Christina Thielst

Christina Thielst, FACHE, is a skilled and innovative hospital and healthcare administrator and entrepreneur with a deep desire for continually improving the health of the community being served. Christina is also the author of "Applying Social Media Technologies in Healthcare Environments."

Articles by Christina Thielst

• New hospital quality and safety ratings released, show improvements from 2016

  Tuesday, June 04, 2019

  The Leapfrog Group, which represents employers and other purchasers of healthcare services, has released its new spring 2019 Leapfrog Hospital Safety Grades. Overall, there has been a significant improvement in 2019 (160,000) from its 2016 estimate (205,000) of lives lost from avoidable medical errors. Through its affiliation with the Johns Hopkins Armstrong Institute for Patient Safety and Quality, it has also updated its estimate of deaths due to errors, accidents, injuries and infections at hospitals. Like other hospital rating systems, the grades can be viewed as triggers for asking questions for more informed patients.

• Improving guidance to patients, family caregivers on care facilities

  Monday, May 13, 2019

  Family caregivers and patients struggle with choosing quality care facilities. This includes both those who have not yet been hospitalized and those who are being discharged to a lower level of care. Unfortunately, sometimes they find their choice isn’t the best fit or safety concerns arise. Delays in choosing a facility increase the risk of discharge for hospitalized patients. Choosing the wrong facility can also strain resources with an unnecessary hospitalization or re-hospitalization. A recent Kaiser Health News article addresses the need for smarter decisions on where to recover after a hospitalization, starting with better guidance from hospitals themselves.

• Perceptions of opioid policies and implications for pain treatment in older adults

  Wednesday, April 24, 2019

  Pain management can be complex for the 66 million individuals in the United States experiencing acute pain and the 100 million suffering from chronic pain. Opioids successfully alleviate pain for many; however, morbidity and mortality rates are rising. State responses to this public health threat include the creation of prescription pain management policies. A University of Michigan National Poll on Healthy Aging examined the views and experiences of adults aged 50 to 80 years on opioid prescribing and related policies.

• Can patient-physician recordings be good for care?

  Tuesday, April 16, 2019

  Historically, healthcare administrators have been concerned about the risks of patients recording their conversations. Perhaps they should be more concerned about the risks of patients not having a recording of their physician or other caregiver. A recent article in Healthcare Executive examines the issue from an ethics perspective and looks at the benefits for the patient’s understanding of what is being communicated during an encounter. Patients or their family caregivers can replay sessions to clarify information they believe they have received, or simply to reassure themselves.

• Ghosting patients: Is that effective healthcare leadership?

  Tuesday, March 26, 2019

  Administrators of hospitals, clinics and medical groups know there is competitiveness in their ranks just as there is in the rest of the business world. However, some actions to protect business interests may interfere with the quality and safety of patient care. This brings us to "ghosting;" when a physician disappears…or is evacuated away from their patients as a result of the breakdown in a professional relationship. A recent Kaiser Health News article shines a bright light on the potential risk to patient health and the unintended consequences caused by these business decisions.

• Palliative care: A slippery slope for hospice providers?

  Monday, March 18, 2019

  Hospice and palliative care have traditionally been two distinct services, with the former being focused on the last six months of life. More recently, perhaps due to the aging population and shifting beliefs about end-of-life care, hospice is finally becoming more accepted. The growing number of baby boomers with chronic conditions and the desire to improve quality of life are also contributing to increased demand for palliative care. The response by some providers has been to expand the operation of their hospice programs to accommodate palliative care services.

• What is Safety II? New opportunities for safety leadership

  Monday, March 11, 2019

  Researchers in Europe may have defined and given structure to the challenges associated with safety. Their white paper on Safety I vs. Safety II highlights where scientific methods, standardization, root cause analysis and reliability alone fall short. They assert that safety needs to progress beyond a bimodal model to employ multiple approaches for reducing error/failure and achieving fully resilient systems. Safety I, as experienced today, is the push to eliminate all accidents, system failures and injury. Safety II recognizes that medicine and healthcare processes are not an exact science and that there is sometimes an art to caregiving.

