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Lessons for hospitals from the Uber mess

Paul Keckley, Ph.D., the healthcare analyst, writes in Hospitals & Health Networks about  lessons to be drawn from Uber’s public-relations nightmare. Among them:

“Social media exposes an organization’s culture. Despite anti-disparagement warnings in separation agreements intended to mute shop secrets from former employees, the proliferation of information sharing via social media and in sophisticated competitor intelligence gathering done by top-tier organizations makes keeping workplace secrets virtually impossible. And it’s especially important to manage relationships with employees who leave or are dismissed from an organization: Their impact on the organization’s performance and reputation is profound.’’

‘’Hospitals are tough places in which to work. Highly talented and opinionated professionals work in settings where margins are shrinking and media attention is intense. Hospital boards must pay close attention to how CEOs behave; who they promote, keep or run off; and how our workplaces are affected.’’

“Boards must broaden their CEO evaluation processes beyond usually perfunctory annual reviews tied to their compensation. They must gather objective data about the workplace culture from employee surveys and direct interaction with the human resources team. They must identify areas for improvement in hiring, performance measurement and cultural healthiness, directing these suggestions to CEOs and key senior managers. They must be vigilant about how their CEOs behave and be willing to make changes when they are known to bully or condescend in interactions with peers and subordinates.’’

To read more, please hit this link.

Population health: Partner with Uber?


Uber driver on his way to customer.

Nick van Terheyden, M.D.,  chief medical officer of Dell Healthcare Services, writes in Becker’s Hospital Review that population health must, of course, focus on primary care. But his specific suggestions include:

On data analysis, he cites:

“A western Massachusetts integrated health system includes in their risk algorithms factors such as distance from a patient’s home to a primary-care provider and availability of transportation and family support. Their thinking is that if you live too far from a clinic or don’t have transportation or family support, you are less likely to get regular care.”

“This is just one example of the kind of challenges we face in population health. It’s going to be as much about social support as it is about medical intervention. Income, location, health literacy, family support and a dozen other factors will have far more power over outcomes than anything that happens in the exam room.”

“….I wrote about high-value primary-care providers, those who got stellar outcomes with only about half the per-capita healthcare expense as other practices. These primary-care teams (and they are teams, not just physicians) exhibit significant cultural differences from other practices, starting with a laser-like focus on patient needs that go beyond diagnoses and medications. When they invest in technology, they choose carefully….”

“Notably, all of these practices make sure their physicians have mobile access to the electronic health records of their patients. That means a physician on call will have all the information needed to help a patient and to make good care decisions. ”

“Physicians  {should} take their own after-hours calls most of the time, making use of mobile access to the EHR to ensure all knowledge of each patient’s condition is available for decision-making.”

“Transportation is also a barrier for many patients, and some healthcare systems are partnering with Uber to get patients to checkups. While the cost may not always be covered I’m willing to bet the data will quickly show the payoff from this will justify the expense of providing the transportation.”

“But telehealth, remote monitoring and even free rides with Uber won’t make a lasting difference unless they are part of a culture that cares more about patient convenience than provider convenience.”

To read Dr. van Terheyden’s entire essay, please hit this link


Hail a flu shot


The Boston Globe reported that “For four hours Thursday {Nov. 19}, people in Boston and 35 other cities had the opportunity to summon a nurse to their doorstep to give them a flu shot.”

“An experiment in ‘on-demand health care,’ which involved the use of hundreds of Uber drivers, heralds what some consider the wave of the future: bringing health care to the people, instead of waiting for them to come and get it. The project, dubbed UberHEALTH, was the brainchild of John S. Brownstein, M.D., a researcher at Boston Children’s Hospital and Harvard Medical School who develops technologies that track and promote public health.”

“The concept of bringing on-demand services . . . bringing physicians and nurses to people has so many opportunities,” Dr. Brownstein told The Globe. Indeed, startup companies let people order home visits from clinicians. For example, PediaQ, available in four Texas communities, “provides an app parents can use to summon a pediatric nurse practitioner to their homes during evenings and weekends,” the paper said.

The Globe said that the Uber project came out of Dr. Brownstein’s HealthMap Vaccine Finder, a Web site that “provides a list of recommended vaccines, tailored to the individual, and locations nearby where the vaccine can be obtained.”


Uber and ACO’s


“Uber and/or Accountable Care Organizations?”

Becker’s Hospital Review reports that that was the question on the first side of the presentation of Brad Helfand, Sg2 ‘s associate vice president for consulting,  at a  recent Becker’s  conference, where he talked about  “Health System Strategy in the Age of a Retail Consumer.”

He said that  three  core concepts for consumerism today include:

1. Shopping online.

2. Price comparison.

3. Freedom of choice.

“We think that now is the time to think about your channel strategy. We are starting to see channels that never existed in healthcare in the past, including mobile applications, virtual health, direct-to-employer contracting and onsite clinics for employers.”

“Within the new consumer-driven healthcare market, the concept of leakage is very real. Patients who were previously loyalists could go into a channel directing them to another organization….”


And he noted: “There aren’t many organizations creating service area strategies for the ambulatory footprint, but that’s where consumers are headed.”






A kind of Uber for physician house calls


Now there’s a kind of Uber to summon physician house calls, The New York Times reports.

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