I don’t get sick.
OK, perhaps that’s an overstatement. I have conditions, like a heart that had a problem with blockages and a couple other things middle-aged guys get. Every condition I have is being successfully treated and I have a full life.
I don’t get sick. I can count my bouts with colds and flu over the past 15 years on one hand, I don’t get the crud that’s going around. I’m convinced that’s because I don’t because I do some things: • I eat right • I exercise • I don’t smoke • I don’t drink alcohol or take recreational drugs • I don’t participate in drama or other far too emotionally serious matters
Sounds a little dull, but like I said, my life is full.
In a recent AOL News interview, David Feinberg, CEO of the UCLA Hospital System, shared that the argument on capitol hill is not about health-care reform. It’s about health-care insurance reform.
I agree. I haven’t read the entire bill, but that’s the deal on the surface. Democrats are scrambling, Republicans are striking fear into the hearts of senior citizens, and business as usual. It’s intense drama, but has little if anything to do with health care and everything to do with money and how much insurance companies will lose if everybody’s somehow insured under a plan they don’t control.
He goes on to estimate 50% of his 800 patients in his hospital have illnesses that could have been prevented by changes in lifestyle. • Eat right (we all know how, learned in grade school) • Exercise (we all know how, learned in grade school) • Avoid smoking, & alcohol (if you can’t, free help’s available)
I didn’t know that the surgeon general was obese like Feinberg says…so I Googled her. I’m not so sure she’s 100 pounds overweight, but she’s a big woman.
Here’s what she says on the Surgeon General’s home page.
“Americans will be more likely to change their behavior if they have a meaningful reward–something more than just reaching a certain weight or dress size. The real reward is invigorating, energizing, joyous health. It is a level of health that allows people to embrace each day and live their lives to the fullest without disease or disability.”
I am in violent agreement that health gets better if we take care of ourselves and feel powerless over the lies and misdirection coming from Capitol Hill. For now, I write my little blogs and help provider agencies get their EMR running right…and follow Feinberg’s advice.
Read more →Gaining user trust is a special skill, and sometimes the project managers from software companies just don’t have it.
Software companies love bean counters as project managers because they keep track of billable hours. It’s always good to get paid. It’s better to gain the users’ trust, have a successful rollout with some aftercare, and get paid more. Some software companies’ solution to this is to insist on a person from the provider’s staff as an internal person to do the touchy-feely work with the users.
Sometimes the separation of implementation resources in to “us” (provider) and “them” (software vendor) causes problems.
Recently, a CFO friend’s boss has been getting testy about the EMR not being on line a few years after buying an expensive enterprise software system that’s expensive to maintain. Not his fault. Not even the vendor’s fault or the software’s fault. Some people simply have trouble relating to humans on a human level when it comes to business, and I think that’s what’s happened in their implementation.
The thing that strikes me as the most important thing to do is gain the trust of the users and get it up and running before they have a chance to think about it. There are always Negative Nelly’s around, and if given a chance, they will unwittingly sabotage the effort with negative rumors. Once you quietly design the software, move fast to implement. Having elements of the EMR, like progress notes, successfully operational creates a fabulously positive buzz in the organization, so be ready to roll something else out, quick!
There are a ton of experts out there who tout Rapid Cycle Implementation and other systems for making your software work. Mostly, they’re good and embody the ideas we pioneers had about getting software up and running years ago. They also add a bundle of good ideas every project manager should steal.
That said, gaining trust of the users is the one foundation that deserves more attention than it gets. Is that because there’s no line item in the budget for that?
I’m available at info@ehrsio.com
Read more →I was catching up on some reading this morning, and reviewed a January editorial from the NY Times about the increasing role of the feds in supporting Medicaid to meet expanding demands.
It seems that a decade of tipping the income scales has left a bundle of families of four bringing in less than $30,000 a year, which expands the Medicaid culture (a social issue I love to talk about, but won’t today). The political argument is whether the feds or the states pay for the increased Medicaid usage. There are disparities among states in how they pay their share, which leaves shortfalls of billions and billions of dollars. In the face of this problem and increased demand (those families I just mentioned), the dam will burst on capitol hill, something will happen, even if it’s wrong, to increase federal participation in Medicaid funding.
