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Interview with Kathleen Benner Part III: Doctors Need to Listen More Than 18 Seconds

Posted by ClearDirections on April 12th, 2011 in Communication, Financial, Hospital Management, Innovation, Lack of Coordination | No Comments

After reading about Kathleen Benner, the vibrant and energetic president of Hospital Companions and Empowering Pages, both of which are based in Hinsdale, IL, in a Crain’s Chicago Business article last year, I connected with her to find ways to help her healthcare startup. She also is an attorney and mother of three with her entrepreneur husband, all who keep her balanced. To view more about her healthcare businesses, visit http://hospitalcompanions.com/ and http://empoweringpages.com/. Her companies’ mission is to bring peace of mind to both the patients and families they serve. Read on to hear more about her ideas to help you become a “Best Competitor.”

Stillman: Any other overall suggestions for improving America’s healthcare system, not just looking at the patient experience?

Benner: Of course. I can’t say it loudly enough: medical malpractice reform. It’s coming from a legal background and reading some of the cases. Yes, there are some horrendous things that happen, of course. But, we have to reform that system. It is dragging on costs. It is putting insurance companies in a much more difficult position and the doctor in a much more difficult position. That would be my first recommendation.

I have never written to a senator or President before, but when they were doing the healthcare reform talk, I wrote to the President, to my senators and my representatives and said, “How are you not talking about medical malpractice reform as an integral part of this?” To be able to improve, you have to remove the shackles of malpractice.

The other issue is insurance portability. My husband and I are both self-employed, so our healthcare insurance is our single largest payment every month. I don’t know why I can’t shop in North Dakota for insurance. You know what I mean? Why can’t we compete across state lines? More competition seems to be better. These companies already exist. They’re already providing this type of a service.

You know, my parents went through the same thing when were moving from Illinois to Florida when they had to obtain new insurance from Florida. I think that the portability of your insurance and to be able to compete over state lines would help the healthcare system, because again, you’re going to be approaching costs at that point. More competition would lead to better insurance programs being developed.

Stillman: I have to admit, I never had to think about that in terms of switching from state to state. I wasn’t aware that when you move that you would have to switch insurance.

Benner: The other thing that’s crazy is the volume of patients physicians see in a day. Some physicians I know are seeing 45 to 65 patients a day. How do you provide personalized, effective healthcare to 45 to 65 people a day?

Stillman: That’s pretty much the norm, and some think nothing of it. I agree. How could you possibly connect with 45 to 65 people in one day, and affect their health status in a meaningful way? At some point, it would seem impossible for them to see their patients as anything more than widgets. I have to imagine at the end of a long week, some think, “How many more are we just going to touch and get through the assembly line so I can get out of here?”

Benner: Yes. I read a study that a doctor lets a patient talk for 18 seconds before he or she typically interrupts them. That’s the average. So, some doctors are treating people literally how they present in that moment, but they’re not looking any further back or forward in the lives of their patients. And, that’s not really healthcare. That may be medical care. That’s not healthcare.

Stillman: Wow, 18 seconds. That’s an interesting statistic. Certainly if you want to have a competitive edge as a physician, let your patients talk, and listen. That’s easy.

Benner: They don’t have time. And, you know when people talk, and I know this as an attorney, too, you’ll get a lot of superfluous information. And, you’re trying to dig through it just for what’s important. You want the bullet point. But, that’s not an effective way to get the information a physician needs to effectively treat a patient, right?

In our next post, you’ll hear more of our interview with Kathleen Benner of Hospital Companions and Empowering Pages. Subscribe to the Best Competitor Blog to read stimulating ideas for improving the American healthcare system and ways hospitals, systems, large medical groups and healthcare product manufacturers can better compete in today’s marketplace. We welcome your suggestions for future interview subjects or topics. Simply leave a comment below. We’d love to hear from you!

Interview with Kathleen Benner, Part II: Stars in the Long-Term View Include Delnor in Geneva, Ill.

