Minimization of Human Error within the Scope of Health Information Management

There can be no doubt that the HIM field has become increasingly complex as it has evolved.  Though this evolution has brought about innumerable benefits, it has also brought about a degree of risk that could be considered directly proportional to the former.  This risk is associated primarily with human error and the potentially adverse effects such error may cause.

It is clear that simple mistakes during patient registration can have far-reaching consequences.  Such mistakes can take the form of duplicate records or even erroneous records due to the confused entering of information into other individuals’ files.

The problem begins at registration, which is typically burdened by time constraints.  Most registrars are instructed to enter a patient into the system within two minutes upon arrival so that treatment may be promptly administered.  Erroneous or duplicate file information can be either due to pure accident or, unfortunately, negligence during the registration process.

What is particularly problematic about faulty patient information is that it eventually filters through the larger and more circuitous medical information framework which could potentially cause incidences such as faulty billing, unnecessary treatment (which may prove quite dangerous depending on the circumstance), or wasted time and money in the pursuit of correcting inaccurate file information.

The operational gap between patient registration and HIM departments seems to have led to the exasperation of these problems.  This reality has been recognized by medical professionals and subsequently has lead to the creation of less distance between the two entities, effecting remarkable results.

It has widely become protocol for HIM departments to work more closely with registration staff, providing individuals with feedback and education regarding the consequences of faulty medical recording.  Not only this, but many institutions have set higher standards for the minimization of mistakes during the entrance process, some implementing layoff at three cumulative faulty registrations per year.  Alterations in communication between these departments has lead to vast improvements, the likes of a nearly 60% decrease in duplication rates within some institutions.

Essentially, what was once a considerable problem is now far less of one thanks to the ingenuity of HIM professionals.  The result is less correction, less patient injury, less time, and less money.

Questions: Do you think registration errors are a problem in the facility you work at? Do you have any ideas as to how this process can be improved?

About the Author:  Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog.

Resources:
Dimick, Chris. “Exposing Double Identity at Patient Registration.” Journal of AHIMA 80, no.11 (November 2009): web extra.

The Clear Medical Network

With the rapid improvements in technology and communication, social networking is thriving and full of new potential.  Sites like Facebook, Twitter and LinkedIn are known among all people, young and old.  As the dynamics of online communication are quickly becoming more important, companies are adapting to the trends.  One example is the Clear Medical Network. 

It was formed to provide an avenue for networking, discussion, and fun among all different healthcare professionals, as well as provide opportunities through consulting projects, leadership positions, and per diem work to all its members.  Members can also find supplemental health through the network.  Many people have already joined the free network and are intrigued about the opportunities that have already come their way. 

Members are also informed of any upcoming fun events in their area.  One example is a discounted 8 day cruise next year to the Mexican Riviera!  Starting at $319/person, this is not only great fun, but it’s a great value too.

Joining the network is free and takes less than a minute.  Once registered, members are informed of different forums they can join to network with other healthcare professionals within their specific profession as well as other areas of healthcare. 

If you are interested in joining, the site is www.ClearMedicalNetwork.com.  

There really is no downside, and it’s sort of fun to see the other side of things from the perspective of Doctors, Nurses, PTs, HIM Directors, or any of the other professions that are getting involved.

Questions: What do you think of the Clear Medical Network?

About the Author: Sarah Fore is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog.

Introduction to Music and Healthcare

William Congreve wrote in 1697, “Musick has Charms to sooth a savage Breast.”  Was he expressing the idea that music can heal?  The use of music in healthcare is nothing new.  The belief that music has restorative powers goes back even further than Congreve.  It goes at least as far back as the Ancient Greeks.

They believed music affected the soul.  Plato said almost 2500 years ago, “Music is a moral law.  It gives soul to the universe, wings to the mind, flight to the imagination, and charm and gaiety to life and to everything.”

Music is universal and despite it being used throughout the ages to soothe the soul, it’s only fairly recently that it became accepted within modern medical circles.  It gained accepted recognition in 1944 when Michigan State University offered the first accredited music therapy program.  Today there are more than 70 colleges and universities offering programs in music therapy and approximately 5000 music therapists.

Hospitals use music to aid patients in many ways, including pain management, to elevate patient’s moods, and to encourage movement in physical therapy.

As of 1994, music therapy services have been identified as reimbursable under Medicare.

But what about music promotes healing?  How does it work?

Every known culture has music.  Music touches us, affecting us physically, psychologically, emotionally, and spiritually.  Has a song ever come on the radio and you find your feet tapping?  Upbeat songs make us feel good.  Our body’s physical responses to music are observable and measurable.  Music can affect your pulse rate, blood pressure, respiration, temperature, and even your brain waves.