• New opportunities for telehealth, mHealth reimbursement that providers don’t even know about

  Tuesday, February 26, 2019

  There has been pressure on the Centers for Medicare & Medicaid Services (CMS) to address telehealth and mHealth reimbursement for years. The fruits of that labor by policymakers, healthcare providers, telehealth networks and information technology professionals are continuing to materialize with new reimbursement for remote patient monitoring and virtual visits. In a recent article, Eric Wicklund, a longtime reimbursement proponent and editor at mHealthIntelligence, presents survey data that finds providers aren’t paying attention. This includes that out of "280 health systems, two-thirds of those surveyed don’t know about CMS’ expanded telemedicine reimbursement opportunities."

• Financial world weighs in on new CMS price rule

  Wednesday, February 06, 2019

  The Motley Fool is a media channel dedicated to helping the world invest for a better financial future. It is no surprise, then, that it has addressed the Centers for Medicare and Medicaid Services' (CMS) new Hospital Inpatient Prospective Payment System rule, which requires hospitals to publish their standard charges online in a machine-readable format. In The Fool’s words, "hospitals are now required to list prices for all of their services, thereby giving patients a clearer notion of what to expect. But while it's a good idea in theory, so far, the rule is only adding to consumers' confusion without in any way alleviating the cost burden for patients."

• Are hospitals compliant with patient access to medical records?

  Tuesday, January 29, 2019

  Are U.S. hospitals compliant with federal and state regulations in their medical records processes? That is the central question in a cross-sectional study of 83 hospitals featured in the U.S. News & World Report Best Hospital Rankings for 2016-2017. The Health Insurance Portability and Accountability Act establishes the patient’s right for access of their protected health information within 30 days and in the format they prefer. In the study, researchers attempted to conduct scripted interviews (simulating a patient experience) with each medical records department, but three were deemed nonresponsive.

• Virtual reality: From the OR to the bedside

  Tuesday, January 15, 2019

  Increasingly, healthcare professionals and consumers are digital natives, meaning they have lived their entire lives with technology. Their worldview is a bit different than those of us who are digital immigrants. One of the latest and most promising applications in digital health is virtual reality. Researchers began using virtual reality in healthcare environments in the 1990s and applications have become more sophisticated over time, especially as today’s digital natives increasingly envision the possibilities.

• Smarter mobile health for addiction recovery

  Monday, April 23, 2018

  Social and mobile health tools are making a significant impact on consumer health and wellness. They have played an important role in efforts to break care processes free from the confines of hospital and clinic walls and to activate consumers. Their engaging features support consumers in self-management activities, helping them to understand and act upon relevant information for better health.

• Integrated systems for smarter telemedicine

  Wednesday, April 11, 2018

  Over the last several years, integration has been building in the world of health information technology and is most visible in medical centers and healthcare systems. Visit your clinic doctor, she wants to order lab tests and on your way out you stop by the lab for the blood draw. A few days later you get a message saying your results are now on the clinic's patient portal. This efficient and streamlined workflow benefits both providers and patients.

• Evolution: Telemedicine to digital health

  Monday, March 26, 2018

  Digital health continues its expansion beyond more traditional telemedicine modalities as health professionals find new ways to apply technologies. In recent years, this expansion has become more of an evolution as the Internet, health information technology and even social media are blended into systems and processes.

• Lessons learned from nurse practitioner claims history

  Thursday, March 22, 2018

  ​The lessons we learn can come from our own experiences or those of others. In the case of risk management, closed malpractice claims provide a particularly valuable source of information. This includes aggregation of data and objective case studies, from which review and analysis can occur.

• Managing challenging patient relationships

  Wednesday, February 28, 2018

  Challenges in healthcare are the norm. However, some patients present significant challenges to healthcare professionals and the care environment that rise to the point of creating unnecessary risk. While healthcare providers and their staff should always attempt to resolve patient concerns, there comes a point when the best course of action may be to terminate the provider/patient relationship.

• Let’s improve the response to pain, not place blame

  Thursday, January 04, 2018

  ​When observing conflict, I've often pointed out that it takes "two to tango," meaning each party has a role in managing conflict. To point the finger at one group/individual or another is simply assigning blame.

• How can we bridge the engagement gap?

