I See You: Putting the Patient in the Center of the Healthcare Team

What Avatar Teaches Us About Using an Empathetic Approach to Treating Patients

In our blog post for this week, guest blogger Rebecca Bryan, DNP, adult nurse practitioner and Owner of Rebecca Bryan Consulting LLC, discusses the importance of understanding health concerns from the patient’s perspective.

My favorite moment in the movie Avatar is the love scene between protagonist Jake and Neytiri, a female Na’vi on the planet Pandora. Neytiri finds Jake’s Na’vi avatar unresponsive in the forest and realizes that his human form is in the mobile lab.

She jumps through the shattered window to find him unconscious and near death, suffocating in Pandora’s atmosphere. Desperately placing the oxygen mask on his face, she watches as Jake comes to life, looks Neytiri in the eyes, and says, “I see you.” Neytiri, who prior to this point, has only seen Jake in his avatar form, smiles and responds tenderly, “I see you.”

To appreciate the fullness of this moment, understand that humans were the enemy to the Na’vi, appropriating and destroying their sacred planet. Neytiri had fallen in love with Jake in his avatar form and was devastated when she learned he was human. This love scene was the moment when masks, paradoxically, removed, and soul saw soul, regardless of form.

Etic vs. Emic

That’s the shift in perspective from etic to emic.

That’s the paradigm that can put the patient in the center of the healthcare team.

I have been lecturing about, and helping organizations become, trauma-informed since 2013, but only recently discovered the vocabulary of “etic vs emic” as two ways to understand human behavior. This language was first coined by Kenneth Pike, a linguistic theoretician, in 1954, with etic pertaining to objective findings and emic pertaining to the meaning behind a finding.

With regard to human behavior, particularly through biomedical lens, an etic approach looks at a problem from the outside in. It relies on objective criteria to make a diagnosis, which is consistent with the traditional allopathic model.

Take cigarette smoking, for example. An etic intake would include the patient’s age of smoking onset and packs smoked per year, and the diagnosis would be ICD-10 code F17.200: Nicotine dependence, unspecified, uncomplicated.

An emic approach would respond to that ICD-10 label with a snort; is cigarette smoking ever uncomplicated?! Because an emic approach looks at things from the patient’s perspective – or, from the inside out, so to speak. An emic intake to evaluate cigarette smoking would include understanding what was happening when a patient started to smoke, the good things that smoking does for the patient (“it calms me down…it distracts me from my pain”), the barriers to quitting and the level of desire to quit. Asking patients questions like these gets to what I like to call “the root of why.” It gets to the bottom of things and can be transformative.

The Importance of Personal Experience

Trauma-informed practice calls for shifting from etic to emic, from “What’s wrong with you?” to “What happened to you?” The kind of trauma I am writing about here is relational, as compared to situational trauma like a car accident or a hurricane. While trauma can occur at any age, it is particularly impactful in childhood, and much of the science generating evidence-based practice stems from the Adverse Childhood Experiences (ACEs) studies.

ACEs are common, cumulative and strongly associated with most of the leading causes of death in the U.S., as well as health risk behaviors like smoking, disordered eating and substance abuse. ACEs impact brain development, immune and hormonal systems, and even genetic expression – across the entire lifespan.

Positive events like growing up in a loving home, living in a safe space, and getting good at something counteract ACEs, again across the entire lifespan. In other words, our lived experience becomes our biology.

Walk a Mile in the Patient’s Shoes

That’s why it’s important to understand health concerns from the patient’s perspective. Research from the Robert Wood Johnson Foundation found that 80 percent of health outcomes are the result of factors other than healthcare. Traumatic experiences and adverse community challenges play a big role in this.

When we take the time to step in the patient’s shoes, we have a better chance at understanding what is driving health outcomes – and how to intervene. After all, the patients are the experts of their own lives!

Affirming patients’ experiences and helping them connect the dots across their lives is healing and places them in the center of the healthcare team. It facilitates relationships that are empowering. It says, loud and clear, “I see you.”

Workplace Violence in Healthcare is a Real Threat

New Technologies Increase Security

SPRYTE Communications is an active member of the Chamber of Commerce Southern New Jersey’s Health Issues Committee. At our quarterly meeting on September 10, Symtech Solutions Marketing and Business Development Director Brittany Countis provided an overview of workplace violence towards healthcare providers, a growing concern. Countis shared her presentation with SPRYTE. We are running it as SPRYTE Insights’ guest blog this week.

