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Social media – #hospitals

A recent issue of Hospitals & Health Networks (H&HN) featured a gatefold article on hospitals’ growing use of social media – Facebook, Twitter, YouTube, etc. – not only to create a presence for themselves in that most fluid and intimate of communications market, but also as a tool to promote healthier habits in 140 characters or less.  According to the Mayo Clinic’s Social Media Health Network, there are just under 1,300 hospitals with active Facebook pages.  Other venues include Twitter, YouTube, LinkedIn, and blogging.

But it’s not just hospitals who are using social media to discuss health care and health care services.  Consumers (a/k/a patients) are also sharing their experiences – both positive and negative.  A survey conducted by PricewaterhouseCoopers found that consumers are only slightly more likely to share a positive experience as they are a negative experience about any one of the following:

  • The care they received at a hospital or other type of medical facility
  • Their experience with a particular medication or treatment
  • A particular physician, nurse, or other health care provider
  • The level of customer service offered by their health insurer
  • The cost of their health insurance
  • The coverage offered by their health insurance
  • The cost of care received at a hospital or other type of health care center

Social media: what your hospital should know.  Hospitals & Health Networks.  88(2):41-48, February 2014.  Full text available at http://www.hhnmag.com/inc-hhn/pdfs/2014/GAT_SocialMedia_feb14.pdf

Other sources cited in the article:

Social Media Health Network: http://network.socialmedia.mayoclinic.org/

Computer Sciences Corp.  Ready to Interact: Social Media Use by U.S. Hospitals and Health Systems.  2012.  Full text available at http://assets1.csc.com/health_services/downloads/CSC_Survey_Social_Media_Use_by_U.S._Hospitals_and_Health_Systems.pdf

PricewaterhouseCoopers.  Social Media “Likes” Healthcare: From Marketing to Social Business.  April 2012.  Full text available at http://www.pwc.com/us/en/health-industries/publications/health-care-social-media.jhtml (free registration required)

Society for Healthcare Strategy & Market Development.  Optimizing the Use of Social Media: A SHSMD Panel Study.  Parts 1 and 2.  Full text available to SHSMD members at http://www.shsmd.org/resources/prcomm/reports.shtml

RAC Recap

The Centers for Medicare and Medicaid Services has posted summary data on the overpayments recovered and underpayments returned through the Recovery Audit Contractor program from its implementation in October 2009 through March 2013.  Data are reported by fiscal year.  To date, the RAC program has recovered $4.5 billion in overpayments and returned $333.6 million in underpayments.  The summary also identified the leading issues investigated in each of the four regions; three out of the four RAC contractors were focused primarily on questions of medical necessity revolving around cardiovascular procedures.

Source: CMS.  Medicare Fee-for-Service Recovery Audit Program. April 2013. http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Recovery-Audit-Program/Downloads/National-Program-Corrections-FY-2013-2nd-Qtr.pdf

Volunteering in the U.S. – 64.5 million points of light

In his 1989 inaugural address, George H. W. Bush invited Americans to volunteer – to become one of a “thousand points of light”.  America was listening! According to data from the U.S. Bureau of Labor Statistics, there were 64.5 million volunteers who provided service at least once between September 2011 and September 2012. Most volunteers put in time through a religious or education/youth service organization; however, 7.8% – or approximately 5 million individuals – provided service in a hospital or health care setting.

The report, available online, provides a number of statistical analyses:

  • Demographics: age, gender, race/ethnic group, educational attainment, marital status, employment status, parents of children under the age of 18 (it makes a difference!)
  • Hours of volunteer service provided: almost 6% of all volunteers reported 500+ hours of service in the year; the median was 50 hours
  • Number of organizations for which one volunteers
  • Type of primary organization for which one volunteers: civic/political/professional/international, educational/youth service, environmental/animal care, hospital/health care, public safety, religious, social/community service, sport/hobby/cultural/arts, other 
  • Main volunteer activity: the greatest number (10.9%) collected, prepared, distributed, or served food
  • How volunteers become involved: self-directed, asked by someone else (boss, relative/friend/co-worker, someone in the organization, etc.)

The summary portion of the report also includes historical data back to September 2008.

Source: U.S. Bureau of Labor Statistics.  Volunteering in the United States – 2012.  [press release]  February 22, 2013.  http://www.bls.gov/news.release/pdf/volun.pdf   Earlier reports (back to 2002) are available at http://www.bls.gov/schedule/archives/all_nr.htm#VOLUN.