There are four types of brain waves; beta, alpha, theta, and delta.  Beta waves occur when we are alert and active.  Alpha waves occur when we are relaxed.  Theta waves occur when we are meditating or drowsy and falling asleep.  Finally, delta waves occur when we are in deep sleep.  Music can affect these brain waves.  Calm, relaxing music can induce theta or delta waves, whereas loud, fast music will put the brain into an alpha state.

Everyone has heard of “runner’s high”, it’s what happens at a certain point during physical exertion when the body starts to release endorphins, a group of peptide hormones that increase the body’s threshold of pain and can affect mood.

Many activities besides running can cause the release of endorphins, for example, eating spicy food, time spent in the sun, intense pleasure such as sex, strong emotions like laughing or crying, and listening to music.

Studies have shown that listening to half an hour of classical or instrumental music has the same effect as taking a Valium.

Many have heard of the exaggerated and unsubstantiated claims surrounding the so-called “Mozart Effect”, that listening to classical music, for example, will make you smarter or will turn your unborn infant into a genius.  Despite these fallacies, however, what the actual study showed was just as amazing without the hyperbole that has since been attached to it.

In 1993, at the University of California, Irvine, Gordon Shaw and Frances Rauscher conducted a study of 36 college undergraduates.  They listened to 10 minutes of a Mozart sonata, then immediately took a Stanford-Binet IQ test to measure their spatial-temporal reasoning.  The results showed an improvement in spatial IQ of eight to nine points, but the effect only lasted for 10-15 minutes.

Despite the fact that the “Mozart Effect” only improved spatial-temporal reasoning and that the effect was temporary, the study still showed the kind of power music has upon the mind.  Other studies have shown that students who study music in high school have higher grade point averages and physically develop faster than those who don’t.

Music has amazing powers in its ability to affect our body and mind and is becoming an effective healing tool.  As author Berthold Auerbach said, “Music washes away from the soul the dust of everyday life”.

Questions:  Do you feel music has the power to heal?  Have you or a loved one experienced music’s healing power first hand?

About the Author:

Ed Pahule is a Staff Writer with the Clear Medical Solutions Communication Team.  His work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog.

Why Consumers Need to Demand More From Drug Companies

A recent article in the New England Journal of Medicine, Lost in Transmission- FDA Drug Information That Never Reaches Clinicians reported that key information is missing from prescription drug labels.  Authors Dr. Lisa M. Schwartz and Dr. Steven Woloshin wrote, “Much critical information that the Food and Drug Administration (FDA) has at the time of approval may fail to make its way into the drug label and relevant journal articles.”  They go on to explain, “FDA approval does not mean that a drug works well; it means only that the agency deemed its benefits to outweigh its harms” and “drug labels are written by drug companies, then negotiated and approved by the FDA.”  

Schwartz and Woloshin profile three drugs, Zometa, Lunesta, and Rozerem as examples of how drug labels are missing information.  All three drug labels were indeed missing information.  In their review of Lunesta and Rozerem however something stands out, both Lunesta and Rozerem had intense direct- to- consumer advertising campaigns.  Lunesta is reported have spent more than $750,000 a day in its 2007 advertising campaign and to have sales reaching almost $800 million last year.  Rozerem is described as being “aggressively promoted to consumers.”  This information could easily be omitted from the article without detracting from the issue of drug information not reaching clinicians; the inclusion of this information is interesting.

 In 1997 the FDA issued new regulations governing television advertising of prescription drugs; following this change direct- to- consumer drug advertising soared.  Prescription drugs became commercialized; direct- to- consumer advertising repackaged drugs into a shiny product to be sold to the public.  In this light, is it surprising that drug companies would over exaggerate the benefits of their drug and down play the risks?   The purpose of advertising is to make consumers think they need a product and make them want to buy it; drug companies are no different.  Consumers have learned to be skeptical of the dubious claims made by advertisements but direct- to- consumer drug advertising is new.  Consumers have more faith in the claims made by drug companies because the idea that drug companies might manipulate information at the risk of the consumer is so unsettling.

By including information on the direct- to- consumer advertising campaigns of Lunesta and Rozerem, Schwartz and Woloshim provide further insight into the motivations (money) behind excluding certain information from drug labels.  It also highlights how for years the public has accepted and believed the claims of drug companies without question despite numerous incidents of drug companies being exposed as less than forthright.  You can be angry with the drug companies for omitting information or mad at the FDA for not making it easier to access the information.  But isn’t it time we as consumers start to demand more from drug companies?

