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4 Strong Pillars for Healthcare

In Health, Healthcare, Medicine on June 8, 2012 at 8:00 am

According to a recent publication from the Institute of Medicine(IOM), Health care in the United States is at a critical point. Excessive costs are no longer tenable and mediocre outcomes are no longer tolerable. For 32 of the past 40 years, health care costs have grown faster than the rest of the U.S. economy. Federal health care costs—expected to reach $950 billion in 2012—will become the largest contributor to the national debt.

Change is highly needed. Policies and procedures needs another look. Strategies and management from the Healthcare leaders need to be well defined. We need strong pillars to sustain current healthcare and to build the future ones.

The 4 pillars of  a strong and long-term viable organizations are as under.

Foundational elements
• Governance priority—visible and determined leadership by CEO and Board
• Culture of continuous improvement—commitment to ongoing,
real-time learning
Infrastructure fundamentals
• IT best practices—automated, reliable information to and from the point of
care
• Evidence protocols—effective, efficient, and consistent care
• Resource utilization—optimized use of personnel, physical space, and
other resources
Care delivery priorities
• Integrated care—right care, right setting, right providers, right teamwork
• Shared decision making—patient–clinician collaboration on care plans
• Targeted services—tailored community and clinic interventions for resource-intensive patients
Reliability and feedback
• Embedded safeguards—supports and prompts to reduce injury and infection
• Internal transparency—visible progress in performance, outcomes, and costs

‘Doctors do not Sign Up for Sainthood’

In Health, Healthcare, Medicine on June 7, 2012 at 8:00 am

Each society in this world has many ‘Bad Fish’ which make it all dirty looking. We just blame the whole water to be dirty instead of getting rid of the bad fish. ‘Doctors don’t sign up for sainthood.’ But the general public seems to knows better about doctors. When people make derogatory comments on the medical profession and healthcare, they only highlight the presence of unacceptably high numbers among them some who deserve such criticism.

To err is human and problems exists in all professions. But since medicine concerns a person’s health, drawbacks and failures of doctors are over-projected. Doctors may be hindered by: hospital owners who make heavy investments and encourage them to ensure maximum revenue; inefficient staff in laboratories and radiological centers; pharmacies which dispense incorrect, spurious or stale medicines; pathological and radiological centers which corrupt them with lures of incentives for referring patients to them; and the failure of patients or their attendants to follow their advice.

While we should take note of all these points before passing a judgment on doctors, we have a right to expect them to abide by the solemn oath they take before they enter the medical profession.

Corruption and malpractice are common in all professions. I don’t understand why a particular profession should come under the scanner. I agree though that present-day doctors do not have the same degree of dedication as old-timers. When education becomes a business to make money, we cannot expect to have true saints.

When doctors get attached to money, the noble quality of their work suffers. So does the effect of their medicine and treatment. History has seen a number of doctors who worked purely to alleviate the sufferings of the sick, not to accumulate wealth. They were concerned about our health rather than their wealth.

We should have a social responsibility to get together to fight the wrong-doings wherever it may be. Sometimes you have to play part of a doctor to cure these social diseases. But do not blame all doctors to be making money by corrupting the system. Most of them just want to help you and make a living as everybody else.

25 Ways to Sky-Rocket Patient Experience in any Medical Practice

In Health, Healthcare, Medicine on June 6, 2012 at 8:00 am

Most healthcare practices struggle on getting their bottom line met in current economic times with everyday changing healthcare trends. Very few of them are using some basic techniques to improve patient satisfaction and outcomes.  I have complied a list of 25 golden principles that a medical practice can adopt to improve their overall turnover and patient experience.

1. Remind patients of their upcoming appointment at least 24-48 hours prior.

2. Patients should be reminded of any paperwork to bring at the time of appointment.

3. Check-in process should be easy and quick.

4. Manage the schedule in a way that patients do not have to wait longer than 10-15 minutes.

5. Rooms should be well lighted.

6. Patients should be told about their vital signs in comparison to the old ones by the Medical Assistant when putting information in.