Managing workplace violence in healthcare is a challenge, but life safety systems such as wearable panic buttons can help speed up response time to an emergency. When implemented in a solid violence prevention program, panic buttons can increase the safety of staff and patients, while mitigating risk for the enterprise.

Panic Buttons Are Vital in Violence Prevention Programs which is why they are being mandated in various cities, states and industries due to increase in violence. In hospitality, the city of Miami Beach and state of NJ have mandated the use of panic buttons in hotels over 100 rooms. In the education sector NJ is requiring panic buttons in schools K-12 and PA has provided state grants towards the purchase of panic buttons. The demand for panic button technology in healthcare is on the rise as violence against healthcare workers is being exposed.

Requiring Panic Buttons in Hospitality and Education

The House Education and Labor Committee recently passed the Workplace Violence and Prevention for Health Care and Social Service Workers Act (H.R. 1309) which seeks an enforceable federal standard to disrupt the growing level of violence against nurses, physicians, social workers, emergency responders and other caregivers. This bill would offer protections to public-sector workers in the states not under OSHA oversight while calling on employers to identify risks; specify solutions; and require training, reporting and incident investigations. The legislation also would require an interim final OSHA standard one year after enactment and the completion of a final standard within 42 months.

Healthcare professions are at an increased risk for workplace violence. From 2002 to 2013, incidents of serious workplace violence requiring days off from work is four times more common in healthcare than in the private industry. According to the Bureau of Labor Statistics, in 2016, health care and social service workers suffered 69% of all workplace violence injuries and were nearly five times more likely to experience violence on the job than the average US worker.

Healthcare workers are more likely to get injured at work than police officers and prison guards; nurses suffer in particular. The U.S. Bureau of Labor Statistics tracks incidence rates of nonfatal occupational injuries and illnesses involving days away from work, including “intentional injury by other person.” Of the 18,400 injuries reported in the private industry in 2017, 71% were reported in the healthcare and social assistance sector. And this only includes incidents that involved

Symtech Solutions Wearable Panic Button

A solid prevention program offers an effective approach to reduce or eliminate the risk of violence in the workplace. Emergency Call Systems such as Symtech Solutions’ wearable panic button are a vital tool as they can save time in locating a victim during an emergency or attack which can decrease the amount of damage done. Here is how it works:

  1. When an emergency occurs, every minute counts so it’s important to know the exact location of the victim so security can respond directly to the incident. With Symtech’s wearable panic button, security can identify the victim with 100% location accuracy.
  2. Auto-tracking of Symtech’s panic buttons, after the call for help is initiated. This allows security to track them throughout the facility and even into the parking garages.
  3. With Symtech’s wearable panic button, security will know who placed the call, so there is no need to take a roll call.
  4. Symtech’s wearable panic buttons have two-way feedback which indicates to the victim that the call for help was received and help is on the way.
  5. The use of Symtech’s wearable panic buttons reduces the disruption of patients and visitors in the event of an emergency by isolating the incident and responding to the location directly.
  6. Symtech’s wearable panic buttons are a discrete and silent way to call for help without escalating the situation as they can be worn inside clothing and do not annunciate upon activation.
  7. Having a means to call for help provides piece of mind to caregivers who risk themselves for the safety of others everyday.
  8. Panic buttons can prevent bad PR by minimizing the catastrophic damage of an attack and costly legal disputes.

Workplace Violence Costs Healthcare Providers

Workplace violence is taxing on the worker, but also on the organization. A 2017 report prepared for the American Hospital Association estimated that workplace violence cost U.S. hospital and health systems approximately $2.7 billion in 2016, including $280 million related to preparedness and prevention, $852 million in unreimbursed medical care for victims, $1.1 billion in security and training costs, and an additional $429 million in medical care, staffing, indemnity, and other costs related to violence against hospital employees. Further, health workers who were victims of violence experienced an average of 112.8 hours per year of sick, disability, and leave time (excluding long- and short-term disability), which was 60.4 hours more per year than counterparts who had not experienced workplace violence, therefore mitigating the risk for the enterprise. – Brittany Countis

Use Personnel News to Showcase Your Organization

Who Personnel Are Often Reflects Who You Are

When it comes to telling your story, one of the most overlooked – or under-appreciated – opportunities is the classic personnel announcement.

Many times, personnel announcements end up falling into the “we’ll get around to it” category of priorities. After all, healthcare organizations often expend a great deal of time and energy (as well as expense) in attracting and landing top-flight professional staff to help them move forward.

Why not take the opportunity to tell the world (or at least your key clients and industry colleagues) about the exciting new developments taking place and the new people that are joining your healthcare organization?

