Is Team Training Effective at Healthcare Sites?

Jul 14 2020 Published by under Uncategorized

In the June 2016 issue of the Journal of Applied Psychology the authors Eduardo Salas, Lauren Benishek, Megan Gregory and Ashley Hughes in an article titled “Saving Lives: A Meta-Analysis of Team Training in Healthcare” set out to answer the question as to whether team training is effective in healthcare, whether it leads to reduced mortality and improved health outcomes.

Their research stated that a preventable medical error occurs in one in every three hospital admissions and results in 98,000 deaths per year, a figure corroborated in To Err is Human. Teamwork errors through failure in communications accounts for 68.3% of these errors. Thus, effective team training is necessary to reduce errors in hospitals and ambulatory sites.

The authors used a meta-analysis research method to determine whether there are effective training methods in the healthcare setting that can have a significant impact on medical errors, which would in turn improve outcomes and reduce costs by eliminating the costs associated with the errors. A meta-analysis is a broad research of existing literature to answer the research questions posed by the research team or authors.

The research team posed three questions to answer:

1. Is team training in healthcare effective?

2. Under what conditions is healthcare team training effective?

3. How does healthcare team training influence bottom-line organizational outcomes and patient outcomes?

The team limited its meta-analysis to healthcare teams even though there is a great deal of research available about the effectiveness of team training in other industries and service organizations. The team believes that healthcare teams differ significantly from teams in other areas in as much that there can be much greater team fluidity in healthcare. That is, team membership is not always static, especially at sites such as hospitals and outpatient surgical centers. There are more handoffs at these sites.

Although there is greater fluidity in team membership at healthcare sites, roles are well defined. For instance, a medical assistant’s role at a primary care site is well defined even though different MA’s may be working with one physician. These roles are further defined and limited by state licensure. As the research team stated in their article, “these features make healthcare team training a unique form of training that is likely to be developed and implemented differently than training in more traditional teams… “

The team assessed their research of articles using Kirkpatrick’s model of training effectiveness, a widely used framework to evaluate team training. It consists of four areas of evaluation:

1. Trainee reactions

2. Learning

3. Transfer

4. Results

Reaction is the extent to which the trainee finds the instruction useful or the extent to which he enjoys it. Learning is defined as a relatively permanent change in knowledge, skills and abilities. The authors note that team training is not a hard skill, as learning to draw blood. Rather, it is a soft knowledge skill. Some researchers question whether it is possible to measure the acquisition of these soft team skills effectively. The team of authors effectively argue that it can.

Transfer is the use of trained knowledge, skills and abilities at the work site. That is, can team training be effectively applied in the work setting? Results are the impacts of the training on patient health, the reduction of medical errors, the improved satisfaction of patients and a lowering of costs in providing care.

In order to assure that the changes in these four areas were ‘real’ the team only used literature that had both pre-assessments and post-assessments to see if there were statistically significant changes in the four areas.

Using this assessment rubric the team was able to answer the three questions that it posited. First, team training in healthcare is effective. Healthcare team training closely matches training in other industries and service organizations.

Secondly, training is effective, surprisingly, regardless of training design and implementation, trainee characteristics and characteristics of the work environment. The use of multiple learning strategies versus a single training strategy does not matter. Simulations of a work environment are not necessary. Training can occur in a standard classroom.

Training is effective for all staff members regardless of certification. Training of all clinical personnel as well as administrative staff is effective. Team training also is effective across all care settings.

Lastly, the team’s meta-analysis shows that within the Kirkpatrick rubric team training is effective in producing the organizational goals of better care at lower costs with higher patient satisfaction. In the rubric trainee reactions are not nearly as important as learning and transfer in producing results. It is important that trainers use both pre-training assessments and post-training assessments to measure whether there learning of skills, knowledge and abilities were learned and whether these were transferred to the work site. Effectiveness of training should always be assessed in order that training programs can be consistently improved.

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Healthcare Quality Methods

Jul 14 2020 Published by under Uncategorized

Healthcare organizations can employ different health care methods for quality improvement. Since healthcare is not a simple phenomenon, industries find it hard to adopt the controls and standardization of quality improvement methods. However, general methods that define quality, grow improvement measures and identify variation through PDSA cycles and control charts have been successful in the application of healthcare processes. Let’s take a look at some healthcare quality improvement methods.

#1: Facilitate Adoption

It’s not enough to introduce new ideas to clinicians and discuss case studies. The reason is that it won’t motivate them to follow the improvement initiatives. It’s better to learn the quality improvement theory via hands-on improvement work. In other words, it’s applied to the real clinical setting. Also, identifying important areas for clinicians and develop the platform for betterment can help make the adoption much easier.

#2: Defining Quality & Reaching an Agreement

If we agree on what quality means in a certain context, we can establish the measures and then collect data based on them. Also, the Institute of Medicine made a quality framework based on 6 aims for the systems for healthcare. However, the most important of them is the one that is patient-oriented. In other words, it stresses the provision of care based on the values and needs of an individual patient. Also, it ensures that the clinical decisions are made based on the patient’s values.

