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Improving the Patient Experience

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In Rural Areas Without Pain Or Addiction Specialists, Family Doctors Fill In The Gaps

January 01, 2020

In Rural Areas Without Pain Or Addiction Specialists, Family Doctors Fill In The Gaps

In many ways, rural communities like Necedah have become the face of the nation's opioid epidemic. Drug overdose deaths are more common by population size in rural areas than in urban ones. And rural doctors prescribe opioids more often by far, despite a nationwide decline in prescribing rates since 2012. Meanwhile, rural Americans have fewer alternatives to treat their very real pain, and they disproportionately lack access to effective addiction medication such as buprenorphine.

It used to be rare for primary care physicians outside of big cities to take on the challenges of opioid misuse, according to Dr. Erin Krebs, a professor of medicine at the University of Minnesota who researches chronic pain management. Now, Krebs says it's becoming increasingly common "out of necessity."

"We just have a lot of people who need this kind of care and they need it where they are," Krebs says.

The full NPR article can be viewed at this link.  

Name: 
Anna

Physician Burnout, Resilience, and Patient Experience in a Community Practice: Correlations and the Central Role of Activation

December 29, 2019

Physician Burnout, Resilience, and Patient Experience in a Community Practice: Correlations and the Central Role of Activation

Clinician burnout and patient experience are important issues that are often considered separately. New measures of resilience may influence both. We explored relationships among clinician resilience, burnout, and patient experience. Analysis included 490 physicians who completed surveys measuring burnout and resilience (decompression and activation) and had at least 30 patient experience surveys available for analysis. Burnout was measured with 2 items from the Maslach Burnout Inventory (MBI) which were part of the organization’s ongoing measurement of clinician experience. Resilience was measured with 8 items from 2 Press Ganey validated subscales related to clinicians’ ability to decompress from work and their experience of feeling of activation and connection to purpose while at work. Clinicians reporting more frequent symptoms of burnout based on the MBI items reported less ability to decompress (r for individual measures ranged from .183 to .475, P < .01) and less feeling of activation (r for individual measures ranged from .116 to .401, P < .01). Individual elements of decompression and activation were significantly associated with patient experience. In terms of activation, feeling that one’s work makes a difference (r ranged from .121 to .159, P < .05) and believing one’s work to be meaningful (r ranged from .102 to .135, P < .05) were positively associated with patient experience with their care provider. However, elements of decompression such as being able to free one’s mind from work (r ranged from .092 to .119, P < .05) and being able to disconnect from work communications such as e-mails (r ranged from .094 to .130, P < .05) were negatively associated with patient experience with their care providers. Patient and provider experience are intertwined in that clinician resilience is associated with both burnout and patient experience, but individual mechanisms of resilience may be beneficial for the clinician but not for the patient.

The full article can be downloaded below.  

Name: 
Anna

Show ‘Em the Money: Paying Patients to Shop for Affordable Medical Care

December 20, 2019

Show ‘Em the Money: Paying Patients to Shop for Affordable Medical Care

After three months of physical therapy, her doctor told her that it was time to get an MRI. She had already paid off her annual deductible, meaning the imaging test would “only” cost her the $150 co-pay. An imaging center near where she worked charged $1500 for the test. Just two miles away, another facility would have just charged only $900 for the same test. She arranged to go to the more convenient location knowing the difference in price would be picked up by her insurance company.

Until…!

She found out she was eligible for a rewards program. She called a rewards advice line and found out that if she chose the less expensive imaging center, her insurance company would send her a check for $400. She’d make money on the deal!

I’ve been describing the kind of program that insurers are increasingly turning to in an effort to incentivize patients to be price sensitive when receiving blood tests, imaging exams, or common procedures. It’s one of the consumer oriented innovations I explore in Sick to Debt (currently ranked one of the top five books authored by people with the last name Ubel).

The full Forbes article can be viewed at this link.  

Name: 
Anna

Why Big Tech Companies Won’t Solve Healthcare’s Biggest Challenges

December 17, 2019

Why Big Tech Companies Won’t Solve Healthcare’s Biggest Challenges

With a combined market cap of more than $2 trillion, technology giants Google and Apple are placing big bets on disrupting the $3.6 trillion healthcare industry. 