Points of Distinction

What is the story you’re looking to tell? Is it solely about a new hire, or is there something more to say that can help brandish the image of your organization and distinguish it from your competition? At the very least, that’s a point you should consider whenever such opportunities arise.

Recently, SPRYTE reunited for a special project with a client that we’ve worked with off and on for the past 20 or so years. The opportunity brought back a lot of warm memories about past campaigns and projects, so we were thrilled to get the  call to help Home Care Associates (HCA), a prominent Philadelphia based agency providing in-home respite and senior care to clients throughout the city and region. One of the things that makes HCA unique is that it is a women-owned business and worker-owned cooperative that has received national recognition as a welfare to workforce model. (In fact, more than 60 percent of HCA’s employees formerly received public assistance.) In addition, it is certified as a socially-conscious B Corp.

Back to the Future

The new project involved the announcement of a new CEO. The retiring CEO was well-known throughout the Philadelphia region as community-involved, politically-connected and every effective leader. HCA wanted to make sure they were hiring the right person. So a national search was conducted.

After several months of searching, it became apparent that the best candidate for the job had been there all along.

Tatia Cooper had begun at HCA in 1994 as a job coach.  She’d held numerous positions at HCA in a steady rise up the organization’s ladder and was considered for the CEO role even as the national search began.

The Company You Keep

HCA leaders readily understood the message that Ms. Cooper’s appointment would send. Even after a national search, the qualified and capable candidate turned out to be an individual who had steadily worked her way through the organization, learning the various aspects of the company and earning her promotion to the top job.

In fact, Ms. Cooper personally developed a number of professional tools and approaches that directly impact HCA workers’ success, including supportive approaches to housing, health, transportation and child care challenges.

For a company that prides itself on being a woman-owned, worker-owned model, it would be hard to imagine a better example to reflect the values and the commitment of the organization as it moves forward.

Rollout and Response

Regional business, newspapers and other media outlets were quick to pick up the story, highlighting Ms. Cooper in an assortment of “Personnel News” and business announcement columns.

As part of the follow-up, we concentrated on Ms. Cooper’s personal story – in particular the fact that her family story of community commitment is one that goes back generations. Her grandmother, for example, was a well-known and highly-respected advocate for economic and social justice who served many years in the Pennsylvania Department of Education looking out for the interests of students.

Her mother, meanwhile, is a widely-respected community activist in her own right, was one of the original staff members and later became Executive Director of the Elizabeth Blackwell Health Center for Women.

In addition, her aunt is President of the Uptown Entertainment and Development Corporation in Philadelphia and has been working for years to restore and renovate this famous North Broad Street community venue.

All in all, it’s an impressive story about a very impressive family of community leaders.

The angle has led to one local radio interview appearance, with other opportunities in the works.

For healthcare communicators, the moral of the story is to think creatively. It may sometimes seem that personnel announcements are a necessary chore that simply need to be disseminated in a timely fashion.

It often pays to look deeper. Is there a more meaningful and relatable story that can be told that will advance the interests or the image of your organization?  At the same time you’re sending a message internally, that a promotion or new hire is in fact newsworthy.

You might have to dig a little deeper, but very often the extra work will be worth the effort.

Palliative Care’s Patient Focus

Putting the “Care” Back in Healthcare

We live in a remarkable era of scientific and medical advancement.

The healthcare industry has developed a vast array of techniques and tools that can be used to treat patients. Surgery. Medications. High-tech things such as gene therapies.

There is so much more we can “do” to patients than ever before!

But is it always the right thing to do?

According to Dr. Timothy Ihrig, an internationally recognized authority on palliative care and Chief Medical Officer at Crossroads Hospice & Palliative Care (Full disclosure: A SPRYTE Communications client), the answer is a resounding “NO!”

The Tao of Palliative Care

In his blog, What’s Wrong with Healthcare? It doesn’t Care (Part II), Dr. Ihrig suggests that as doctors have become more adept at fixing the physical ailments that patients suffer, they’ve grown less mindful of them as human beings, perhaps to the point of callousness in regard to how patients feel about the treatments being thrust on them. He believes the healthcare industry needs to do a much better job of educating patients about procedures, treatments, and the likely prognoses, so they can be part of the decision-making process.

“My experience is, the more we ‘do’ to patients, the more we risk negatively impacting the quality of their lives – and the more we risk actually decreasing how long they live, as well.  In addition, too often – almost always – we are not giving the patient an opportunity to choose HOW they want to live.” Dr. Ihrig says.

