Women In Health IT

Large employers are taking more control over health care costs and quality by pressuring changes to how care is actually delivered, based on the results from the 2017 Health Plan Design Survey sponsored by the National Business Group on Health (NBGH). Health care cost increases will average 5% in 2017 based on planned design changes, according to the top-line of the study. The major cost drivers, illustrated in the wordle, will be specialty pharmacy (discussed in yesterday’s Health Populi), high cost patient claims, specific conditions (such as musculoskeletal/back pain), medical inflation, and inpatient care. To temper these medical trend increases, large employers are looking to change the way health care is accessed and delivered through funding telehealth (for 90% of companies), providing price transparency tools (among 85% of companies), building and referring workers to Centers of Excellence (in 85% of firms, focused most on transplants, bariatric surgery, joint surgery, heart care, and cancers), and to a lesser extent, promoting accountable care organizations (among about one-fourth of employers). Consumer-directed health plans (CDHPs) will be a universal health insurance plan design by 2020, shown in the second chart. At least 84% of large employers will offer a CDHP option in 2017, and one-third will offer only a CDHP. Most high-deductible health plans in 2017 (92%) will be accompanied by a health savings account (HSA) The median employee cost-sharing amount this year was a $1,600 deductible for employee (single) coverage in a CDHP, and in-network out-of-pocket maximum payments were $4,000. For families, the out-of-pocket max was $7,200 with a $3,200 deductible. Telehealth is expected to be a universally-sponsored service among large employers by 2019, and most companies already use virtual care. One-third of large employers directly contract with telehealth vendors, according to NBGH’s survey. While most employers are offering telehealth services, in the first half of 2016, only 3% of employees had utilized this benefit. Looking to the future, employers are bolstering investments in mental and behavioral health, and in the financial wellbeing of their workforce. Influence physical well-being is a top-three priority among 85% of employers, followed by improvement employee engagement in healthcare decision making (that is, consumerism) for 65% of companies, emotional/mental wellbeing among 59%, and financial security and wellbeing for 58% of employers. Health Populi’s Hot Points:  Large employers are emboldened to drive changes in health care delivery — especially for virtual care via telehealth channels and narrowing networks for high-cost specialty care like transplantation and bariatric surgery via Centers of Excellence. Most employers are also deploying at least one cost transparency tool to support employees’ healthcare consumerism and decision-making chops. However, only 3% of employees have used telehealth services that have been available in the first half of 2016; this is an important proxy for understanding just how “consumerist” employees are with respect to saving money in deductible spending. The consumer-patient’s cost difference  between a virtual vs. in-person visit is significant: a telehealth visit with American Well is currently priced at a low of $49 compared with a face-to-face primary care visit for $95, urgent care for $140, or emergency department admission for $750. NBGH identifies employer tools and programs more companies are offering in 2017, including nurse coaching for care condition management, disease management, lifestyle management, self-service decision support tools, price transparency tools (fast-growing in 2017), and medical decision support/second opinion services. Large employers clearly understand the importance of these tools to support their mass adoption of high-deductible health plans. There’s no consumer-direction without such programs, and less optimal ROI on employers’ significant investments in health insurance without them. This week’s announcement of Accolade receiving a $70 million investment to further scale the company’s healthcare concierge services is an example of the market’s recognition of the importance of these employer-sponsored programs. This is health reform, playing out in the private sector. This blog first appeared at Health Populi.

