WOMEN IN HEALTH IT

Lygeia Ricciardi's advice for leadership, and social media, in a time of political uncertainty around the Affordable Care Act and the fate of health reform in America. 

Results of two polls published in the past week, from the Kaiser Family Foundation and Pew Research Center, demonstrate growing support for the Affordable Care Act, aka Obamacare. The Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid was published February 23, 2017. The margins in February 2017 were 48 percent favorable, 42 percent  unfavorable. While the majority of Republicans continue to be solidly against the ACA, a larger share of voters who identify as Independent have shifted to a favorable position on Obamacare. Furthermore, the KFF survey found that more than one-half of Americans overall say Medicaid is important for their families, with fewer Republicans saying so. Fifty-six  percent of Americans said they had some connection to Medicaid, either currently or in the past. The KFF survey was conducted February 13-19, 2017 by telephone among 1,160 U.S. adults ages 18 and older. The Pew poll asked people if they approved or disapproved of the healthcare law passed by Barack Obama and Congress in 2010. The difference between pro- and con- in the Pew poll was wider than in the KFF survey, with 54 percent approving and 43 percent disapproving. Among people who disapprove of the law, more want to see Republican Congressional leaders modify the law versus repealing it, now with 44 percent of Republicans seeking repeal and 42 percent looking for a “repair.” There’s also a big difference in how younger Americans view the ACA compared with older people by a 2:1 ratio: 65 percent of younger adults approve of the law vs. 31 percent who disapprove. Support for Obamacare has also grown among Americans between 50 and 64 years of age. Note that the divergence in positive/negative responses in both polls reversed in 2017, lines crossing in the opposite directions as the 2017 new year set in with the eventual confirmation of Secretary Tom Price to lead the Department of Health and Human Services, and the reality of prospects for an ACA repeal. Finally, college graduates are more likely to support the Affordable Care Act than people with no college. The Pew poll was conducted among 1,503 U.S. adults the week before the KFF study, February 7-12, 2017. Health Populi’s Hot Points:  Media outlets repeated the Democratic Party leadership’s mantra that “Republicans could make America sick again.” The UK’s Financial Times reported that, “Trump warns party on speed of health reform as lawmakers push alternative visions.” The column pointed out: “The day after Republicans took a first step towards repealing the Obama reforms, the president and Mr. Pence separately met lawmakers who are pushing alternative visions for improving healthcare while trying to insulate themselves from future public ire.” The issue “spans household budgets, government spending and the profitability of the health industry,” the FT called out. Indeed: the U.S. healthcare economy is $1 in $5 of the national economy: As such, the healthcare economy is the national economy. At last week’s annual HIMSS conference, which attracted more than 40,000 healthcare information technology users and developers to Orlando, there was a growing number of vendors focused on patient payment systems – to deliver greater transparency, medical banking, and so-called “revenue cycle management.” Healthcare providers, hospitals and physicians alike, are confronted by patients who are now payers: paying first-dollar coverage out-of-pocket whether in high deductible health plans, working through health savings accounts, or paying @retail without insurance or under-insured. These patients are Democrats, Independents, and Republicans alike, all seeing $1 in every $5 bill in their pocketbook going to healthcare costs. Over one-half of respondents to the February 2017 KFF poll reported some connection Medicaid: a fact that Congress, President Trump, and Secretary Price should note. I’ll put a real-life, fine point on this: I spent last Friday morning, February 24, with the Kansas Hospital Association brainstorming the growing role of patients as consumers in U.S. healthcare. Kansas Governor Brownback had not expanded Medicaid to-date, and neither had the State House been keen to do so. The night before my speech to the Association, the State House had voted in favor of expanding Medicaid. That issue will now be considered by the Kansas State Senate. This is a state that has been very conservative about Medicaid expansion. Now, in February 2017, we see a sign that state representatives seek a change. Kansas could be a bellwether. Watch this space: “ad astra per aspera” means, “through hardship to the stars.” There are few greater hardships than a very sick person facing a choice between paying for healthcare services and life-saving drugs, and paying for food, shelter, and heat in the winter.

