Healthcare Talent Transformation

Learn about the BUSINESS of Medicine

We are pleased to introduce our newest blogger, Andrea Morgan. Andrea is the founder and President of AndreaKnowsEMR.com  As an EpicCare Ambulatory Certified technical trainer and consultant with over 15 years of pharmaceutical and EMR training experience, her areas of expertise include project management, curriculum development, and instructor led training as well as providing support to multiple medical specialties before, during and after EMR implementations.

The implementation of an electronic medical records system impacts the providers fundamental ability to make money. We have to be cognizant of this as we make decisions that will impact that business. It isn’t enough to say that software is user-friendly or intuitive and that productivity will return to normal *eventually* when the real costs of losing productivity can be jobs and practice stability.

I’m not advocating learning about billing per se, but about all the things that impact a provider’s financials – staff costs, office space, insurance, licensing, pretzels in the break room – for the purpose of looking at the EMR as a tool to support the existing functions and have as little negative impact as possible.

I recently read a great book by Dr. Steven Hacker, The Medical Entrepreneur that goes into great detail about the business aspects of setting up a medical practice. This book provides excellent depth of knowledge for a topic that is often overlooked by consultants and even by providers.

When assessing EMR solutions, very often providers want to know the bottom line – how much will it cost, how long will it take, how frustrated will I be – and while those answers may be (relatively) easy to come up with, they may not encompass the business costs on a holistic (as opposed to strictly fiscal) level.

For consultants, I think this book will give excellent insight on how to best support the practice during the implementation process. Understanding how the business of medicine works can only improve the level of analysis, quality of solutions and empathy that you will be able to provide to client.

Good Business Acumen for Healthcare IT

David Scher, MD, DLS Healthcare Consulting

When one discusses business acumen, it is usually applied to individuals.  What I plan to discuss is the business acumen that hospital administrators should have when considering implementation of IT and mHealth technologies. 

It is well known that one of the biggest priorities of hospital administrators today is implementing IT technologies that will have their institutions meet Meaningful Use (MU) standards.  The most important step in this process in my view is having the right Chief Information Officer (CIO) in place.  Many hospitals did not invest or invest wisely in CIOs. Good ones are now hard to find. There are presently hospitals that are actually outsourcing this position. The job is taking on increasing importance, not only because of the focus on MU, but because of the role of the CIO in implementing even more complex projects including wireless technologies and strengthening IT security (a daily headline grabber). Along with the CIO are other IT employees.  Many IT workers wanting to get into healthcare are getting formally trained but are being turned away while being told they do not have enough clinical experience. These people might thrive under the right administrator and support.

Good business acumen is always planning for the future. That includes budget planning and care coordination around outcomes-based and patient satisfaction-driven reimbursement.  Out-of-the-box thinking is required for this. Wireless health technologies including remote monitoring, patient adherence, diabetic, COPD, telemedicine, and others will be adopted by those with a superior vision, I believe.

The above points may seem simplistic but are quite critical. The basics include the right leadership and vision. A good CIO who adopts technologies which are game changers is the formula. Understood in this discussion is the administrative and financial support given the CIO by the CEO, who likewise needs to share this vision. It is a difficult road for hospitals that plan on weathering the storm ahead.  Let’s plan carefully and invest wisely in key personnel and technologies.   

David Lee Scher, MD, FACP, FACC, FHRS, is Director at DLS HEALTHCARE CONSULTING, LLC concentrating in clinical and business development of wireless health products. He is a former cardiac electrophysiologist with 20 years experience as a well-respected clinical trial investigator, human subject research committee chair, Medicare committee member, and medical device industry consultant and key opinion leader. Board Certified in Internal Medicine, Cardiovascular Diseases, and Clinical Cardiac Electrophysiology, Dr. Scher was a pioneer adopter of remote patient monitoring. He lectures worldwide on the benefits of wireless technologies.

Linkedin: http://www.linkedin.com/pub/david-lee-scher-md/27/16a/90

Dr. Scher can be reached at: dlschermd@gmail.com

Twitter:dlschermd

Health Wonk Review: Unadorned

Health Wonk Review Unadorned edition is posted for this week. Thanks to the Health Affairs Blog for hosting.

TBD Consulting's president, Jonena Relth, has been watching a lively LinkedIn discussion among healthcare executives, and “the one piece of the puzzle I haven’t heard mentioned is that of patients now demanding that their health care be more cost-effective.” One way to make care more cost-effective would be to limit damages in malpractice suits. Read Jonena's entire post: What Can Healthcare Learn from the Business World?

HEALTH WONK REVIEW: All Hallows Eve Edition

With the mid-term election candidates scaring up votes and Halloween just days away, we hope you aren't to frightened by this week's Health Wonk Review.

New Learning Modalities Advance Health IT

Posted by: Peggy Salvatore, www.healthsystemed.com

Online learning, e-learning, m-learning, asynchronous learning, web-based curriculum. What do you call it? What is it? And what might it have to contribute to transforming healthcare?