  Friday, October 27, 2017

  Change Healthcare recently surveyed consumers, payers and providers to gain insight on their unique perspectives regarding consumer engagement investments and effectiveness. The findings demonstrate that value-based care is propelling investment in consumer engagement, but consumers are still thirsting for change, relevance and access.

• Report details first 6 months of California’s End of Life Option Act

  Friday, July 14, 2017

  The California Department of Public Health released its report detailing usage information during the first half-year of the End of Life Option Act's implementation. The law — Health and Safety Code section 443.19 (b) — gives mentally capable, terminally ill adults with six months or fewer to live the option to request a doctor's prescription for medication they can decide to take to die peacefully in their sleep if their end-of-life suffering becomes unbearable.

• What to do instead of making accreditation reports publicly available

  Wednesday, June 21, 2017

  Accrediting organizations (AO) like the Joint Commission evaluate hospitals against established standards of care upon invitation and payment for services. State licensing groups and the Centers for Medicare and Medicaid Services (CMS) inspect hospitals for compliance with state regulations and Medicare's Conditions of Participation. There is a bit of duplication and overlap between the two types of surveys, and perhaps this led to CMS' decision to allow hospitals accredited by a CMS-approved accreditation program to substitute accreditation under that program for survey by the State Survey Agency.

• Honoring end-of-life wishes with DNH orders

  Thursday, June 01, 2017

  "Do not resuscitate" (DNR) orders have not been as effective as hoped for every patient who has one. The emotion of the moment, family conflict and confusion are too often the cause. There are unnecessary costs associated with everyone involved, but more importantly, the patients' wishes for their end-of-life care are not being honored or respected.

• H7N9 virus: Planning for the next pandemic

  Wednesday, May 24, 2017

  Most public health officials agree that the next pandemic is not a matter of if, but when will it arrive in the United States. And they have been closely watching China and the H7N9 virus. Since March 2013, China has reported human infections from an Asian-lineage avian influenza A virus — H7N9. Annual epidemics of sporadic human infections have occurred there each year, with the latest (the fifth) being the largest to date. Those infected suffer from severe respiratory illness.

• Reducing misdiagnosis with virtual second opinions

  Thursday, May 04, 2017

  ​Telemedicine and telehealth services have been connecting patients and providers who aren't sitting in front of each other for many years. The trend has been picking up speed in more recent years as some encounters leverage the internet and go virtual.

• Integrating primary and behavioral care

  Monday, April 24, 2017

  Mental health and substance abuse treatment have for too long been delivered entirely separate from medical and surgical care. The reality is that medical conditions can contribute to behavioral health; and some mental health conditions co-exist with medical disease.

• How can healthcare leaders ensure safety?

  Monday, April 10, 2017

  Leadership is multifaceted, complex and full of daily challenges — especially in the healthcare field. When talking to most healthcare CEOs, one often hears that their people are their greatest resource, helping them keep pace with the evolutionary changes. If this is true, investments made in this area can yield great results.

• Why is no one using our patient portal?

  Friday, March 24, 2017

  Patient portals and the functionality they offer have the potential to increase access to service, improve convenience and more effectively engage patients and consumers. They can also increase efficiencies for both patients and their providers.

• Collaboration in Texas: Ensuring patient access to virtual visits

  Tuesday, February 28, 2017

  ​The Texas Medical Board has wrangled with telemedicine companies on policy covering virtual patient and practitioner visits. It came to a showdown in 2015 after the Medical Board adopted a policy requiring physicians to meet with patients in person prior to providing virtual medical care.

• Making sense of the political conflict surrounding healthcare

  Friday, February 24, 2017

  ​There are significant risks to crafting new legislation without bipartisan and public support. Former President Barack Obama's signature healthcare legislation — the Affordable Care Act (ACA)— did not have bipartisan support, but it was passed when Democrats controlled the federal government. Now that power has swung to the Republican Party, we expect changes, if not an outright repeal of this legislation.

• Women in medicine: Providing higher quality and better patient outcomes?

  Monday, January 16, 2017

  In 1973, Billy Jean King changed the way the world felt about women in sports. Today, a new analysis of patient outcomes might begin a shift in how we view the contributions and value of women in medicine. The gender gap in medicine is closing. In 2016, female physicians accounted for 46 percent of U.S. medical school graduates and one-third of the U.S. physician workforce. In addition, women are increasingly choosing to pursue a care in medicine — including the 10,474 women who enrolled in medical school during 2016.