The definition of quality refers to what the patient thinks is important. It’s to make sure that the patient is getting the best care possible for their illness.

#3: Improvement and Accountability

Both data and measurement make the backbone for quality improvement. This is the point where it’s difficult to take care of the matters associated with healthcare. Typically, when it comes to quality improvement methods, clinicians think that they involve performance measures that require accountability. However, it’s important to remember the difference between accountability measures and improvement measures.

Typically, the accountability measures are processed to get percentages. An accountability measure, for instance, gathers data about the number of ER patients who had to hang on for over 30 minutes for their turn. And then management is asked to keep the waiting time below half an hour. So, the improvement measure figures out the actual waiting period in minutes in order to find out the system performance and them improve it.

#4: PDSA Cycles and Quality Improvement Framework

For healthcare quality improvement, many frameworks are used:

  • The DMAIC model of Six Sigma
  • Lean methodology
  • The Model of Improvement was designed by the API in 1987
  • PDSA cycles are the most important part of healthcare quality improvement

Given below is the explanation of the PDSA cycles:

  1. Plan
  2. Do
  3. Study
  4. Act

#5 Variation in Data

With a deeper insight into the Mode for Improvement, the plan can help you achieve your improvement goal. Some of this insight comes from getting to know the variation in data and its causes.

Also, healthcare processes include two types of variations: intended and unintended. The intended variation refers to do something in a different way on purpose. And this defines patient-oriented care.

On the other hand, unintended variation happens when many clinicians prescribe different types of antibiotics for a problem at hand regardless of the rationale of the variation. And an out of habit or a free of thought variation is called an unintended variation.

So, this was a description of 5 healthcare quality methods.

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The Evolution of Healthcare Mystery Shopping

Jul 14 2020 Published by under Uncategorized

Patients answer patient satisfaction survey questions based on their perception, and yet there is limited context for the healthcare provider. It leaves one asking the questions – who were they interacting with, what was said, when did it happen, and how capable and reliable was the patient to make those interpretations? So instead of convening a committee to explore the reasons for poor scores, healthcare mystery shopping provides healthcare clients with the research intelligence needed to make real-time improvements.

In an era of value based purchasing with a focus on inpatient stays, I have estimated that over 80% of the lives touched by health systems in this country are not patients at all, but rather family members, visitors, outpatients, and consumers of everything from equipment to Starbucks. By all means make the patient room environment as clean and silent as possible, communicate effectively with the patient, and ensure that they are fully prepared to be discharged, but the emphasis must still be on the patient’s perception. Observations, opinions, and ultimately consumer decisions derive from that source.

The elevated importance of patient satisfaction data means that as the data is digested, more and more questions will arise. For instance, a survey will tell you there is a concern with the friendliness of the radiology staff. Instead of creating a broad-brush customer service program for the Radiology Department, the logical next step is to determine how the department is being perceived by end-users, what the department’s behavioral weaknesses are, and who on the staff is exhibiting those behaviors.

Together patient satisfaction data and healthcare mystery shopping can begin to focus on meaningful solutions that cause providers to say, “We know from patient satisfaction there is a problem and from mystery shopping we know what that problem is and who is primarily responsible.”

While it is recommended that managers look for coaching opportunities by observing their employees in action, expecting them to alter the service culture is less likely since – for the most part – they created the culture. Because this type of research is strictly consumer perception, it provides an unbiased view of a department or organization’s culture. This gives managers a third party perspective that increases coaching opportunities.

Types of Healthcare Mystery Shopping

From those early days of healthcare mystery shopping, healthcare provider requests have gotten more creative, more targeted, and more sophisticated. For example, a client may request something as all encompassing as a 24-hour inpatient stay in which the shopper is admitted for a 24-hour period to evaluate the patient experience from registration to discharge. Or shoppers may be asked to call physician offices to make appointments with the intent of determining how long it will be before they can be seen tying the research to more efficient use of resources.

In 2008, healthcare mystery shopping received significant national press when the American Medical Association attempted to take up a position on the practice. What was not as readily reported was the fact that the issue was tabled indefinitely. In fact, it was already the custom of one of the leading providers (prior to the accusation that healthcare mystery shopping was unnecessarily taking up physician time) to utilize what they call process observations. This form of mystery shopping, which is most effective in Emergency Departments, avoids taking up valuable patient time by having a shopper join a patient as a friend as they go through the patient experience.

Two of the most beneficial types of perception research are: 1) shopping the competition, and 2) evaluating individual employees. Call it spying, many do, but it is important to know your competition’s culture. For example, what do they believe in and how is it transferred to the patient, and can the anecdotal stories you’ve heard be verified?

A great deal of value can be derived from conducting evaluations of individual employees. For a number of reasons – cost certainly being a factor – this works best in a departmental environment and gives managers an apples-to-apples comparison of each employee as it pertains to specific standards, i.e., is Cindy more likely than Jeff to greet patients immediately (setting up a coaching opportunity for Jeff)? Or, does Jeff do a great job of cross-selling services and should be commended?