Earlier in the year, Apple CEO Tim Cook repeated a claim that “there will be a day we look back and say Apple’s greatest contribution to mankind has been in healthcare.” Meanwhile, Google Cloud CEO Thomas Kurian wrote in September that “we can transform healthcare and improve lives.” 

Based on their past innovations (and earnings), there are very few things Apple and Google can’t do. One of those things, I predict, will be transforming healthcare. 

Three announcements last month suggest that Google and Apple stand to make a lot of money on health-related products and services. But none of their recent acquisitions or consumer plays will make a substantial impact where it matters most: On the quality and cost of U.S. healthcare. Here’s why. 

  1. Consumer Preferences Are Different Than Medical Needs 
  2. No Major Tech Company Is Willing To Accept Medical Liability
  3. Tech Companies Will Face Major Data-Ownership Issues Ahead  

The full Forbes article can be viewed at this link.  

Name: 
Anna

An $800 Head Cold? Time to Fight for Price Transparency in American Healthcare

December 16, 2019

An $800 Head Cold? Time to Fight for Price Transparency in American Healthcare

Jay Singh had a nasty head cold. Not a “will-I-survive-this-plague” kind of infection, but also not one he thought, if left to its own devices, would blow over in a day or two. So he went to the primary care clinic near his exurban New York City home. The doctor spent ten minutes examining and talking to Singh (a pseudonym), a quick look at his throat, a cursory listen to his lungs. The doctor ordered a routine “respiratory viral panel” and prescribed a cough suppressant. Singh had already anted up a co-pay for the office visit, but a few weeks later he received a bill for the services rendered: $800 to cover his doctor’s time and the cost of the viral panel.

I spoke to Singh several months after his appointment, and he was still determined to leverage his experience into political action: he thinks it’s time for the state of New York, perhaps the whole U.S., to bring healthcare prices out of the dark so patients like him can make informed decisions about their medical care.

The full Forbes article can be viewed at this link.  

Name: 
Anna

2019 IMPACT REPORT: PRESCRIPTION PRICE TRANSPARENCY

December 14, 2019

2019 IMPACT REPORT: PRESCRIPTION PRICE TRANSPARENCY

Prescription price transparency offers patients and prescribers the power of informed decision-making at the point of care. It improves outcomes, reduces costs, increases medication adherence and enhances the care experience between doctor and patient. The data we present in this report reflects a strong and growing demand for prescription price transparency at the point of care. For example, the number of prescribers leveraging patient-specific information on drug costs and therapeutic alternatives in their electronic health record (EHR) more than doubled in 2019, from roughly 100,000 in January to nearly 250,000 in November.

The full Surescripts report can be viewed at this link.  

Name: 
Anna

Want To Improve The Social Determinants Of Health? Here Are 8 Solutions

December 08, 2019

Want To Improve The Social Determinants Of Health? Here Are 8 Solutions

This wasn’t your typical discussion about social determinants of health. Today at Day 2 of this year’s Forbes Healthcare Summit in New York City, one of the sessions bore the title, “Four Solutions to Improving the Social Determinants of Health, Right Here, Right Now.”

Yes, that’s the word “solutions” in the title. Not “problems” or “99 problems” or “yeah, such is life.” Social determinants of health (SDOH) are the “conditions in the places where people live, learn, work, and play” that “affect a wide range of health risks and outcomes,” according to the Centers for Disease Control and Prevention (CDC). It’s been established over and over again that your environmental, social, job, and economic situations can greatly affect your health. In the words of Spandau Ballet, this much is true.

