Don’t Just Sit There! Do Something!

Every so often researchers find data that enlightens us profoundly and at the same time ruins some of our favorite pleasures. Chinese food, cheeseburgers – maybe we should have known they were not great for our bodies. Now we are learning that we can’t even afford to sit down — at least not for too long. U.S. News recently reported that “mounting evidence suggests that those who spend hours with little movement are at higher risk for developing blood clots, diabetes, cardiovascular disease and a constellation of other maladies fueled by insufficient physical activity.”

And guess who is not exempt from this diagnosis? People who exercise vigorously and regularly. group_running_cropped

Really? You could be forgiven for doubting, but the surprising conclusion is that even super fit sitters are at risk from the biochemical effects of being sedentary for continuous periods of time if they routinely sit still for more than an hour, research says.

There is an answer. Get up and move around every hour. US News indicates that a 2015 study in the Clinical Journal of the American Society of Nephrology recommends two minutes of exercise per hour of sitting to reduce the chance of death by one third!

What other good ideas do they have for us?

  • Count your steps – Try an innovative wearable or even a simple pedometer!
  • Just move it – Even mild exercise that breaks up sitting spells is a big help.
  • Ping yourself – A reminder from your watch or smart-phone is a great idea.

Cardiologist Edward J. Teufel, MD has a few other ideas on how to avoid the sitting disease:

“Get up and move at least once an hour, and walk at lunchtime.  There are even some companies that are providing employees with ‘walking desks’ which is basically a standing level desk with a treadmill in front of it that allows you to walk while you are working!  Another idea is to put a set of pedals under the desk (which are available at medical supply stores, often used for physical therapy) and pedal while sitting. I think it is up to employers as well to make accommodations for their workers to prevent these issues.  It will benefit them in the long run to have healthier employees.”

The upshot: Don’t give up on plain old diet and exercise as secrets to a healthy life, experts say; but whatever you do or don’t do for exercise, get up and move around for two minutes every hour. And put simple personal technology to use to keep you on track!

The Patient Will Indeed See You Now – If You Really See The Patient

In the United States, the public still puts more trust in nurses and doctors than in any other two professions. But the patience of patients trying to get an appointment is wearing thin. We all know the feeling of relief upon hearing the words, “the doctor will see you now” but thought leader, physician and author Eric Topol stood those familiar words on their head in the title of his recently published book in order to make his point. The Patient Will See You Now, is a book he wrote to shed light on how the doctor-patient relationship is getting better for everyone involved, thanks to…smartphones.

Dr. Topol believes that mobile technology puts patients in the driver’s seat and can both save lives and dramatically improve lifestyles. As a physician he also knows that updating their way of doing business is very good for practice management and patient satisfaction.

There are many apps to enhance chronic care. Physician ratings sites are available at the tip of a finger. Telehealth has arrived too, bringing the exam itself right into the palm of your hand. Scheduling is joining the category and has much to contribute.

In The Patient Will See You Now, Dr. Topol acknowledges that scheduling appointments is one of many categories where a patient has long been expected to accommodate the needs and norms of a busy doctor and his or her office. Consider the original 1847 Code of Ethics of the American Medical Association, which Dr. Topol quotes from in the book’s first chapter:

“[p]atients should .. avoid calling on their medical adviser unnecessarily during the hours devoted to meals or sleep. They should always be in readiness to receive the visits of their physician, as the detention of a few minutes is often serious inconvenience for him.”

There is a growing consensus that getting a convenient appointment simply has to be made easier, given the computing and communication power most of us are holding in one hand. Serious studies including a June 2015 report from the Institute of Medicine are placing the blame for delays in access to care on scheduling systems that benefit providers more than they do patients.

Study after study about smartphones shows that almost everyone has one, and we almost always have them by our side. And smartphones may be the first technology to truly cross the digital divide, reaching equally high levels of penetration in traditionally underserved communities.

Why not tackle the challenge of scheduling appointments via smartphone if we are already using this technology to improve efficiency in so many other parts of our lives?