• Coverage expansion, utilization increases lead to health spending growth

  Wednesday, January 04, 2017

  ​A new analysis from the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) estimates that 2015 healthcare spending in the United States grew at a rate of 5.8 percent and reached $3.2 trillion. In comparison, 2014 spending increased 5.3 percent, following five consecutive years of historically low growth from 2009 to 2013.

• Where you live affects how long you live

  Friday, December 02, 2016

  Variation in life expectancy across counties in the United States is substantial and not fully explained by traditional social determinants of health, such as race and socioeconomic status. A recent study in Health Affairs finds that life expectancy is more broadly linked to individual and community-level factors ranging from the burden of disease to the safety of neighborhoods. It is the first study to establish a relationship between a summary measure of population well-being and life expectancy in a nation sample of 3,092 counties.

• What does data analytics really mean?

  Monday, November 28, 2016

  There are times in every healthcare leader’s life when they feel overwhelmed by information and they struggle to make sense of it all. The chatter of big data and analytics tools indicate there are solutions, but some don't know what these words mean. Many healthcare professionals have already embraced data-driven decision-making, so what exactly do data analytics have to offer?

• The frustration of nurse midwives and corporate practice of medicine bans

  Wednesday, November 09, 2016

  Kaiser Health News recently reported on the failure of California's AB 1306 to expand the scope of practice for certified nurse midwives — allowing them to practice independently. The bill failed to pass because the California Medical Association opposed it after an amendment was removed that would prohibit hospitals from employing nurse midwives, some of whom are already employed by hospitals in the state. The result is frustration among women and their families who want more choice and affordability in their options.

• Health systems science: The third pillar of medical education

  Thursday, November 03, 2016

  ​The American Medical Association (AMA) will soon release their new "Health Systems Science" textbook to help prepare students to become physicians who understand how patients receive and access care in today's healthcare systems. The focus of the text is on value in healthcare, patient safety, quality improvement, teamwork and team science, leadership, clinical informatics, population health, socio-ecological determinants of health, healthcare policy and healthcare economics.

• CMS aims to bolster emergency preparedness

  Tuesday, October 04, 2016

  Healthcare is increasingly being delivered outside of hospitals in widely diverse settings. However, the level of preparedness for disasters and emergencies varies — even though disasters stress the entire system. The latest Centers for Medicare & Medicaid Services (CMS) final rule establishes consistency with requirements for all who participate in Medicare and Medicaid. The regulations will lead to increased patient safety during emergencies and more coordinated responses to natural and man-made disasters.

• Salesforce report shows increasing acceptance of telemedicine

  Thursday, September 29, 2016

  Salesforce recently published a survey of U.S. adults to gain insight into their communications with providers and preferences on telemedicine, wearable devices and post-discharge care. Of those surveyed, 85 percent had health insurance and a primary care physician, and virtual care treatment options were of interest.

• Reducing prescription medication use with medical marijuana

  Monday, September 19, 2016

  Researchers at the University of Georgia have found that prescribing patterns change with the implementation of state-level medical marijuana programs, according to a recent Health Affairs report. They found the use of drugs approved by the Food and Drug Administration (FDA) for which marijuana could serve as a clinical alternative fell significantly once a medical marijuana law was implemented by states.

• Telehealth parity laws still face obstacles

  Tuesday, August 30, 2016

  A new policy brief from Health Affairs and the Robert Wood Johnson Foundation examines telehealth parity laws in the United States. With 20 percent of Americans living in areas that have physician shortages, telehealth could help these underserved U.S. residents obtain access to care — to treat illnesses and monitor chronic conditions.

• Getting care to where the patients will be

  Thursday, August 25, 2016

  Wayne Gretzky famously said his success came from "skating to where the puck will be." The recent InTouch Health Innovation Forum was an exploration of the telehealth ecosystem, and it highlighted a number of healthcare organizations that are creating strategies to deliver care to where the patients will be.