Questions: Do you agree with the above statement that as consumers, it is time to start demanding more from drug companies?  Have you experienced any type of negative side effects to your medication that was not listed on the label?

About the Author:  Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:
Lost in Transmission- FDA Drug Information That Never Reaches Clinicians
http://healthcarereform.nejm.org/?p=2126&query=home

Lean Organizations: A Novel Strategy in Health Care

Efficiency is arguably always worth striving for.  American industries of all sorts have been doing just that for the better part of the twentieth century, following the examples of their foreign counterparts.  However, only as of late have various health-related institutions been adopting such measures.

The health care industry is reorganizing in order to pursue a more efficient and higher quality model of care.  The cleverness of this lies in its adaptation of a particular manufacturing scheme known as “lean” organization.  Pioneered by the renowned Japanese automotive manufacturer, Toyota, in the years following the Second World War, the strategy was born out of pure necessity.  During the post-war period, Japanese manufacturers were faced with extraordinary deficits with respect to a variety of resources, subsequently leading them to change all facets of the manufacturing process itself.  What was situated at the center of this change was maximal efficiency; the removal and potential replacement of all practices which did not contribute to a product’s value.  Additionally, the model is extremely conscious of the consumer, basing all interpretations of value upon consumer demands.  According to the MAMTC, a more concise definition of “lean” manufacturing is as follows:

“A systematic approach to identifying and eliminating waste (non-value-added activities) through continuous improvement by flowing the product at the pull of the customer in pursuit of perfection.”

Of course, the system entails a vast range of contingencies that theoretically lead a given enterprise to its ultimate goal of maximal efficiency and quality.  Such items include the elimination of overproduction, excessive inventory, motion, and space.  Given the nature of this analysis, the complexities of the matter will not be discussed.

This is all very exciting for the world’s manufacturers, but what of the health care industry? Naturally, when a model such as this is applied to the business of health care, similar results seem to occur. In fact, the phenomenon is so utterly profound that the Massachusetts Institute of Technology is at the forefront of its research.

Simply expressed by the coordinator of the Lean program at the University of Iowa Hospitals and Clinics, Sabi Singh:

“In manufacturing, lean principles are about adding value to a product… In health care, the focus is on improving the patient’s experience, which leads to eliminating waste and non-value added steps, which in turn improves finances.”

However, these abstractions seem to only supply so much to one’s understanding of the “lean” system.  Perhaps an illustration of such concepts will be of greater benefit.  For example, at a hospital in Iowa, a nurse suggested that the location of particular chemotherapy supplies be moved from a distant storage room to carts located in greater proximity to certain patients.  Not only this, but these patients were also grouped into pods which were assigned to various nurses.  Consequently, “those two simple changes reduced the nurse’s walking time by 90 percent, reducing the patients’ waiting time and increasing the number of patients the clinic could care for in a day,” according to Singh.

In essence, “lean” methods are staggeringly logical.  It should be no surprise that the implementation of a system of this nature is improving the efficiency, quality, and cost of health care. 

Questions: Have you had personal experience working with a lean organization?  Do you feel there are benefits with working in this type of environment?

About the Author: Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

“UI Helps Health Care Organizations Control Costs”, Ruzanna Harutyunyan. September 21, 2009. http://www.emaxhealth.com/2/10/33678/ui-helps-health-care-organizations-control-costs.html

“Intro to Lean”, MAMTC. http://mamtc.com/lean/intro_intro.asp

Experiences with Health Care in South Korea

One of our writers for Clear Medical Solutions is currently residing in Seoul, South Korea and wanted to share her experiences with the health care system.  Below is an interesting article on her experience and point of view of the South Korean health care system and how it differs from health care in the U.S.

 I teach English in Korea and have lived here for little over a year.  During my stay, I have had several encounters and experiences with the health care system.  Korea has a National Health Insurance Corporation (NHIC), which guarantees health insurance for all Korean Citizens.  Foreigners are also covered by the National Health Insurance (NHI) provided they meet the necessary requirements.  My status as a registered, employed alien, with a proper visa (E2 for me) grants me access to the same NHI benefits as those for Korean nationals.

I am by no means an expert on the NHI; most of my knowledge about the NHI and health care in Korea comes from experience.  However, I do know the basics of how it works, the benefits, and what is covered.  Only properly documented and employed foreigners are eligible for NHI.  A monthly contribution is deducted from each pay check.  The contribution is determined by the monthly wage multiplied by the contribution rate (currently 5.08%).  The employee pays half of the contribution and the employer is responsible for the other half. 