If you are developing a smartphone scheduling innovation agenda for your practice, clinic or institution, here are three things to think about while you finish Dr. Topol’s thoughtful book:

  1. Don’t just put an appointment booking tool on your website (even if it has a mobile format option). After all, that merely carries the same old relationship and dynamic over to the internet and fails to turn the new technology into an opportunity for real improvement.
  2. Think about allowing a patient to indicate the times she or he is available, and let your office respond rather than doing it the other way around? If the result is you are seeing more patients and seeing them at times more closely tied to the needs of their health, everyone is going to be pretty happy.
  3. Don’t go it alone. There are discussions emerging among all of your professional groups about how to tackle the future of scheduling. Get connected to the conversation.

There are many new terms for this kind of thinking. Participatory care and patient-centric care are two you will see increasingly.  Find the language that works for you and make it a part of your practice. Maybe you like the nice ring that Dr. Topol’s turn of phrase has: “the patient will see you now.”

Don’t Wait! See Your Doctor Now!

MillennialsHow many times have you cancelled a doctor’s appointment because of work? I can personally say that I have rescheduled or cancelled about five doctor appointments in the last six months. For many people, especially those of us in the millennial generation, this is not uncommon. According to a study, 41% of Millennials would cancel a doctor’s appointment because they are too busy. Why go in to the doctor when you can just research your symptoms?

While it may be a more convenient to sit in bed and self diagnose, it’s not exactly the best option for your health. Making time for the doctor is hard, but it’s worth it. People who visit the doctor for regular checkups are less likely to be diagnosed with preventable chronic diseases like heart disease, diabetes, and cancer.

Maintaining a healthy lifestyle with regular exercise and proper nutrition can help you avoid seeing the doctor frequently for different illnesses. But, there are other reasons why it’s a good idea to see your doctor at least once a year. Here are a few to consider:

  1. Avoid preventable diseases – Your primary care physician preforms many routine checks and tests to catch anything out of the norm before its too late. It’s also their job to gather information about your lifestyle to make sure that you’re maintaining healthy habits. Asking questions and educating you about weight management, alcohol abuse, stress & anxiety, and tobacco use can prevent issues later in life.
  2. Build your medical records – Creating a base line to monitor your health from will be extremely valuable for you over time. If an emergency comes up, your medical records can be used to rule out any existing conditions and any changes to your health can be a sign that something is up.
  3. Maintaining a trusted relationship – Building and maintaining a trusted doctor patient relationship is extremely important so that the doctor knows your specific wants and needs in your healthcare. Having a relationship with your doctor will also make it easier to talk about hard or uncomfortable issues you may be having.
  4. Get your appointment faster – When you become an established patient, the doctor will often make time to squeeze you in, and may even be willing to treat or diagnose small issues over the phone or email. This is great news for us Millennials who hate leaving work to go to the doctor.

While it might be a pain to schedule an appointment with your doctor now, it will definitely make a difference in the long run. With Everseat, you never have to worry about the hassle of booking an appointment over the phone. All you have to do is show up once a year.

A Plethora of Patients; A Deficit of Doctors

The medical world in the United States has a perfect storm approaching – we could have a shortage of 90,000 doctors by 2025 as our population ages and lives longer. With fewer funds, fewer doctors, and more demand for healthcare, technology for running a more efficient practice will become a necessity for every office and hospital.

doctor demand

The crux of this problem is that there are already not enough doctors, and this deficit will only increase if certain issues are not taken care of. There are plenty medical students – a record 49,480 people applied to medical school all over the US in 2014, a number that continues to grow year after year. But, only 20,343 – less than half – were admitted. More people than ever before want to be doctors, and many are going to school and studying to be doctors. So why is this large group not making it all the way to practicing?

Because there is an on-going 17-year cap on residency program funding, there is a limit on the number of newly graduated medical students getting into these programs. In 2014, several hundred medical students did not match to a residency.

To combat this issue, medical schools have started accepting more students, and learning hospitals are willing to expand their programs. But, because there isn’t the federal funding to cover the cost of residency, hospitals cannot expand their programs and these students are not becoming practicing doctors.

Additionally, as many as a third of the nation’s doctors will be hanging up their stethoscope and retiring this decade. Not only will they not be replaced fast enough, they will become part of another piece of this puzzle: the aging Baby Boomer generation.