• Specialist medical homes: Keeping patients out of the hospital

  Tuesday, August 16, 2016

  Specialty medical homes provide a tremendous opportunity to control costs with better management of complications and the prevention of hospitalizations. Lawrence Kosinski, M.D., a gastroenterologist, has been successful at doing just this for his Crohn's disease patients, and his accomplishments were highlighted in a recent H&HN article.

• Data analytics for the patient population

  Tuesday, July 26, 2016

  Traditional electronic health records are designed around the care delivered during encounters with individual patients. However, incentives for improved outcomes, value, and expectations of those paying the bills, including patients and taxpayers, require more efficient and effective care processes and decision-making. These factors are driving a shift in the healthcare delivery system and the way we think about care processes.

• As out-of-pocket costs rise, patients seek value and convenience

  Monday, July 18, 2016

  Consumers are assuming more and more responsibility for their healthcare costs — higher deductibles and growing out-of-pocket costs. As a result, they are starting to ask about the value and convenience they receive in return. This includes educating themselves on pricing, lower-cost strategies and convenient options.

• Ransomware: Healthcare’s latest cyberthreat

  Tuesday, June 21, 2016

  Ransomware attacks are a form of digital extortion and a way for hackers to easily monetize health information by holding it hostage. The 2016 Ponemon Institute Study of Privacy and Security of Healthcare Data reveals that criminal attacks are the leading cause of data breach among healthcare organizations, and 45 percent of healthcare organizations and their business associates are worried about ransomware.

• Medical errors: Are they really the third‑leading cause of death?

  Wednesday, June 08, 2016

  The 1999 Institute of Medicine (IOM) report "To Err is Human" focused national attention on patient safety and preventable medical errors. The report, based upon an analysis of prior research, estimated that 44,000 to 98,000 deaths annually were due to medical error.

• Senior population health: National data and state rankings

  Thursday, June 02, 2016

  America's Health Rankings has released their 2016 Senior Report, an analysis of the 65-plus population's health on a state-by-state and national basis across 35 core and supplemental measures of health and wellness. The report is a resource for provider and communitywide planning and improvement activities — especially since the number of seniors is projected to increase by 49.5 percent by 2030 (from 49.4 million currently to approximately 73.8 million).

• Workplace safety in healthcare: Strategies and resources

  Tuesday, May 24, 2016

  Workplace injuries and illness are expensive — both in terms of the organization's bottom line and the morale of employees. As the healthcare delivery system continues to evolve, new workflows and ways of accomplishing the work to be done will change, necessitating updates to policy, plans and training.

• Workplace safety in healthcare: Identifying the problem

  Monday, May 09, 2016

  The healthcare industry has one of the highest rates of work-related injuries and illness, and the impact is great. According to the Occupational Safety and Health Administration (OSHA), the number of days healthcare workers are away from work is higher than both construction and manufacturing — industries traditionally believed to be more hazardous. OSHA also reports workers' compensation losses result in a total annual expense of $2 billion for hospitals alone.

• 7 steps for guiding patients through behavioral changes

  Tuesday, April 19, 2016

  Value-based purchasing and other drivers of change have led to improvements in models of care. One of these — the patient-centered medical home (PCMH) — is being implemented in primary care practices around the country. The essence of a patient-centered medical home is that the primary care provider coordinates all of a patient's care with an emphasis on patient engagement and prevention.

• CEOs offer top issues confronting community hospitals

  Wednesday, April 06, 2016

  The American College of Healthcare Executives conducts an annual survey of community hospitals to identify the top issues of immediate concern. Not surprisingly, the CEOs of these hospitals are most concerned with financial challenges. Patient safety and quality, governmental mandates, personnel shortages and patient satisfaction round out the top five issues.

• Depression and diabetes: Improving outcomes with telehealth

  Monday, March 21, 2016

  Almost 10 percent of the U.S. population has diabetes, and it is one of healthcare's greatest challenges due to the financial and personal costs associated with complications and hospital care. According to the American Diabetes Association, the average medical expenditure among people diagnosed with diabetes is 2.3 times higher than those who don't have the diagnosis.

• California bill requires patients to identify family caregivers

  Monday, March 07, 2016

  Healthcare is one of the most overly regulated industries. Sometimes the ideas that motivate creation of legislation seem simple and straightforward, but the complexity of healthcare environments and relationships is too often misunderstood.