When I was a child we looked forward to our birthdays with joy and trepidation.  Yes, we would get a few presents, a birthday cake and for a few very fortunate children there would be a birthday party to attend. But we would dread school on our birthdays.    Back then there were birthday spankings. Ah, the acute embarrassment of going to the front of the classroom and bending over a desk to receive a spanking for each year of our lives.  These spanks weren’t too painful, but then there was the “one to grow on.” That final spank packed quite a wallop and many a child would return to their seats rubbing their behind.     When Alex Fair asked me to paint him a new jacket for him to wear in the Walking Gallery, I painted him with a birthday cake and candles. I named it "The candles that never go out."  I painted his happy face in darkness lit by flames and wrote Medstartr Ventures upon that cake for his work to help raise funds to improve healthcare. I have known Alex for almost seven years.  I know he still fights to improve healthcare when so many have dropped away from our cause.  I know he celebrates each year that his work struggles on as our changing economy and riotous political structure provides a type of encouragement that closely resembles that final birthday smack. Alex’s first jacket is falling apart. He wore it often in the last six years. He joined in the beginning, when I did not know you should not paint on corduroy.   I am glad he will wear this new one.  As I said on twitter the other day, “An army of change needs uniforms.”  I want you to think about that. Why do armies need uniforms?  Most importantly it shows which side you on in wartime. Joining The Walking Gallery shows that you are very much on the side of patients and overall improvement within healthcare.  Uniforms also make it really hard to set down your mantle of beliefs.  When we publicly wear our stories upon our backs it can be as heavy as a rucksack, yet not as easily set aside.  This blog was first published on Regina Holliday's Medical Advocacy Blog.

There could be as many different wrap-ups on HIMSS17 as there were people there – over 42,000. No one sees the same vendor exhibits, hears the same presenters, or talks to the same people. There are conferences within conferences. So, here’s just one wrap-up – mine The first speaker I heard did a great job of scaring all the CIO’s. Kevin Mitnick, the world’s most famous hacker and security consultant, and author of several books including his most recent one, The Art of Invisibility, was the opening keynote at the CIO Forum on Sunday. His talk, “The Art of Deception: How Hackers and Con Artists Manipulate You and What You Can Do About It.” included real-time demonstrations. He drove home the point about how vulnerable we are as individuals and organizations.  I highly recommend checking out his website to learn more or get scared yourself. Dr. B.J. Miller was the final speaker at the CIO forum. His talk, “What Really Matters at the End of Life”, was a very sobering view of palliative and hospice care yet strangely inspiring at the same time. As he said, “spending time thinking about your time on the planet while you have time is important – don’t wait.” I highly recommend listening to his Ted Talk with this same title. I have been asked to serve on the CHIME Education Foundation Board again so Monday morning meant a board meeting. It’s gratifying to know that after serving as the initial chair of the foundation board 10 years ago, approximately $170,000 in scholarships is now being awarded annually. An important part of our collective commitment to developing the next generation of health IT leaders. Another part of that commitment is reflected in CHIME’s new initiative focused on women’s leadership development. At an early Monday morning breakfast meeting, current CHIME board chair, Liz Johnson, shared the results of the CHIME women’s survey and the women in attendance discussed leadership development opportunities for the coming year. The HIMSS conference opened Monday morning with a keynote from IBM CEO, Ginni Rometty. She challenged us all as she talked about IBM’s Watson, the new “moonshot” and her own personal journey as a technology leader. With an increased focus on women in technology and STEM, no question that she is an inspiring and strong role model for women. Views from the Top sessions on population health and connected health rounded out the first two days for me on the education front. On Tuesday night I was honored to be part of a panel on value based care and population health at a private IBM dinner hosted by IBM Watson Health General Manager, Deborah DiSanzo. It was great to hear what Joe Kimura, MD, chief medical officer from Atrius Health, and Joe Reilly, CIO from Central New York Care Collaborative, are doing in this space and share my perspective. With the help of social media I kept up on the hot topics – this year the AI sessions were overflowing and the tweets highlighting the blockchain forum on Wednesday gave me a good sense of its potential for healthcare. In just the first two days, there were 52,020 #HIMSS17 tweets. Check out the #HIMSS17 Influencers for the full conference here. There’s even a cool interactive visual map from MDigitalLife.com you can mouse over to see the interconnections between influencers here. With my newly launched health IT advisory firm, StarBridge Advisors, it was a different kind of HIMSS for me. We talked with potential clients and had several meetings with other firms who we may partner with on engagements. While I skipped the HIMSS awards gala, I was able to congratulate in person several of the award winners that I know well — Pam Arora (HIMSS/CHIME John E. Gall, Jr. CIO of the Year), Marion Ball (one of the Most Influential Women in Health IT Award recipients), and Dana Alexander (HIMSS-ANI Nursing Informatics Leadership Award). Kudos to these incredible women and all the 2017 award winners! While HIMSS is tiring and our feet ache at the end of each day, we all head home with renewed energy and passion for what we do – advancing healthcare and making a positive difference through technology! This post was first published on Sue Schade's Health IT Connect blog.

