Healthcare Intelligence Network

Broome County, New York's Community Alternative Systems Agency -- also known as CASA -- has a bird's eye view of every type of care setting, explains its director, Michelle Berry. The program's in-home longterm care assessment looks beyond the individual's physical condition, she says, taking note of social, emotional and environmental factors. To help patients own their care plans and improve recordkeeping, CASA hopes to soon train the homebound to use a "guest book" that will require visiting caregivers -- nurse, physician, physicial therapist, etc. -- to "sign in" and record the reason for each visit. This hard copy record would be the prototype for an eventual online care record, Berry explains. Berry, along with Nora Baratto, manager of the case management department at St. Peter's Hospital's CHOICES program in Albany, New York, described the strategies their organizations have used to improve the hospital discharge process during an October 23, 2007 webinar, Best Practices in Hospital Discharge to Reduce Preventable Readmissions.

Dr. Peter Kongstvedt, a partner in the health and managed care consulting services division of Accenture, comments on how to effectively use new media in today's healthcare arena, as well as what many healthcare organizations are calling the biggest road block pay for performance initiatives. Experts from key areas of healthcare examined the trends that are shaping today's healthcare industry. Kongstvedt, commented on health plan trends, Nathan Kaufman, on hospital trends, Dr. Joel Diamond, on trends impacting physician groups and Elizabeth Opland, on trends impacting the wellness and health promotion sector during a October 10, 2007 webinar, Healthcare Trends and Forecasts in 2008.

Dr. Karen Amstutz, regional vice president and medical director at Wellpoint State Sponsored Business, and her colleague Dr. Lakshmi Dhanvanthari, staff vice president and medical director at Wellpoint, discuss how their organization educates patients on appropriate ED use and how health literacy of members is a key element in reducing ED overuse. Dr. Amstutz and Dr. Dhanvanthari described WellPoint's strategy for reducing ED overuse during a September 25, 2007 audio conference, Developing Effective Strategies to Reduce Non-Emergent Emergency Department Use.

Dr. Jim Glauber, medical director for Neighborhood Health Plan of Massachusetts, defines ED overuse for his organization and discusses the differences between urgent care and emergent care and when patients should use each. Dr. Jim Glauber provided details on the strategies his organization has implemented to address non-emergent ED use during a September 25, 2007 audio conference, Developing Effective Strategies to Reduce Non-Emergent Emergency Department Use.

When you ask patients for feedback on care, you may not always like what you hear. Nonetheless, HealthPartners includes patients in program design sessions, and its patient advisory councils have more candidates than the organization can currently use. Beth Waterman, HealthPartners vice president of primary care and clinic operations, describes how patients and others were selected to participate in the two-day rapid design session in 2002 that developed the award-winning prepared practice team model. The prepared practice teams have since been carefully duplicated at more than 20 HealthPartners clinics. A Care Model Process oversight team sends quarterly program updates to all practice teams to ensure the structure and consistency that are program hallmarks. Waterman will describe the role of practice teams in her organization during a September 19, 2007 audio conference, Building Patient Care Continuity with Prepared Practice Teams.

Current quality measures focus on care upon admittance and care at end of stay and/or at discharge but ignore all aspects of care during the patient's stay, says Dr. Dale Bratzler, medical director of the Hospital Interventions Quality Improvement Organization Support Center. He identifies several areas that if given attention may result in better transitions of care, including the patient's discharge from the hospital. A cultural shift toward accepting quality ratings as part of practicing medicine is occuring in healthcare organizations from the top down, he observes, and believes that team-based training -- both for medical students and current doctors and nurses -- will help ensure high-quality care for patients. Bratzler will provide a brief overview of the potential unintended consequences of public reporting that could lead to patient harm in both direct and indirect ways. Bratzler will also describe how avoiding these unintended consequences of performance measurement requires careful attention to the development of measure specifications and setting realistic goals for improvement. Conference participants will then have the opportunity to probe for more details and bring to the "table" the areas of concern in their organization during a September 6, 2007 audio conference, Ensuring the Benefits of Public Reporting and Pay-for-Performance Programs Outweigh the Unintended Consequences.

Leanne Huminski, chief nursing officer, McLeod Regional Medical Center, comments on capitalizing on computer technology, McLeod's initiatives for eliminating adverse drug events (ADEs) and the role information technology is playing in reducing ADEs. Huminski, Lenore Blank, Michelle Gilbert and Donna Isgett will describe how their organizations are implementing perfect care processes in heart failure and medication management with details on how they've implemented their programs and the results they are achieving during a August 22, 2007 audio conference, Pursuing Perfect Care: Improving Chronic Care Outcomes by Treating the Whole Patient.

Collaborative patient care models that empower the primary care nurse to communicate patient needs to physicians has not only improved patient care and outcomes but also fostered a cultural change at Hackensack University Medical Center, explains Lenore Blank, a nurse practitioner and administrative manager of HUMC's heart failure and pulmonary hypertension team. Her team is part of Pursuing Perfection, a healthcare quality initiative from the Institute of Healthcare Improvement. As HUMC creates the partnerships mandated by Pursuing Perfection, it is extending the knowledge and benefits they've gained with other organizations -- and reducing hospital readmissions in the process. Blank, Michelle Gilbert, Donna Isgett, and Leanne Huminski will describe how their organizations are implementing perfect care processes in heart failure and medication management with details on how they've implemented their programs and the results they are achieving during a August 22, 2007 audio conference, Pursuing Perfect Care: Improving Chronic Care Outcomes by Treating the Whole Patient.

