Building Sustainable Communities with Public Health Professionals

Public health was a large part of my graduate studies. I recall after a long day at work and late night of class work I would drift off to sleep thinking about rebuilding communities; bringing health care to places that had few choices. I know that sounds like an exaggeration–dreaming of rebuilding communities. Who does that?

In my grandest dream, a public health association opens in a town fraught with insecurities. Health insecurities and others such as, food, shelter, employment. These insecurities make an unstable, poor living environment. Over time, this insecure town or city in my head would blossom into a thriving community. It all begins with health.

Now remember, that was a dream. In reality, I  use my skills and passions to serve the masses of this state. Later I may go to another, or just a struggling population in the U.S. that is lacking essential services. There are more than I want to count of such communities in this country. The essentials lie in the breaking down the masses—to people, then bringing in services for the masses. The process is, of course, more complicated than I can say here.

We all need public health. It is, in my opinion, the most under appreciated aspect of health. Often, people do not realize that they benefit from local public health professionals. Public health is about people and sustaining communities. The people I work with share my passion for a thriving, healthy population. New Hampshire already is that way. Still, we want to do more.

Where does your community or state stand on the issue of public health? Do you know? Support your local public health affiliate where you live. Your support keeps people healthy.

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Obama administration approves reference pricing for insurers

If reference pricing is not a term you hear about often—or ever, let’s talk about it now. By definition, reference point pricing is a strategy or a basis or standard for evaluation. It’s like the suggested manufacturers retail price. Check out the short video as another example.

News from the White House is the Obama administration approved reference pricing for insurers. In other words, insurers can cap payments to providers.

I am a consumer and you are a consumer. At some time, we are all healthcare consumers. In the marketing and consumer world of retail, reference point pricing sells merchandise or services. As a strategy it works in subtle consumer convincing that they are paying a reasonable priced for a service or product. This strategy reflects how much consumers expect to pay. We do it all the time. If the price is too high, we shop around or wait for a sale.

In an article released today by Healthcaredive.com, reference pricing will save more than $10,000 per hip or knee replacement surgery. That is a figure to stop and think about. The burden to the people is the difference, or the balance, between the reference price and the hospital charge. The burden to physicians is a smaller reimbursement.

There are 332,000 hip replacement procedures happening in a year in this country. In addition, just for the sake of knowing, the Centers for Disease Control and Prevention also report 719,000 knee replacements. Saving $10,000 per procedure is a staggering amount of money. The difference between what the hospital charges and what insurers will pay, falls to the patient.

The sum of money a hospital pays for collections now will be higher in the future. Individuals and families that, now, have medical bills they cannot pay, can expect more of the same down the road. It all comes down to shopping. If you need that hip replacement, you will want to shop around.

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Teens FaceTime and Virtual Reality

Imagine this scene:

You are the parent of Ann. Ann has just turned 17 two weeks ago. You know that Ann dates a boy named Todd. They have been together several months. Todd is a senior in high school. You have not met his family.

Let’s peeby Xenattk into Todd’s home. Todd’s parents, Mark and Kelly, know that Todd is always texting to Ann, and FaceTime is common too. Todd turned 18 early in the year. Mark and Kelly are coping with the challenges of Todd’s independence.

Todd’s parents are aware that Todd is on the computer in his room and constantly connected to Ann. They know this from various times when they have knocked on his door for any reason, and even when Todd is home during the day.

Early one morning, Todd’s father knocked gently at Todd’s bedroom door thinking Todd overslept. Mark opened the door and saw his sleeping son. Beside Todd on the bed, his smartphone was face up, on FaceTime, connected to Ann, who was also sleeping, nude.

Mark stood stunned for a moment. It seems the too young lovers really do connect 24/7. Mark left the room quietly without waking Todd. Days later Mark told Kelly about the scene. Kelly believed they ought to tell Ann’s parents. Or at least test the water and see what they know about the couple.

Now, we have heard of sexting among teens, and adults too sometimes, but that is different, isn’t it? Still, risky and not recommended behavior. As parents, we face the eventual sex talk with our growing children. Today however, that talk extends into social media of all forms. In general, it’s not wise to put anything online that you would not say to your mother’s face. It may come back to haunt you.

In the case of Mark and Kelly, their son was 17 when he met Ann. Ann was 16. Neither Mark nor Kelly has met Ann’s parents. Have you faced this FaceTime scene in your home? What did you do about it? Do you think Ann’s parents ought to know about this? Assuming, of course, they do not know.

Aside from the social etiquette, this story touches on health communication at a most personal level. Would you want to know if your young teen daughter is virtually sleeping with her boyfriend? The implications are boundless. As parents are we hypocrites, remembering our own teenage years? If you had the technology back then, how would you feel? What would you do?

