Homes and Accountable Care Organizations to Improve Healthcare

Innovating with Patient-Centered Medical Homes and Accountable Care Organizations to Improve Health Care

With the close of the third National Accountable Care Organization (ACO) Summit in Washington, DC last week, it got me thinking about the Patient Centered Medical Home (PCMH) and ACO models.  Specifically, what are the differences and which is more appropriate for the future delivery of healthcare?

As defined by the four primary care societies (AAFP, AAP, ACP, AOA), the Patient-Centered Medical Home is as an approach to providing comprehensive primary care as a health setting that facilitates a continuous relationship between patients, the patient’s family when appropriate, and the patient’s personal primary care physician.  The joint principles supporting this model include:

  • Personal physician – serves as the primary contact and coordinator of care for a patient.
  • Physician directed medical practice – is led by the personal physician who directs the practice team to ensure continuous, comprehensive patient care.
  • Whole person orientation – in which the personal physician arranges and oversees care throughout patients’ various stages of life.
  • Care is coordinated and/or integrated – by the personal physician in connection with specialists and across settings facilitated by information technology and other appropriate tools.
  • Quality and safety – serve as primary guideposts for all aspects of a patient’s medical care.
  • Enhanced access – using tools such as open scheduling, extended hours, and various modes of communication between patients and providers.
  • Payment – is value driven and reflective of case mix, enhanced technologies, quality improvements, and shared savings achieved by successful patient management.

In keeping with these principles, the medical home goal is to deliver coordinated care in a seamless and efficient manner, thereby improving quality and reducing cost.

MedPAC has defined accountable care organizations (ACOs) as a set of providers associated with a defined population of patients, accountable for the quality and cost of care delivered to that population.  While the population is larger and generally involves multiple practices, similar intent remains for the ACO to reduce cost through enhanced preventative care, disease management and improved quality through coordination of care.  In order to manage a population effectively, ACO governance models often include not only physician members, but also, hospital or physician hospital organization (PHO) and/or payer representatives.  Structured purposefully in opposition to fee-for -service (FFS), ACO members are rewarded for efficiency in the form of a shared bonus.  If, on the other hand, an ACO underestimates the cost of operation, the providers will earn less, thereby becoming ‘accountable’.

Healthcare is, and likely will continue to be, a local service.  Determining whether a PCMH or ACO is more appropriate will be fueled by the local physician community’s appetite for and ability to change. Establishing clear goals with corresponding metrics, creating a path for process improvement and developing appropriate financial incentives will be integral  to driving this process forward.  In the absence of interoperable data, both organizational models must also find creative solutions for their health technology constraints.

As we prepare to learn the fate of the Patient Protection and Affordable Care Act, we find ourselves with the potential to transform care delivery through healthcare information technology, innovative team approaches and other new models of care.  With more than 500 physician practices in the United States, the metamorphosis to medical homes or ACOs will be a monumental undertaking.  Will it fundamentally improve care?  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

Imagine a World Where mHealth, Telemedicine and EMRs Integrated Seamlessly

Imagine a World Where mHealth, Telemedicine and EMRs Integrated Seamlessly

With the close of the American Telemedicine Association’s 2012 Conference and Exposition this week, I have seen a number of articles regarding the confluence of tele and mobile health in care delivery innovation.  In HIMSS editor Erick Wickland’s article, ATA Panel:  mHealth could make the smartphone a valuable piece of real estate, he reiterates Qualcomm Life vice president Don Jones’ comments, “Not all mobile health is wireless and not all wireless health is mobile. Maybe the user is mobile. The key may lie in connectivity – connecting physicians and patients to each other and to important data no matter where any of the three are located and by any number of secure means of communication.”

While there were many exciting announcements regarding mobile apps for remote monitoring services, medication adherence tracking, specialist consultations and real-time video visits between physicians and patients, the question still remains….can this important information be seamlessly integrated with EMR data for a comprehensive picture of the person being treated?

Scott Feinberg, Director of Telehealth at UnitedHealth Group, tackled this question at the ATA Fall 2011 Forum, so listen in to hear his thoughts.  And then imagine a world where….

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