C-level executives of provider organizations that I know are faced with increasing workloads and per-service recompense dwindling at the state level. The states have to adjust their budgets and have passed the problem on to my friends. A number are worried that their agencies won’t be around to offer mental health and social services to this increasing population that needs the help. Think about the resulting world a minute. Overworked surviving agencies serve a smaller percent of the population, poorly, and America has a lot of sick people on the streets. Homelessness increases, crime increases, hospital emergency rooms go nuts and jail population explodes. America the beautiful.
Think it’s not that bad? OK. Perhaps I’m reactive, perhaps not.
I only know only a little: I can help in a small way. I help agencies serve more people and increase their quality of care. More people can be served in an agency that demands its practitioners to use concurrent documentation and other efficiency directed aspects of the Electronic Medical Record. Quality of treatment increases when all practitioners and agencies have instant access to electronic records and the right-hand provider knows with professional certainty what the left-hand provider’s doing with the patient.
You can contact me now at info@ehrsio.com
Read more →It’s a slow news day for Health & Human Services.
So, like any dutiful blogger, I dug and burned till I came up with a great topic: Five Factors for Optimal Software Selection, as shared by Joe Naughton Travers at Open Minds. I liked Joe’s five topics, which are actually the foundation of the list, and added my twist: • Functionality: Having helped many companies to implement software, I can say the key to success is more than just what the software does out of the box…meeting workflow demands in positions from the front desk to counselor to the CFO are key; how flexible is the product? • Company stability and reputation: Has the company made it past the first big “choke point”? Are you comfortable the company can weather a financial storm and not leave you out in the cold, looking for software support? • Vendor customer support and service: Talk with a few customers in addition to the vetted, strong supporters (who might have a marketing agreement with the vendor). • Implementation expertise: Implementing software is a partnership between you and the vendor…your businesses are getting married, and remember, the vendor is a polygamist. Devise a plan with the vendor to bring the software up quickly, one area at a time, starting with the area you can get running effectively first. This increases staff buy-in and keeps the excitement going about the ongoing implementation that can take from a few months to a few years. • Cost: Software’s Return On Investment can be measured. I use a tool that’s tailored to your exact situation to determine potential service delivery that can be added, throw in some marketing plans and come up with a goal. Joe advises a three to five year budget plan, which is what I’ve used and like. Software vendors will offer a significant product upgrade that includes technology they were unable to add to the platform you bought every five years or so. Oh, and by the way, they commonly charge big bucks for these upgrades. There are a boat-load of other factors that need to be considered when purchasing software. For the sake of business success, juggling these elements into a reasonable plan seems to be the approach most providers take. Contact Terry McLeod at info@ehrsio.com for help purchasing, replacing, or upgrading your current software.
Read more →I was invited as a guest to a group meeting of CFOs who meet on Long Island, and shared my insights about the conversation.
One topic I mentioned prompted note-taking: Marketing.
Once all the efficiencies of the EMR are introduced and measures are taken to shorten the time between the inquiry and delivery of service, staff will have time to provide more services. The methods of gaining referrals for Health & Human Services agencies that rolled off my tongue in closing were to establish relationships at the local Hospital Emergency Room and Police Precinct (not with CEOs and Captains, but the people who actually tell prospective patients where to go for help).
Coincidentally, this morning I was pointed to three reasons why patients may not refer others to an agency’s vital services. This observation from a chiropractor can be applied in many healthcare environments; see the article “The 3 Reasons Patients Don’t Refer “.
1. Patients will refer you to others if you ask them to. It’s a simple matter to have the front desk person smile at the person as they exit and exclaim “Be sure to tell folks we’re here to help!…or something of that ilk. Remind the person at the front desk in your EMR, or even with a billing system pop-up if the patient owes a co-pay.
2. Patients don’t feel comfortable referring you to others. Is this a treatment issue for the patient? A quality assurance issue for the agency? A suggestion aimed at building business could start with the person at your agency who knows the patient best, hopefully their counselor. This sort of discussion extends to the entire staff, and can be repeated with every patient visit. It should be simple enough to set up a reminder for the counselor in your EMR, perhaps to appear during concurrent documentation of the session.