 

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Patient TalkBack: Exceptional Health Care at Your Command

Have you ever been angry after a visit with your doctor? The reaction to that question varies from eye rolling “Oh yes!” to table slap, “Let me tell you….”. People are not shy in discussing frustration with their health care providers. On the other hand, people are also open when they say what wonderful care Dr. so and so provided at a critical time.

If you cannot relate, you know someone who had a disappointing experience with healthcare. It’s frustrating communication in some cases. Or, disappointment with the staff.  Or, maybe you waited twenty or more minutes in the waiting room, or worse, you waited in the exam room. That kind of waiting can change the patient experience dramatically.On the other side of that wait, is a visit too brief. Your physician was in and out of the room so fast, you couldn’t think straight.

You may know by now the Affordable Care Act (ACA) is holding physicians accountable for care, tying quality from the patient point of view with reimbursement at the federal level for Medicaid and Medicare.

Haven’t they always been accountable? The answer to that is yes, and no, not in this way. Thinking back to the late 80s and my first professional experience with health care, insurance, reimbursements, lifetime caps, pre-existing conditions, times have changed for the better. Then, in my mind I recall the 90s when thought turned to the Health Maintenance Organization (HMO). The HMO model would curtail costs via managed care, it was thought.  Another decade, into the new millennium, sticker shock in health care by the late 90s brought cries for reform into the 21 century. National spending for physician services rose like rockets in the 1980s from $63.1 billion to $117.6 billion in 1989. From there, cost for care continues to escalate today.

Now, however, the ACA is the new game in town. Technology today tries to improve the patient experience and satisfy care providers too. The Health Innovators are launching a patient satisfaction tool that, used properly by physician organizations and consumer patients, will level the playing field for both sides. Patients will be happier controlling their care through Patient TalkBack and physicians will be happy because their reimbursements, linked to the federal government quality assurance scores will rise. It’s a win-win. So, tell your friends, family, and most importantly your health care team that Patient TalkBack  will be a win-win for all concerned. Patient TalkBack has identified the pain points of health care and patient engagement, satisfaction, and education. Patient TalkBack is well received in the Boston and Cambridge areas and the team of representatives from Health Innovators is working into other states as well. In fact, Joslin Diabetes Center is using it, as well as Tufts Medical Center, and St. Vincent Hospital. Patient Talk Back is a mobile solution, step-by-step on a smartphone or tablet. You say you don’t have a smartphone? That’s okay, your care provider may have Patient Talk Back available on a tablet or laptop for you–before you leave their office.

The answers, or data, that you give is seen in real-time by the designated staff person for immediate action. Believe me, health care providers want Patient TalkBack to be successful, not only for their population of patients, but also so they are certain that the care they give truly is exceptional.

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Risk Assessment in Research and Development (R&D)

Health tech apps are rising and falling as developers across the spectrum scramble to create, improve, out-do, the current generation of devices. Medical devices are super hot in health care present and future.

To some degree following trends in the industry can give us a glimpse of what is to come. Still, foresight and staying power are tough for all involved in health and tech entrepreneurship and engineering development, R&D.

Nike illustrates well the cut-throat action necessary to keep up or grow today. In December, 2013, Mashable published a list of health tech trends to watch in 2014. One hot category they note is wearable tech such as the Fitbit and Nike Fuelband.

A mere four months ago the wearable devices group; devices that encourage healthy habits–get-healthy apps that track and reward users fitness–were leaders. Today, Techcrunch announces Nike is abandoning the Fuelband. Health tech is progressing so fast, the Fuelband couldn’t keep up and big companies like Nike know when to kill their children. Metaphorically speaking, of course. Many health start-ups end up killing themselves before they ever get to have children (metaphorically again).

Know when to pause and when to stop. By pause I mean do an assessment of the business you are trying to create. Have you met goals so far? Are you on target? Do you even know what your goals and target are? These are simple examples of many critical questions. The answers lie in the experience each team member brings to the table, and in how well the team follows success trails, trails that no doubt include a few failures.

When to stop is a much harder call. We all know the Nike company walks in big shoes. More than that,  everyone knows that Nike has been around for a long time. Long enough, monitoring trends and competition, to know when to stop and move on to R&D new ideas in which they can compete.

Update from Techcrunch: Nike isn’t abandoning Fuelband, new color options coming soon.

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Funding innovation and the entrepreneur

Do you watch Shark Tank on your flat-screen? It’s a great look into the minds of venture capitalists and the budding new business. As you know, not all of them succeed with the Sharks, yet some do, and often the producers give us a view of these businesses one year later–after the VC Shark has helped them out. What a wonderful feeling that must be. Of course, that’s not how it happens for most people. Even for the winners on Shark Tank who get funded it’s a tough road ahead of them to make their baby idea a real, marketable reality. As a three-time entrepreneur myself, I relate to the new idea as a baby. Fragile and new, the parents overwhelmed with how to care for it and help it grow. It’s a lifetime commitment.