He believes palliative care practitioners are well-positioned to show the healthcare industry how best to engage with patients so they can participate in treatment decisions and establish goals that allow them to enjoy a high quality of life for as long as possible. Read!

Published September 11, 2018 by Spryte Communications in Public Affairs

Writing is the Common Denominator for Healthcare PR and Content

Don’t Forget You Blog to Generate Business!

When SPRYTE Communications was launched early last year, we also launched our Blog, SPRYTE Insights and we’ve been very disciplined about posting new content every Tuesday morning ever since.

The depth of our content bank is impressive.  SPRYTE Insights’ “editorial approach” is to delight healthcare communicators with practical information they can use in their everyday professional lives in the healthcare provider space.

Of course, those same healthcare communicators and their managers, investors and owners are also our prospects for business development.

We have to remind ourselves that a more focused sales and marketing platform was one reason we relaunched a general agency, Simon PR in to SPRYTE Communications, a healthcare specialist.

But the PR DNA that makes us outstanding at healthcare earned media and influencer engagement isn’t always our friend as we advance as content marketers.

And anything we dedicate time to for ourselves has to be a best example of our work as we try to win more healthcare digital and social business.

Here are some of the SPRYTE Insights’ shortcomings we’ve noticed as we plan to evolve and decide what to put on our Agency to do list moving forward.  Perhaps  other healthcare communications bloggers out there are also experiencing similar sentiments.

The Granular Shortcomings of Our Weekly Blogs

Visual Imagery: We will prep an incredibly compelling written piece and then illustrate it with poor imagery, totally undervaluing the need and opportunity for strong art.  As writers we’re enamored with words but to be successful in content we need strong words and visuals.

Headlines and Subheads can be so pedestrian.  Our blogs are often truly original and pithy to boot but then we’ll put pedestrian headlines on them that do nothing to invite readership or build our brand.  We can do better!

Embracing SPRYTE’s Brand Voice: The SPRYTE Insights blog is an owned media property of SPRYTE Communications.  As a relaunched agency, we have a highly articulated brand voice, well defined service lines and five known target healthcare industries: hospice, home care, hospitals & health systems, medical practices and social service agencies.  Our content needs to build our brand as it’s defined not as a make it up as we blog or as an individual soapbox for issues near and dear to the author.

Paying for It: The PR DNA typically doesn’t include a gene for paying for exposure.  We are so attuned to earning media that it’s extremely difficult for us to pay for it.  We aren’t natural boosters and we don’t really know how much to spend on boosting.  But just posting and not boosting SPRYTE Insights’ Blogs on SPRYTE’s LinkedIn, Facebook and Twitter channels is a very big missed opportunity to reach more healthcare eyeballs, the ones that might hire us!

So now that we’ve identified where we need improvement, how will we advance as content marketers supporting the SPRYTE brand and what will we be doing differently or additionally?

How SPRYTE Insights will Evolve:

  • Archived SPRYTE Insights Blogs Will be Better Illustrated with Improved Imagery and Reposted.
  • A Healthcare Guest Blogger Program Will Debut. (Note:  We are accepting blogs written by proven healthcare communicators for consideration.)
  • Blog Archiving Under Our Five Target Healthcare Industries: Hospice, Home Care, Hospitals & Health Systems, Medical Practices and Social Service Agencies Will Be Added to the SPRYTE Insights Page on the SPRYTE Communications Web Site.
  • A SPRYTE Communications Branded Annual Blog Editorial Calendar Will be Designed and Deployed.
  • A Meaningful Plan and Budget for Social Media Boosting Will Be Established.

As defined by the Content Marketing Institute, content marketing is “a strategic marketing approach focused on creating and distributing valuable, relevant and consistent content to attract a clearly defined audience – and, ultimately, to drive profitable customer action.” While complimentary visual and creative skills are required, like public relations, content marketing is rooted in good writing.  SPRYTE is ready to up our game as we grow with our SPRYTE Insights Blog.

 

Curing What Ails Healthcare

Hospice and Palliative Care Blaze a Path for Needed Changes:

We’ve all heard the old healthcare adage: “The cure is worse than the disease.”

Medical education trains physicians to fight disease. Generally, that means treating the symptom that the patient is experiencing. And then the next one. And then the one after that.

How much say does the patient have in the treatment plan? Too often, very little, if anything at all.

That’s a real problem, according to Dr. Timothy Ihrig, an internationally recognized authority on palliative care who joined Crossroads Hospice & Palliative Care (a SPRYTE Communications client) as Chief Medical Officer earlier this year.

