Women In Health IT

Could it be than men and women negotiate differently?

AHIMA said it will create a new model for releasing patients’ health information, Flip the Clinic will add actionable ideas for change and Farzad Mostashari’s ACO startup Aledade will run pilot programs with its customers.

Many organizations have a Project or Program Management Office (PMO). If not at an organization wide level, at least within the IT department. There are different models. Some PMOs provide standards, tools, methodology and overall tracking. Others provide this foundation as well as a team of project managers (PMs) who can be assigned as needed to major projects. Our PMO at University Hospitals is the latter model. Our PMO has evolved under our new manager, Joe Stuczynski. He and his team are making significant improvements with the support of IT leadership. They have developed a roadmap for further changes and improvements for the next year. It is refreshing to be in an organization where we are not debating about the tools and whether they are good enough. We are not debating about what projects need to run through the PMO and if everyone needs to follow the standards. Instead, we are embracing and leveraging the tools and the PMO is able to focus on what it should be – tracking projects and providing PMs to manage projects. Our 90 minute weekly PMO meeting is attended by department leadership and PMs. It has a standing agenda that includes: Action Items from previous weeks – represents a level of accountability and tracking Process Updates – keeping everyone informed on changes New Project Requests – these are later vetted through the IT governance process Project Successes – acknowledging what was completed the previous week Architectural Review Overview Dashboard – shows total number of projects with Green, Yellow, Red project health by major area and change from previous week Detailed review of each project in Red Program review – each major area (i.e. business, clinical, ambulatory, infrastructure, security) is on a rotation for deeper dive Scope Reviews for new major projects – provides chance to “connect the dots”, discuss any interdependencies and ask questions Outputs from this weekly review that get posted on our IT visual management board are: Project successes Dashboard of all projects by health status For each project in “Red,” we cover the issues, impacts and the action plan to resolve, as well as risks and mitigation plans. The green/yellow/red is noted for the project overall, as well as scope, schedule and cost. With this information at a glance, it is easy to identify where help is needed and what it will take to move the project from Red to Yellow or Green. Scope reviews for new projects include summary, scope, business objectives, budget, timeline, and team members. Having a chance to discuss interdependencies and raise any questions or concerns is critical for a new project. The PMO has a number of goals. Two are particularly pertinent here: Improve Project, Program, Portfolio Management maturity – “get everyone on the same page” Incorporate a continual self-evaluation process Looking at the last few months, these two goals are clearly being met. And that’s powerful. Blog originally posted on www.sueschade.com.

Hillary Clinton, the Democratic presidential nominee, revealed her Tech & Innovation Agenda on June 28 while on – where else? – the campaign trail.

My fourth grandbaby was born this week. I helped out by taking care of his 19 month old big sister while his parents were at the hospital. Being able to be present to give this support to my daughters is one of the reasons I started my next chapter back in January. Why is it so important for me to spend time with my family as my four grandchildren grow up?  My father died when I was just 4 years old. His death left my mother to raise my 3 older siblings and me alone. Her parents lived 3 hours away.  We only saw them a few times a year – a 3 hour drive for a mom and four kids was a big deal back then. My father’s parents had died before my parents were married. And my own daughters grew up without grandparents. By the time my husband and I were in our 30’s, all of our parents were deceased. None of them lived to age 70. As a professional woman, I have worked far more than 40 hours a week since my late 20’s and been in management since 1984. When I had babies, a 6-week maternity leave was the norm. Both my daughters went to infant programs in daycare centers when I went back to work. I learned that babies start to smile at their parents (and it’s not just gas) at around 6 weeks old. I realized that I would miss her first smile being back at work. I treasure the times I have now with my grandkids. My daughters are appreciative of the help I can give but don’t want it to be a burden. I have heard people my age say being a grandparent is great but it’s really nice to be able to hand the kids back to their parents. Yes, kids are demanding and tiring when you are no longer young. And as the grandparent there is so much we don’t know about their specific routines even though we successfully raised our own kids many years ago. My 19 month old charge this week has had a fever and an ear infection. I had to figure out how to get her to take her medicine on top of the normal routines. I’ve quoted various articles and leaders in previous posts, but never a children’s book. As we read the popular and prize winning book “Olivia” by Ian Falconer at bedtime last night, the closing struck home: When they’ve finished reading, Olivia’s mother gives her a kiss and says, “You know, you really wear me out. But I love you anyway”. And Olivia gives her a kiss back and says, “I love you anyway too”. I hope to be a positive role model for my grandkids as they grow up. I look forward to all the fun times we’ll have together. As I watch the debate about gun control in Congress, I hope that our leaders will do the right thing and help move us toward the safe and loving country we want for our children and grandchildren. One of the most powerful health care organizations, the American Medical Association, took a big step last week in calling gun violence a public health crisis. I applaud them for that. Blog originally posted on www.sueschade.com.

McNeil, a professor in the Harvard-MIT Division of Health Sciences and Technology, founded Harvard’s healthcare policy department in 1988.

Harvard Business Review article explores findings and what they mean.

This week we all grieve for the families and victims in Orlando.

We define “health” broadly in Health Populi and in our work at THINK-Health, so I am thinking about health disparities today that people in the LGBT community face every day. Let’s call them out.