The NHI has a co-pay system; patients pay 10- 20% of the total cost for inpatient care. Outpatient co-pay varies between 30- 50%.  General hospitals require 50% co-pay, while hospitals require 40%.  The co- pay for clinics and pharmacies is 30%.   There is mandatory minimum payment of 3,000 Won for visits when the charges do not exceed 15,000W. 

Currently 1 USD equals about 1,164W or .85 USD equals about 1,000W.  It may be easier to think 1 USD equals 1,000W, since I will be quoting all prices in Won; just remember the actual cost in U.S. dollars will be slightly less.

In my experience, the quality of health care in Korea is equal to the U.S.  The major difference is NHI makes the healthcare vastly more affordable and accessible.  The costs for doctor visits and prescriptions are literally pocket change.  Appointments are unnecessary for small clinics.  Hospitals and dental offices usually require (or strongly recommend) making an appointment, but there is rarely more than a two day wait for an appointment.

Recently, I severely burned my feet in a few places.  I tried treating them myself at first but was unsuccessful.  On my way home one night, I sought the advice of a pharmacist.  I showed the pharmacist my burned feet and he sold me a box of Band-Aids and a tube of Silmazin Cream (1% silver sulfadiazine cream; the Korean equivalent to Silvadene or Flamazine).  The total cost of the cream and Band- Aids came out to be around 6,000W.  The next morning I went downstairs to my regular pharmacist and bought gauze and medical tape; 3,000W.  A few hours later, I noticed one of the burns was developing a red circle around it, was warm to the touch, and was increasingly uncomfortable.  I headed back downstairs to the pharmacist hoping she could help me and she sent me to the doctor on the second floor.  The doctor examined the burns, cleaned them, put an ointment on them, dressed them and wrote me a prescription for antibiotics; 4,000W.  Back downstairs at the pharmacy, I filled the prescription, a 2-week course of antibiotics; 7,000W.  The total expenditure for treating my 2^nd degree burns was 20,000W; I did not have to make any appointments nor sit idly in the waiting room of a doctor’s office. 

All foreign teachers must undergo a yearly physical.  These are usually performed at bigger hospitals opposed to clinics.  The physical includes but is not limited to a chest x-ray, vision and hearing test, urine test, CBC, and HIV/ AIDS STD test.  You change into a hospital gown/top and you are pushed from one room to the next for each test to be performed. The most jarring aspect of the physical for me was the urine test.  The nurse handed me a Dixie cup, which I thanked her for and used to get a cup of water before proceeding with the test.  As I turned back from the water cooler and saw her face, I realized the Dixie cup was meant to collect my urine, not for me to drink out of.  I do not think it matters how many times you do it, walking out of a bathroom holding a Dixie cup of your own urine and placing it on a tray next to other cups urine always feels wrong.  Dixie cups aside, the physicals are easy to get and it usually does not take more than 30 min from when you walk in the door to when you walk out.  I paid 60,000W for my physical this year, but the cost can vary from 55,000- 70,000W depending on where you go.

Dental work also costs much less in Korea than in the U.S.  Friends of mine have had root canals, cavities filled, and crowns made (all things covered by NHI);they all rave about the price and how the quality of care was the same (some said better) as what they were used to back home.  I have not had dental work of that nature done.  However, I am currently undergoing Invisalign treatment for cosmetic purposes, which is not covered by NHI.  Even without the benefit of NHI, I am saving a great deal of money by having it done here rather than in the U.S.   Invisalign performed in the U.S. by an American doctor costs on average $5,000.   My Korean dentist received her degree from Tufts University, is an ADA member and is licensed to practice in several East coast states. I am paying 3,500,000W for my treatment (note: at the time of payment the exchange rate was different so 3,500,000W was about $2,800USD).   And my experience with Invisalign in Korea far surpasses the one I had with braces in the U.S.

The health care system in Korea also has some differences which are cultural.  Confidentiality, which is paramount and a cornerstone in health care in the U.S. is pretty much non-existent here.  I read warnings about this before I came here so I was prepared for it to be a little lax, but I was beyond shocked when my co-teacher showed the parking attendant the results of my physical in order to get her parking validated.  When I recovered from my shock and asked her about it, she did not see anything wrong, strange, or inappropriate with sharing the test results with a stranger whose job it was to monitor a parking lot.  As it turns out, it is not uncommon for doctors or nurses to discuss one patient in front of other patients or for the pharmacist to talk to other people about what medication you are taking.

Koreans typically do not play an active role in their health care.  For the most part, they believe in their doctors, trust them completely and never question them.  As a result they are often less informed about their treatment.  Experience has taught me not to question a Korean on the specifics of any treatment they are receiving because the answers alternate between “Because the doctor told me to” or “I don’t know.” 