 

A major foreseeable challenge over the nexkey findingst few decades is the aging Baby Boomer generation. This generation is much larger than the generations it precedes, meaning less funding from taxes, and fewer doctors to take care of them as their medical needs increase. Also, because medicine has advanced, people are living much longer lives, with more expensive care needed as they age. There is a huge need for doctors to provide healthcare to these patients, a need which will only continue to grow in the coming years.

With healthcare patient demand shooting way up and healthcare provider supply sinking, every person will be affected. Wait times for appointments will become staggering. A study done by Merritt Hawkings, Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates, shows wait times in Boston average 45.4 days. Boston had the longest average wait time of the 15 cities surveyed and Dallas had the shortest wait time, still 10.2 days. Overall, wait times are down across the country from 2009 but that trend could change soon with the continued shortage of doctors and aging population. Perhaps one of the more shocking stats is “The average appointment wait time to see a family physician ranged from a high of 66 days in Boston to a low of 5 days in Dallas.” Boston has many doctors, but even more demand.

This issue could also cause a larger gap in care provided to the poor, and possibly all the way up through the middle class. Although the Affordable Care Act allowed for many people to get coverage, there is a large group that falls between the cracks of coverage. This group cannot get coverage on their own or through the state. If the current trends continue, this type of problem could grow to where premium care is only for the wealthy.

Technology is needed now more than ever to face these challenges. Doctors’ offices and hospital units will need to become their most efficient to keep up with the growing demand. Schedules need to be optimized – appointment gaps will become much more than frustrating. The inner workings of the medical system will hopefully change in time to ensure the nation continues to provide top of the line healthcare throughout every hospital. Until that happens, to level out supply and demand, we will have to rely heavily on technological advancements.

Got Allergies? Stop Suffering and See Your Allergist Now!

allergy_fieldIt’s that time of year again. The sun and fun of summer are quickly slipping away to be replaced by the crisp cool of fall. This seasonal change means that many of us will once again have our sinuses assaulted by those pesky allergies.

If you are one of the 50 million people in the United States who suffer from sneezing, runny or stuffy nose, and itchy throat, eyes or skin around this time every year, you may have seasonal allergic rhinitis.

Seasonal allergic rhinitis, or hay fever, is most often caused by ragweed in the fall. On the East Coast, allergy symptoms spring up in August when ragweed starts to bloom, are at their peak in mid-September, and can last through November. While ragweed is the most common allergen, other triggers include mold spores and pollen from trees, grass and weeds.

According to the American College of Allergy, Asthma & Immunology, there are many different climate and weather factors that can go into how bad your allergies will be on any particular day:

  • Expect pollen counts to rise the day after heavy rainfall or when it’s windy and warm out.
  • Mold tends to grow faster in the heat and high humidity.
  • Don’t bother trying to move to get out of the way of your allergies; triggers can be found in all parts of the United States.

So what can you do about your allergies? There are many little things you can do throughout your day to lessen the effects of allergies:

  • Seasonal allergies can often be controlled with over the counter medication like decongestants and antihistamines.
  • It might be helpful to keep windows in your home and car closed during the day, so pollen can’t get in.Also, if you can, stay indoors in the middle of the day when pollen is at its peak.
  • If you do go outside for an extended period of time, shower and wash your clothes right away.
  • Hair can often carry a lot of pollen or other allergy triggers. Women with long hair should change your pillowcase frequently to avoid allergens sticking to your pillow and rubbing your face while you sleep.

If these at home remedies aren’t enough to control your symptoms, you should see an allergist. The doctor will be able to narrow down your triggers and put you on a specific treatment plan.

One of the treatment plans an allergist can recommend for seasonal allergy sufferers is immunotherapy. Immunotherapy is a series of shots that your doctor will give you that contain small doses of the allergen that you are allergic to. Over time, your body will start to produce an antibody that will reduce the symptoms you experience when exposed to that allergen in nature. Treatment plans can last up to 5 years depending on how bad your symptoms are, but the success rate is very high so it is usually a worthwhile investment.

So instead of suffering through yet another fall with a box of tissues and countless meds, you should go see your allergist. Your body will thank you.

Getting the School Year Off to a Healthy Start!

Your kids are going back to school! It’s been a wonderful, warm summer hopefully full of relaxation and adventure. But all good things must end and the school year is starting back up. We have a couple of tips to get you and your children ready to go back healthy and happy.