7. Staff should greet them with a smile.

8. Be a good listener.Let them finish their talking before you start talking.

9. Address the key issues and give specific written recommendations. Provide patient handouts when necessary.

10. It is good to address one more issue as a bonus. Patients feel good about it.

11. Follow up recommendations should be clear and concise.

12. Easy Checkout is must. If it is going to take some time, have patients sit in waiting area and address their needs as soon as possible.

13. Inform the patients of any abnormal labs and actions to be taken as soon as results are obtained.

14. Engage family members in case is Older patients and patients with special needs.

15. Try to know their social engagements. This makes them friendly.

16. Reassure, Manage and Recommend sensitively.

17. Review charts before patients visit so that you may mention what you talked about last time.

18. Offer Same day appointments.

19. Offer access to their own records including lab work and radiology reports.

20. Send them a Satisfaction survey to see what their experiences are and how you can improve.

21. Make them part of the decision-making. Always give them options when possible and guide them to choose one for themselves.

22. Send Periodic Health maintenance reminders. This include follow-up screening tests.

23. Provide Online resources and references to patients to get educated about their health conditions.

24. Have a well-designed and well informative website for the practice.

25. Most Importantly, be clear about your policies and procedures, what services you offer and what you don’t,  before even patient shows up, to avoid any surprises on patient’s end. Patients have  unreasonable expectations sometimes, which can be avoided by giving them clear understanding of what you can provide and what you cannot.

All the above mentioned tips are very easy to follow and the results are amazingly good. See your practice Sky-rocket in few weeks after applying these principles.

Treat Patients the way you would like to get treated

In Health, Healthcare, Medicine on June 2, 2012 at 8:00 am

I  was a happy man when I passed my USMLE Step 3 exam. All doctors in US have to pass the USMLE Step 3 exam which deals with how you ‘Treat’ the patient. It is not just the medical diagnosis and treatment, it is the whole process of management that starts as soon as you enter the room. Doctors get graded heavily on their behavior towards the patient.

With changing healthcare and pressure of documenting everything, doctors are finding it really hard to keep that connection going. 15 minutes for a patient’s visit is not enough most of the times. If you increase the times, the ‘bottom-line revenue gets hurt. It has come to the point where doctors are taking their work home,making it hard for them to enjoy family time. That is why, medicine is no more one of the top demanded profession.

Despite all the hassles and pains, doctors in US continue to treat their patients in the best way they can. What is patient’s need? That somebody listens to them and help them. When listening, analyzing and actions become time-bound, the connection gets lost somewhere leaving both the parties unsatisfied most of the times. We are not paying much ‘Attention’. The doctor-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics. There are very few physician practices who are actively involved in patient satisfaction surveys to know exactly where they are in terms of their services.

This loss of connection is nobody’s fault. It is the fault of the system that we as a society have designed. Health is no more a personal issue. It has become ‘E-Health’ (electronic health). Now you go for a doctor’s visit, what you hear is clicking(mouse and keyboard). We have lost the personal touch.

Is there a way to revive back the relationship and improve quality on top? Yes. The emerging concept of Patient Centered Medical Home(PCMH) takes away that burden off from the physicians and satisfies the patients. It is a multi-disciplinary integrative  approach towards patient. It does not just deals with the current problems, but helps manage overall wellness. It ensures that patients get the attention required to manage their issues.

PCMH aims to collaborate the various divisions of healthcare on a single platform to give a ‘One Stop Shop’ for health and wellness. AHA, HITECH,ACO and all other reforms added recently, have led Healthcare institutions to come up with processes to reduce waste, improve quality and deliver best possible care. The Healthcare IT industry is the busiest industry in current times. New softwares and techniques are being launched on a daily basis to make the current systems efficient.

But, whatever the case may be, Medicine is about ‘Connecting with the Patient’. We need to focus on E-Health, but not at the stake of Physician-Patient relationship. Whenever I feel myself swaying away by the winds of technological pressures, I stop and think to myself, “Is this the way I would like to be treated if I am a patient?”

From a doctor’s perspective, I would appeal to all the patients that the behavior of  doctors towards health is not by personal choice. The changes in Healthcare are coming too fast and sometimes it is hard to keep holding the ground for the healthcare providers. I am not sure how long this may take. But one thing is for sure, E-health can never overpower the strength of ‘Physician-Patient Relationship’.

