Janet Napolitano is Cooler Than You

The following post is from Stephen Texeira.

When Barack Obama took over the top job in government earlier this year, he made it clear to anybody who would listen that social media was a priority for him, and therefore would become a priority for the White House and the rest of the federal bureaucracy. Late last week the Department of Homeland Security, under the direction of former Arizona governor Janet Napolitano, became the first cabinet-level agency to fully embrace President Obama’s philosophy.

So what did DHS do? First, they redesigned their own website and made it into one of the most user-friendly government sites I’ve seen in a long time. Really, spend some time on the site, and you’ll quickly see that you won’t ever find yourself muttering, “Now where is . . . .?”

DHS also has their own YouTube channel that at this point only has a smattering of videos, but shows great promise. Secretary Napolitano also said that during emergencies, DHS will be using it’s Twitter account to communicate with the public. At this point they have only a bit over 12,000 followers, but it’s a start.

Finally, DHS also launched its blog earlier this month that is updated regularly, is simple to navigate and actually has some pretty interesting posts.

And in Secretary Napolitano’s own words, “Social media plays an increasingly large role in our engagement with the public, especially in the event of an incident or disaster. These new tools will facilitate an open dialogue about the department’s security efforts across the nation and around the world.”

So, yeah, Janet Napolitano is most likely cooler than you, more forward thinking than you, and probably more tech savvy than you. Kind of embarrassing don’t you think? Now get out there and catch up.

Health Care Quality Transparency: Should We Care?

The following post is from Stephen Texeira.

With all due respect to the folks at the Center for Studying Health System Change (HSC) and the Robert Wood Johnson Foundation (RWJF), I think they may have missed the boat on one of their recent reports.

This morning I received an email titled “Exploring Health Care Quality Transparency Initiatives.” Well with a sexy title like that I couldn’t wait to read through it, and I have to say I was disappointed from the word go. Not in the quality of the research nor in the quality of the reports, those are unimpeachable. No, I was disappointed by the very assumption that seemed to motivate the report.

Let me explain. First off, the email touted an issue brief on Designing Effective Health Care Quality Transparency Initiatives, as well as a commentary by HSC President Paul B. Ginsburg, Ph.D., and Nicole M. Kemper, M.P.H., an HSC health research analyst. It’s the commentary that I have a problem with. In the very first paragraph, the authors make the following statement:

Unlike price transparency, where consumer needs vary greatly depending on whether they are insured or not, and if they are insured, how their benefits are structured, theoretically all consumers can benefit from the same information on the quality of care provided by individual physicians, medical groups, hospitals and other providers. Until consumers are motivated to use quality information to choose providers, the main value of public quality report will likely be to motivate providers to improve their performance.

Now don’t get me wrong, I am a huge fan of quality information and consumers using that to make decisions about providers. The problem I have is the assumption that “theoretically all consumers can benefit from the same information on the quality of care provided by individual physicians, ….” What theory would that be? Health care is and always has been a very personal thing. Sure consumers make their decisions based on recommendations from friends, family and doctors, but so what? I think that a serious look at consumers’ preferences would find that most would rather see a physician with a less than outstanding rating but with great personal skills and an amazing front office staff (if such a thing really exists). Those are the things that do and always will motivate consumers in making their choices, as will things like convenience, proximity, etc.

And what do we all remember from our Logic 101 class in college? That’s right, if you start with a false assumption, the conclusion you draw is neither true nor false.

Having said all this, I encourage you to read both reports, they are compelling and full of good information and perspectives. I also encourage you to think long and hard over whether a public fully-informed about the quality of physicians, medical groups and hospitals is likely to choose their providers any differently. I’m inclined to think not.