“You need to go beyond puppies and rainbows.” That’s the advice this week from a search firm expert. I’m part of the search committee for the new president of a non-profit organization where I am a board member. The search expert was telling us to go deeper in our questioning. Get past the fluff and canned responses. He said it’s ok to make candidates uncomfortable. I’ve done a lot of hiring in my management career for direct reports. And I’ve been on search committees for executive positions. I’ve also been on the other side of the search process being interviewed for CIO positions. You review resumes, you listen to the search firm’s summary comments on each candidate, and then you finally meet the candidates in the first round of interviews. It’s a process. And you only have an hour or so to get to know each person. What you see on paper are the qualifications. In the interview you get to know the person. I said in one of my first blog posts, hiring the right people is one of the most important decisions managers make. For executive positions, the process is more rigorous with more people involved. After all there is much more at stake when you are choosing one of the top executives. You are all working off the same position description and the organization’s mission and strategy. Yet search committee members come to the process with different perspectives. As a result, they may be looking for different attributes in the candidates. They need to be open to executives taking the organization in new directions and not just finding someone like the outgoing leader. John Glaser, the Partners HealthCare CIO told me when I was interviewing for the Brigham and Women’s Hospital CIO position,”It’s not just what you say but how you say it.” John made it clear that personality was critical. No pressure. Another way of saying it — “Is there the right chemistry?” If the candidate gets to the interview stage, it’s assumed they have the knowledge, experience and skills to do the job. So then it’s about fit. Is this someone people can work with? I met over 20 people during the Brigham and Women’s search process, so there were plenty of people to weigh in on whether I was the right candidate. And as the candidate I was also able to assess if they were an organization and group of people that I wanted to work with. I did. I was there for almost 13 years and loved the leadership team I worked with. When I advise my colleagues in the search process, I remind them that it’s a two-way street. The organization is evaluating them and they are evaluating the organization and the people they’d be working with. I encourage them to be sure they know what they are looking for. If it’s not the right organization or opportunity, say so and withdraw; don’t waste anyone’s time. If there are concerns but you want to know more, keep going until all your questions and concerns are answered. A job change is a big decision, especially at executive levels and when it means relocating your family. It’s fair to say that both sides need to go deep, go beyond puppies and rainbows. Blog originally posted on www.sueschade.com.

HIMSS VP: Disparity between male and female compensation rates has widened in the past decade.

Join us in addressing the gender gap in health IT, and the need for more community, resources and recognition of women who have made a difference sector-wide. on Jan. 17.

Leveraging nine years of data (2006 to 2015) from the biennial HIMSS Compensation survey reveals that on average, female HIT workers in the United States have consistently been paid less than their male peers. A gap which seems to exist no matter how the data is cut, and one which appears to have widened over the years. That said, the magnitude of pay disparities tend to vary under select conditions suggesting compensation equity is possible.

As patients learn to manage high-deductible plans and health savings accounts, convenience, accessibility and neighborhood connections are shaping patient's financial decisions.

It’s been 3 months since the IT leadership team here launched a visual management board and started a thrice-weekly huddle. Since then, we have made numerous adjustments to improve our process.

Mortality rates have not improved, and obesity is on the rise, but there Is some good news.