‘Brand’ name: Must for Physicians in Current Times

In Health, Healthcare, Medicine on May 25, 2012 at 1:28 pm

Do you stand out in competition with other healthcare providers? We all know what a ‘BRAND‘ means. It means ‘Value’. How much are you willing to pay for a certain name item depends upon what value you give it. Whether it be shoes, clothes, electronics, cars or whatever, we all have our brands that we prefer. The contents in this post are true for any business.

Giving a ‘brand’ name to a physician is something that was never thought or heard of. It sounds like business. But wake up my friend. Like it or not,” Medicine is Business“. It is a service oriented business where patients are the customers. As a customer, I need to make sure I get the right Brand that meets my needs and gives me peace of mind.

Healthcare has been very ‘Fragmented’. People boast of differentiated markets in healthcare, but that is not true. Almost all have the same services that they provide to the patients. Most of the practices have inbuilt labs and other diagnostics to attract patients.The value of services that you receive is called Branding. We all want the better brands at affordable price. Some segments in society do not even mind paying higher as long as they get what they want.

A lot of healthcare businesses want to grow their market share. But in service sector, as opposed to products, the improvement in ‘Bottom Line’ is more important. Generating revenue is the key. They need not worry about the market share. How many people shop at Jos A Bank stores. Not too many. Does the company want to get most market share. They don’t because they can’t. They focus on the bottom line and generating revenues. Healthcare is specialized service that should not be compromised on. People should know what they can get from you as a provider that they will not get anywhere else.

So how should doctors position their ‘ Brands’?

Many ways:

1. Focus on Service consistency: Make sure all the patients are getting the similar services without any variations. Any significant variations break the Branding structure very fast. For example, make sure all patients are seen within a certain time frame so that they do not have to wait. If waiting times variate, your brand equity goes down. So, focus on Consistency.

2. Connect to the needs of the patients:All customers have a different mindset. they all expect something different. Make sure their needs are assessed and addressed appropriately. It could be overwhelming sometimes to make everyone happy, but try your best.

3. Tap the patients’ emotions: Connecting emotionally is must. It has been a saying that ” Patient gets half better already by talking to a doctor”. I feel it is a true statement. Reassurance and good explanation of the disease process helps patients get a clear idea of their outcomes.

4. relevance to the needs and desires of the patients is must: Stick to the relevance of the issues patients are coming in for.

5. A smile goes a long way: Smiling is addictive. It is hard to see people not smiling back to you if you greet them with a smile. Smile creates positive emotions. It helps the connection emotionally.

6. Social Media: It is a must for Physicians to utilize the wonders of Social media. There are so many social networking sites to help you share the thoughts and ideas you may have with the world out there. An attractive, well informative website always helps. Pictures of the facility and the staff  is a must. New Patients can easily connect with you if they see your picture before. A short video would work as icing on the cake. Tell them what you can offer and your mission. Believe me, it will sky-rocket the practice.

7. Get a logo and Tag Line: It is also a crucial step in getting branded. The Logo and tagline should convey what you can offer.

It is not an easy journey for a lot of physicians to be Brand Oriented, but that is the need of the day. Those who will do it will be successful.

From a patient’s perspective, it is a wise thing to know the provider you will be seeing before hand.See who offers what in the market. Health should not be compromised. The media presence and knowledge of a physician is a very strong factor that you should look for to get the best care. Do your research and make the best decision for yourself. Talk to your friends and family to get some insight about their providers and ‘Get the Best Brand’ for yourself.

Healthcare in US: When is it going to be Cost Effective?

In Health, Healthcare, Medicine on May 20, 2012 at 11:04 pm

It is important as a healthcare consumer to understand the history of the healthcare delivery system, how it operates today, who participates in the system, what legal and ethical issues arise as a result of the system, and what problems continue to plague the healthcare system.  We are all consumers of healthcare.  Yet, in many instances, we are ignorant of what we are actually purchasing.  If we were going to spend $1000 on an appliance or flat screen television, many of us would research the product to determine if what we are purchasing is the best product for us.  The same state should be applied to purchasing healthcare services.