If you are still unconvinced, spend half an hour today looking at the website for the Berkeley Parents Network. For those of you who are unfamiliar with this site, it is operated with the sole purpose of parents providing parents with advice and reviews about everything from pediatricians and OBs to schools, products and services. For many physicians in the East Bay, it’s a nightmare. For others it’s a endless source of referrals. As you read through it, however, you are unlikely to find an overwhelming number of comments about the quality of doctors and hospitals. That’s not what people care about, no matter how much we think they should. You’ll find many more comments along the lines of: “We really liked how calm and confident he was….” And, “…knowledgeable, warm, and extremely accessible.” And, “…friendly, funny,and low-key.” And finally, “…every visit there was some new rudeness to us or to others in the lobby. I am still angry, because I bent over backwards to be friendly, punctual, and considerate in my dealings with the office staff to try to make it work, and they were just unbearable.”

Catholic Healthcare West: A Leader On Important Health Care Issues

The following post is from Robert Polzoni.

Last week Catholic Healthcare West (CHW) sponsored a Community Town Hall on Health Reform at its Saint Francis Memorial Hospital in San Francisco. A packed crowd of 200 people heard an aide to Mayor Gavin Newsom, San Francisco Director of Public Health Dr. Mitch Katz and Wade Rose of CHW discuss the future impact of health reform.

The forum was one of eight CHW has sponsored so far in California, Arizona and Nevada – all before packed houses.

In addition, CHW is involved in a national issues advertising campaign in support of reform that is aimed at Washington D.C. media including the Washington Post, Wall Street Journal, Politico and Roll Call. CHW also has participated in health forums at the White House and in Los Angeles.

This is not the first time that CHW – true to its mission – has taken a public and proactive role in advocating on behalf of issues important to the industry and to the patients and communities its hospitals serve.

During the contentious budget debate in California in 2008 and the threat of more health care budget cuts, CHW helped form the California Health Care Partnership — a coalition of doctors, nurses, hospitals, health care providers, seniors and consumers concerned about potential health care cuts and their impact on patients and health care in California. The coalition included the AARP; California Medical Association; Service Employees International Union; Kaiser Permanente; and Health Access.

The Partnership ran ads and held press conferences throughout the state on the impact of the proposed budget cuts.

My hat is off to CHW for the important role it is playing in the ongoing discussion of health reform and on other issues important to the provision of health care.

Old, Online and Loving It

The following post is from Stephen Texeira.

Well I just got back from vacation yesterday (a week camping and hiking in Santa Fe if you really want to know), and I saw this lovely little survey announcement: “Kaiser Permanente Survey Shows Seniors Embrace Internet to Manage Their Health.” According to the survey of Medicare beneficiaries registered to use My Health Manager, Kaiser Permanente’s personal health record, seniors are loving being online and are using the PHR at Kaiser several times a month.

I have to say that I am thrilled by such unsurprising news. On almost a daily basis I find myself talking to clients, potential clients, colleagues, etc. throughout the industry who still are convinced that the only people online are the under-30 crowd, and that seniors are all thumbs when it comes to computers. To which I say, “Get your head out of the cyber sand and look around you.” Most Americans become eligible for Medicare at 65, right? Well guess what, Baby Boomers are just inches away from that magic number. You remember the Baby Boomers, right? They fought to ban the bomb, fought to end the war, rallied and burned their bras and got in their cars and drove to Woodstock. Oh yeah, they also started all those cool computer companies, made millions of dollars and pretty much ran the country. Of course these guys are computer savvy and will remain so as they age. It’s not surprising, then, that the folks five and 10 years older are nearly as computer literate as they are.

It’s time to stop thinking that older Americans are luddites — actually, it’s way past time, but if you haven’t done it yet, do it now.

Stubborn? Need more convincing? Take a look here at this recent report by Dynamic Logic, I know cool name. I’m not sure what they do other than gather statistics about old people online, but they at least did that, and I’m grateful. You should be too. Now get out there and start talking to seniors.

Healthy San Francisco – Once Again We’re the City That Knows How

The following post is from Robert Polzoni.