Some entrepreneurs are so excited about the conception of their idea, they want to move to quickly from baby to toddler. Often, that’s when good ideas go bad. There is a mourning period for the team. Then they ask, what did we do wrong? They review the plans, reams of  paper create a visual of how it will work, learning about patents and the arduous process to becoming patented. Money is not easy to come by these days. We all know that. I believe in the old saying, you get what you pay for. There are some things that do not lend themselves to full value in cutting corners. Attorneys know this; especially patent attorneys. Yet, what’s the starry-eyed entrepreneur supposed to do? The drive to succeed is greater than the need to eat, it seems. Good ol’ Kraft Macaroni and Cheese, it’s always there. Ramen Noodles; remember cooking those in a hot-pot at college? Ah, the good old days. Back to funding and the starry-eyed entrepreneur, there are levels of help available. It’s all the money the founder has, maybe added to a co-founder or two, and if that’s not enough, there are the parentals who did so well saving all of their lives, and made oodles of money back in the ninety’s, now it’s their investment into retirement. Or is it? Above the parental level, the starry-eyed entrepreneur happens to see Shark Tank and learns about Venture Capitalists. On the same level but seeming far more generous and gentle, the Angels. It’s just an illusion. The starry-eyed entrepreneur has entered reality shark tank and their baby idea is put to the test. Will it thrive? Or will it fail to thrive? There is more work to do, is how it usually goes. There is so much homework to do it truly is at times, overwhelming. Where to being? The answer; at the very beginning. For more information and a great opportunity to meet a panel of VCs, RSVP to http://www.healthinno.org/upcoming.html.

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RSVP Today for the Google Glass blast with the Health Innovators!

The Health Innovators are very excited to host an evening of discussion about Google Glass. We have four fab speakers who will introduce the audience to:

  •  Glass in the Operating Room;
  • specialties developed as a result of Google Glass;
  • optimization of patient visits through Google Glass;
  • how Google Glass is transforming health education;
  • the challenges health professionals face in use of Google Glass, such as dealing with personal health information (PHI), HIPAA, and integration into electronic medical records (EMR).

Please join us for refreshments and to welcome the presenters who have first hand experience of Google Glass and where it fits in healthcare, how it will change healthcare. Who doesn’t have questions about Google Glass?

Dr. Mahek Sartori

Dr. Mahek Sartori

Dr. Mahek Shah is a former business and finance banking professional now active in redesigning the healthcare experience. He has lived and studied abroad where he examined United Kingdom’s National Health Service (NHS), Spain’s European Union (EU), integration, and effects on the global economy.

Andrew Sartori

Andrew Sartori

As a proud Google Glass owner and high-tech expert within Healthcare industry, Andrew Sartori previously enrolled and completed as a participant in the last Boston/Cambridge class of Healthbox—an accelerator that advance technology, redefine change, and grow companies in healthcare by driving action in collaboration between inventors, entrepreneurs, and the healthcare industry. In addition, he is the founder of CASAGEM, the startup company, known as the eHarmony for Homecare. CASAGEM provides a platform that includes mobile tools for caregivers through in-home care coordination and documentation accuracy, assessments in homecare and nursing, data visualization and analytics. This includes a list of front-end features, such as a barcode scanner and a native GPS app.

Darren Tseng will also present his experience and skills in Cloud Health Technologies. As an innovative, conceptual designer and relentless entrepreneur, Darren Tseng seeks to leverage and combine wearable computing platforms

Darren Tseng

Darren Tseng

Sony Salzman

Sony Salzman

in the industries of finance and healthcare delivery. Formerly responsible for market research at OpenView Venture Partners and now a consultant at CloudHealth Technologies, Darren is a Founder of Zimension Inc. – an emotional response-modeling platform for financial traders.

Sony Salzman, managing editor of MedTech in Boston will present about
emerging trends in healthcare innovation on Google Glass. Ms.
Salzman is a science journalist delivering high quality coverage of
the newest technological advances to MedTech Boston readers. See more information at www.healthinno.org.

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Google Glass, it’s cool and emerging innovation

Glass, as it’s known, is still in the early stages of the product life cycle. The truth is, no one knows exactly how great Google glass reach will grow in terms of value and ability—yet. This is especially true in health care.

Google has plenty of competition in the Glass arena. Samsung, Sony, Apple, all the big dogs in technology are creating or introducing copycat products appealing more to the masses in price point. In my opinion, the most interesting part of this new wave of Glass is its impact on society. It’s clear the novelty is exciting, and different.