The countdown to HISS17 continues. As I wrote last week, the best way to think about it is in three ways – education, vendors, and networking. This post is the second in a three-part series – focusing on vendors. If you already registered, you have been inundated with vendor emails and snail mail since then. The ginormous exhibit hall beckons when you get to Orlando. So how do you make the vendor aspect of HIMSS17 as productive as you can? Here are some tips to consider based on many years of navigating the exhibit floor: Meeting with your current vendors – I’ve talked with colleagues in the past who always start here. They schedule meetings in advance or stop by just to say hello at all their primary vendors’ booths. I never fully understood this. Maybe I was a CIO in an organization with mostly internally developed systems for too long. You can connect with your primary vendors throughout the year so do you really have to spend a lot of time with them at HIMSS? It’s up to you and your specific needs and issues. If you want to see the latest and greatest products available or coming in the next year OR you have some big issues to discuss with their executives, it makes sense. Visiting vendors that you are evaluating – IT teams are in the planning phase for new systems all the time. If you are using HIMSS to check out the market in a focused product area, this is a great chance to get the lay of the land. Scheduling meetings and demos in advance makes sense. Exploring new products – You might be curious as to what new start-ups and innovators are doing and have a list of small firms to check out. You’ll have to work to find them since the big, established vendors buy the best floor space. But do find them – they will most likely be swarming with booth staff ready to talk to you. Special showcases – Be sure to check out the Interoperability Showcase to see what level of integration is possible these days. And look for the HX360 Innovation Zone where many new start-ups are demonstrating their products. You control your time – Booth staff are there to get your attention and tell you all about their products and services. They will keep you if you’re willing to stay. But you control your time and your plan. If you just need a quick informational conversation, want to pick up some materials, and leave your contact info (or not), then do that. Be polite and respectful but move on when you are ready. Being recognized – There are lots of ribbons that attendees can wear on their badges. The CIO ribbon is one that CIOs treat differently – some would never wear it because they think they’ll be aggressively approached by everyone on the floor selling something. I am of the mind that by wearing it, booth staff easily see you are a CIO and a decision maker and you might more easily get their attention when you visit them. Go back to my previous point – remember, you control your time and which vendors you talk to. Divide and conquer – Like my advice on education last week, plan with your team if you are going to meet with certain vendors together or you are splitting them up to cover more ground. Maps – You can download maps in advance from the conference site. This is especially helpful for planning your time in the exhibit hall.  Make your list of vendors to see, mark up the map and break it down in sections for each day. Social media ambassadors – They can help you prepare, keep up while there, and stay connected afterwards. Follow these influencers to get the most out of HIMSS17. #HIMSS17 Hashtag Guide – HIMSS has provided a helpful guide that lists key hashtags. Before, during and after the conference these hashtags may be helpful as you focus on what you want to learn about and follow. On both Twitter and LinkedIn, you can find related posts using the hashtags. And last, but not least, pack comfortable walking shoes – HIMSS conference veterans understand this. New attendees may not. You will easily walk several miles each day between education sessions and exhibits. Practicality not vanity is what attendees need to think about when packing shoes. Ladies, comfortable flats or low heels should rule! This post was first published on Sue Schade's Health IT Connect blog.  