Last week I was sitting in the dentist office waiting room. In walked a Latino woman with her two children to schedule an appointment to see the dentist. She was asked about dental insurance and responded that she was covered by Healthy San Francisco.

I thought to myself how fortunate I was to live in a progressive city where everyone has access to medical and dental care. This past year I’ve worked with the California Primary Care Association, which represents 600 community clinics and health centers throughout the state, attempting to raise awareness of the devastating effects of cuts to Medi-Cal optional benefits.

Unlike other areas of the state, where dental programs for the uninsured and underinsured are being scaled back or cut altogether because of the budget crisis, in San Francisco this mother and her two children still have access to care.

As Mayor Gavin Newsom wrote in a blog posting on the Daily Kos:

“In San Francisco, we are finding that one of the most effective reforms, and the most affordable by far, is simply using the purchasing and persuasive power of our city to promote the kind of healthy habits that keep residents away from costly medical interventions and prevent chronic diseases.

Many readers already know that the only existing “public option” in America is the Healthy San Francisco program that has already covered 72% of the previously uninsured residents at a dramatically lower cost than private insurance. The data is in – and the results show that a public option like Healthy San Francisco is more affordable than private insurance.”

As the debate rages on in Congress about health care reform, San Francisco stands out as a shining example of how to make it work.

Finding the Best Medical Care

On a recent segment of the Today Show, Patrick Malone, a lawyer who has spent a lot of time suing physicians and hospitals for malpractice, discusses how to find the best medical care, including the best primary care physicians with privileges at the best hospitals.

You can view the video here.

Health Care Reform: The Squeaky Wheel Gets the Grease

The following post is from Robert Polzoni.

Much like the Central Valley in August, the debate over health care reform will continue to heat up through the summer months.  Every special interest group – from the insurance industry and the American Medical Association to the AARP and the pharmaceutical and hospital industries will have their say and stake out their position.

The question is who will speak the loudest so their messages cut through the cacophony of advertisements, press conferences and media blitzes?  Will those that speak the loudest be the victors and leave the others to divide up the spoils?

We all remember those “Harry and Louise” ads the health insurance industry ran against the Clinton health care plan in 1993.  Those ads were credited with helping to sink “HillaryCare,” which was pronounced dead on arrival in the Senate by November 1994.

Harry and Louise are back but this time their singing a different tune.  They’re asking Congress and the President to put health care reform at the top of their agenda.

Harry and Louise won’t be the only ones making their voices heard.  Unlike 1993 there are many different venues to make the case for or against any health care reform package that comes out of Congress and the White House.  We have the 24-hour cable channels, the Internet and social networking sites.

You can expect that President Obama will use all of those venues to make his case for health care reform.   He’ll use the powerful presidential bully pulpit and his immense popularity in town hall meetings and long interviews with network and cable news outlets.   The Obama Administration also will use the Internet and social networking sites to reach out to the millions of supporters from the presidential campaign.

Hospitals, drug makers, insurers and doctors all want to make sure their voices are heard in the debate too.  What they lack in media savvy, they make up with money.

To improve the likelihood of being heard, the health-care industry has hired more than 350 former government staff and members of Congress to lobby on their behalf, according to an examination of disclosure records by the Washington Post.

Spending a lot of money lobbying in Washington is nothing new for groups like the pharmaceutical industry. But many health-care stakeholders are spending even more now: The health-care industry as a whole is spending more than $1.4 million on lobbying, according to the Post.

So it seems that the battle lines are drawn.  I expect it’s going to be a long, hot, loud and very, very expensive summer.

Healthcare Leaders Turning to “Healing Environments”

The following guest post is from Natalie Zensius at The Center for Health Design.

More and more design professionals and healthcare leaders are finding value in utilizing an evidence-based design process to build better buildings that help improve quality and safety. While the terms “evidence-based design” and “healing environments” have become mainstream, many healthcare leaders and design professionals are still just beginning to understand what they really mean.