Healthcare mystery shopping also gives managers concrete examples of the specific behavior that “turns patients on.” This sets up the perfect opportunity to present to staff the behaviors the organization would like emulated while giving kudos to the employee who displays them.

Quantitative and Qualitative Appeal

Healthcare mystery shopping appeals to managers and administrators whether they are left brained (numbers focused) or right brained (narrative focused). On the one hand, mystery shopping is about story telling. Fred Lee wrote in If Disney Ran Your Hospital, “What seems to be a major component of both loyalty and dissatisfaction are stories. A satisfied person has no story to tell.” Stories are important in articulating the who, what, when, where, and how of the patient or consumer experience. The right brain approach to mystery shopping allows clients to clearly discern the difference between a completely satisfactory experience and all the various facets that went into it, and those elements of an experience that triggered displeasure or frustration. At the same time, healthcare mystery shopping is an effective compliance tool. Standards that are specific to the healthcare industry, and therefore can be benchmarked, are mixed with organizationally specific standards to create a quantitative amalgam that can be data spliced in any way necessary. Healthcare mystery shopping primarily answers the following question – How well does your organization perform on the behaviors and processes you told your people are important? In addition, it lets organizations measure those standards against perception-based goals.

The Flexibility of Healthcare Mystery Shopping

Patient satisfaction surveys are, for the most part, static. They are unchanging for a reason. Conversely, healthcare mystery shopping is much more flexible. It can be designed as a program that measures the same standards or processes over time, or studies can be developed to determine exactly what behaviors or processes are being performed.

Healthcare mystery shopping can also be redirected ‘on the fly’ if the desired objectives are not being met. For example, to their surprise, a physician practice that was asking shoppers to make appointments found out they weren’t accepting new patients. Another practice that was evaluating the customer service of their registrars discovered that none of the calls were being answered by a ‘live’ person. In both instances, the practice put on the brakes until they could fix the issue. One hospital was having shoppers go to their website to look for specific information and then having them request a response. What this uncovered was that the requests were accumulating on a PC that was not being used. This finding allowed the hospital to avoid upsetting hundreds of consumers who felt they were being rudely ignored.

How does one know if a service initiative is really working? Healthcare mystery shopping is an excellent complement to any service initiative. It can be directed in such a way that it provides real time verification that the initiative is being effective. Anything from a discharge process to valet service can be shopped at various times to ensure that the initiative’s message was received and implemented.

Flexibility does not, however, extend to internal programs. Sometimes in the name of saving money, healthcare providers will launch a do-it-yourself program. They attempt to get employees or volunteers to perform the same function that professional healthcare mystery shopping firms do. This rarely if ever works for any duration for obvious reasons. Insiders have internal biases and, despite their best intentions, are no longer able to be objective. The other reason this is not effective is that employees (and even volunteers) can think of a million things they should be doing or would rather be doing. And the lack of staying power for a do-it-yourself program puts a tremendous burden on the manager assigned to administer the task.

What Clients are Looking For

Hospitals, health systems and physician practices seek out healthcare mystery shopping vendors for a number of reasons. In some cases, they want to validate “good news.” For example, one health system client entered into a long-term relationship with the primary goal of proving that their services were superior to the competition that was also shopped. A recent wayfinding study of over 300 ‘shops’ conducted for a large hospital on the east coast concluded that less than 76% of their employees received a top box score of five for greeting consumers with a smile. This finding was indicative of a culture that was not treating consumers in ‘a personal and memorable way.’ However, healthcare mystery shopping afforded them the advantage of validating their original concern, isolating where this concern is most prevalent, and using the shopper’s language to convey to staff why greeting people was critically important to overall perception. Much like satisfaction surveys, healthcare mystery shopping is able to monitor improvement over time, but with the added benefit of story telling to pinpoint issues. It can also be instrumental in determining the specific nature of the concern and identifying where weaknesses exist.

A healthcare mystery shopping executive, who is undergoing therapy for breast cancer, wrote in a blog recently, “What matters to healthcare organizations are things like how many steps it takes to check a patient in, scripted greetings for frontline employees, record keeping for correct billing, and clinical training for new safety measures. However, as a patient, I notice if the person checking me in for chemo is smiling and greets me because she cares, not if she delivers a scripted sentence. Next, I notice if the nurses in the chemo area are working as a team and greet me personally (they should know me after two months). But what is most important to me is whether or not the clinical staff is aligned with my recovery goals.”

While this executive may be more attuned to her surroundings than most patients and able to articulate what it means to her, the goal for any healthcare mystery-shopping program is to use the shopper’s heightened sense of awareness and their ability to effectively communicate their experiences in a way that is clear and concise.

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Corporate Behemoths in Healthcare: Will the Patient Win?

Jul 14 2020 Published by under Uncategorized

The past several weeks have been abuzz with the mergers and acquisitions in the healthcare arena. CVS has purchased Aetna for a cool 69 billion dollars and went through the regulatory process with flying colors. Amazon (on their quest for world domination) has teamed up with Warren Buffett, CEO of Berkshire Hathaway and financial powerhouse J.P. Morgan to use their resources, influence and power to, according to Buffett, “tackle healthcare costs in our nation.” Buffet also said that because the U.S., at 18% of our gross domestic product, the U.S. is at a competitive disadvantage, at 3.3 trillion dollars annually. He believes the private sector can handle healthcare better than the government.