Dr. Ihrig believes patients deserve to be fully informed of their condition, what it entails, the likely prognosis, and the likely trajectory of the disease. And that  patients should be involved in important decisions that can affect their quality of life.

“True palliative care” offers an important, proactive, inclusive way of addressing individual patient needs and wishes, while at the same time serving as a key driver in the effort to reduce healthcare costs.

In his blog, What’s Wrong with Healthcare? It Doesn’t Care (Part I), Dr. Ihrig begins to map out how that perspective underscores his desire to “start a movement of thought and inspire others to seek not healthcare reform but a reforming of how we care for others within the healthcare system.”

Find out more about SPRYTE’s Public Affairs services.

Published August 14, 2018 by Spryte Communications in Public Affairs

Juneteenth – America’s Other Independence Day

Patient Experience Relies on Understanding Diverse Perspectives

Americans love their Fourth of July holiday. After all, it’s America’s birthday – the day we traditionally set aside to celebrate the signing of the Declaration of Independence and the establishment of a free nation where “all men are created equal.”

But for many, those hallowed words proved hollow. Hundreds of thousands of slaves throughout the young United States – especially in the South – would need to wait almost another century before their rights to equality were officially recognized.

Another View of History

On July 5, 1852, famed African American abolitionist Frederick Douglass, himself a former slave, delivered an impassioned speech spelling out the irony inherent in the July 4th celebration:

“This Fourth of July is yours, not mine. You may rejoice, I must mourn,” Douglass said. “What, to the American slave, is your Fourth of July? I answer: a day that reveals to him, more than all other days in the year, the gross injustice and cruelty to which he is the constant victim…”

It would take another 13 years, hundreds of thousands of lives, and a Civil War that tore apart the fabric of the American nation before four million African-American slaves would get their own taste of freedom.

Juneteenth – Freedom Reborn

On June 19, 1865, Union General Gordon Granger, military commander of the defeated Confederate state of Texas, read aloud General Order No. 3, telling the populace of Galveston that: “The people of Texas are informed that, in accordance with a proclamation of the United States, all slaves are free.”

Spontaneous celebrations among the newly freed African American population quickly erupted across the South as Juneteenth was born. African-American communities across the U.S. soon adopted Juneteenth as their own holiday, using it as an occasion for celebrating freedom with public events, picnics and church gatherings.

Understanding Leads to Compassion

Once we understand the history of Juneteenth and how it came into being, it’s easier to appreciate why many African Americans consider Juneteenth to be a day to celebrate not only the vision of freedom President Lincoln described in his 1863 Emancipation Proclamation but also the original promise of the Declaration of Independence.

Since our childhood, we’ve been told that America is a melting pot, comprised of people from all over the world, representing a multitude of religious backgrounds, races, cultures, customs, languages and lifestyles.

Healthcare providers face the everyday challenge of understanding how these differentiating factors may affect individuals’ or families’ attitudes toward illness, pain, coping and death. It is important to appreciate why these attitudes are held, because they can significantly influence their willingness to explore various treatment options. Hospice, in particular, can be an especially touchy discussion topic.

For example, according to statistics, African-Americans comprise approximately 12% of the U.S. population, but they make up only 7.6% of hospice patients. Ironically, African-Americans have a disproportionately higher rate of cancer and heart disease, which are among the top hospice diagnoses.

Researchers point out several reasons for this incongruity. As a rule, African-American families tend to be less trustful of the American healthcare system. In addition, because medical decisions tend to be made within the family, there may be a reluctance to consult with a new, unknown healthcare professional or someone outside the home. Finally, statistically speaking, African Americans tend to be especially reluctant to cease life-prolonging procedures such as tube feeding, organ donation, and palliative care in the hospice setting – because extending life is generally seen as something to be preferred.

Honoring Differences

Healthcare communicators need to recognize that their messages may be perceived very differently by diverse audiences and adjust accordingly to ensure positive patient experience.

As the U.S. healthcare system continues to evolve to one that is more population health-oriented and patient-centered, there is a growing need for healthcare providers to educate patients, families and the general public about what they can do to stay healthier, as well as the nature of specific healthcare challenges and treatment options.

Understanding their emotions, how they think, and the reasons behind these different perspectives is vital to helping patients and families make treatment decisions that are most appropriate for their individual situations.

It’s not unlike coming to appreciate the Juneteenth holiday. The better we understand the history and background of our patients, the better we can understand and honor the views and emotions that influence their decisions and actions.