So, rather than waste any more words, let’s get to the solutions that the panel discussed:

Best Practices

  • Improve people’s diets and access to healthy food - Since diet can affect so many aspects of health, it’s not surprising that one of the solutions that emerged involved food. Another panelist, Jean C. Accius, Ph.D., Senior Vice President of AARP, emphasized that reducing food insecurity can have a “ripple effect,” because locations with food insecurity also have higher levels of diabetes and other chronic diseases.
  • Improve the physical environment such as increasing housing options, transportation options, and parks - Many of AARP efforts have focused on creating more “age-friendly communities.” We need to “think about how to create more livable communities.” That includes ensuring “greater housing options and greater transportation options.” 
  • Improve access to the Internet - These days, there’s much talk about the possibility of developing mobile and Internet-based approaches to improve the health of communities. Ah, but there’s one problem with that. Many people still don’t have reliable access to the Internet or have experience navigating the Internet.
  • Better understand the needs of individuals and bring care to them - All of the panelists agreed that healthcare needs to better understand the needs of patients. Not patients as one big glutinous mass, but as a range of different individuals. 
  • Integrate health care with retail - One panelist offered the possibility of “healthcare getting together with retail. Integrating retail more with the healthcare system.”
  • Develop and use technology to bridge the gaps in social determinants - Find ways to develop and use technology to overcome current gaps and disparities in SDOH. The other panelists talked about how technology can help better understand what consumers need and want.
  • Re-structure financial incentives to motivate addressing social determinants - The panel briefly discussed a seventh key solution: re-structuring financial incentives to further motivate the aforementioned solutions, a solution to help other solutions so to speak. “it is hard to get someone to do something when their salary depends on them not doing it.”
  • Changing the focus of healthcare in general - The emphasis of healthcare has to turn a completely new direction. There is an “urgent need for healthcare to better address social determinants, which is 80% of health. Too long has social determinants been relegated to the end of a meeting or conference."

The full Forbes article can be viewed at this link.  

Name: 
Anna

“Patient Journeys”: improving care by patient involvement

December 07, 2019

“Patient Journeys”: improving care by patient involvement

“I will not be ashamed to say ‘I don’t know’, nor will I fail to call in my colleagues…”. For centuries this quotation from the Hippocratic oath, has been taken by medical doctors. But what if there are no other healthcare professionals to call in, and the person with the most experience of the disease is sitting right in front of you: ‘your patient’.

This scenario is uncomfortably common for patients living with a rare disease when seeking out health care. They are fraught by many hurdles along their health care pathway. From diagnosis to treatment and follow-up, their healthcare pathway is defined by a fog of uncertainties, lack of effective treatments and a multitude of dead-ends. This is the prevailing situation for many because for rare diseases expertise is limited and knowledge is scarce. Currently different initiatives to involve patients in developing clinical guidelines have been taken, however there is no common method that successfully integrates their experience and needs of living with a rare disease into development of healthcare services.

The full article can be downloaded below.  

Name: 
Anna

Development of the mHealth App Trustworthiness checklist

November 30, 2019

Development of the mHealth App Trustworthiness checklist

Mobile health applications (mHealth apps) currently lack a consensus on substantial quality and safety standards. As such, the number of individuals engaging with untrustworthy mHealth apps continues to grow at a steady pace.

The purpose of this study was to investigate end-users’ opinions on the features or actions necessary for trustworthy mHealth apps; and to convey this information to app developers via a succinct but informative checklist: the mHealth app trustworthiness checklist.

The checklist was formulated in three stages: (a) a literature review of studies identified the desirable features of the most prolific mHealth apps (health and fitness apps); (b) four focus group sessions with past or current users of these apps (n ¼ 20); and (c) expert feedback on whether the checklist items are conceivable in a real-life setting (n ¼ 6).

Five major themes emerged from the focus group discussions: informational content, organizational attributes, societal influence, technology-related features, and user control factors. The mHealth app trustworthiness checklist was developed to incorporate these five themes and subsequently modified following expert consultation. In addition to the trustworthiness themes, we identified features that lie between trust and mistrust (limited digital literacy and indifference) as well as 10 features and actions that cause end-users to mistrust mHealth apps.

This study contributes to the evidence base on the attributes of trustworthy mHealth apps. The mHealth app trustworthiness checklist is a useful tool in advancing continued efforts to ensure that health technologies are trustworthy.

The full article can be downloaded below.  

Name: 
Anna