I on the other hand like to know about my treatment.  I want to know what’s wrong with me.  I want to know what medication I am being given and why and I want to know the possible side-effects of this medication.  All this proved to be too much for one doctor.  My questioning of him during the examination and then disagreeing with his initial diagnosis that I had an STD (an unfortunate assumption sometimes made about foreigners, which is why a test is included in our physical) did not go over well.  I think I pushed him too far when I asked him for a translated version of the prescription he was writing so I could know what I was taking (or could at least Google it).  He was taken back by this request and stunned for a moment before he ordered one of his nurses to do it and shut the door on me.  The other doctor I have seen did not have a problem with this request and in addition to writing the English name of the drug he also wrote its purpose.

The physical manner in which prescriptions are filled is another difference between health care in Korea and the U.S.  Instead of the nice little orange bottles, clearly labeled with a patients name, drug dosage, and instructions; prescriptions in Korea come in rows of sealed little bags.  Each bag represents one dose.  When I filled my prescription for two weeks of antibiotics, the pharmacist handed me 14 little rows with three bags to each row (take 3 times a day for 2 weeks).  My qualm with the bag system is the loss of control I feel by not being able to control my own medication and again not knowing what I am taking.  However, I see how this system might have its merits for older patients taking multiple pills a day and how it could help prevent them from missing a dose or taking the wrong medication.

Korean pharmacies bare little resemblance to the big corporate owned pharmacies like Walgreens and CVS found the in the U.S.  The wide florescent lit aisles with rows upon rows of cold, flu, headache, stomachache, heartburn, etc., medicine are replaced with surprisingly small shops, stocked floor to ceiling with foreign medication, most of it behind a counter and controlled by the pharmacist.  When you have a cold (or any other ailment) in Korea you go talk to the pharmacist and s/he supplies you with the proper medication (in baggies) based on your symptoms; opposed to going to the drugstore in the U.S. and matching your symptoms to a box of cold medication.  I prefer the U.S. system and so do most foreign teachers, which is why there is a cabinet stocked full of Advil, DayQuil, NyQuil, Imodium AD, etc., in most of our apartments.  The benefit of the Korean system is that more drugs are available over the counter than in the U.S.  The Silmazin I bought for my burns would have required a prescription in the U.S.  More significantly, birth control does not require a doctor’s prescription and can be obtained from a pharmacist.

Health care in Korea has its pros and cons; it has been an adventure for me to experience and has given me numerous stories to tell.  In the end, what has surprised me the most about health care in Korea is how even as a foreigner who does not speak the language; I have never had a problem accessing the health care.  Come January 1, 2010 I will no longer be covered under my mother’s health insurance (which was very good insurance).  With that date looming I have actually started to think about health insurance and health care for the first time in my life.  I know the high quality health care the U.S. is capable of providing because I am used to receiving it; however, as of January 1^st I am not sure how to access that care.  I am dismayed by this fact; the fact that accessing healthcare in a foreign country where I am temporarily residing may be easier than accessing healthcare in my home county where I am a citizen. 

Questions: Based on the above story, how do you feel about the health care system offered in South Korea? Patient confidentiality is a huge focus point for health care in the U.S.; would you be willing to give up patient confidentiality for more available and affordable health care?

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

NHIC- National Health Insurance Corporation
http://www.nhic.or.kr/eng/

 Invisalign Payment Options and Treatment Costs
 http://www.invisalign.com/WillFit/Pages/PaymentOptions.aspx

Some Alternative Ideas During Breast Cancer Awareness Month

For the last 25 years, Breast Cancer Awareness Month has been an international campaign aimed at sharing information about the disease as well as raising funds in order to find better treatment and hopefully a cure.  It appears as though this effort is finally beginning to prove successful, as evidenced by a plateau in incidence rates that has now occurred after decades of steady increases.  

In what promises to be a turning point in the battle against Breast Cancer, new cases of Breast Cancer actually experienced a decline from 1999 to 2005.   This drop in new cases has led to quite a bit of speculation, and some have even gone so far to say that this drop may be due to a sudden accompanying drop in the use of mammography or post-menopausal hormone replacement therapy.  This idea (and other similar ideas), if proven true, would fly in the face of conventional cancer treatment, and is worthy of discussion. 

In one such case, a Norwegian study that appeared in the Journal of American Medical Association’s Archives of Internal Medicine in 2008 revealed that there was a sudden 22% increase in breast cancer occurrences in women who began regularly receiving mammography screening (i.e. every two years).  Though there are a number of possible reasons for this increase (such as radiation and trauma to breast tissue), it seems to be the case that the increase in cases is not, at least purely, a result of heightened awareness linked to more frequent testing.    