Mosquitoes bearing Zika — a virus that can cause birth defects when contracted by pregnant women — are expected to reach the United States as soon as this summer, with Florida and Texas likely to be among the hardest-hit states. But in both, support for women’s health care, along with family planning resources, has been dramatically scaled back, in part because of funding restrictions placed on women’s clinics that, in addition to other services, provide abortions. Also, both states declined to expand Medicaid. Those decisions, many advocates say, are putting a squeeze on the health care system’s ability to educate women about Zika’s risks and minimize its impact. “The ways to prevent it are to either, one, not be pregnant and, number two, if someone is pregnant, avoid exposure — which I think can be more challenging,” said Anthony Ogburn, chairman of the department of obstetrics and gynecology at the University of Texas-Rio Grande Valley School of Medicine in Harlingen. Texas and Florida are advancing prevention plans that emphasize mosquito surveillance and targeted spraying. Some public health campaigns also have been launched to raise awareness, but funding is limited. Neither state’s legislature has provided specific funding for those initiatives and neither is scheduled to meet again until after mosquito season. And those campaigns miss a key element, advocates say, given the heightened stakes for pregnant women. The states aren’t addressing the challenge low-income women face in getting birth control. And, for those who do get pregnant, there are still major barriers to accessing potentially helpful prenatal care. “No amount of mosquito repellent is going to get us out of this,” said Christine Curry, an assistant professor of obstetrics and gynecology at the University of Miami Miller Medical School. For most people visibly affected, Zika’s symptoms are comparable to at worst a bad flu, plus maybe a rash. Although much less common, it also has been connected to Guillain-Barre, an autoimmune disorder that causes weakness, temporary paralysis and, in rarer cases, permanent nerve damage or death. But for pregnant women, the virus can cause severe birth defects like microcephaly, which impairs brain development, or loss of the pregnancy altogether. That underscores the need to ensure women of child-bearing age know the risks and protect themselves. In Florida, the state health department is sending out multiple updates each week to anyone who’s expressed interest — “media and community partners,” mostly, said Mara Gambineri, a department spokeswoman. These updates note confirmed cases and strategies to avoid mosquito bites. It’s also put up billboards and distributed educational door-hangers for residents of high-risk areas and infographics for doctors. Similarly, Texas is launching a media blitz, using venues like local radio, social media and ad buys to talk about prevention. Outreach is in English and Spanish. The state is leaning on local governments and health departments to help with prevention efforts, said Carrie Williams, a spokeswoman for the state’s Department of State Health Services. Congress has debated allocating emergency funding, but its progress has been slow. The Centers for Disease Control and Prevention has indicated that, if additional dollars are provided, it would use some of that money to support such state activities. The federal government has said states can use Medicaid dollars to help with Zika prevention, covering services from purchasing mosquito repellent to family planning. But Texas still “is reviewing” that proposal and how Medicaid could fund the Zika fight, said Bryan Black, a spokesman for the state’s health and human services commission. In Florida, Medicaid plans are encouraged to cover repellent, said Shelisha Coleman, a spokeswoman for the state’s Agency for Health Care Administration. But Medicaid eligibility is tight in both states, so even that added benefit skips over a fair number of women. Since neither Florida nor Texas opted into the health law’s Medicaid expansion, these women fall into a so-called “coverage gap.” They are too poor for subsidies to buy insurance on the exchange but too wealthy for the low-income health insurance program. Since they don’t have coverage, family planning and prenatal care can be cost-prohibitive or difficult to get, so they may have limited access to health providers who could help with taking precautions against the virus. That makes outreach efforts now, early in the season, critical. While people are hearing about Zika, it hasn’t yet triggered the level of action that drives women to see the doctor, said Linda Sutherland, executive director of Healthy Start Coalition of Orange County, a Florida nonprofit clinic that focuses on child and maternal health. In Florida, the uninsured can visit a community health center, or a clinic run by the state health department, Sutherland said. If Florida sees Zika transmission, and patients get worried — so there’s “an avalanche of people” trying to avoid pregnancy — she doesn’t think there are enough affordable family planning facilities to meet that demand. And state clinics have seen budget cuts in the past several years, meaning they are smaller and less likely to offer comprehensive prenatal care. As a result, “it is a daily occurrence that someone who has lived in this state her entire pregnancy presents for delivery having not interfaced with the public health system,” said Curry, who also sees patients at Jackson Memorial Hospital, in Miami. Those services take on new importance now, in addressing the Zika virus, she added. “These are huge opportunities for preventive care.” Texas has made it easier for pregnant women to enroll in Medicaid, which can cover services like prenatal care, said Melissa McChesney, outreach coordinator at the Center for Public Policy Priorities, a left-leaning Texas think tank. Most women do get some kind of check-up before giving birth, but getting care as early as medically wise is another question. About 40 percent of pregnant women won’t see a doctor in their first trimester. That’s likely in part because of challenges like not knowing how to pay for it or lacking experience navigating the health care system, McChesney said. Improving on-time access to prenatal care is “a top priority in Texas” — especially given the Zika threat, said Black of the state’s health and human services commission. Community health centers in both states are trying to help educate women of child-bearing age. The women relying on these clinics are often among “the poorest of the poor,” said Jose Camacho, executive director and general counsel for the Texas Association of Community Health Centers. They might live in housing that lacks air-conditioning, or that allows easy mosquito entry. Or they may not have the money for repellent or preventive clothing. “We’re extremely concerned that health centers, because of the housing and conditions around the housing that our patients live in, are going to start seeing quite a few of the Zika patients,” Camacho said. Providers at those clinics are trying to advise women at risk — telling them to avoid standing water and repair mosquito netting around their houses, Camacho said. But for many, getting to the clinic is even a challenge. Transportation is a barrier. And it can take weeks to get an appointment. And if clinicians hope to reach women, they really should visit them at home, Camacho said. That requires manpower, time and money. All are in short supply. Most states rely on information pamphlets produced by the CDC, he added. And those are available in English and Spanish, but many patients also speak other languages. “Are the proper things being funded that help at the local level? I’d have to say no,” he said. “And the communities our patients reside in are usually the last ones to get the attention.” This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.