Instill good habits for days at school.

Washing their hands regularly. After using the bathroom, after recess, before eating, make sure children wash their hands or use hand sanitizer. Lots of germs are spread rapidly through schools, especially with the younger grades, so remind them of how important it is. And, if they’re young enough, discuss using warm water, soap and washing for 20 seconds.

Being active. Going from the endless, unrestricted activity that is summer to the highly structured school day can be hard for active children, especially while the weather is still beautiful. Remind children to use their recess and free time wisely – if they don’t have time during school hours, try to make some time after school for them to have unstructured free time.

Trying to choose healthy snacks. It’s easier in the summer to make sure sugary snacks are balanced out with healthy alternatives and activity. However, even if you pack lunches and snacks, you have less of a say in what kind of snacks they might be choosing. Remind them that they’ll feel better, be more focused, and have more energy throughout the day with healthier options.

Wearing their backpack properly. Books are heavy and have to be carried everywhere all day long. Be sure your child’s backpack is fitted properly and that they wear both straps. Learn more about how to do that. Backpacks are a better alternative to messenger bags but if you choose to go with a messenger bag, be sure to switch sides every day.

Keep good habits going at home, too.

Encouraging open communication. The beginning of school can create a lot of anxiety for children because of all the change – new students, new friends, new teachers, new responsibilities. Fostering communication for both good and bad topics will help them adjust.

Keeping bedtime. A good morning starts with a good night’s sleep. Bedtime hours may have been fudged a little over the summer, and may have included a few nights of falling asleep in front of the television. But during the school year, its important to be disciplined about bedtimes to be sure they (and you!) get a good night’s sleep.

Scheduling consciously. At the beginning of the year, there is an endless buffet of fun groups and activities to sign up for, but make sure your eyes aren’t too big for your stomach. It may be hard to pick just one or two things for your kids to commit to, but it’s not worth the nerves and stress of running around with sports equipment, dance shoes, instruments and Girl Scout cookies in the car while kids do homework in the back seat.

Creating a distraction free zone. Speaking of doing homework in the car – that’s an OK idea for sometimes, but shouldn’t be the norm. Choosing an area in the house that has no TV, or other gadgets that might distract them, will help your studious children focus better on homework and studying.

Checkup

And make sure you’re breathing easy.

Double check the safety of bus and walking routes to school. Make sure you’re familiar with the areas they’re walking, that you know the bus route, or if they’re carpooling, that you know who’s driving. It’s a simple step to take early in the year to give you some peace of mind.

Book all necessary appointments. The most important thing is your child’s health. Before the school year gets in full swing, book any annual check ups, shots/vaccines, physicals, or any other appointments needed to make sure they are fully ready to rock this school year.

We hope that these tips help get your school year off to a great start.

Food is the First Medicine: How Food Deserts Affect Healthcare

A-lister Gwyneth Paltrow of Iron Man and Shakespeare in Love recently tried to live off a food stamp budget for a week for the #FoodBankNYCChallenge. Her groceries, laid out and arranged neatly on her marble counter, looked more like rabbit food than a sustainable diet for a week. Her purchases included various fruits & vegetables, beans, brown rice & eggs, avocado, garlic, parsley, and seven limes.

Within four days the actress gave up, stating publicly, “My perspective has been forever altered by how difficult it was to eat wholesome, nutritious food on that budget, even for just a few days.” Little did she realize that her small budget was only part of the nutrition problem crippling the United States. Even scavenging for money for healthy, more expensive alternatives to junk food, soda, and snacks, families living in low-income locations often have no access to healthy products. The USDA estimates that 23.5 people in this nation are stranded in food deserts.

Food deserts exist in rural and urban impoverished areas with limited access to affordable, nutritious foods. In Baltimore, the sixth poorest city in America, one quarter of civilians live in food deserts. Families in food deserts have little or no access to fresh produce, low-fat dairy, whole grains, or other healthy alternatives, like Paltrow did.

Often, the only option in a food desert is fast food and convenience store products. These families struggle with obesity and chronic, diet-induced conditions that lead to heart trouble and premature death. As geographical scientist Paul Robinson acutely put it, “food is the first medicine. The doctor tells you you’re pre-diabetic and to eat healthy, but where do you go to get the food that the doctor has told you to eat?”