This is the sixth year of the Walking Gallery of Healthcare.  We now number over 300 members walking around the world with patient story paintings on our backs.  We are attending medical conferences where often there isn’t a patient speaker on the dais or in the audience. We are providing a patient voice, and by doing so, are changing the conversation. An artist or artists interviews medical professionals and lay individuals to form a patient centric narrative. The artist then creates representational imagery and paint that picture story upon the business jacket of the provider of the narrative account. The provider of the patient story aka “Walker” wears the jacket to medical conferences and events in order to disseminate the patient story to a large group of policy minded attendees and to represent the individual patient voice in venues where they are underrepresented. Further, both artist and walker will support the spread of the story and image via social media. As of July 2016, 396 unique Walkers have joined the Gallery wearing 434 jackets.  The Gallery has representatives on five continents, but the majority of Walkers reside in the US. One artist creates the majority of the art, but new artists are frequently joining the movement.  The Gallery is promoted heavily on twitter, facebook and personal blogs.   Its widening appeal within the health conference community is creating a new space for patients at such events. The names of the Artists of The Walking Gallery followed by the quantity of jackets they have painted:   1. Regina Holliday, 376 jackets 2. Isaac Holliday, 1 jacket 3. Becca Price, 1 jacket 4. Miriam Cutelis, 1 jacket 5. Ess Lipczenko, 1 jacket 6. Ben Merrion, 1 jacket 7. Courtney Mazza, 8 jackets 8. Michele Banks, 1 jacket 9. Megan Mitchell,1 jacket 10. Robert J. Filley, 3 jackets 11. Anita Samarth, 1 jacket 12. Mary Welch Higgins, 2 jackets 13. Richard Sachs, 2 jackets 14. Jonah Daniel,  1 jacket 15. Fred Trotter, 1 jacket 16. Leela, 1 jacket 17. Gayle Schrier Smith, 1 jacket 18. Moira Simms, 1 jacket 19. Joan Holliday, 1 jacket 20. Adalyn, 1 jacket 21. Chris Chan, 1 jacket 22. Amy O'Hanlon, 1 jacket 23. Vera Rulon, 1 jacket 24. Jessica Nicula, 2 jackets 25. Nikai, 1 jacket 26. Deonm, 1 jacket 27. Daquane, 1 jacket 28. Olivia Dias, 1 jacket 29. Donnell Bonaparte, 1 jacket 30. Hazel F., 1 jacket 31. Rachel Fields, 1 jacket 32. Zoe Carr, 1 jacket 33. Thomas Richardson, 1 jacket 34. Tamela Mack, 1 jacket 35. Julia Anderson, 1 jacket 36. DJ Hamilton, 1 jacket 37. Jenn Toby, 1 jacket 38. Camala Walling, 1 jacket 39. Jordan Lanham, 1 jacket 40. Josh Miller, 1 jacket 41.  Te'j Matthews, 1 jacket 42.  Tony Zieger, 1 jacket 43.   Shannon Shine, 2 jackets 44.   Melody Smith Jones. 2 jacket 45.  Kay Seurat, 1 jacket    For more information about joining the movement or to see all 400 plus jackets, please scroll to the bottom of this post. The Walking members who joined in Year Six:   434. "Growth" a jacket for Corinna West   433. "The Anointed Ones" a jacket for Benjamin Berlin     432. "Boston Heart Mom"  a jacket for Tami Rich   431. "At the End of my Rope" a jacket for Abby Bott   If you are interested in joining the Walking Gallery, here is the info: http://reginaholliday.blogspot.com/2016/03/how-do-you-join-walking-gallery.html If you would like to help fund the movement: https://www.gofundme.com/h2dsdwe4  Here is a short film about the movement: Read: http://reginaholliday.blogspot.com/2011/04/walking-gallery.html  to understand the origin of the idea.  

Many organizations have a Project or Program Management Office (PMO). If not at an organization wide level, at least within the IT department. There are different models. Some PMOs provide standards, tools, methodology and overall tracking. Others provide this foundation as well as a team of project managers (PMs) who can be assigned as needed to major projects. Our PMO at University Hospitals is the latter model. Our PMO has evolved under our new manager, Joe Stuczynski. He and his team are making significant improvements with the support of IT leadership. They have developed a roadmap for further changes and improvements for the next year. It is refreshing to be in an organization where we are not debating about the tools and whether they are good enough. We are not debating about what projects need to run through the PMO and if everyone needs to follow the standards. Instead, we are embracing and leveraging the tools and the PMO is able to focus on what it should be – tracking projects and providing PMs to manage projects. Our 90 minute weekly PMO meeting is attended by department leadership and PMs. It has a standing agenda that includes: Action Items from previous weeks – represents a level of accountability and tracking Process Updates – keeping everyone informed on changes New Project Requests – these are later vetted through the IT governance process Project Successes – acknowledging what was completed the previous week Architectural Review Overview Dashboard – shows total number of projects with Green, Yellow, Red project health by major area and change from previous week Detailed review of each project in Red Program review – each major area (i.e. business, clinical, ambulatory, infrastructure, security) is on a rotation for deeper dive Scope Reviews for new major projects – provides chance to “connect the dots”, discuss any interdependencies and ask questions Outputs from this weekly review that get posted on our IT visual management board are: Project successes Dashboard of all projects by health status For each project in “Red,” we cover the issues, impacts and the action plan to resolve, as well as risks and mitigation plans. The green/yellow/red is noted for the project overall, as well as scope, schedule and cost. With this information at a glance, it is easy to identify where help is needed and what it will take to move the project from Red to Yellow or Green. Scope reviews for new projects include summary, scope, business objectives, budget, timeline, and team members. Having a chance to discuss interdependencies and raise any questions or concerns is critical for a new project. The PMO has a number of goals. Two are particularly pertinent here: Improve Project, Program, Portfolio Management maturity – “get everyone on the same page” Incorporate a continual self-evaluation process Looking at the last few months, these two goals are clearly being met. And that’s powerful. Blog originally posted on www.sueschade.com.