As the United States resumes debate over options for achieving universal health coverage, policymakers are once again examining insurance systems in other industrialized countries. More recent attention has focused on countries that combine universal coverage with private insurance and regulated market competition.

A Basic Screenshot of what US healthcare is Comprised of

Medicare: Medicare is a social insurance program for the elderly, some of the disabled under age 65, and those with end-stage renal disease. Administered by the federal government, the program is financed through a combination of payroll taxes, premiums, and federal general revenues.

Medicaid: Medicaid is a joint federal-state health insurance program covering certain groups of the poor. Medicaid is administered by the states, which operate within broad federal guidelines. States receive matching funds from the federal government, varying among states from 50 percent to 76 percent of their Medicaid expenditures.

Private insurance: More than 1,200 not-for-profit and for-profit health insurance companies provide private insurance. They are regulated by state insurance commissioners. Private health insurance can be purchased by individuals, or it can be funded by voluntary premium contributions shared by employers and employees on an employer-specific basis, sometimes varying by type of employee. Employer coverage is the predominant form of health insurance coverage. Some individuals are covered by both public and private insurance.

Out-of-pocket spending: Out-of-pocket payments, including both cost-sharing insurance arrangements and expenditure paid directly by private households, accounted for 12 percent of total national health expenditures in 2007, which amounted to US$890 per capita.

Based on the fragmented development of US health care, the system is based on individualism and self-determination and focusing on the individual rather than collectivistic needs of the population. For example, there are over 20 million citizens who have type 2 diabetes, a chronic and serious disease that impacts how your body breaks down food to obtain energy. This chronic disease has severe complications if not treated appropriately. Unless something is done to prevent this insidious disease, there will be 35 million heart attacks, 13 million strokes, 8 million instances of blindness, 2 million amputations, and 62 million deaths over the next 30 years.

Both private and public participants in the US health delivery system need to increase their collaboration to reduce these disease rates. Leaders need to continue to assess our healthcare system using the Iron Triangle to ensure there is a balance between access, cost, and quality.

Although the Health Care Reform intends to take away the flaws the current system is infested with, the journey is going to be long and tough. But it will  definitely lead to a better outcome as compared to current situation.

Patient Centered Medical Home: Patients equally responsible as Providers

In Health, Healthcare, Medicine on May 19, 2012 at 8:15 pm

 WHAT EXACTLY IS A PATIENT CENTERED MEDICAL HOME?

The patient‐centered medical home is a model for care provided by physician practices that seeks to strengthen the physician‐patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long‐term healing relationship. Each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care. The physician‐led care team is responsible for providing all the patient’s health care needs and, when needed, arranges for appropriate care with other qualified physicians. A medical home also emphasizes enhanced care through open scheduling, expanded hours and communication between patients, physicians and staff.

Based on emerging research, the medical home model has the potential to improve health outcomes and reduce overall costs. One way to fix the problem of spiraling health care costs is to try to change the health care system. It isn’t easy. It means completely changing the way everyone does business. But we can’t keep doing what we’re doing because things will just keep getting worse.

The problem is the way the health care system pays for care. It’s called a fee-for-service business model, and it hasn’t changed much since the start of modern health care. Under this model, doctors, hospitals, and other providers are paid for every service they provide – every visit, every test, and procedure they do – whether or not these things improve our health. It’s based on quantity instead of quality.

It can lead to unneeded tests, screenings, and other expensive care that adds to health care costs each year, without making people healthier and, in some cases, making them even less healthy. And it often results in doctors not having enough time to give the care they want to give. According to a recent study, a primary care provider (PCP) would need more than 22 hours a day to finish all of the work expected of them, whether giving care or doing paperwork.

To try to fix this system, insurers, hospitals, doctors, the government, and professional and trade groups are working together to change the way health care works. The major part of that effort is moving from the fee-for-service model to a new patient-centered medical home model. It’s kind of a weird name, but if you think about what it’s trying to do, it makes sense.