Albertson’s, a grocery company, is ready to acquire retail pharmacy giant Rite Aid. And now, Cigna, the insurance behemoth, is buying Express Scripts in a deal for upwards of 50 billion. Software giant Apple is dipping their toe into employee health, while things are starting to rumble at Wal-Mart, the retail monster.

After all of that information, you need a breather. But will a disruption by these companies be the thing that makes healthcare better in the U.S.?

Yet, as a patient advocate and caregiver supporter, my main concern is this: Will all of this be a win for patients, caregivers and families? You know – the healthcare customers?

While the shake-up in healthcare is oh-so-long overdue, is the combination of behemoths the right way?

First, this healthcare shake-up won’t be the last of the behemoths to combine. I would be willing to bet on that. We have yet to hear from the likes of Microsoft, Walgreens, Google or any of the Generals (Electric, Motors, Mills). What about other insurers? Where is Humana or United Healthcare in this game?

Many companies will follow suit. It’s just a matter of time. I liken it to the most popular girl in high school getting into a relationship with the most popular boy and becoming a force to be reckoned with. Everyone will see the trend, its benefits and potential, and jump into it. Sorry for the high school analogy.

The point is everyone sees that it is time for change in healthcare.

So what’s in it for patients/customers?

Something we must question is this: Are these corporations in it for the billions of dollars that healthcare is worth or do they really want better conditions, cost and efficiency for patients? Will the combination of all these behemoths reach past their employees and meet the needs of all patients in our nation? What are their motives?

My mission is to empower patients and caregivers to navigate healthcare confidently and correctly, to save them and all parties involved time, money and frustration. I show them that they have rights and responsibilities in their Healthcare journey and must take a strong and active role in their care. Patients are the lifeblood of the healthcare system.

None of these behemoth combinations will be successful without patient/customer buy-in. They’d better put all of their goals into a nice and helpful package for patients so they feel supported and empowered. If these corporations can show how the patient will be helped and how their alliances can save money for all parties involved, they should have no trouble in the regulatory processes they face.

But I implore all of you behemoths… DO SOMETHING.

Do something for the 64% of Americans who avoid getting care because they are afraid of the costs.

Do something for the working poor who make too much for Medicaid and not enough to afford skyrocketing healthcare premiums.

Do something that shows how healthcare can actually be affordable and where service prices do not have to be excessive.

Do something to empower patients and establish real healthcare cost transparency.

Do something about actual care and system processes to show that it doesn’t have to be as difficult or time-consuming as it is currently.

You behemoths have the power to change healthcare for the better for the foreseeable future and possibly, forever. Please don’t look down from your Ivory Towers upon us mere mortals and pity us or hope for the best. Do something.

Make it a win for patients, and we all will win.

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Revenue Cycle Management’s Importance in Healthcare

Jul 14 2020 Published by under Uncategorized

The Healthcare industry transition from fee-for-service to value-based care reimbursement impacts the traditional RCM (Revenue Cycle Management) in different ways. Every healthcare organization or an individual veteran practitioner needs to be financially balanced or strong to deliver their uninterrupted services. This is a time where best healthcare RCM service comes in.

Revenue Cycle Management in healthcare is the financial process that facilitates the control of complex administrative processes and clinical functions such as patient eligibility, claims processing, reimbursement, denied claims management, and revenue generation.

RCM is the backbone of healthcare organizations that helps them to pay their bills, manage their resources and much more. According to international standards report, in medical billing, more than 25% of claims have been rejected and up to 40% of those claims are never re-submitted i.e. the healthcare organizations suffer from major revenue loss.

On the bright side, with proper RCM process, the healthcare sector can get greatest benefits with minimum bad debt write-offs. To understand the exact phenomenon of healthcare revenue cycle management, first, you have to understand its basics in the medical billing process.

Basics of Healthcare RCM:

  • It starts from the appointment of a patient to seek any medical assistance and completes when the health organizations collect their payments.
  • At the beginning, the health group administrative staff manage an array of processes like scheduling, insurance eligibility verification and creation of patient’s account.

“From the perspective of Revenue Cycle Management, immaculate submission of patient information at the time of patient scheduling and registration improve the cash flow of the healthcare organization.”

  • After the patient’s treatment, the process of claims submission begins. An advanced coder submits the claims with right ICD-10 codes, the codes define the value of reimbursement and an approved code prevent claims denials.
  • Then comes the important part of private or government payer for payment. They evaluate the claim values, verify the details i.e. insurance coverage, contracts, etc. and process for reimbursement.
  • Most claims are denied due to improper coding, incomplete patient accounts, patient chart errors, etc.
  • Then comes the last outcome of revenue cycle management i.e. maximum claims reimbursement. RCM helps the healthcare organizations to get paid maximum claims reimbursement on time with fewer denials.
  • After that, the healthcare groups or the individual veterans perform the AR Follow up in which they create Healthcare claims i.e. manually or automatically and sends them to various Insurance companies.
  • In the final stage i.e. Payment Posting, the medical billing management software records every patient’s payment with accurate information including patient’s name, account number, denial info, service dates, etc. for future reference.