00infrographic_fooddesert

Obesity, hypertension, diabetes, hyperlipemia, gout, and arthritis—all of these chronic diseases may result from poor food choices and a lack of fresh, unprocessed foods. Doctors and health care providers try to educate patients in food deserts about eating healthy, but without the money, access to healthy food, or a history of eating healthy, it can be difficult to affect positive long-term change.

Doctors, public health officials, and non-profits are trying to tackle this health epidemic.  Farmers markets are beginning to accept food stamps. Non-profits are attempting to bring community gardens and healthy food trucks to impoverished, urban areas. There may be no capitol gain to opening a supermarket in a poor area with less money and less demand for healthy food, but the effect on a community would be paramount.

A good grocery store would not only generate jobs within a community; it would help provide healthy meals to families and break a cycle of poor nutrition. It is not enough, but it is a start. If we can sympathize with skinny, starving Gwyneth Paltrow, surely we can find a voice for these impoverished communities too.

Happy 50th Birthday to 9,000 of the Most Patient-Focused Clinics We Know

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Simply put, America’s Federally Qualified Health Centers are marking 50 years of providing access to affordable primary and preventative healthcare to the uninsured and medically underserved across the United States.

That is cause for celebration.

Throughout National Health Center Week (August 9-15), centers across the US will be telling their stories. There are some facts everyone interested in patient care should know, according to HealthCenterWeek.org:

Serious Volume.

Since their formation in 1965 as part of the War of Poverty, Community Health Centers have grown into a vital nation-wide network. Now 1,200 Community Health Centers serve a remarkable 28 million patients (in 2015) at more than 9,000 delivery sites nationwide. One in every 15 Americans depends on the services of a community health center.

Cost Effective.

Uninsured people living near a health center are less likely to visit the emergency room or have a hospital stay compared to others who are uninsured. By reducing emergency room visits, community health centers produce $24 billion in annual health system savings.

Economic Stimulus.

Health centers stimulate economic growth in their communities.  Over $23 billion in economic activity was generated and more than 212,000 jobs were produced by health centers in 2012.

High Quality.

Community health centers maintain patient satisfaction levels of nearly 100 percent.

The spirit of these very special institutions is elegantly captured by the mission statement of Everseat partner Harvard Street Neighborhood Health Center in Boston: Providing care in a compassionate, patient-centered healing environment.

Happy Birthday to 9,000 of the most patient-focused clinics we know!

How to Digitize Your Practice in 4 Easy Steps – Part 4: Keep it Secret, Keep it Safe

Health_Security

The number of customers affected by data breaches in the healthcare industry this past year have been staggering:

  • Anthem Blue Cross: 80 million customers affected
  • Premera Blue Cross: 11 million customers affected
  • Community Health Systems: 4.5 million customers affected

The Anthem breach, the biggest one yet, is expected to have damages that exceed its $100 million insurance policy.

That kind of money is quite attractive to thieves. According to PwC, the private information attackers were after can command $1,300 per patient record on the black market.

Between electronic medical records and bring your own device trends (or “shadow-IT”), the transition from paper files to tablets, and a whole host of other “digitizing” practices are changing how we view patient privacy.

The process of securing your patient’s data can be daunting – especially if you’re a small business without an IT department.

However, the fact is that in the majority of these breaches, both within and outside the healthcare industry, implementing well-known security measures could have prevented these attacks from happening in the first place.

Securing your data with these measures is a must if you want to avoid a data breach – even the smallest breach for a small business can be enough to send it into bankruptcy.

A full explanation of all these measures requires a certified security engineer. While they may be pricey, it’s well worth the money.

But like implementing any piece of technology, you should never go into the security contracting process without knowing some of the industry lingo to help you understand what is being recommended to you.

Here’s some of the measures your security engineer may tell you about:

Firewalls:

These are hardware or software devices that filter traffic based on certain criteria such as where the traffic is going, where it is coming from, and what kind of traffic it is. Most routers these days come with a firewall built in, but to get full protection it should be configured by a security professional.