A patient-centered medical home, or PCMH, is not a physical building. It’s a way to care for patients so that you feel “at home” with your care. PCMH changes the emphasis from quantity to quality, helping everyone be healthier and reduce the need for costly care.

It’s been proven that when people have a long history with their PCP, they are healthier and have lower health care costs. Kind of makes sense, right? The better your doctor knows you and is aware of factors that might affect your health, such as stress, the more likely it is that diseases can be prevented or caught early, when treating them costs less and before they cause big problems. And as a bonus, when you have a good relationship with your doctor, you’re usually better informed about your health and lead a healthier lifestyle. It’s easier for a doctor who knows you well to effectively nag you!

A key goal of PCMH is to improve the relationship between you and your doctor. A big part of that is giving doctors the time they need to give that familiar level of care. So PCMH helps PCPs change their practices. They are put in charge of teams of providers customized to meet your unique health needs – so if you have a chronic condition, health care “extenders” with expertise in treating your condition could be on your team. The team may also include staff members and health and wellness organizations that offer education, screenings, and other support.

The PCMH system supports these teams with information and a new way to pay for care. Using the latest technology, like electronic health records, makes the team more efficient and improves communication. New detailed reports of patient histories help the team identify patients who need screenings, follow-up visits, and immunizations. That means your doctor and your whole team will have more information to better help you. It will also increase the coordination between different providers on your team. And instead of getting paid for every service they provide, providers are rewarded for making sure you get the right care you need when you need it. It’s about paying for quality.

HMSA members who have a primary care provider and a patient-centered medical home get recommended health screenings and immunizations at a higher rate than those without a PCP and PCMH.

But it’s not all up to the team. As the name implies, PCMH puts you at the center of your care, encouraging you to take an active role in improving and maintaining your health. After all, a team of doctors can only make recommendations. You are the only one who can make yourself exercise, eat right, get your recommended screenings and tests, take your medications as prescribed, and do what you need to do to manage any chronic conditions you have.

Social Media In Healthcare

In Health, Healthcare, Medicine on May 19, 2012 at 4:38 pm

Social media in healthcare gives a substantial promise, including the construction of valuable information sprung from collaboration, patient-to-patient social supports, and more sustained and collaborative patient-provider relationships across the continuum of care. The benefits of integrating social media into healthcare marketing efforts are priceless – from improving patient care to gaining media coverage to attracting new patients and staff. If your healthcare organization hasn’t already taken advantage of social networking channels, now is the time.

The rise of social media has been phenomenal.

Use of social networking sites has grown from 5% of all adults in 2005, to half of all adults (50%) in 2011.For example, Facebook, which began with 5 million users in 2005, today has 845 million participants, more than the entire population of Europe. Twitter has also shown tremendous growth, reporting 460,000 new accounts created on average per day. More than 1,200 hospitals participate in 4,200 social networking sites.

 Current Obstacles

  • Privacy and security are top consumer concerns when sharing their health information through social media. Consumers are most concerned with personal health information being shared in public and information on social media being hacked or leaked . The main stumbling block is the lack of a set of accepted best practices that would enable organizations to become less risk-averse.
  • Ethical questions are a major concern. Are we violating patients’ privacy by listening in or soliciting comments online? Are we ignoring the people who don’t participate in social media?
  •  Return-on-investment questions present another barrier. Should we devote scarce resources to explore this unmapped territory? What risks do we face if we embrace social media, and what if we don’t? Will social media really help us reach the people we want to reach?
  •  Healthcare organizations are also concerned about practical questions. How ready are we to use social media? How should we use it most productively for our own goals, and what is the best way to start? What policies do we need to support this work and what level of the organization should approve them?
  • Negative effect on workplace productivity.
  •  the risks of exposing the hospital’s networks to viruses and malware,
  • HIPAA concerns and
  • Consuming the hospital’s bandwidth.Image

Despite the issues,Social media is here to stay in health care. It will evolve quickly. Patient engagement will continue to characterize this change. Organizations will use social media tactically within their overall marketing and communications efforts — videos and mobile technology will likely dominate these approaches.  Online patient communities will expand and will become a rich source of information for others. Physicians and other health care providers will discover social media, which will have the potential of progressing medical research.

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