Category: Uncategorized

Bringing “care” back to healthcare by caring about those who care

Jun 3, 2018• 4

By VINITA PARKASH MBBS, MPH and ANDREW FAAS

In the depths of winter, America was shocked by the video of a young, bruised and confused woman being discharged from a Maryland Hospital – alone into the cold night, wearing nothing but a thin hospital gown and socks. Hospital security officers dropped her at the nearby bus-stand and then briskly wheeled away the chair in which they had brought her out, deftly avoiding the questions of a concerned citizen who bore witness to this inhumane act. Most healthcare workers in the U.S., physicians and nurses, allied health professionals, and janitors alike felt a wretched sadness watching the video, recognizing as they did another sign of the sickness that ails the healthcare system today.

As our culture has become increasingly more consumeristic, healthcare has become increasingly more commercialized. A “provider interaction” has become a commodity; and hospitals have become the factories producing that commodity. This has shifted the balance of power from healthcare providers to professional managers. This change, ostensibly done to provide doctors more time to practice their art, instead has insidiously but surely changed the culture of our healthcare institutions.

The daily-lived values of our institutions have changed from the core values of medicine – caring, compassion and empathy for the patient, to more corporate values of productivity metrics and profits. What was to be a properly balanced socio-economic model for hospitals has gone tragically wrong. The goal was efficacy – efficient and effective patient-centric care. However, the disproportionate focus on efficiency, achieved by applying industrial engineering and productivity standards to patient care, has compromised effectiveness. More importantly, this has eroded the core of patient-centric care – compassion and empathy. That the CEO of the Maryland hospital insisted that the patient was provided appropriate medical care, even as he acknowledged the failure of humanity and compassion, sadly demonstrates that compassion and empathy are no longer the core values of healthcare.

Penn State’s Wellness Disaster: How to Avoid Employee Rejection of Wellness Programs–and Even Get Buy-In

Jun 1, 2018

By Brad Wolfsen

One of the lessons I frequently relearn in life is that people do not want unsolicited advice. An example that most parents can relate to is that my 6-year-old daughter does not want my help tying her shoes, even when we’re running late. Similarly, most employees — and certainly their dependents — do not believe they need to change how they manage their health.

This is why Penn State’s moderately structured, but poorly executed, wellness program failed so disastrously. The recent New York Times article about the program reports that “[a]fter weeks of vociferous objections by faculty members” University President Rodney A. Erickson—not the human resources leadership—announced it was abandoning the $1,200 annual surcharge levied against employees who refused to meet certain requirements. Those requirements included filling out a health risk assessment (HRA), participating in a biometric screening, and getting a medical check-up.

Human resources professionals’ fear of this type of outcome prevents many potentially meaningful and engaging wellness programs from even being introduced. To overcome this inherent resistance to wellness, broad employee understanding and support of the program is a prerequisite. The administrators at Penn State failed to attain this goal. Wellness — like any major change — cannot solely be a top-down effort, launched with a letter from the president, especially at consensus-driven academic institutions.

At Penn State, the outcome could have been successful if leaders had built a consensus prior to launching that wellness programs can save lives, reduce costs and improve performance. This is not the type of organization where decisions can be defended by saying: “This program is the one recommended by our health insurer.”

Building consensus for better outcomes

Through consensus-building, Miami University in Ohio successfully launched its voluntary health risk assessment, biometric screening and doctor visit program in 2010 and transitioned to a premium discount program in 2011. Premium discounts started at $15 per month and increased to $45 per month in 2013. More than 85 percent of the covered faculty and dependents participate in the program, and age-specific preventive screenings have increased substantially. The top three factors contributing to Miami University’s success are communication, consistency, and C-suite and departmental manager support.

Will Palo Alto Ever Make a Successful Healthcare IT Company?

Jun 1, 2018

[youtube width=”560″ height=”270″]http://www.youtube.com/watch?v=M16lw6Piias[/youtube]

From CurrentMedicine.TV:

With the troubles at the medical doctor social network Sermo, we thought it would be interesting to speak with a healthcare IT venture capitalist about the reasons why the healthcare sector has not adopted Internet technologies such as LinkedIn or Facebook, or other IT business models. We interviewed Bijan Salehizadeh, MD, Managing Director at Navimed Capital in Washington, DC.