• To attain precision medicine, we must first personalize

  Monday, February 22, 2016

  In his 2015 State of the Union Address, President Barack Obama announced the launch of a new Precision Medicine Initiative and its goal to cure diseases and help us all improve our health. One year later, in his 2016 State of the Union address last month, Obama reinforced his support for this initiative and announced his goal of curing cancer.

• Social media and healthcare: Offsetting liability with policy

  Tuesday, January 12, 2016

  Social media is a powerful communication and connection tool that is being applied in healthcare environments for a range of purposes and audiences. Despite its many benefits, it does present some risks — the most common concern being the posting of private health information causing a HIPAA violation and legal liability.

• Finding balance for patients: Hospitals and marijuana

  Monday, December 14, 2015

  ​Stories abound about how marijuana has helped relieve symptoms in those who are seriously ill, and thousands of basic science studies provide the foundation for these claims. So it is not surprising that 23 states and the District of Columbia have passed legislation permitting cannabis use for some medical purposes.

• Leadership in healthcare: Not so different from splitting wood

  Monday, November 23, 2015

  As winter approaches, this is an excellent time to reflect on trends in healthcare and self-assess one's leadership style. A few weeks ago, as I was preparing for the winter and splitting wood, I thought about the similarities of this activity with my experience leading people in healthcare environments.

• 16 ideas for reducing healthcare energy costs

  Wednesday, October 28, 2015

  ​Healthcare organizations are constantly under pressure to reduce costs these days. That often means turning to variable staffing and supply costs for solutions. Some healthcare leaders view energy costs as somewhat fixed, but they are probably more variable than one thinks. Energy costs are based upon consumption, and as with electricity, costs are usually higher at times of peak demand.

• Innovating and disrupting in telemedicine

  Monday, October 26, 2015

  In the fee-for-service era, healthcare providers focused on those who were present in the clinic — that is, those who made and showed up for an appointment. However, the question today becomes "Who hasn't been seen in the clinic?"

• Disaster: 6 actions to avoid leaving the elderly and disabled in danger

  Tuesday, October 13, 2015

  The recent wildfires once again shine a light on the importance of increased attention to the needs of the elderly and disabled during disaster planning, response and recovery phases. Nearly 75 percent of those who died in the Hurricane Katrina disaster were older than 60. Two years later, busloads of elderly and disabled were evacuated from care facilities in San Diego County, but were left stranded and trapped by flames as wildfires raged.

• Securing electronic health records on mobile devices

  Wednesday, September 30, 2015

  Healthcare providers are breaking free from the nursing station and using mobile devices to receive, store, process and transmit patient clinical information from where they happen to be located, when the need presents itself. Sometimes, this is in a cafe over lunch with colleagues or while waiting for their child's baseball game to begin on a Saturday morning.

• Striving for balance: Bundling payments for joint replacements

  Thursday, September 10, 2015

  The world of orthopedics is good for the bottom line of many hospitals, but joint replacement surgeries can present some challenges for both hospital leaders and those paying the bills. The patient population requiring hip and/or knee replacements tend to be older adults or the elderly, so Medicare has an invested interest in the effectiveness and efficiency of care. This is likely one reason why they have selected joint replacement for a five-year demonstration of alternative payment and delivery models.

• Waves of change: Helping staff navigate the turbulent tides of healthcare

  Thursday, August 20, 2015

  With an emphasis on reducing costs while improving quality and access, the transformation of the U.S. healthcare delivery system is creating additional pressure at the point of care — the encounters between clinicians and their patients. While change is due, it also requires balance and support for those who are caught at the crux as new models of care are being rolled out and payment models are still being developed and implemented.

• Healthcare providers preparing for dialysis pay-for-performance change

  Tuesday, July 28, 2015

  Beginning Jan. 1, 2016, the Centers for Medicare and Medicaid Services will pay outpatient dialysis facilities for performance. The End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) will promote high-quality services by linking a portion of payment directly to the dialysis facility's performance on quality-of-care measures.