Anecdotal evidence isn’t enough to convince decision makers to invest more in new healthcare facilities. If hospital CEOs are to embrace and implement evidence-based design, they will first want to evaluate potential costs, identify benchmark facilities, and see credible and relevant research. This is where The Center for Health Design’s (CHD) Pebble Project comes in. It plays an important role in contributing to the body of knowledge and evidence that exists in the field of healthcare design today.

In its early years The Center’s work mostly involved pulling together pre-existing data and information and finding funding for various research projects. The idea to engage healthcare providers to conduct and document research that affects outcomes emerged through the CHD Board of Directors, who gave the initiative its iconic name. The goal was to create a ripple effect in the healthcare community and contribute to what was then the relatively unknown science of evidence-based design. By committing to using an evidence-based design process and then documenting and sharing the results, Pebble Partners would help advance the field and promote change.

Apparently, it was an idea whose time had come. Launched in 2000, the Pebble Project has grown rapidly. There are now has more than 65 Pebble Partners (five of whom are international) at various stages of project development, providing ongoing researched and documented examples of how design has made a difference in the quality of care and financial performance of their institutions. Also included are several product manufacturers who have joined as Corporate Pebble Partners to collaborate with providers to conduct specific research.

To learn more about The Pebble Project, visit The Center’s Web site.

Robert Wood Johnson Foundation Index Means More Work for You

The following post is from Stephen Texeira.

It’s never an easy thing to market a hospital. Whether you are facing stiff competition from a big, university-affiliated research center; cutbacks in reimbursement rates; unions jockeying for a better position; or the the memory of a not-so-distant negative press event, your job as a health care marketer is going to be difficult. But now more than ever it is incumbent upon all of us to overcome those challenges and strive to improve the image of hospitals, physicians and health care in general in any way that we can.

Last month, the Robert Wood Johnson Foundation published the first of its monthly reports on consumer confidence in health care. The Robert Wood Johnson Foundation Health Care Consumer Confidence Index (RWJF Index), dropped from its initial starting point of 100 to 98.7 in just the first month.  A few other interesting bits of information from the survey that creates the index: nearly half of all Americans (46.0 percent) reported that they are worried they’ll be unable to pay for their future health care needs; nearly a quarter (22.4 percent) said that they or a family member delayed seeing a doctor for financial reasons; and about the same percentage (22.7 percent) said that they are having trouble paying their medical bills.

Let’s face it, if consumer confidence in doctors and hospitals drops, if consumers stop getting needed treatment, and if they further stop paying their bills, that’s a bad thing for all of  us. Not only will we have a sicker nation (hard to imagine), but there’s a good chance that you’re going to be out of a job. Now obviously you can’t affect the mood of the entire nation, but we all know that health care is personal and health care is local. If we all start to focus on our communities a little more and directly address the issue of confidence in health care, that can only be good for all of us. So next time you are sitting around brainstorming a new ad campaign or planning a potential viral video, keep in mind that if you aren’t working to inspire confidence in your immediate consumers, you are doing us all a disservice.

Revenue Squeeze on SoCal Hospital ERs

The following post is from Robert Polzoni.

This KCET video explores the financial pressures on emergency rooms in the Southern California area due to low reimbursements rates from Medi-Cal (Medicaid) and uncompensated care. Several ERs have closed, putting added pressures on those that remain open.

Emergency rooms throughout California will begin to feel even more pressure due to the state’s ongoing budget mess and the first eight Medi-Cal services slated for elimination.

The services set for elimination, the first of many cuts to be felt by Medi-Cal enrollees, include dental, podiatry, optometry and five other services the federal government does not require state Medicaid programs to provide.

Dr. Carla Docharthy, representing the California Podiatric Association, warned Tuesday at a rally in front of the state capitol of impending increases in emergency room visits as enrollees have no where else to turn for care.