Importance in Healthcare:

It can help the healthcare organizations to track the exact performance of their financial growth. They can easily determine the claims approval and denial rates via proper RCM process. With immaculate RCM process, the healthcare organizations managed their medical billing process effectively and fixed their claim denial issues quickly.

Here are some key benefits of effective RCM:

  • Fewer denied claims
  • Improved patient care
  • Higher Reimbursements
  • Immaculate administrative records i.e. no other penalties or fees
  • Faster Turnaround time for claims payments

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Healthcare Risk Assessment

Jul 14 2020 Published by under Uncategorized

Introduction

The purpose of a Risk Assessment is to identify threats and vulnerabilities and develop a plan to mitigate the risks identified within the assessment. Like all processes, we can make it easy or extremely complicated and difficult. Planning is the key.

C-I-A Triad

The C-I-A triad consists of three elements: Confidentiality, Integrity and Availability of data and data systems.

Confidentiality simply means controlling access to those who have a legitimate need to know. Integrity is ensuring that the data hasn’t been altered; and Availability means the data can be accessed and used by those who need to access the data.

This is a relatively simple concept that has far-reaching impact in the world of Healthcare and HIPAA.

A Risk Assessment will help administrators and compliance personnel identify risks to their medical practices before they become a problem.

An annual Risk Analysis is required by the Department of Health and Human Services.

Risk Analysis and the Security Rule

The Department of Health and Human Services through its lower level agencies requires an annual Risk Assessment. This Risk Assessment is based on Special Publication 800-66, by the National Institute of Standards and Technology, which provides instructions for conducting a Risk Analysis as defined by the HIPAA Security Rule.

The outcome of the Risk Analysis is critical to discovering and mitigating actual and potential vulnerabilities from your information systems and workflow practices.

Failure to comply may cost your business money due to fines and penalties.

Risk Analysis Process

Like anything else conducting a Risk Analysis is a process and your first one can make it seem like an overwhelming task. Let’s tame this beast.

The first step is to understand the basic information and definitions regarding conducting a Risk Assessment.

Definitions

Have you heard the old joke about how do you eat an elephant? Answer: One bite at a time.

This punch line could have been expressly written for conducting risk assessments.

First, we need to know the jargon used in the process. We need to develop a baseline for understanding what we are going to do, how we do it, and finally what are we going to do with it.

Vulnerability

NIST SP 800-33 defines vulnerability as a… ” flaw or weakness in system security procedures, design, implementation, or internal controls that could be exercised (accidentally triggered or intentionally exploited) and result in a security breach or a violation of the system security policy.”

No system is without vulnerabilities. Vulnerabilities arise out of coding errors, changes to procedures, system or software updates, and changes of threats over time. The analyst must be aware of evolving threats and vulnerabilities, while actively working to resolve currently defines problems.

This process never ends.

Threats

A threat is “the potential for a person or thing to exercise (accidentally trigger or intentionally exploit) a specific vulnerability.

A vulnerability isn’t necessarily an issue until there is a threat to exploit the vulnerability. Common natural threats are fires, floods, or tornados. Human threats are computer hacks, careless control of ePHI, or inadvertent data exposure. Environmental threats are things like power failures.

Risks

Risk is defined by the presence of a vulnerability that can be exploited by an appropriate threat. You can’t have one without the other.

The level of risk is determined by the expected level of damage that could result from the vulnerability being exploited combined with the likelihood of the vulnerability being exploited.

Risk = Severity of potential damage + Likelihood of the Threat

Elements of a Risk Assessment

By breaking the Risk Assessment process into smaller, more manageable pieces, we can complete our task quickly and efficiently. Well at least efficiently.

Scope

The Scope of a Risk Analysis in an understanding of what the analyst is attempting to determine. Different industries have difference requirements so the Analyst must be up to date on their processes and procedures.

In the scope, the analyst and the business entity clearly define the goals of the project. They determine how to accomplish those goals, and how the required data can be gathered based during the Risk Management process.

Data Collection

Care must be taken to not compromise ePHI during this data collection process. Part of the data collecting process refers to how protected data is stored and should be treated like any other data point.

Identify Potential Threats and Vulnerabilities

As each threat or vulnerability is identified, it must be recorded for evaluation. This evaluation should include, level of risk should the threat or vulnerability be exploited.

The analyst can only mitigate risks that are known. This is why it is critical that the Risk Assessment Team have access to the data.

Assess Current Security and Potential Measures

All identified risks, threats and vulnerabilities must be evaluated. Some risk will always be present. The analyst must categorize what is harmful and what is possible, and then develop security measures to correct the perceived risk.

Determine the Likelihood of Threat Occurrence

Likelihood is based on how likely the vulnerability is to be exploited. If the likelihood is low then it is less likely to happen. If so, then the risk is lower.

