Politics and Healthcare

I was sitting in a plane the other day and got to talking to an individual who was in pharmaceutical sales sitting next to me. During the conversation, the phrase, “I wish those guys in Washington, D.C. would get out of the healthcare business!” came up. Healthcare has always been a political hot button topic in the United States.

I’m not sure if it is that big an issue elsewhere as it is in our country. Politics in healthcare means so many different things though. Whether it is politics of the Washington D.C. variety, it is lobbying for changes in regulatory mandates (like the push that is currently going on in Congress to delay yet again, the adoption of ICD-10 to October 1st, 2015) or politics in a healthcare provider project where interpersonal differences between project team members could affect the quality of the output due to ambiguity in project processes. Nowhere in the world is healthcare as intertwined with politics as it is in the United States, especially over the last few years where to some, the Affordable Care Act, ICD-10 requirements and the Meaningful Use stages are not what they have been used to. Change is always difficult. That’s one of the reasons why I usually, at the outset of any project or program I have managed, I work with the project members to try and get them used to a process over the first few weeks and make it a habit. Everyone will take time (akin to starting a new diet taking 3 to 4 weeks) to get accustomed to the process. I’ve seen project team members get overly stressed because “Meeting Agendas or Minutes” weren’t in the “proper” format without having ever explained or demonstrated what the “proper” format was. “Politics and healthcare” and “politics in healthcare” are often symbiotic in nature.

These days, care delivery organization’s IT departments understand their responsibilities well. I have seen that IS&T is usually ahead of operational leadership, thanks largely in part to IT leadership seeing things coming down the road, many times prompted by their vendor community (sometimes now, as in the case of many application vendors still ambiguous with firm dates of their ICD-10 application version compliance timelines).

This week is also CSO HIMSS Healthcare IT Day on Thursday, April 2nd, so come out to Columbus to the Ohio Statehouse and be a part of influencing how healthcare will play out in the great state of Ohio. For readers of this blog who live in other states, please participate in your local HIMSS advocacy. Your volunteerism and activism will help shape the quality of care you receive.

To bring a smile to your face at the start of the week, click here to some political healthcare humor.

 

 

 

The Happiness Factor in Healthcare

I enjoy catching up with many people on my drive home. Not only does it break up the monotony of that traffic filled drive, but it allows me to connect with many people I haven’t had the fortune to talk to for a while. People who have worked with me know that I try call as many people as possible and hope to keep in touch as often as I can. That’s my Zen Place. The time and place I’m the happiest. 

Working with, connecting with people.  I enjoy being in a crowd and in the thick of things. 

In healthcare,  many people have realized that being an EMR consultant or analyst may not have been all that it was meant to be. The lure of the money and opportunity,  was too much and the amount of work and updates wasn’t in the brochure when they sold it to you.

You may now be out of sync with the ‘Zen you’.

I was recently having a conversation about the country of Bhutan. The people are the happiest people on earth. The individuals that are respected are monks, the royal family and finally teachers.

The King told his people that they should be a democracy, but they refused and asked him to continue. Truly, a fairy tale land. They want to have a simple life where electricity and water are 24 hours a day and their exports are to India.

As per Wikipedia, “The Constitution of Bhutan charges the Royal Government with ensuring a “safe and healthy environment,” and with providing “free access to basic public health services in both modern and traditional medicines.”

Bhutan is not a “rich” country by currency perspectives, but more in terms of satisfaction with the government and happiness perspective. With all of our drive towards digitizing our medical records, are we moving too far away from what really matters? Empathy for your fellow human beings?

Why to, is the song “Happy” by Pharrel Williams, doing so well and resonating with so many people? Is this the “Holy Grail” of the health and well being of our population? (I’ve included the link below…its quite uplifting)
m.youtube.com/watch?v=y6Sxv-sUYtM

Net Neutrality and how it affects Healthcare Providers

What is Net Neutrality? Why are we talking about it in a healthcare context?

Well, the U.S. Court of Appeals in Washington D.C. rejected the FCC’sopen internet rules, making way for cable companies to give some broadcast companies and video streaming services preferential treatment.The 2010 Federal Communications Act forced companies like Comcast and Verizon to treat all video streaming equally. Net neutrality puts users in control Services succeed or fail based on what users like and, until now, Youtube, Netflix & Hulu didn’t have to worry about striking a deal with the internet service providers.