Healthcare’s Future Lies in Transformation

Dr. Ezekiel Emanuel Offers a Compelling Argument

What will the future of healthcare look like? It’s an issue that public affairs commentators and policymakers across the political spectrum continue to debate.

In 1994, the late Dr. William Kissick, a professor emeritus at Wharton and the University of Pennsylvania Schools of Medicine and Nursing, identified three competing issues that the healthcare industry has struggled to address effectively. These issues – access, quality and cost containment – what Dr. Kissick called the “Iron Triangle of Healthcare,” continue to perplex policymakers and healthcare decision-makers to this day.

Recently one of the nation’s leading healthcare policy experts, Ezekiel J. Emanuel, MD, PhD, Vice Provost for Global Initiatives and Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, offered some important insights into where the national healthcare system is heading, and what it might mean for the Philadelphia region. In part he rejected the conventional notion that it is possible for health care systems to only achieve two of the three parts of the Iron Triangle.  He argued all three had to be achieved together. It was all part of a symposium on “Shaping Health Care” sponsored by the Chamber of Commerce for Greater Philadelphia and The Wistar Institute.

Lowering Costs

Finding a way to provide high-value care for all Americans – namely care marked by high quality and low costs with universal coverage – is a goal shared by providers and policymakers alike. According to Dr. Emanuel, “the only way to lower healthcare costs is to change the delivery system to ensure high quality care.”

Traditionally, one of the most significant contributors to the high cost of healthcare has been the combination of providing unnecessary services and inefficiency in how necessary healthcare services are delivered.   One example is standardization of practices so everyone – from physician to nurse to medical assistant – handles the same complaint according to agreed-upon guidelines. For instance, physicians in one local oncology practice were treating mouth sores after chemotherapy in different ways.  The practice standardized to one optimal practice that everyone followed.

Another common example is the fact that some health care groups allow their physicians to control their schedules, leading to double-booking, limited hours, and an inability to work around no-shows or walk-ins.

Creating Efficiencies

Dr. Emanuel identified 12 transformational practices that he says can help physician practices and healthcare organizations improve the quality and cost of care they provide to their patients:

  1. Scheduling
  2. Registration & rooming
  3. Shared decision-making
  4. Performance measurement
  5. Standardization
  6. Chronic Care management
  7. Site of service
  8. De-institutionalization
  9. Behavioral health management
  10. Hospice
  11. Community interventions
  12. Lifestyle interventions

Many of these practices will improve  efficiencies – lowering per unit costs by finding ways to improve a healthcare process or system, or working in collaboration with partners in a way that benefits all involved parties. Others will eliminate unnecessary and undesired services – lowering total costs.

Even seemingly minor changes can show major results. For example, streamlining scheduling practices can offer several benefits: 1) It allows practices to accommodate walk-ins without long wait times instead of sending them to the more expensive emergency room; 2) it increases provider efficiency, as physicians no longer double book or adjust schedules; and 3) it decreases the amount of time wasted due to missed appointments.

Similarly, Dr. Emanuel noted that transformational organizations are providing more services, such as palliative care, in the home. This care is initiated well before a patient becomes terminally ill and is ready for hospice. This approach elicits patients’ preferences for life-sustaining treatments, such as respirators, ICU admission, or dialysis, and tries to keep them at home for the last year of life. It also makes transitioning to hospice in the last weeks of life less abrupt. All these changes lead to care that is both less costly and more in accord with patients’ wishes.

Performance Measures

The pathway for healthcare providers to truly transform also involves the use of real-time performance measures, Dr. Emanuel said. Standardizing clinical practices and treatment procedures based on measurable qualitative data is vital to reducing costs and improving outcomes.

While some physicians may insist that “their” way is the best, organizations need to convince them to adhere to guideline-driven standards. Paradoxically, one effective way to persuade doctors to adapt to standardized measures is to task them with developing the standardized practices and encourage adherence through financial incentives.

At the same time, organizations need to improve their risk adjustment skills in order to continue to improve their healthcare management practices. Risk adjustment is defined as “a statistical process that takes into account the underlying health status and health spending of the enrollees in an insurance plan when looking at their healthcare outcomes or healthcare costs.”  This ensures physicians who see sicker patients are not penalized.

The ultimate goal is to transform the U.S. healthcare structure into a truly patient-centered, efficient and cost-effective system.  Dr. Emanuel notes that the Philadelphia region is a leading example of how organizations are learning to work together to achieve those goals. He said he is confident that by 2030, the entire world will be looking at the United States to understand how healthcare transformation is accomplished.