At an ASTD (American Society for Training and Development) Chapter board meeting last spring, we elected to start a special interest group to discuss elearning, and we grappled with finding an identity for what historically has been known as computer-based training. As it turned out, no matter what definitions we used, the concept generated a lot of enthusiasm from our own members and people outside our organization. To date, our elearning special interest group started just two months ago has met or broken attendance records for its first two online meetings.

Knowing our experience, I was a little surprised to see this link in the eLearning Insider Newsletter this week:

Is the LMS Dead?

My answer to that question is another question: Have We Even Started to Tap the Potential of the LMS?

More likely, online knowledge capture, transfer, and measurement for organizational improvement is in its infancy. Even bricks and mortar institutions are looking at their asynchronous classroom offerings and seeing their web-based future. This week, the Chronicle of Higher Education asked the survey question: What role does online learning play on your campus? And then posted this announcement:

"Due to an overwhelming response from our readers, the Online Learning Survey will remain open until Friday, October 29. Don't miss this opportunity to voice your opinions. Online, distance, and blended learning programs are playing a significant role in the way institutions deliver courses and are becoming a part of many institution’s strategic plans."

The move to web-based, asynchronous, online, mobile learning – partnered with social media platforms – means the way we relate education and information can be real-time, all the time. This has important implications for bringing nearly 20% of our economy online and all moving in the same direction. Healthcare (which yes, does account for almost 20% of our economy today) will need to bring millions of providers online in a unified and concerted way to extract the true value and benefit of electronic patient records.

We need face-to-face, boots on the ground teachers to translate some of the high-touch aspects of patient interactions to fully electronic patient records, but a lot of the education can be done in a consistent way, with rapid deployment at the point of service, using all the elearning modalities available to us today.

The LMS isn’t dead. It is one very important piece of a growing healthcare pie.

Peggy Salvatore writes training for the healthcare industry. She developed Health System Ed, a basic health IT training program to advance the uptake of electronic patient records. In addition to the basic e-learning program available online, Health System Ed can be customized for specific healthcare environments and software applications. To learn more about Health System Ed visit www.healthsystemed.com

Natural Evolution of Change Takes Awhile. Got Time?

Posted by: Peggy Salvatore

You might have people who accept the evolutionary change and stay, people who don’t and leave, or people who can’t and are eventually eliminated by some organizational variant of natural selection.

In moving from a paper-based to electronic medical records system, change may appear in either form in an organization. It may come in as a revolution and up-end the status quo, sweeping away the old way of business and bringing with it all new systems and processes. For most organizations, federal mandates are the change agent. Do it or don’t get paid (eventually).

Without government mandates, without a doubt, electronic medical records would eventually be integrated into the healthcare environment through a more gentle, evolutionary process. Simply, medical schools are graduating tech-savvy providers who are used to doing everything online. The nurses, doctors, pharmacists, staff and executives in healthcare organizations do everything better, faster and smarter with technology in other areas of their lives. Over time, healthcare providers will expect to take those technological advantages to work with them.

Because the change is being pushed from the top down, rather than being sought from the bottom up, it takes a little more organized effort from the training and human resources staff to pull through the technology. In a revolutionary change model, you’ve gotta prepare people for change and the new technology you are requiring;  in the evolutionary change model, you just have to manage the naturally occurring change and supply the technology for people who are seeking it.

Most healthcare organizations are in a revolutionary, top-down mode for managing the change in their environments. Some organizations are in the evolutionary, bottom-up mode, but they are still fewer and farther between. [HIMSS EMR Adoption Model]

In another generation, the full integration of IT into the healthcare environment would be a natural and evolutionary process. And that might seem like a kinder, gentler approach. But you have to start somewhere, sometime, setting standards and goals, and putting the network in place to handle the integration. That calls for a revolution of sorts – change here, change now, and change according to a master plan. That’s where we are today.

By requiring providers to integrate health information technology into their work environments now, the federal government is pushing the revolution from the top down. What that means in terms of organizational development is that the change will require some hands-on management from the people responsible for pulling it off on the ground.

Evolution is nice, things change according to the natural flow of events within the context of their times. Revolution sometimes is necessary to move things firmly forward toward a defined vision in an organized way.

Welcome to the revolution.

Engage OD Professionals BEFORE You Embark on a Change Path

Posted by:  Jonena Relth, President and Leadership Evangelist at TBD Consulting, Inc.

There has been a lot of chatter on LinkedIn's healthcare groups around change management issues. While the posts don't always mention the words,"change management," any major change such as going from paper to EMR/EHR is HUGE for everyone involved.

Being a performance consultant for 20 years, I've seen many change initiatives that involved technology, new processes and workflows for everyone involved.  What I would recommend is that if you do not have an OD department with proven success at guiding your organization around the "alligators in the swamp," you should contract an organization of seasoned organizational development professionals who can manage the people side of your changes. 

Similarly, if you don't have an internal Lean group that has the time and passion for what you are attempting to do, retain a Lean consulting firm that specializes in the OD side and process side of the engagement. They all should understand adult, behavioral theory and can help you strategize, plan and implement a smooth transition through all the changes that will ultimately take place.