Determine the Potential Impact

Putting everything together allows the analyst to determine the potential impact of a specific event. For example, if your area is prone to flooding, how would that affect your business?

Determine the Level of Risk

Combining all the data you have collected into a Risk Matrix or Risk Register will help you determine the potential for damage.

For example: If your identified risk is low, the potential for damage is low and the likelihood of occurrence is low; then your risk will be low. However, should one of these items be high or medium impact or likelihood, then your potential for risk will be increased.

Using a risk register is essential to completing your risk assessment properly.

Finalize the Document and Report

After gathering and analyzing your data you will need to present a report Risk Assessment. This report must be clear and concise, detailing all activities that took place, their outcomes and potential risks.

The HHS website has some tools to assist with this effort.

Risk Mitigation

Risk mitigation is often the hardest part of completing a Risk Analysis in that now actual resources and money must be allocated. Establishing a priority list here is essential.

Your goal is to mitigate all negative issues. You probably won’t reach that goal, but you should try. At the very least, you should start you mitigation process with the most dangerous processes first and work your way down the list in order of severity.

Continuous Updates

By conducting an annual Risk Assessment, you can ensure you are meeting compliance standards, protecting your patients, and minimizing the overall risk to your medical practice.

Conclusion

Risk Assessments aren’t glamorous or even fun, but they are necessary to help prevent security related problems and meet governmental regulations.

Creating an outline of your Risk Analysis plan and breaking it into smaller pieces will help you complete it with the least amount of time and frustration. Unfortunately, the larger your medical practice, the more complicated the Risk Assessment.

The department of Health and Human services has several tools to help you conduct your own Risk Assessment. Oh, and remember Risk Assessments are required!

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The Changing Face of Healthcare

Jul 14 2020 Published by under Uncategorized

Several significant forces in the last several years have been changing the way healthcare has and will continue to be delivered. The emergence of more unique ways to deliver care such as clinics incorporated into businesses and factories, the increased use of mid-level providers (nurse practitioners & physician assistants), the increase integration of technologies such as telemedicine and robotics and the shift from interventional reimbursement to outcomes reimbursement are just a few examples.

Compounding these are the ever-increasing costs of healthcare, the strain of funding Medicare on the U.S. economy, and the complications of insurance and healthcare payments under the affordable care act, ACA.

This has led to changes in how businesses intend to interface with the healthcare system going forward. CVS’s acquisition of Aetna will try to leverage healthcare delivery through their pharmacy structure. United Healthcare’s acquisition of DaVita hopes to leverage cost containment and resource control by directly controlling physicians. And the recently announced collaboration among Berkshire Hathaway, Amazon and J.P. Morgan Chase presents a yet unknown structure whose stated goals is improved quality and less cost. How they will implement their strategy is yet to emerge.

The decline in hospital admission over the last several decades has further led to restructuring by hospital corporations such as Tenet. Premise Health has emerged as a company placing physicians and other healthcare providers directly in corporate/business offices.

The big question then with these new ventures are how do organizations know what works financially and how do they track performance… In other words, how do you track, measure and value the relationships between cost and outcomes?

How can the analyst measure which methods(s) may generate better or best outcomes?

A simple return on investment, ROI, calculation will not provide needed nor valid insights. However, the use of cost-effectiveness analysis (CEA) would provide quite useful, valid and actionable information. CEA uses decision tree models to compare not only cost outcomes but effectiveness outcomes of various treatments on patient health and even on future healthcare usage based on various current actions. It can further be used to determine how effective a set amount of money spent on a particular treatment or method will impact outcomes (i.e. willingness to pay calculation). CEA models are flexible and can incorporate a wide variety of scenarios. As opposed to Big Data, CEA makes use of Broad Data so that comparisons of treatment modalities can be evaluated using real life outcomes. It can compare effects on a discrete problem such as a cancer tumor, or on chronic ongoing diseases such as COPD or CHF.

As the delivery of effective yet profitable, or at least cost effective, healthcare becomes more challenging, methods for evaluating treatments and programs become more necessary if not essential. Methods must be implemented to evaluate these new treatments and programs once they are in place so adjustments can be made. CEA enable organizations to both initially evaluate and subsequently monitor new methods and programs in a meaningful way.

If your objective is to provide the best decision-making for your organization and take a global view of your business, expanding your sights beyond ROI, and educating other decision-makers, Cost Effectiveness Analysis can make your organization more competitive and more profitable.

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Why Is Medical Coding Essential in Healthcare?

Jul 14 2020 Published by under Uncategorized

Nowadays, there are a lot of health care professions out there, but medical billing is on the list of top professions. Around 20 years back, there were not many job opportunities in the healthcare industry. Now, there are lots of job opportunities in the healthcare market. And this has increased the demand for medical coding professionals. Let’s find out why medical coding is essential in healthcare.

What is medical Billing and Coding?

What do you do when you are sick? You go to a medical doctor. At the doctor’s office, you deal with a doctor and his assistant. But you may not have noticed but there is another professional in the process who ensures you get the best treatment. They work in the background but are just don’t pay attention to them because of our health problems. The role of these professionals is to make sure your medical claims are billed and processed properly.