Consumerism: The Future of Healthcare

Patient-Focused Care is a Growing Challenge

Even before the advent of the Affordable Care Act, a primary goal for healthcare providers has been to get consumers more involved in their own healthcare decisions.

From the now-defunct federal Health Systems Agencies (the original HSAs), to Health Maintenance Organizations (HMOs), to Flexible Spending Accounts, to Health Savings Accounts (the new HSAs), to the more recent Accountable Care Entities, engaging and empowering consumers to make informed choices about their healthcare needs has been both an ongoing objective and challenge.

Healthcare communicators, who are at the heart of providers’ consumer relations and community relations efforts, need to understand what’s driving this important movement.

 

Key Drivers of Healthcare Consumerism

In a recent webinar sponsored by Thomas Jefferson University’s Jefferson College of Population Health and IBM Watson Health, Dr. David B. Nash, dean of the college, noted that the two biggest factors driving the evolution of healthcare consumerism are utilization and costs.

Dr. Nash pointed to data from 2015 showing that the total expenditure for healthcare in the U.S. topped $3.2 trillion, accounting for 17.8% of the country’s gross domestic product. Per capita national health expenditures amounted to almost $10,000. Almost 60% of those expenditures were tied to two areas of spending: Hospital Care (32.3%) and Professional Services (26.2%).

One key problem, he noted, is quality. More “socialized” national systems found in Canada and Europe provide consumers with better quality at a better price compared to the U.S. health system. At the same time, U.S. consumers are shouldering more of the total healthcare cost burden, including unanticipated costs. According to the Kaiser Family Foundation, U.S. workers’ share of health insurance premiums grew 221% since 1999, while premiums themselves increased 203%.

From a healthcare finance perspective, it’s an unsustainable situation. Empowering consumers to exercise more control over their healthcare spending is part of the solution.

 

More Education, Transparency Needed

Unfortunately, too many consumers don’t understand what they’re paying for – or how they’re paying for it. Lack of awareness about insurance terms, processes and pricing tend to inhibit patients from getting involved more directly in their healthcare decisions.

“If you can’t define what a copayment is, you won’t be an empowered consumer,” Dr. Nash explained.

Consumers want to understand what is happening, but available data can be overwhelming. Many are turning to social and public sources for information, but lack the ability to translate the data in a meaningful way that would help their decision-making.

 

Social Determinants of Health (SDOH)

Other key factors driving the evolution of healthcare consumerism are social determinants that describe conditions in which people live, learn, work and play – all of which can have significant impact on an individual’s health risks and outcomes.

Poverty, not surprisingly, is the number one social determinant of health. Those without insurance, or access to regular healthcare checkups inevitably fare worse in terms of early detection of adverse conditions and ensuing complications, chronic health issues, and life expectancy.

A recent Robert Wood Johnson Foundation survey asked American physicians what kind of prescriptions they wish they could write to assist patients with social needs. Among their top answers: Fitness Programs (75%), Nutritional Food (64%), and Transportation Assistance (47%). For doctors whose patients were predominantly urban and low-income, the responses were just as telling: Employment Assistance (52%), Adult Education (49%), and Housing Assistance (43%).

 

Engagement is Key

To help address many of these needs, many health systems are increasing their focus on community-based care, meeting patients closer to where they live and addressing their individual needs. This trend can be seen in a number of ways:

  • Increasingly, large regional health systems are affiliating with traditional community hospitals, based on level, type of condition or geography.
  • The popularity and prevalence of retail clinics continues to grow, as health systems see a means to deliver lower-cost local services beyond primary care.
  • Bedless hospitals are springing up – newer entities that are often multi-specialty and offer traditional hospital services except for inpatient care.
  • The BCBS Institute is partnering with the ridesharing company Lyft to address transportation-based SDOH. The Institute and Lyft will work together to coordinate rides in neighborhoods with limited public transit access and low rates of vehicle ownership.
  • The growing popularity of telehealth, mobile technology and digital therapeutics, that allow physicians to provide lower cost care and regularly monitor their patients’ progress almost anywhere at any time.

In addition, spending more time with patients – encouraging them to ask questions, taking time to explain procedures, treatments and options – can be a major factor in improving healthcare outcomes individually and in the community. Healthcare insurance professionals can also play an important role by working closely with consumers to make sure they understand options and nuances involved in their insurance decisions.