3. Patients are reluctant to share with friends & acquaintances that you’re helping them. This could be an issue ranging from confidentiality to not liking somebody who needs help. We want to “do good” in this business, and the appropriate staff could help the patient overcome this reluctance with patient coaching. Staff would help their charge do some good, and it shouldn’t hurt the patient to help others. Another simple reminder to the appropriate staff in the EMR or billing software would help.
Staff may be unwilling to help…They can be sold on it. Company policy must be upheld for an agency to survive, and staff should want the agency to survive and thrive, not shrink. An employee joins the team when they’re hired, so engage them.
Staff may just plain forget to mention it at the end of a session. Remind them with your EMR and build in redundant impressions for the patient, like posters. Message repitition is a big key to advertising.
Staff may be opposed to helping build business: it’s not their job, man!. Everybody on the team needs to pull for the team.
Optimization of the EMR can help with these details, and we always need to provide more services with fewer resources.
Contact me if you need help.
Read more →New York judges have saved New Yorkers $41 Million by testing the Rockefeller drug law reform statutes.
In a recent paper “Drug Law Resentencing: Saving Tax Dollars with Minimal Community Risk”, the Legal Aid Society’s Criminal Defense Division in New York City says that drug law sentences have been proven too long, and that shorter re-sentencing is effective and less expensive.
Lesser sentences for lesser offenders is apparently working by saving millions of dollars and returning citizens to productive lives after the wake up call in jail. Meanwhile, major offenders who are determined by the courts to continue to give New Yorkers trouble remain behind bars a long time.
Naturally, addiction treatment providers are charged with a number of these lesser offenders, which just may lead to recovery….good news for all, and as an added “plus” I see a growing revenue stream.
Sounds good to me, what do you think? Is this version too good to be true?
Read more →The law firm of Moritt, Hock, Hamroff & Horowitz, LLP just won a landmark case for people in early recovery in Suffolk County, NY.
Judge Joseph F. Bianco of the United States District Court for the Eastern District of New York decided for the benefit of Oxford House, annulling Suffolk County’s local law regulating substance abuse houses on the basis that the law was facially discriminatory and was preempted by the Federal Fair Housing Act. The decision was a huge victory because upholding that law would deprive people disabled by alcohol and substance abuse problems of their ability to maintain recovery housing.
I’m from Oregon, and as far as I know, they don’t have sober houses there. Insomuch as recovering alcoholics and addicts are extremely vulnerable to that first drink or drug in their early sobriety, and it’s the first drink or drug that sets the monster loose, sober houses may be a good environment for a group of recovering folks to try to stay clean.
That being said, alcoholics do relapse, early recovery is a struggle to change the mind. The outcome of this case is a baby step in attempts to make laws more reasonable with regard to addiction and disease, from which nobody’s immune. Better to support recovery than not.
Sober Houses are a controversial subject, and your thoughts count.
Read more →The emergence of computer games as treatment appears to be sensible and effective according to experts like Henry W Mahncke, VP of Research & Outcomes at Posit Science.
I was at Starbucks yesterday, and a woman was there with her grade school-age son. In the Long Island way, she was talking with the boy, loud enough for all to hear, about his upcoming use of a computer game as treatment for his ADHD. As a former aficionado of Duke Nuk’em and Doom, I’ll vouch for the need to pay attention if you’re going to play. It caught my interest.
In a recent presentation I received from Open Minds, a consulting group, Dr Mahncke shared the statistical proof that his game-treatment works with schizophrenics. The more they play, the more it pays off.
So since computer game therapy, or rather “applied brain plasticity”, appears to increase in effectiveness with more hours of play, how will that be charged? Should it be charged? We can bet the insurance companies, funding sources like Medicaid, will resist paying for this.
Read more →Apparently, substance abuse treatment has an advocate in President Obama. His recently released budget request contains modest increases for a number of program budgets. Programs that disappeared have been combined with others to benefit “Successful, Safe and Healthy Students” and included in the proposed budget.
It’s only the first step of the budget process, so to assure the gains aren’t turned into losses you may want to get active.
Here are the budget figures I received.
Please let me know if my source is faulty.
Read more →