Some researchers speculate that the procedures that follow positive mammographic results may actually be the culprits in the progression of cancer.  Typically, after one becomes aware of a cancerous growth in one’s body, discovering whether or not the growth is malignant is the subsequent step.  However, the way some practitioners go about this task has become the target of new research to learn more about the progression of the relevant cancerous activity.  

Traditionally, biopsy is the main method utilized in discovering the nature of the cancer.  This procedure is one in which a sample is removed from the growth for the purpose of observing its behavior on a cellular level.  Though the biopsy does achieve its objective, some researchers wonder if it may lead to a greater problem.  

When a person is experiencing a cancerous growth within their body, sometimes the body itself responds in such a way as to create a barrier around the growth in order to contain it.  When this barrier is broken, particularly in the case of biopsy, metastasis (the spread of cancer) may occur more rapidly than it would otherwise.

One alternative form of screening that does not involve radiation is known as thermography.  This method utilizes a medical screening device that emits infrared detectors, which produces little to no harm to the bodily tissue.  Obviously much more research is needed on the subject, and is just one more reason why we need to raise more money for research.  

In addition to alternative treatments out there, there are also some alternative prevention ideas out there as well.  It appears that some in the community believe that vitamin D may be a tremendously effective route towards the avoidance of developing a variety of cancers.  

When the body produces vitamin D, organs such as the kidneys and liver activate a hormone.  This hormone causes a phenomenon called cellular differentiation, which is an effect that in many ways seems opposite to that of cancer.  In fact, human cancer cells have been shown to have specific receptor sites for vitamin D.  As exhibited in lab animals, vitamin D3 also inhibits a process known as angiogenesis, or the growth of new blood vessels that permit the spread of cancer.

In conclusion, we have a long way to go towards minimizing the effect of Breast Cancer on our loved ones, and it is always helpful to have an understanding of varying ideas on treatment and prevention.  This month, donate money to research and continue to urge your loved ones to be aware of their bodies and the very real potential for Breast Cancer.  Together we can help make a difference.

 

(Clear Medical Solutions and Clear Medical Agency do not actively engage in cancer research and this article is not a position paper supporting any particular school of thought on treatment or prevention of Breast Cancer.  This article is for information purposes only and is only meant to stimulate discussion and awareness about this very serious topic.  We are thankful for all the men and woman that work day and night to make a difference in this fight and we believe that preventing the deaths of thousands of loved ones around the world is a noble cause worth investing in.  We support all research and ideas that may lead to a safer world where the fear of Breast Cancer can someday be history.)

Question: Do you agree or disagree with the Norwegian study done in 2008?

About the Author: Ashley Montore is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearFinanceMatters.com blog.           

References:

“Breast Cancer Rates Soar after Mammograms and Some Cancers May Heal Naturally.” Sherry Baker. November 24, 2008. http://www.naturalnews.com/024901.html

“The Risks Associated with Biopsies.” Jo Hartley. December 24, 2008. http://naturalnews.com/025159_cancer_biopsy_Prostate.html

“Vitamin D is Nutritional Key for Prevention of Breast Cancer.” Mike Adams. October 13, 2009. http://www.naturalnews.com/027230_cancer_Vitamin_D_brst.html

Home Health Care Approved by Patients, Families, and Hospitals

In the 1950’s the average American lived to be 68.  Thanks to medical breakthroughs and advances the average American can now expect to live to be 78.   This increased life expectancy coupled with the fact that the baby boomers are beginning to enter their “golden years” is a growing concern among the medical community.  The aging baby boomers will require more medical attention, will make up a greater proportion of hospital patients, and will have more demands and expectations of the health care system.  Yet, the number of doctors and nurses can not increase at the same rate as these demands nor can the capacity or capability of hospitals.  Due to the growing imbalance of supply and demand of the health care system, home health care has become an increasingly popular option.   

Home health care allows patients to receive the necessary care in the comfort of their own home by trained professionals.  It reduces hospitalization time and opens more beds in the hospitals.   Both patients and their families benefit from home care and it reduces the strain put on the hospitals.  The services provided by home caregivers are diverse and are suited to match the patient’s needs.  Home caregivers do more than tend to the medical needs of the patient.  They can help with housekeeping, cleaning, washing/ bathing, transportation to appointments, and any other duties that help the patient return to a level of independence.