There is a difference between medical billing and medical coding as different individuals handle them. For this purpose, individuals train and prepare for the job. Let’s find out the difference between their roles.

The primary role of a medical coder is to decode the procedure or service mentioned on the documents given by the doctor to the patient. Next, he decides on the right type of procedure and diagnosis code for submission. Actually, the medical coder takes their time to assess and code the data to ensure the billing is free of errors.

Next, the medical biller uses the right codes to enter the claims and then submits them to the relevant insurance provider for billing. For updates, the biller keeps in touch with the insurance provider to ensure the approval of the claims. In case of any discrepancies, the medical biller may update the patient on what is going on.

Career Opportunities

If you want to ensure that the medical institutes run efficiently, the importance of medical coders and medical billers can’t be denied. The billing and coding professionals are an integral part of the system to ensure that the records are updated and handled properly.

Recently, there has been an increase in job opportunities for trained medical coding and billing professionals. As the life expectancy and population increases, the demand for these pros will keep on going up, says the reports released by the Bureau of Labor Statistics.

Actually, these professionals are appointed at nurse care, medical billing companies, rehabilitation facilities, insurance companies, private clinics, and hospitals, just to name a few.

If you want to join this field, make sure to get certificates by undergoing proper training. Usually, these pros need to undergo post-secondary training.

It’s not hard to achieve this feat. All you need to do is sign up for a medical billing and coding program. As soon as you have gone through short training, it’s time for you to apply for your desired job at a nearby medical facility.

So, this was a description of the importance of medical coding in healthcare.

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Two Way Radios in Primary and Acute Healthcare

Jul 14 2020 Published by under Uncategorized

Communication plays a crucial role in healthcare. Timely dissemination and sharing of information is critical for acute healthcare providers. Similarly, primary healthcare can be easily administered by using practical and handy communication channels. However, there are several factors that need to be taken into account before deciding upon an effective mode of communication in both primary and acute healthcare institutions. Reliability, coverage and confidentiality of transmitted information along with the institution’s capacity in handling the equipment, play an important role. Healthcare institutions can largely benefit from a mobile clinical staff and two way radios can provide prolific results if used effectively for sharing information.

Functionality and Build of Two Way Radios

Two way radios allow only one function at a time – either receiving or sending the signal. This helps the users efficiently communicate without interrupting the interlocutor. These devices are helpful in exchange of crisp information, rather than constant communication. Two way radios are also known as transceivers or walkie talkies.

Two way radios are simple devices made of primarily six components: power source, receiver, transmitter, microphone, speaker and the crystal. This implies that running and maintenance costs for these devices are not too high. Two or more communicating devices operate on the same radio frequency and a push-to-talk button switches the device between receiving and transmitting modes.

Primary Healthcare and its Challenges

There is a growing emphasis to offer primary healthcare to one and all. This requires creating an environment where equal emphasis is laid on healthcare for all individuals. However, shortage of trained medical practitioners poses a serious threat to achieving this objective. Medical planners have to focus on the use of technology to make the maximum use of the available resources.

Isolation of patients is a big problem that surfaces in primary healthcare. Patients who need medical attention are usually dispersed, especially in rural areas and may not have access to medical facilities. The supply of drugs and medical tests are difficult to conduct and this defeats the very objective of primary healthcare. Lack of communication is another major problem in administering primary healthcare.

A quick exchange of information offers a suitable solution to meet all these challenges. Two way radios enable exchanging of crucial medical information and gradation of current medical practices. The absence of advanced technologies in many locations also increases the importance of two way radio communication devices.

Using Two Way Radios in Primary Healthcare Settings

The most important use of two way radio in delivering primary healthcare is in connecting local medical practitioners with hospitals in cities and more advanced areas. This is critical to diagnosing a patient as well as for prescriptive purposes. A timely decision whether the patient must be referred to a hospital with advanced facilities can be crucial in saving lives. The hospital can also monitor the condition of a patient at another location through two way radios.

How well two way radio technology is implemented for primary healthcare will be dependent on medical and health protocols. Doctors in some countries contact health aides and monitor the situation of the patient by use of two way radios. The medical structure of a community and the country determines how effectively the two way radio can be used for primary healthcare.

Emergency situations can also be addressed by using two way radio. Lack of good transportation and communication facilities can jeopardize a community in case of a medical emergency. Two way radios can be used to send news of such medical exigencies to hospitals or district headquarters and help save many lives.

In some countries, two way radios are used to connect fieldworkers with doctors who are constantly on the move. Use of airplanes helps attend to critical patients in a very short time as soon as the news is delivered by way of two way radios.

Two way radios can also help in training field workers who play an important role in primary healthcare. It depends on the level of existing competence of the medical workers and the desired levels of training. Moreover, field workers can listen in to the conversation of co-workers with physicians and learn by observing the standard medical practices adopted in different cases.