Posted by ClearDirections on March 29th, 2011 in Communication, Hospital Management, Lack of Coordination | No Comments

After reading about Kathleen Benner, the vibrant and energetic president of Hospital Companions and Empowering Pages, both of which are based in Hinsdale, IL, in a Crain’s Chicago Business article last year, I connected with her to find ways to help her healthcare startup. She also is an attorney and mother of three with her entrepreneur husband, all who keep her balanced. To view more about her healthcare businesses, visit http://hospitalcompanions.com/ and http://empoweringpages.com/.  Her companies’ mission is to bring peace of mind to both the patients and families they serve. Read on to hear more about her ideas to help you become a “Best Competitor.”

Stillman: Where have you seen a lot of advancements in healthcare, such as in the hospital environment, like the Planetree model and effective use of the medical home?  Are you seeing a lot of that in the Midwest in the hospitals you’re talking with here, or more in different pockets of the country?

Benner: I have to say that Delnor’s a Planetree hospital, and we’ve been out there once, and that’s a great environment.  Central DuPage Hospital has instituted some new concepts when they built their new wing and really made it a more comfortable kind of family-enhanced atmosphere.  The best place that we have seen, the leading edge, is Mayo in Phoenix.  They do a damn good job.  It’s a team approach, and it is a medical home team, and the team gets together and talks.  They do a real fine job escorting the family coming out, and keeping the communication in a big file together for the doctor that you’re going back to.  That doctor is always welcome to call.

Physicians who have reached a pinnacle in their career and are very good at what they do seem much more open to helping others.  Those who are the best in their field seem to feel this obligation to spread their knowledge, and they do.  They do a nice job at Mayo, which is not a surprise.

Stillman: That’s great to hear, because I do find that there are pockets of expertise in the country, and I think that the Midwest by far has quite a bit of work to do compared to the coasts and the South.  I know from looking at many hospital organizations, looking at new buildings as far as just green design and Planetree design, there’s not a lot of it here.

Benner: You would think that they would have at this point figured out that their bottom line will be affected.  Now, I know it’s not a direct effect necessarily, but I know when I had a heart issue a couple years ago, I found the best darn heart doctor for the electrical issue I had.

I ended up at University of Chicago, with the best doctor, but not the best care environment.  Now, if I were to do it all again, would I go back to him?  Yes, I would, because we’re talking about my heart.  But, if I am going to have an chronic issue where I’m was going to be in and out and need care, and I’ll need support, my family will need support, you really, if you have a Planetree approach or a patient-centered care approach, you are going to get a better outcome.

So, maybe hospitals aren’t seeing it because the urgency versus the experience.  As educators in the industry, we need to create that nexus for people between experience and outcome.

Stillman: I believe one of the problems is that view is not long enough.  The leadership is looking at today’s bottom line versus someone’s long-term health status, and it is easy to forget that the impact they have today on someone’s health for the rest of their lives. So there’s just no incentive because the hospital leadership is incentivized to keep this year’s bottom line intact.

Benner: Right.  Now, if they’re having a wonderful experience and there’s good communication, they’re going in for their follow-up.  They’re not readmitted.  So yes, if we could create a nexus where you show the effect and bottom line impact, we’d be able to change how the hospital business is run.

Stillman: Longitudinal projections of how a good experience today impacts your health 20 years from now, and then be able to quantify that.  I think that would be an amazing study.

In our next post, you’ll hear more of our interview with Kathleen Benner of Hospital Companions and Empowering Pages.  Subscribe to the Best Competitor Blog to read stimulating ideas for improving the American healthcare system and ways hospitals, systems, large medical groups and healthcare product manufacturers can better compete in today’s marketplace. We welcome your suggestions for future interview subjects or topics. Simply leave a comment below. We’d love to hear from you!