Intrusion Detection and Protection System:

These are devices that are placed across your computer network that are able to detect and/or react to cyber attacks. There are a few different types of IDPSs based on whether they just detect an attack or whether they detect and respond (passive vs. active), whether they sit on a networking device like a router or on the host system like your desktop computer (network vs. host), and how they analyze the traffic (knowledge based vs. behavior based). This last one is of special importance, as one security analyst said that a behavior based (aka anomaly analysis) IDPS could have prevented the Anthem attack. Whereas a knowledge based system utilizes a library of known attacks to determine if the network traffic is friend or foe, a behavioral-based system looks to see if the traffic is deviating from normal traffic patterns.

Encryption:

This is a process of using letters, numbers, and mathematical formulas to make your data unreadable to outsiders. There are thousands of different encryption techniques and technologies. For instance, HTTPS, which is a secure internet protocol, you probably use everyday. If you have any kind of patient data, there are probably legal requirements that say it should be encrypted – and if not, you should be encrypting anyways. Encryption is one of the simplest ways to make sure your patient data stays private.

Penetration testing:

Penetration testing is when a professional versed in information security attempts to hack into your network. They’re looking for all the vulnerabilities that hackers would be looking for in an attempt to compromise your data security. After their hack, testers will give you a report of all the weak points in your computer and network security, allowing you to patch them and prevent the bad guys from getting your important information.

Authentication:

This is the process of confirming that the user is exactly who they say they are. The most well known authentication process is submitting a username and password to log on to your computer. The general rule of them is that the more levels of authentication, the more secure your data will be (the harder it is to impersonate an authorized user). So for example, in addition to a username and password, many companies (especially in the defense industry), will also require the user to swipe their ID card into a reader attached to the computer or scan their thumbprint.

I know a lot of these technical terms may be overwhelming – but there is a good piece of news when it comes to creating a secure environment for your data. While technical controls get all the attention in the news, they will never be as important as good policy and human resource controls.

A few of these include:

  • Training users about how to detect and protect themselves from common cyber attacks (like phishing and downloading viruses and other malware)
  • Conducting the appropriate background checks on new hires
  • Utilizing secure work practices like separation of duties and task rotation
  • Making regular security reviews/audits a core part of your business
  • Limiting employee access to important patient data on a strict need-to-know basis

So now you’re ready to really protect your patient’s valuable information. Patient privacy and security is extremely important, so arming yourselves with knowledge is the first line of defense against security breaches and attacks. The next step is to find a security engineer consultant to help you implement all the security measures we just addressed.

That concludes our four part series on how to digitize your practice. We hope that this information has been informative and useful as you start on your journey to digitizing your practice.

Control Your Healthcare Through Technology

Everyone can relate to being sick. To feel powerless or helpless in our own healthcare is a debilitating feeling. In these moments, we look for a sense of control and transparency about the status of our condition, facts and explanations in a language we can understand, updates on our progress, and the ability to have input into our own care.

Basically, sick patients need accessibility, convenience, and a sense of control.

When an individual falls ill, the most common diagnosis is with an acute condition, such as the flu or a cold. Treatment for these conditions is so routine that doctors often skim over treatment plans, and the patient may leave feeling unsure about the specifics. Patients are turning to the Internet to try and find medically accurate answers, and end up feeling more confused about their condition than they had been when they started.

If patients leave an appointment equipped with tools to help debrief their visit and properly prepare them for treatment, they’re likely to feel more in control, and thus more satisfied.

Chronic conditions, such as a cancer diagnosis, always come with a long-term care plan that involves the patient and their family. While tools like patient portals are available to help distribute information, there is still significant room for improvement. There are many technological tools that can be implemented to assist the patient and family in educating themselves on their diagnosis and subsequent treatment.

St. Jude Children’s Research Hospital recently asked patients and their families which technological tools would be most useful to aid in their care. Many cited expanding a patient’s portal to include their entire medical record, complete with diagnostic imaging results. Others thought scheduling help, such as a tool to plan medications, would be beneficial. A number of families also suggested a tool “to be alerted to schedule changes [in] real-time prompts.”

Although St. Jude Children’s Research Hospital acknowledged that their patient population is primarily chronic patients, they maintain that the suggestions are likely representative of all healthcare consumers. Time and time again we have heard the patient speak, and repeatedly they have asked for improved accessibility and transparency into their care. Developing technological tools to assist in improving their care is the first step in this absolutely necessary direction.