The countdown to HIMSS17 is on. It’s less than three weeks and if you’re anything like me, you’ve not figured out your HIMSS schedule yet. You’re getting those emails from HIMSS and vendors about what to do, starting to see the “HIMSS preview” type articles in your favorite publications. As the conference website says – 5 days | 300 sessions | 1,200 exhibitors | 45,000 colleagues. It’s as overwhelming as it sounds. The best way to think about it is in three ways – education, vendors, and networking. This post is the first of a three-part series – focusing on education. After all, you’re paying a hefty registration fee and travel expenses so you should get some education time in, right? It’s not just about the massive exhibit hall and seeing all your friends in the industry! Bottom line, you need a strategy and a focus. No more getting a big thick conference book to page through in advance – it’s all online for you to peruse and develop your plan. The conference website has education organized by topics, professional roles, specialty education, and types of session. Here are some tips as you plan your education at HIMSS17: Sunday pre-conference symposia – if you haven’t registered for one of these yet, consider doing so. They are an additional cost but an excellent full day focus with experts on topics such as cybersecurity, interoperability and health information exchange, nursing informatics, medical device security, and precision medicine. Keynotes – you should certainly look at the program and decide which ones you’ll try to attend. Remember, the main room can be full with an overflow room. Don’t think you can walk in at the last minute and get a seat. Session levels – look at the level of the sessions you want to attend — introductory, intermediate, or advanced. This is HIMSS way of helping you figure out if the content is at the right level for you. There is always a “Views From the Top” track which is aimed at senior IT leaders. Don’t be put off; anyone can certainly attend. I’ll be checking them out. Key topics – Pick a couple focus areas you want to learn about and make sure you get to the best of those sessions. HIMSS helps by organizing sessions under broad topics such as: clinical and business intelligence connected health consumer and patient engagement health IT public policy leadership, governance, strategic planning privacy, security and cybersecurity process improvement, workflow, change management With all the changes in DC these days, I will be paying close attention to the public policy ones.  And I’m going to see if there is anything in the connected health and consumer and patient engagement areas I want to attend. Divide and conquer – If you are attending with work colleagues, don’t all go to the same sessions. Plan to go to different ones and share your notes. The most effective IT teams will be working together in the next two weeks to map out their game plan to get the most from their investment. At this stage, these are the sessions I’m most interested in: Integrating Technology into Medical Practice for Better Patient Care The Best Exotic Marigold Hospital: Hilton digital experience Using Data to Understand the Full Value of Patients Improving Patient Outcomes and Health Economics through Connected Health Innovation Welcome to the Age of the Patient: Transform Patient Relationships and Results with CRM Nationwide Trusted Exchange: Are We There Yet? This post was first published on Sue Schade's Health IT Connect blog.

While healthcare entities are waiting for EHR vendors to make data more interoperable, a raft of emerging technologies are enabling information exchange in ways that work effectively today, according to Lisa Moon, a partner with the Timmaron Group. 

Eight in 10 U.S. patients would welcome some aspect of virtual healthcare, but only 1 in 5 providers is meeting that need.