Health in 2 Point 00, Episode 28

May 31, 2018• 1

Another late night Health 2.0 Europe related episode of #Healthin2point00. Filmed (yet again by Jennifer Lannon) in front of a live studio audience (well, a bunch of people at the restaurant in Spain), with more reflections on the conference, Indu Subaiya’s talk and where we go next (Hint, way up North!) — Jessica DaMassa & Matthew Holt

Health in 2 point 00, Episode 27

May 29, 2018

With .health‘s Jennifer Lannon again running the camera and with guest appearances from Bayer’s Aline Noizet and Health 2.0’s Emily Hagermen, Jessica DaMassa asked me about Health 2.0 Europe, DCtoVC, the other goings on in Stiges, Spain. And yes, filmed in a nice Spanish restaurant over a Rioja or 2–Matthew Holt

Health in 2 point 00 — Episode 26

May 28, 2018

This week we’re on location in Europe! Sitges near Barcelona to be exact, the site of the 2018 HIMSS Europe & Health 2.0 Conference. There, with our friend Jennifer Lannon from .health acting as emergency camera crew, Jessica DaMassa pins me down about HHS CTO Bruce Greenstein, Bayer & cannabis, Entraprenurses and where HIMSS/Health 2.0 is going next in Europe. It’s all in a day’s work (well 2 minutes) in Health in 2 point 00! — Matthew Holt

Double Standards, Trojan Style

May 24, 2018• 6

By NIRAN AL-AGBA, MD

The University of Southern California (USC) appears to look the other way when male physicians harass or assault women. In reality, sexual violence spares no occupation, including medicine, but the way an organization responds to crime against women indicates a certain level of integrity. The World Health Organization estimates sexual violence affects one-third of all women worldwide. In a nation where women make up 50% or more of each incoming medical school class, only sixteen percent of medical school deans are female, making gender imbalance in leadership positions nearly impossible to overcome.

For the second time in less than a year, USC President C.L. Max Nikias is grappling with sexual misconduct allegations against a physician faculty member. Complaints go back to the early 1990s from staff and patients about inappropriate comments and aggressive pelvic exams done by Dr. George Tyndall, the only full-time gynecologist for the past three decades at the campus clinic. USC ignored complaints until a nurse contacted the campus rape crisis center.

Dr. Tyndall was initially suspended pending inquiry and forced to resign shortly thereafter. More than 100 complaints have been received and five are suing USC.Continue reading…

A Picture is Worth a Thousand Words

May 23, 2018• 4

By MEGHAN CONROY

These days I’m spending a lot of time getting in depth with many tech companies. From time to time I’ll be asking those innovators to tell their story on THCB, and suggest what problems they are solving. First up is Meghan Conroy from Captureproof—Matthew Holt

Today’s doctors are communicating with their patients less than ever before, even as their days grow longer and busier. Physicians are pressured to see more patients in shorter encounters, while at the same time shouldering more of the administrative and documentation tasks associated with electronic medical records (EMR). The result is physicians who are spending more time looking at patients’ EMRs than looking at – or interacting with – the patients themselves.

Research bears this out. A recent RAND study shows that providers are frustrated by the high volume of clerical work, and the implementation of poorly designed technology, that hamper their efforts to deliver effective, efficient care. Primary care physicians spend nearly two hours on EMR tasks for every hour of direct patient care, with an average of six hours – more than half their workday – interacting with the EMR during and after clinic hours. The same study found that U.S. physicians’ clinical notes are, on average, four times as long as those in other countries.

No wonder the country is facing an epidemic of physician burnout. Doctors have become high paid data entry workers rather than caregivers. They are tethered to their screens, filling out countless forms and responding to multiple messages, eating into their face-to-face time with patients. With more patients to see, they have less time to prep for each encounter, leading to sub-optimal patient experiences and poorer outcomes.

Ironically, while technology helped create this problem, it also could provide the solution. Continue reading…

Health in 2 point 00, Episode 25

May 22, 2018

It’s late late at #hin2pt00 central. But somehow Jessica DaMassa wakes me up enough to get my views on Redbrick & Virgin Pulse, the VA finally inking the Cerner deal and Iora Health getting another $100m to build out their primary care model. Be warned, Jessica thinks I’m not full of cheer about any of it!–Matthew Holt

The Ethics of Keeping Alfie Alive

May 21, 2018• 12

By SAURABH JHA

Of my time arguing with doctors, 30 % is spent convincing British doctors that their American counterparts aren’t idiots, 30 % convincing American doctors that British doctors aren’t idiots, and 40 % convincing both that I’m not an idiot.

A British doctor once earnestly asked whether American physicians carry credit card reading machines inside their white coats. Myths about the NHS can be equally comical. British doctors don’t prostate every morning in deference to the NHS, like the citizens of Oceania sang to Big Brother in Orwell’s dystopia. Nor, in their daily rounds, do they calculate opportunity costs for keeping patients alive on ventilators.

Conversations such as this are vanishingly rare.

Administrator: “It’s costing an arm and leg keeping this sick baby alive – to balance the annual budget we need to stop dialyzing a granny.”

ICU doctor: “We’ll have to send poor Ethel to her grave. That’s a shame. She was beginning to grow on me.”

Health Ethicist: “Wait, let me check with National Institute of Clinical Excellence, the rationing experts, who should be relieved of intensive care first. Perhaps it should be Winston, not Ethel – because Winston is an alcoholic. We need to make rationing scientific and fair.”