The ruling will be bad for cord cutters, especially if they get their broadband from a cable company. If Net Neutrality is eroded, then what will it mean for healthcare’s broadband’s requirements for telemedicine capablities?

The middle seat view of Healthcare IT

As my plane backs up and heads home,  I reflect on my past week working for a Healthcare provider organization in another state. It’s been a while since I was on the road for work and I’m not as young and nimble as I used to be, but I know that I know that much more since I last was traveling some years ago. Meeting new people both in Operations and IT and getting to understand their organizational culture and dynamics is one of my initial objectives. Another is remembering many people’s names and the responsibilities they have. What is the scope of each person’s work effort,  where are they located,  what is the best way to interact with them?

Each organization has their own set of rules and regulations and one needs to try and understand what they are so as to not rub them the wrong way.

Ok,  so by now you’re wondering why I called this blog post what I did.  First of all,  I’m sitting in the window seat. As I was boarding and sat down in my seat and when I needed to get something out of my laptop bag,  I had to dive down and in the process,  the gentleman who sat in the middle seat had to maneuver to not get an elbow in his face. I apologized and he said…well, “you know, it’s life in the middle seat”. We talked about what each does and I tried to impress upon him the work that all healthcare provider organizations had done in recent years and the resurgence of healthcare IT and technology oriented life of a physician and patient.  I also met an individual earlier that same afternoon who had been to an orthopedic surgeon’s conference and as we were chatting about the long security lines,  we discussed my favorite topic of empathy in healthcare.  James from North Dakota,  success be with you and the patients in your community. Sounds like you already have what it takes to be great. Hopefully our discussion helped a little. (The picture above was taken at Houston airport and was very inspiring.  I wanted to share it with my readers.)

Did your Provider bill you extra due to Daylight Savings Time?

Healthcare providers across the country have been busy with recurring yearly work effort this past weekend. If you or anyone you know were in the hospital over this past couple of days, you may want to double check your hospital charges to make sure that you that if you were charged hourly during this past weekend for a hospital stay, you may want to take a second look at your bill just in case you were charged extra for your overnight stay due to the time change.

If the care provider’s system is configured to bill you hourly for bed charges, some systems may not have taken the Daylight Savings Time changes into account so the organization may have had to update or configure these settings manually during that time (and all said and done, they’re only human, so it might be better to validate with the billing office when you get your bill).

Most, if not all organizations have a plan for this time change, but it never hurts to double check. Another one of those operational necessities in the healthcare delivery systems world.

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MU gets a Breather! Healthcare Providers heave a sigh of relief!

 Marilyn Tavenner, the CMS Adminstrator announced last Thursday at HIMSS ’14 in Orlando that CMS would be flexible on “hardship exemptions” for meaningful use requirements, which I am sure the healthcare industry heaved a collective sigh of relief.

Expectations were high for this to happen as it had been suggested earlier that this was to come.

In reviewing the CMS document titled “Payment Adjustments & Hardship Exceptions Tipsheet for Eligible Professionals” that was last updated in  October 2013 has hardship exemptions for eligible professionals with the following information:

EPs can apply for hardship exceptions in the following categories:

*Infrastructure — EPs must demonstrate that they are in an area without sufficient internet

access or face insurmountable barriers to obtaining infrastructure (e.g., lack of broadband).

 New EPs

— Newly practicing EPs who would not have had time to become meaningful users can apply for a 2-year limited exception to payment adjustments. Thus EPs who begin practice in calendar year 2015 would receive an exception to the penalties in 2015 and 2016, but would have to begin demonstrating meaningful use in calendar year 2016 to avoid payment adjustments in 2017.

Unforeseen Circumstances

—Examples may include a natural disaster or other unforeseeable barrier

Patient Interaction:

1.  Lack of face-to-face or telemedicine interaction with patients

2.  Lack of follow-up need with patients

Practice at Multiple Locations:  Lack of control over availability of CEHRT for more than 50% of patient encounters 

With the number of initiatives currently under way at every single care delivery organization, ICD-10, optimization, Patient Portals, Patient Engagement, workflow optimization and so on, we continue to move at, what can only be considered, lightening pace through this decade as we regain American dominance in the healthcare technology sector and then shift our focus to lowering the cost of care delivery and leverage process improvements, better preventative care options.

With current clinician retirement trends the way that they are, I also foresee a great need for qualified physicians and clinicians over the next few years and migration to the United States for technology savvy medical professionals from other countries could assist with this demand in major population centers across the country.