Using Two Way Radios in Acute Healthcare Settings

Clinical information in a hospital can be shared with the help of two way radios. A mobile unit of clinical staff will be more efficient in dealing with day-to-day problems faced by patients and in specific cases where a patient requires immediate attention. A patient who undergoes a complicated heart surgery may require constant monitoring for a few hours after the operation. However, it may not be possible for the doctor who operated on the patient to stay by his side all the time. Two way radios can prove to be a handy solution for helping healthcare institutions, solve such critical operational issues. A nurse attending on the operated patient can inform the doctor about the patient’s progress or whether the patient needs immediate attention, using two way radios. This will not just update the doctor on the patient’s condition but also help him take immediate decisions based on the available inputs. The healthcare industry has successfully tested and used two way radios for acute healthcare. Hospitals make wide use of two way radios for exchange of information among healthcare workers.

Two Way Radios: Advantages

Two way radios provide for a cost effective medium of instant communication. Healthcare industry requires rapid and extensive sharing of information in the most cost effective and efficient manner. A large healthcare institution can be brought under the ambit of wireless radio communication without running up high costs. Moreover, radio signals are quite reliable as compared to mobile networks, where one must depend on the network strength and connectivity. Also, issues of interference do not surface often. Maintenance costs for these devices are also considerably low.

Two Way Radios: Standard Practices for Operation

Some of the standard practices followed for using two way radios in healthcare institutions are:

  • The devices are used in “receive only” mode in patient areas.
  • Medical staff is advised to leave the patient area if the device has to be used for outgoing communication.
  • Two way radios must be kept at a distance from highly energized medical devices.
  • Lowest possible setting must be used to avoid any interference if the device so permits.
  • In case of malfunctioning of any medical equipment, the use of radio devices must be stopped immediately.
  • Unnecessary use of two way radios may distract a medical practitioner during surgery. Therefore, such devices must be used only when required to avoid any delay in patient care.
  • Using Two Way Radio Systems: Interference and Other Issues

Two way radios do not generally interfere with other medical equipment. Research studies have proved that hospitals can safely use two way radios for communication purposes. These devices can be safely used at a distance of 0.5 meters from most medical equipment. The reason is that these devices operate at high frequencies and do not cause any interference. However, the use of two way radios is discouraged in highly sensitive medical environments like the ICU.

Some of the other issues with two way radio systems include problems, like poor maintenance, lack of power, non-availability of spare parts and poor training of the medical staff regarding the usage of these devices. Any compromise with the quality of the device can prove disastrous and defeat the entire purpose of setting up two way communication radios.

Conclusion

Two way communication systems have been in use for more than seventy years in the field of healthcare. Even today, with the advancements in technology, radio systems play a vital role in setting up communication in healthcare institutions. This is because no other technology can adequately address all the needs of healthcare communication – little interference with medical equipment and immediate and hassle free communication. This establishes the fact that two way radios will continue to play a major role for communication in primary and acute healthcare as well as improve the provision of healthcare services.

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How Healthcare Providers Use Walkie Talkies

Jul 14 2020 Published by under Uncategorized

As noted in our introduction, the healthcare industry is under attack financially from many different fronts. Providers are pressed to lessen the quality of care because of reduced reimbursements. How do you keep Patient Care at an all time high while being forced to see more patients? How do you see more patients without working more hours? The simple answer is efficiency.

Two way radios are a proven tool to improve efficiency. In restaurants, we help Proprietors turn more tables. In schools, we help Administrators multi-task and manage issues on different parts of the campus at the same time. For Churches, we help keep the production on time and safe. For Healthcare Providers, we can help you find five to seven minutes per hour to spend with your Patients. Here’s How.

Reduce Wait Time. Two Way Radios allow Physicians to move efficiently between patients by coordinating with Nurses. The patient in exam room 3 may be next on the list to be seen but has additional needs being met by nursing whereas the patient in exam room 1 is ready to go. Getting the Physician to the next reduces wasted time, creating happier patients and providing the Doctor needed extra minutes.

Coordinating Care. The Doctor needs a cast set or an additional blood test run. Minutes are saved simply by making the request in the room versus having to go speak to the Nurse. Some facilities even use walkie talkies to dictate notes. Use caution when doing this to not violate HIPPA Laws.

Turning Rooms. Getting the room cleaned up and ready for the next patient wastes valuable minutes. Save time by coordinating with House Keeping immediately to get a room cleaned and prepped for the next patient. If you can save 3 minutes per hour, you can see one more patient a day.

Finding Help. Patients often need extra assistance, and this typically requires the Physician or Nurse to leave the treatment room to summon the extra assistance. Using two way radios, you simply press the button and ask for assistance without leaving the room. You’ll save valuable minutes.

Two way radios aren’t going to increase your efficiency by 10% but walkie talkies will increase your entire team’s efficiency. The goal is to find 20 minutes of efficiency per practicing Physician. That 20 minutes can be used to see another patient, complete chart work, or do research.

Two way radios are easy and affordable to implement. We suggest using Business two way radios to ensure you’re not getting interference from consumer radios. Consumer radios are branded FRS or GMRS and are designed for kids and outdoorsmen. Headsets must be worn in a healthcare setting and HIPPA regulations should always be considered when using walkie talkies.

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