• The graying of the US healthcare workforce

  Friday, July 24, 2015

  The baby boomer generation started reaching retirement age in 2011. As millions of baby boomers are starting to need the additional healthcare services that come with aging, the healthcare industry is considering their labor options. At the same time more workers will be needed, a wave of older healthcare workers will also be retiring. So where will the labor needed come from when there just aren't enough younger workers to fill the gaps?

• Mystery and fantasy: Physicians branch out as fiction writers

  Tuesday, July 14, 2015

  In the last few years, I've received several fictional books written by physicians. This has caused me to pause and wonder about when exactly these guys have the time to write stories. I've known many physicians throughout my long career, and I had never thought of them as authors for the masses. But perhaps I should have recognized this potential outlet to the stressors they experience sharpening their skills and caring for others every day.

• Is America’s broadband infrastructure ready for the Silver Tsunami?

  Tuesday, June 30, 2015

  A couple of weeks ago, the cable guy came out to my house due to slow connections. What I learned from him was that the wire between the street and the house was not capable of handling the current wireless and Internet requirements of my family.

• Study: Best practices for the primary care practice

  Tuesday, June 09, 2015

  ​The healthcare delivery system and payment models are changing. Much more emphasis is being placed on preventative care, engaging patients and their family caregivers as members of the care team, and improving satisfaction and outcomes.

• What we know in Year 2 of health insurance marketplace enrollment

  Friday, May 22, 2015

  The health insurance marketplaces created under the Affordable Care Act are now in their second year of insuring consumers. While there continue to be some glitches, there are more insured Americans — some possibly for the first time in their life. Almost 8.84 million people have signed up for Affordable Care Act qualified plans through Healthcare.gov, and 53 percent of these are newly enrolled in 2015. An additional 2.8 million people have signed up for marketplace plans in states operating their own health insurance exchanges.

• What CMS envisions for physician quality reporting programs

  Tuesday, May 05, 2015

  ​Whether we like it or not, data-driven and value-based decision making is here to stay, and the Centers for Medicare and Medicaid Services has been one of the drivers of this change in healthcare. The new ​CMS Physician Quality Reporting Programs Strategic Vision will help them to evolve, making better use of data collected and adding value for their stakeholders.

• High hopes, unfulfilled promise: Healthcare groups look beyond portals

  Thursday, April 30, 2015

  The healthcare delivery system currently being transformed is moving us much closer toward longitudinal health and a virtual care team approach. This involves continuous and ubiquitous interaction between the care team and patients — whether they are at home, mobile or in a care facility. The process also requires integration of these interactions into the clinical record, along with remote monitor data and information on social support networks.

• Universal precautions: They truly are worth it

  Wednesday, April 22, 2015

  When a Santa Barbara, California, patient tested positive for Hepatitis C last month, local public health officials investigated the cause. Their analysis included a visit to the patient's physician, where they discovered the medical office was performing injections without following standard/universal precautions to protect themselves and their patients from blood-borne viruses.

• Leveraging social technologies as healthcare business solutions

  Wednesday, April 01, 2015

  Last year, a highly respectable group of individuals representing a diverse group of healthcare organizations contributed to a book published by HIMSS — "Applying Social Media Technologies in Healthcare Environments." The contributors represented large healthcare systems, statewide public health departments, community hospitals, clinics, physicians, researchers and a patient. However, the stories of innovation using social technologies to solve business challenges will also be appreciated by nontechies alike.

• Possible HIV cure brings hope to patients and healthcare providers

  Wednesday, March 18, 2015

  The first AIDS case recognized at the time in the United States was reported to the CDC in April of 1980. Today, more than 1 million Americans are living with HIV/AIDS, and many more are inflicted across the world. A diagnosis of AIDS in '80s usually resulted in death. In the mid-to-late 1980s, testing was developed to slow the spread of the disease by more quickly identifying the carriers and to protect those who relied upon the nation's blood supply.

• State medical board licensing: Challenges for telemedicine

  Tuesday, March 03, 2015

  The pressures to reduce healthcare costs and improve access have never been greater. Everything from the Affordable Care Act to the "Silver Tsunami" of aging baby boomers requires a transformation of the healthcare delivery system.