Change a belief and you'll change a behavior, says Allyson Faist, president and CEO of MEDeCoach. There's a formula to the frequency and format of health coach contacts that will engage a client, and ways to handle a client who has received conflicting information from the Internet on a health management issue. An integrated system where the coach and client are on the same IT platform increases the chances for successful, collaborative coaching. Faist will examine how consumer developments are impacting the collection of health risk data and the health coaching sessions that may result from a health risk assessment (HRA) during a September 26, 2007 audio conference, Health Risk Assessments and Health Coaching: How the Web and Consumer's Expectations Are Changing the Landscape.

In this podcast, Margaret Moore, CEO, Wellcoaches, demonstrates how to build positive psychology into health coaching sessions. This live health coaching demonstration was conducted as part of "Teaching Health Coaches to Integrate Positive Psychology with Physical Health to Improve Disease Management Outcomes," a July 18, 2007 audio conference now available on CD-ROM or via an On Demand re-broadcast on the web.

In this podcast, Dr. Philip M. Bonaparte, chief medical officer of Horizon NJ Health comments on the success of his organization's fourth ER-based caseworker initiative and the information these caseworkers distribute to patients. Bonaparte also comments on the benefits and drawbacks retail clinics and convenient care clinics are having on the healthcare industry at this stage in their existence. Dr. Bonaparte and Caryn Jacobi, McKesson's associate V.P. of operations for Illinois, will describe how their respective organizations target and engage Medicaid enrollees for participation and success in disease management programs during a July 25, 2007 audio conference, The Medicaid Population: Identifying, Locating and Engaging a Hard-to-Reach Population for Disease Management Success.

When it comes to making contact with its Medicaid members in Illinois, field work is the name of the game for McKesson Health Solutions. A presence in emergency departments to reduce unnecessary utilization among members and the placement of communication teams in 24 geographical locations around the state is proving successful for McKesson, explains Caryn Jacobi, McKesson's associate V.P. of operations for Illinois. Other efforts include a 24-hour triage line for members and mailings, phone calls and field visits. Dr. Philip M. Bonaparte, chief medical officer of Horizon NJ Health and Jacobi, will describe how their respective organizations target and engage Medicaid enrollees for participation and success in disease management programs during a July 25, 2007 audio conference, The Medicaid Population: Identifying, Locating and Engaging a Hard-to-Reach Population for Disease Management Success.

Having supplemented coach training with live coaching demos for many years, Wellcoaches CEO Margaret Moore has found that the demos are a powerful way to bring to light essential coaching skills. Even during a 15-minute demo with a "volunteer client," she says, you can observe a "mini-transformation" and shift in client energy. She usually recruits the volunteer from among the seminar participants, and describes the ideal volunteer and the pre-coaching preparation that is required. She also weighs in with some suggestions for evaluating a health coach's performance. Moore, will describe coaching theories and strategies and conduct a live coaching demonstration to illustrate the theories and strategies in action. Conference participants will have the opportunity to ask questions on the techniques Moore uses during the coaching session following the demonstration during a July 18, 2007 audio conference, Teaching Health Coaches to Integrate Positive Psychology with Physical Health to Improve Disease Management Outcomes.

Both science and human nature played a part in the success of Healthways' telephonic care support for diabetes patients, explains John Harris, senior vice president of the Health Support Division of Healthways. Even though the program is from Healthways' care management side, he believes that the same results would apply to a coaching effort, since any time a human intervenes with another human, the chances of success go up considerably. According to John, an individual's learning style and risk levels are also factors in determining whether a Web-based or telephonic coaching system would be most effective. John also explains how advances in predictive modeling allow healthcare organizations to find candidates earlier and provide more compelling evidence of the need for a coaching intervention. Harris and Sean Slovenski, president and CEO, Hummingbird Coaching Services, described how to effectively capture and integrate multiple data sources to identify potential clients for health coaching and how to effectively use that information to achieve health coaching success during a June 13, 2007 audio conference, Building a Health Management IT Platform for Health Coaching.

A lack of trust in the use of patient health information and a general reluctance to share patient information with industry competitors are the biggest obstacles to an open exchange of patient health information, says Gary Austin, a healthcare industry consultant on corporate/product strategy and program management. In spite of these roadblocks, the health plans he's met with support a climate of value-based healthcare choices. Many plans have already invested millions to equip physicians with the capability for e-prescribing, and more will underwrite physicians in the use of electronic medical records in the next few years. He envisions that consumer "smart cards" loaded with patient health information will initially be introduced within individual health systems, and eventually be usable between systems. Austin, Linda Davis, a consultant to the Buyers Health Care Action Group (BHCAG) in Minnesota, Sue Lewis, senior vice president of health and productivity solutions at IncentOne, and Mark Xistris, director of provider relations and health information for The Alliance, examined how their respective organizations are using these four strategies to stay competitive in the fast-growing consumer-driven movement during a May 30, 2007 audio conference, Value-Driven Healthcare in Action: A Four-Pronged Approach to Meet Consumer Transparency, Quality and Access Demands.