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Without realizing it, we are learning where we need to make adjustments. Naturally, glass wearers are recording videos and seamlessly taking pictures like never before. This leads, naturally, to the question of where and under what circumstances are Glass allowed. It seems we as a society are again challenging boundaries  previously unknown, like in movie theaters, where the Glass is not welcome for the obvious reasons of video. Unlike the smart phone, Glass sits fashionably above the right eye. The reach for this media is not obvious. It’s working, recording, with no hand effort on people who are unsuspecting and unaware. Imagine that the person, three people behind you in the grocery store line is wearing a Glass and recording the transactions, recording the people waiting, what they are doing while they wait, the mother who stoops down to speak to her little girl. Personally, I find this a bit creepy.

Creepy or not, like most, I am eager to try this technology. I want to see clearly through glass. It is a new dimension for enlightenment. Developers are working on a line of Glass for prescription eye wear. Right now, being a new innovation, the Glass is different from normal eye glasses. By the time I get them, my prescription glasses that I am wearing now, may have glass ability.

What do you think, is it creepy or cool? Are you aware someone may truly be watching you via Google Glass or another brand? How many songs have run through your head on this subject? Here’s a few of my funny Glass thoughts. I hope you enjoy these videos, and let me know if they keep playing in your head. You’re welcome!

I can see clearly now (Johnny Nash, YouTube)

Hold your head up (Argent, YouTube)

When will I see you again (The Three Degrees, YouTube)

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Is Google Glass the new frontier in health innovation?

Google Glass Exploration Edition. Photo credit: Wikipedia.org

Google Glass Exploration Edition. Photo credit: Wikipedia.org

Have you been fortunate enough to experience Google glass? I have yet to see Google Glass in person. It’s not Google glasses, it is singular, glass. It seems that Google has done to glass what Steve Jobs did with Apple.

Apple, of course, is in step with Google as a competitor, with iGlass. It’s true, Google iGlass. I can only hope that Apple brings iGlass in at a lower price point. At $1500 for Google glass, it could be a while before most of us actually own it. That’s just my opinion. When you want something bad enough, you will find a way to get it.

Google Glass is a computer mounted above the right eye. It contains a microphone and bluetooth capabilities. Image credit: Antonio Zugaldia as seen in Medical News Today, January 2014.

Google Glass is a computer mounted above the right eye. It contains a microphone and bluetooth capabilities. Image credit: Antonio Zugaldia as seen in Medical News Today, January 2014.

Google glass responds to voice recognition. If you were wearing the device now, you might say “ok glass, take a picture” and it’s done. Record videos hands free on command. Ask for directions while driving, walking, anywhere. Google glass not only does things; video, pictures, directions, it also knows a vast amount of knowledge. I’m going to guess that Google Glass is more intelligent than Siri. Nothing against Siri, I like her very much. Although, my feelings may change with the tech.

Aside from the entertainment value and instant gratification that we all have come to depend on with technology, Google Glass is said to be the future of healthcare. To date, the Google Glass dance card shows two debuts in surgical procedures to overwhelming reviews.

I hope Google Glass finds its way into hospitals everywhere. No longer will the surgeon need to take eyes off you during surgery to look up or down, or turn their heads, Google Glass saves the day.

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Enabling the Disabled

Perhaps adaptive devices are a lackluster subject. I’ll give you that for now. However, to my mind comes the memories of working as a nurse’s assistant and seeing first hand the need for assistive technology. In most cases I had to learn how to put on and take off items like prosthetic limbs, so I could help my patient. I know adaptive devices make life better for many people in various stages of life for a multitude of reasons.

Technology today is to the point where if any of us should lose the ability to walk, reach, hear or talk, we will still be able to communicate thanks to researchers and scientists, physical therapists, device manufacturers, device engineers, device dealers, hospital purchasers, insurance payers. I cannot think of any sensory or motor skill that if lost, cannot be helped by adaptive technology. Prosthetic limbs liberate wheel chair bound amputees to such a degree that it is hard to tell who is wearing a prosthetic.

Prosthetic devices are adaptive devices. Hearing aids are adaptive devices, false teeth are adaptive devices. Is a pacemaker an adaptive device? Well, it does improve life, it does sustain life, one does need to adjust lifestyle for it and adjust emotionally to it. In my opinion, yes, even pacemakers are an adaptive device.

Take a moment to think about all the people in your life. Everyone has their struggles. However, the disabled have double struggles. Please register today in support of the Health Innovators presentation and collaborative discussion on enabling technology. It’s Feb 18 and possibly it’s two hours that could change your life, or enlighten you in some way.

We hope you take away the awesomeness of innovative technology. We hope you realize anything is possible when people get together and collaborate with a purpose. See you on the 18th? https://febhealthinnovators.eventbrite.com

The Health Innovators, creating better healthcare through innovation and collaboration, brings you Patient Talkback.   PTB2014logo

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