No matter what change methodology you adopt, anxiety amongst the troupes will have a negative effect on the overall success of the program and possibly the organization, so it is vital that you involve the OD folks at the onset your project to emphasize the positive and diminish the negatives caused by the changes.  Keep in mind that everyone in our organization has their own thoughts about what is going on and the changes that are happening. Change, no matter how good it is for the organization, is often seen a just another "thing being forced upon" your staff and physicians.  To combat all this takes fines and communication.  Did I mention communication, communication, communication?

Bringing performance consultants in to "pick up the pieces," which unfortunately is the norm, will not result in the positive growth and feeling of security that you try to achieve.  But I can promise you that if you involve the right people at the table from the very beginning of each and every change initiative, your employees will be happier, your patients will get better care and your bottom line will improve.

 

Related Topics:

Do You Lead with Transparency or Power?

EMR Implementation e-Learning Should Be Part of the Solution, IF...

  

 

  

Breakdown of US Spending $2.3 trillion Yearly for Heathcare

Posted by:  Jonena Relth, President and Leadership Evangelist at TBD Consulting

 

 

 

The breakdown of $2.3 trillion looks something like the pie chart below. The numbers shown are in billions e.g. hospitals receive $718,400,000,000 of the healthcare spending in the US.

 

 

I ran across this graph from the Centers for Medicate and Medicaid.  It illustrates  who is getting how much of the healthcare dollars in the US.  $2.3 trillion is a lot of money for which we (patients) should be receiving excellent care in our country!

Using Social Media to Increase Patient Volume - Online Event 9/14/2010

Posted by: Jonena Relth, President and Leadership Evangelist at TBD Consulting, Inc.

Carol Flagg of HiTech Answers, a member of the Healthcare Talent Transformation group in LinkedIn, is hosting an event I think you should know about.  It's a timely topic that can help many of us improve our marketing savy.

Social Media is only valuable if it can be monetized and used to contribute directly to the growth of a practice or hospital. The key is to use a 3-pronged approach to create a comprehensive social media strategy that is automated and results-oriented. Join John Luginbill, CEO and Founder of THE HEAVYWEIGHTS on September 14, 2010 at 2pm EST for a live learning session to share this 3-pronged approach.

This 2-hour virtual event provides the background and tools to implement a sustainable social media strategy. It includes:

• Social media defined and usage trends
• The opportunity social media presents to increase patient volume
• The 4-step framework for implementation in 60 days
• Guiding principles for developing a strategy
• Tips and tools to stimulate your social media program
• Worksheets to help you select the right technology
• Case studies

THE HEAVYWEIGHTS has helped some of the nation’s largest healthcare systems increase volume.

Register today for this special event.

A Case for Implementing Open Source EMR/EHR

Submitted by: Jonena Relth, President and Leadership Evangelist at TBD Consulting

We're finalizing the WBTs for our hospital client in NY in the next two weeks and thought you might like to hear how it's going. As with every hospital or hospital group, this one has been unique.  Because it's a teaching hospital, the physicians are much more familiar with electronic medical records and computers in general.  Of course we have the "older docs" that need more 1-on-1 training, but overall we'll be able to get the majority of the population trained with the WBTs and superusers before go-live.  The system they are implementing is a customized version of the VA's Open Vista.  The screens aren't "pretty," but the system has the functionality needed and for a much smaller price tag:  The code is free.

For the past couple of years, I've blogged and tweeted asking why more hospital systems and physicians weren't implementing open systems such as the one our tax dollars paid for: Open Vista.  Well, now I have a bit more experience with closed and open EMR systems under my belt and would again like to point out some of the pros of going with an open system.

Open systems allow physicians and patients access to the data they are allowed to see/change from anywhere.

• Imagine being at a conference in East Asia and needing to access data vital to saving a patient's life.  With open systems, this is no problem. If you're tied to a closed system, you're much less likely to get to the data you need as the data if only available when you are at your office or medical facility. Yes, smart phones are the rage, but you can only do so much with a phone.

Open systems allow you to add plug-ins from other open source vendors you choose, thus you're not tied to the one vendor's apps or those of vendors they have contracts with.

• Imagine having the code to build or buy whatever plug-ins you need and when you need them.
• Imagine the amount of money you will save by not having to buy the rights to use a system each year?  You already own it.

Initial training for an open source EMR can be much less complicated.

• While this might not always be the case, open source systems tend to be less complicated than those built by the "big boys".
• The amount of training needed to get people up to speed can be far less than with closed systems. 

Our current open source client needed approximately 1/5 of the WBTs to teach the same skills as those of another client with one of the more popular, closed systems, simply because of less screens and simpler architecture within the open source.

In all fairness, the lack of bells and whistles can be a problem with open source.  However, with the ink for meaningful use not dry, it seems like a good option for those organizations that want to implement an EMR to improve their customer care, but don't have the money for the bells and whistles.

With the economy still in the dumper, I still am asking, "Why spend more than we need to get affordable healthcare IT?"