I recently had an opportunity to advise an IT department on the team’s overall lean initiative. While no two organizations have the same lean journey, there are common challenges. Visual management and huddle components can give a lean management system a boost. Here are some of the common challenges you can expect to encounter and tips for success: “Perfect is the enemy of good” – You must be willing to experiment and get messy. Visual boards take many shapes and forms. Do they help you focus on the right work and metrics as a team? It’s less important that they look pretty to the outside observer. Standard framework with room for variation – Even if there is a standard for what all huddle boards in your organization should look like and include, there must still be room for variation by unit or team. What’s important to one team may not be important to another. If you’re ready to get started and wonder if there will be an organization standard at some point, don’t wait for it. Just get going and adapt later if a standard appears. Find metrics that are meaningful – Ask yourself a few questions. What problems are you trying to solve? What do you need to measure to track progress and show improvement? Shining a bright light on a specific metric may cause some angst but if it is one that needs to be measured to improve, shine away. You are there to solve problems – Be sure your huddles are not a place where people feel beat up. Create a culture of improvement that is blame-free, transparent, metric driven and focused on doing better for your employees and your customers. Be willing to tell the “ugly story” about something that doesn’t work as well as it should. Figure out how to improve it, implement the changes, and measure the results. Celebrate your wins – carve out a place on your board where you can highlight successes and celebrate what you’ve done as a team. Be creative and have some fun with it – I’ve seen huddle boards that take on a sports team and car racing themes. The potential for team ownership is that much greater when people can have some fun with it. If you’ve got a huddle board story or picture to share, I’d love to hear about it. This post was first published on Sue Schade's Health IT Connect blog.  

Shareefa Albulmonem, head of eServices, Office of the CIO at King Faisal Specialist Hospital and Research Center in Saudi Arabia, is one of seven women being honored by HIMSS with a Most Influential Women in Health IT Award. The women will be recognized at a reception and awards dinner, both on February 20 at HIMSS17 Here, in her own words, is Shareefa Al Abulmonem’s reaction to learning she was among the seven winners: I am not sure if it’s just me or does life have some amazing surreal moments … After walking out of a meeting, I received a message in my inbox that stated something around my HIMSS Most Influential Women in Health IT Award nomination.  I never expected to win as there are many deserving women in healthcare and I thought I was just being informed of the nomination process. I passed the phone over to my boss who was standing next to me in the hospital. He read it and let out a loud cheer that made everyone in the hospital corridors stop and wonder what just happened. In his haste, he congratulated me for being shortlisted and said “inshallah we hope you win.” The phone got passed to one of my employees and after reading it she told me, “Shareefa, you won!” How could I win?!  It’s probably a mistake so I checked for other emails from Carla Smith or HIMSS where they might be apologizing for the mix-up. Nothing. I called my husband and told him, I think I need to go shopping as I am experiencing one of those surreal moments. On the way home I read the email from Carla a couple of times and came to the conclusion, “Wow, I won!” That’s when all of the achievements that brought you to this point start replaying in your mind. I would like to dedicate this award to all the women of healthcare in Saudi Arabia. The transformations we are making together symbolize the importance we place on women’s health and the importance of a healthy nation. It gives us an opportunity to be role models to the younger generation as to the changes we would like to happen. Alhamdulillah, the Zahra Breast Cancer Association has grown to become the regional face of women’s health, and I was just a member of an extraordinary team who shared the same vision. My career has been full of individuals who were mentors and guides for me throughout and I would like to thank them all. Saudi Arabia is an evolving country and to be an active part of the country’s transformation is a blessing. I believe technology drives majority of the advancements we are currently witnessing throughout the world, and the same applies in healthcare. King Faisal Specialist Hospital & Research Center – KFSH&RC has given me the platform to leverage and implement technology for the betterment of health, patient and citizen care.  T The launch of SEHATY, KFSH&RC Patient Portal, and the praise it received opened numerous other opportunities to build on continuum of care and to be able to constantly engage the patient in the management of their health. There are endless possibilities of how technology can be utilized in the appropriate and various ways in healthcare. This award has given me a boost on how much more effort lays ahead, so thank you for sharing this surreal moment with me, but I really need to get back to work!