• Disrespectful healthcare cultures and risks to patient care

  Friday, February 20, 2015

  A recent PSQH article listed a dozen persistent medication safety gaffes that need to be resolved. Not surprisingly, No. 8 was "disrespectful behavior: a history of tolerance in healthcare." Disrespectful behavior includes bullying, threats, aggressiveness and even more passive forms such as ignoring and exclusion.

• Managing your online reputation

  Friday, February 06, 2015

  Social channels provide tremendous opportunities to use your voice and find others with similar interests. Being on key social channels also makes it easy for customers, networkers and recruiters to find you and see if your education, skills, interests and goals match with their needs. However, careful consideration and management of one's reputation is imperative.

• Clean hands save lives: A vigilance that must never falter

  Monday, January 19, 2015

  Hand washing in healthcare has long been associated with preventing the spread of disease, but frequent hand washing has its challenges. In the early 2000s, the recipe for alcohol-based hand rubs (gels) was perfected — offering a more efficient, portable and worker-friendly alternative.

• The long road to health information exchange

  Monday, December 01, 2014

  Health information exchange (HIE) is turning out to be one of those really long journeys in which you hear the kids in the back seat asking, "Are we there yet?" while the driver keeps saying, "Almost." The Office of the National Coordinator is focusing on the next 10 years with its soon-to-be-released road map to reach interoperability.

• Coaching: Breaking it down for healthcare leaders

  Wednesday, November 12, 2014

  Great leaders are sometimes measured by how deeply they have impacted the lives of others, and the ability to coach those around them is a common characteristic. What is coaching? It is really just a tool for effective communication between a leader and those they lead.

• Hospital preparedness: Pay now or pay later?

  Tuesday, October 28, 2014

  Recent events surrounding the diagnosis of Ebola on U.S. soil have proven that we can't always predict when and where an infectious disease will present. Texas Health Presbyterian Hospital Dallas wasn't really prepared for a person who would test positive for Ebola to walk into their emergency room, nor were they prepared to support their staff during his treatment after admission.

• 10 ways to apply social tools for an improved patient experience

  Friday, October 24, 2014

  ​The pressures and drivers to reduce costs, improve quality, emphasize prevention and increase access are making social media and the underlying technologies more attractive to healthcare leaders. They can be effective and efficient tools for the delivery of communications to targeted individuals and/or populations.

• Following the money: Cybertheft and healthcare

  Tuesday, October 14, 2014

  Patient records contain personally identifiable information (PII) and protected health information (PHI), both of which have value on the black market. Over the years, there have been instances of insiders stealing this information for their own financial benefit, but outside criminal attacks are on the rise at a time when there is great pressure to reduce healthcare costs.

• CMS projects faster health spending growth over next decade

  Monday, September 29, 2014

  The Office of the Actuary at the Centers for Medicare and Medicaid Services recently released new estimates from its analysis of American health spending in the coming decade. After five consecutive years of low growth rates, we can expect health spending rates to increase by 5.6 percent for 2014 and an average of 6 percent in the years 2015-23.

• New FICO credit score formula may hurt medical collections

  Monday, September 15, 2014

  ​A new version of FICO's credit score formula will be launched this fall that could improve the chances of getting a mortgage. But it also has the potential to impact the collections and cash flow of healthcare providers. While this is good news for the mortgage industry and individuals wanting to finance or refinance, there may be some unintended consequences for medical and healthcare providers.

• Improving performance: Show me, don’t just tell me

  Tuesday, September 02, 2014

  It is amazing how much you can learn about how processes really work by talking to staff, physicians, patients and others involved in those processes. However, actually observing the workflow and how processes unfold can shine a bright light on what really happens — especially when it comes to patient care.

• Business continuity: Planning for a smooth recovery from disasters

  Tuesday, August 26, 2014

  ​Healthcare leaders more often think about their preparedness for disaster response than they do to the process of recovery and resuming normal operations. However, a smooth recovery requires attention to business continuity issues that are integrated across response, recovery and the return-to-normal-operations phases.

• Text-to-911 availability has important mHealth implications

  Wednesday, August 13, 2014

  The Federal Communications Commission has taken another step toward a 911 system that fits with how Americans are communicating. The new rules, adopted Aug. 8, will make Text-to-911 more uniformly available by the end of 2014; and this has important mHealth implications.