Healthcare communicators have a major role to play as well, by paying close attention to the evolving nature of healthcare consumerism and working with their colleagues – healthcare administrators, physicians, nurses and other medical professionals, as well as their allies throughout the community – to reach out, identify and educate consumers to ensure as many as possible get the care and support they need to live healthy, happy lives.

Social Workers Bring Help and Hope

For Them, Caring is a Calling

“Never, never, be afraid to do what’s right, especially if the well-being of a person or animal is at stake. Society’s punishments are small compared to the wounds we inflict on our soul when we look the other way.” – Martin Luther King, Jr.

What is it that makes social workers tick? With March being National Social Work Month, we at SPRYTE thought what better time to delve into some of their motivations and inclinations?

For healthcare communicators, who are often tasked with showcasing the conscience of their organization – whether through corporate social responsibility programs, employee communications, or thought leadership initiatives – understanding how and why social workers do what they do can help shine a bright light on the path ahead.

For Episcopal Community Services’ Neibert Richards, MSW, LSW, it was always about caring and people.

“I originally went to school to major in nursing, but soon after I arrived, the school decided to phase out the major,” she recalls. After that, she was undecided as a major. That’s about the time she was introduced to the opportunity presented by social work.

“The biology and all the other classes just weren’t fitting with what I wanted to do,” says Richards. But the idea of helping others was clearly a guiding force.

 

A Caring Tradition

Those roots run deep. Her father was a minister. Her mother, a teacher. There were four children in all. The family moved to the U.S. from Guyana when she was eight.

“Family was always a huge factor for me,” Richards says. “I was always longing for connections, wanting to know who my cousins are. I was the one who always had an issue when someone couldn’t come to be with the family for the holidays.”

Soon after getting her Master’s in Social Welfare, she joined Episcopal Community Services (ECS), where she signed onto the foster care program. Today, 22 years later, she is Director of Permanent Housing at ECS.

 

Changing Times

Over the years, there have been many changes in the way social workers are viewed, she says.

“I think the career path is better organized. Social workers are viewed more as true professionals.” she says.

Hopefully, that view will supplant what Jeanne Morrison, MSW, Support Services Director for Crossroads Hospice & Palliative Care in Philadelphia, says is probably the biggest misperception people have about social workers.

“Lots of times, people use the term ‘social worker’ for someone who is actually a caseworker,” explains Morrison. “Especially in child welfare situations, there is a belief that it’s the social worker who is there to take the child away.  The reality is that the social worker’s goal is to keep families together whenever possible.”

 

Looking at Strengths

Morrison notes that social workers are trained to evaluate clients from a strength standpoint – whether it’s the family, an individual, or a group dynamic. The initial goal is to identify existing strengths that can be built upon to help address certain issues that the client is facing.

She says the effort is a true collaborative partnership between the social worker and the client.

To do that effectively, it’s important “to meet people where they are,” she says. “In order to identify their hopes and plans, you need to understand things from their standpoint. You can’t expect people to come to you. If you do, you’ll get nowhere fast. But if you can understand and meet them where they are, you can start identifying their hopes and dreams from that stanpoint.”

 

Next Generation of Social Workers

Emily Blumenthal is a student at the George Warren Brown School at Washington University in St. Louis currently working toward her degree in social work.

She says the holistic perspective that social workers are trained to utilize is one of the things that led her in this direction.

“As a social worker, you’re trained to look at the environment the individual is in – you need to pay attention to who they’re surrounded by, family, friends, whatever is going on. It’s important to get the whole perspective,” she says.

Blumenthal is currently in the midst of a practicum with Perinatal Behavioral Health Service working with pregnant women with mood disorders or depression, doing screenings and providing information in a clinical setting. Following this, she will move on to another practicum (focus to be determined) that will last about a year. The experience will provide her with a broader base of training and insights that will assist in a future career decision.

She says her ultimate goal is to go into counseling, perhaps working with young adults, couples, and young famiies. But she’s confident that her background and training in social work will enable her to choose from a number of options.

 

Remembering what’s Important

For ECS’ Neibert Richards, that diversity of opportunity is one of social work’s greatest strengths.

“Social workers are a lot of people who care about helping others, giving someone a helping hand to advance to the next stage of life so they can move in a positive direction,” she says.

“They’re the ones, walking the streets, counting the homeless every year for HUD,” Richards explains. “They’re the ones who have no problem going into a home that’s drug-infested, letting someone know that we have a bed here, the kids can come. They’re trying to get them to think beyond this life that they’re in. It isn’t easy for them. Social workers do it because they care.”

For healthcare communicators, when you’re telling your story, caring and people are usually good places to begin as well.