Patients prefer the comfort of their home to the impersonal sterile hospital environment.  They also recuperate better and faster in familiar home settings.  Patients develop a more meaningful relationship with their home caregiver that is not possible in a hospital setting.  This relationship provides the patient with a sense of security that can aid in the recovery process.  Many elderly patients are resistant to moving into nursing homes or assisted living centers because they feel like they are giving up their freedom; home caregivers are the perfect solution for individuals who need assistance but do not want to lose the independence living in their own home gives them.

Home caregivers help more than just the patient; they give the families of patients the security of knowing their loved one is being taken care of.  Illness of or the assistance required by an elderly relative or parent can be both stressful and overwhelming.  Families do not have to worry about whether or not their loved one is eating properly or taking their medication when a home caregiver is hired.  Nor do they have to worry about if their loved one is lonely or feeling isolated.  Home caregivers provide companionship to their patients and help them stay connected to the world.

 Patients, families, and hospitals all prefer home health care to long hospital stays.  It gives patients more personalized care and lessens the stress put on families. Home health care is usually cheaper for the patient and more cost effective for the hospital.  As a result of the strain the baby boomers are putting on the health care system, the home health care industry is booming.  In light of all the benefits home health care offers, one has to wonder why it has taken so long to catch on.

About the Author:  Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

“The Benefits of Using Home Health Care” http://ezinearticles.com/?The-Benefits-of-Using-Home-Health-Care&id=1892252

 AHA: Press Release: “Baby Boomers to Challenge and Change Tomorrow’s Health Care System” http://www.aha.org/aha/press-release/2007/070508-pr-boomers.html

Fight or Flight, No Longer a Viable Option: How to Manage Stress in the Modern World

 Fight or flight is our bodies’ primitive and automatic response to stress.  In prehistoric times this response essentially saved mankind from extinction.  Imagine the primitive man walking back to his cave after a hard day of hunting and foraging when all of a sudden he is confronted by a saber- toothed tiger.  His stress level immediately rises; he realizes the only way to relieve his stress is to remove the stressor.  He has two options run (flight) or fight the beast.  Either way, the stressor will be removed and he can continue on his way to his cave; hopefully he is victorious in his fight but even if the saber- toothed tiger wins, the caveman’s stress will be relieved.

 Unfortunately primitive man’s way of managing his stress is no longer applicable in the modern world.  You can not punch your boss in the face nor can you run out of a board meeting in tears and hide under your covers, at least not if you want to keep your job.  Today it is much harder, in some cases near impossible, to escape the stressors in your life.  Therefore, it is important to find methods of managing and coping with stress.

A simple search online produces many methods for managing or relieving stress.   Some of these methods are not practical for all people, such as; taking a break to nap, enrolling in an online course, going on vacation, and practicing yoga or meditation for one to two hours a day.  However, there are ways to relieve stress that anyone can do:

1) Learn to Ask for Help: Asking for help is not a weakness, but a strength.  It is a sign of someone who is aware of his or her weaknesses and wants to improve, it promotes better communication in the workplace, and it demonstrates a willingness to learn.

2) Learn to Say NO: Saying no to colleagues or friends may be difficult but it is essential to minimizing stress.  If you are already overwhelmed, adding more to your workload will only increase stress.  You should also consider whether or not the person asking for a favor would reciprocate a favor when you request one.

3) Practice Breathing Exercises: Breathing exercises can help clam you down and focus clearly at the task on hand.  One method is to close your eyes, inhale through your nose for the count of three, hold for 1, and exhale through your mouth for the count of five.  The second one simply increases the time, inhale for the count of five, hold for one, and exhale for eight.  Repeat this exercise a few times or until you feel your stress decreasing.  It can be surprising how much this simple exercise can help.

4) Exercise: If you have time, exercising is a great way to relieve and manage stress.  Exercise has been proven to improve ones mood.  It also provides a distraction from problems and is an outlet for frustration.

5) Create a Schedule: Creating and maintaining a schedule helps keep you on track and focused.  A schedule can aid you in seeing what you have time for and what you don’t have time for.  It prevents you from over booking activities and making commitments you cannot keep.

6) Me Time: “Me Time” is time devoted exclusively to you and is vital in managing stress.  “Me Time” provides an escape to do anything you want.  During this time you no longer have to worry about the stress of work, family, financial problems, etc…  You are freed from the stressors in your life.

 Managing stress can be difficult and affect the quality of you life, which why it is crucial to find a way that best suits you.  Proper management of stress leads to a happier and more fulfilling life. 

Do you have any stress management techniques to add? Have you used any of the aforementioned techniques before and have they helped?

About The Author:

Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog. 