Managing the machine: a QA program for robotic surgery

A framework for assessing outcomes of robotic surgery across multiple specialties was developed by The Ohio State University School of Medicine working with staff at The Ohio State University Medical Center’s Quality Improvement and Operations Department.  The initial groundwork for the new QA tool was based on a retrospective study of medical records for robotic surgery in multiple disciplines, including:

  • Urology
  • General surgery
  • Cardiothoracic surgery
  • Otolaryngology
  • Gynecology

The framework, using the balanced scorecard model (a sample of which is included in the article), provides benchmark data for multiple measures, including:

  • total volume (measured quarterly)
  • length of stay (days)
  • readmission rate at 30 days
  • return to surgery rate at 90 days
  • mortality
  • complications (accidental puncture)
  • conversion to open procedure

The QA framework also accounts for surgeon experience with robotic procedures, length of procedure – cut to close time, and total OR time.  The two latter measures can be used to assess both clinical quality and operating room efficiency.

Source: Gonsenhauser, John, and others.  Developing a multidisciplinary robotic surgery quality assessment program.  Journal for Healthcare Quality.  34(3):43-53, May/June 2012.  http://onlinelibrary.wiley.com/doi/10.1111/j.1945-1474.2012.00205.x/pdf

To boldly go where no medical device has gone before!

Rejoice all you Star Trek fans!  The race is on to produce the first fully functioning medical tricorder  – a handheld diagnostic device for those of you not familiar with the epic space adventure.  If a winner is declared, the Qualcomm Tricorder X Prize will be $10 million. 

Full details of the competition, as well as application forms, can be found on the website of the X Prize Foundation at http://www.qualcommtricorderxprize.org/.  The criteria are few, but challenging:

  • The device must weigh less than 5 pounds (handheld, remember?)
  • The device must be user-friendly (the intended audience is consumers, not health care professionals)
  • The device must be able to accurately diagnose a set of 15 diseases independently (no input from any kind of health care professional or provider)
  • The device must be safe to use (no chance of electric shock, chemical exposure, punctures, infection)

The goal of the competition is to inspire a technological breakthrough that has the potential to revolutionize health care access and delivery by putting the necessary tools in the hands of the patient – literally!

To quote another famous Enterprise captain – “Make it so!”

Source:  Page, D.  Beam me up, Scotty!  Hospitals & Health Networks.  86(6):37.  http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/06JUN2012/0612HHN_FEA_Wireless&domain=HHNMAG

X Prize Foundation.  http://www.xprize.org/

Busy ED flows around patients

Cambridge Health Alliance – a three-hospital system headquartered in Cambridge, MA – has re-engineered its emergency department services using a patient-centered care model that has led to increased efficiency, happier staff, and higher patient satisfaction scores.

The new model includes:

  • Patient partners – non-clinical staff who greet incoming patients, gather necessary information (name, date of birth or Social Security number, nature of emergency), and then take them immediately to either an assessment room or into the main ED for immediate care
  • Multiple triage nurses – instead of one nurse doing all triage, there are now multiple nurses who perform this function, as well as providing nursing assessments and initiation of care for those patients with less emergent conditions
  • Registration on the go – registration staff come to the patient’s room  and complete the registration process while the patient is being assessed and/or treated

The results speak for themselves:

  • For rapid assessment patients, the average length of stay has dropped from three hours to slightly more than one hour
  • 97 percent of patients are in a room within 5 minutes of entering the ED
  • 90 percent of patients are seen by a provider within 14 minutes of entering the ED

Dr. Sayah, ED director sums up his department’s paradigm shift: “The new culture is that the patient is in the room, and we are going to move around that patient.  The nurse will come in, the doctor will come in, the registration will come in, whereas before the patient was moving around us.”

Source: System-wide flow initiative slashes patient wait times in the ED, boosts volume by 25%.  ED Management.  24(6):61-64, June 2012.  Available for purchase from publisher’s website at http://www.newslettersonline.com/user/user.fas/s=6/fp=3/tp=3?T=open_article,50062141&P=article

Patient satisfaction scores comes home

Data from the Home Health Consumer Assessment of Healthcare Providers and Systems (HH-CAHPS) debuted on the Home Health Compare site – http://medicare.gov/homehealthcompare/search.aspx – on April 19, 2012.  Based on the results of a 34-question survey, the data are designed to help consumers make decisions about Medicare-certified home health agencies using both qualitative and experiential information.  Some of the questions include:

  • When you started getting home health care from this agency, did someone from the agency ask to see all the prescription and over-the-counter medicines you were taking?   Yes     No    Do not remember 
  • In the last 2 months of care, did you and a home health provider from this agency talk about pain?   Yes    No
  • In the last 2 months of care, how often did home health providers from this agency treat you with courtesy and respect?  Never    Sometimes    Usually    Always 
  • When you contacted this agency’s office, how long did it take for you to get the help or advice you needed?  Same day    1 to 5 days    6 to 14 days    More than 14 days    I did not contact this agency 

The official HH-CAPHS website is at https://homehealthcahps.org/Home.aspx, providing access to the survey in multiple languages, the protocols and guidelines manual, instructions on data submission, and other support material.