Regional Health Information Organizations have a Long Ways to Go

In reading about Regional Health Information Organizations (RHIO), it is interesting to note how colossal and incredibly complex some possible solutions seem.  Health information exchange (HIE) is the goal of these organizations along with facilitating improvements in healthcare.  Unfortunately, many of the proposals being ping-ponged about today lose track of this goal due to financing, collaboration, and planning issues.  Currently, this movement and the technology are still largely in the visualization and troubleshooting phase.  There never has been a one-size fits all solution that could cure the health care system, and yet that is how many innovations including Electronic Medical Records, Computerized Physician Order Entry (CPOE), and RHIOs are presented.  It is important that development and application do not interfere with the health care process.  As a distant goal, HIE is an excellent idea that has the potential to facilitate a lot of positive developments, but perhaps on a smaller scale.  As a more immediate endeavor, it is presenting with mixed results and stumbling on issues like implementation, usability, and lack of collaboration.   

While each individual HIE endeavor and its successes and failures are unique, collaboration is an element that should be included in business plans more and more.  Many health care professionals continue to maintain that patients, consumers, physicians, IT professionals, and accountants should all be a part of discussion, development, and usage of RHIO and HIE.  In his article, “Health Improvement Technology,” Dennis Schmuland, M.D., writes, “The fixation of the industry and health information technology community on digitizing and exchanging health data and information has caused the industry to undervalue the breakthrough possibilities of collaboration technologies.”  Technology provides a means to achieve, but health information exchange cannot occur without participation from all parties involved.  Here in Milwaukee County, a major part of the Emergency Department Linking Project was an agreement and collaboration between the “CEOs of all the major health systems in the Milwaukee metropolitan area to commit to the project” (Hagland 1). 

Per the ED Linking Project Information Paper, “The primary goal of the ED Linking project is to provide patient health information where currently there often is none or very little available to help ED and Community Health Center clinicians in Milwaukee County provide patients quality, safe, and cost-effective health care” (Webb 1).  Initially, the project focused on sharing information on patients and visits to the emergency department.  Laboratory results, medication data, and insurance information will eventually be exchanged as well, if they are not already a part of this project.  Perhaps what hurts health information development most is extremely aggressive deadlines which make agreeable growth and collaboration between vendors, IT professionals, doctors, health care providers, and patients.  The incremental approach Milwaukee’s ED Linking project has taken allows for adjustment, adaptation, and room for growth.  According to Dr. Mark Friesse, Professor of Biomedical Informatics at Vanderbilt, “Every state is doing great things.  Everyone is teaching us a different part of the answer” (Blair 6).  In some ways, this may broaden perspectives and help piece together a model RHIO or HIE to build off.  Undoubtedly, some will chalk this up to progress being made, but real progress might more clearly be made via collaboration and real health information exchange. 

Unfortunately, there is no shortage of obstacles to tackle and issues to understand surrounding RHIO and HIE foundation.  If everyone was equally motivated, eager to learn, and up to date with the state of health care, modernization might be much to easier achieve.  Kind of like a science fair, this phase will undoubtedly have more successes and flops.  Establishing more meetings to initiate these exchanges is a good way to enable health information exchanges.  There are groups that focus solely on idea sharing, learning experiences, and problem solving dialogue for these reasons.  Listed below are some examples:

1. North Carolina Healthcare Information and Communications Alliance Inc.   http://www.nchica.org/
2. HIE Seamless Exchange Solutions  http://www.hielix.com/

What do you think?  Should there be more collaboration among RHIO development? Please, do hesitate to chime in and share your thoughts. 

About The Author:

Mario Raspanti is a Staff Writer with the Clear Medical Solutions Communication Team.  His work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.  

Bibliography:

Blair, Robin.  “RHIO Nation.”  Health Management Technology:  The Source for Information Systems Solutions.  February 2006.   http://www.providersedge.com/ehdocs/ehr_articles/RHIO_Nation.pdf

Hagland, Mark.  “From Struggles to Success:  Part technology, part cooperation and part good old fashioned trial and error are what it takes to build or break a RHIO.”  Healthcare Informatics.  http://www.healthcare-informatics.com/ME2/Sites/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=AE404FB40DFE434B91B79D9C2AD6BF50&SiteID=Main%20Si_e

Schmuland, Dennis.  “Health Improvement Technology.”  Health Management Technology:  The Source for Information Systems Solutions.  May 2009.  http://www.healthmgttech.com/features/2009_may/0509_health.aspx

Webb, Denise.  “Emergency Department Linking Project Information Paper.”    <http://ehealthboard.dhfs.wisconsin.gov/materials/materials/EDLinkingProjectInformationPaper06102008update.pdf>