Interview with Kathleen Benner, Part I: Enable Communication in New, Meaningful Ways

Posted by ClearDirections on March 16th, 2011 in Communication, Hospital Management, Innovation | 5 Comments

After reading about Kathleen Benner, the vibrant and energetic president of Hospital Companions and Empowering Pages, both of which are based in Hinsdale, IL, in a Crain’s Chicago Business article last year, I connected with her to find ways to help her healthcare startup. She also is an attorney and mother of three with her entrepreneur husband, all who keep her balanced. To view more about her healthcare businesses, visit http://hospitalcompanions.com/ and http://empoweringpages.com/.  Her companies’ mission is to bring peace of mind to both the patients and families they serve. Read on to hear more about her ideas to help you become a “Best Competitor.”

Enable Communication in New, Meaningful Ways

Stillman: Kathleen, tell me a little bit about your businesses, Hospital Companions and Empowering Pages.

Benner: They’re pretty self-explanatory by the titles as well, but Hospital Companions, is  that service, in a service industry, we provide companions for people who are in the hospital, to better support the family and the patient.  So, we have a companion that can go along with a patient all the way from check-in to getting them settled in, staying with them during their stay, check-out and transitioning home or transitioning to rehab.

We don’t do home care, but we do offer institutional care.  So, if you’re in a hospital, if you’re in a rehab center, a nursing home, we’re able to help and assist and become part of that care team.  We don’t provide healthcare.  We fall more on the spectrum of logistical and emotional support.

So, we offer many amenities and supports for patients and families, such as our web application, called a Patient PageSM, it’s a web-based communication tool that keeps family ,friends, patient and the companion engaged in  very effective and efficient communication.  That’s one of our tools.

And, we do everything from travel arrangements for out-of-town family who come in.  We make sure that when family is around, they know the lay of the land.  They know, okay, where is the cafeteria?  What time does it open and close?  Where is the best place to park?  We view our mission as to make this experience, a hospitalization experience, as easy as it can be.  We try to take the little bumps in the road and smooth those out.  The medical team, of course, is attacking the larger issues.  What we’re trying to do is best support the patient and their family through this so that they have more strength on the other end when they’re going to have to do the healing.

Stillman: I love that, more strength on the end when they need to do the true healing after the hospital.  That’s great.

Benner: Yes – recovering doesn’t end right when you’re discharged from the hospital.  You’ve been in the medical community.  You know that when you’re discharged from the hospital, you’re not well.  You are just not critical anymore.  You just don’t need round-the-clock medical expertise.  When they’re discharged from the hospital, people need a lot of support.  Our vision is of someday there being a cooperative experience during the hospitalizations with the families and even once at home with the hospital.  So, if we are better able to support the family, they’re better able to support the patient, and the patient will get better faster.  We don’t have exact data on that, but it’s kind of common sense, so we believe that.

Then, we developed this web application, the Patient PageSM, because we found communication really to be the lynchpin.  The better communication, the better the outcomes will be.  We strongly believe that.  The web application was so popular and such a hit with all of our families, and they gave us lots of input as to what they’d like to see on it. So, we have tweaked it over the couple years that we’ve been using it, and this application became such a useful tool in our business, we decided to offer it to other healthcare companies.  . If they would like to license the application then they are able to brand and offer their own Patient PageSM, resident page, homecare page or patriot page.

The people that we’ve been talking to are mostly in home care, so you can get a branded home care page for your home care company.  We don’t offer home care, but we deal with a lot of home care people because we transition out of hospital.  Now, if someone had a Patient PageSM up in the hospital, it would be so great if they’re transitioned to a home care company where that home care helper could update the page, or the manager at the home care company could update the page, and keep family and friends informed and involved to continue kind of this wonderful communication that allows everyone to help support one another.

Hospice care, of course, would also be a great fit for our web application.  We’ve approached some not-for-profits to allow them to use the application.  We just launched Empowering Pages,  and we already have one program for a residential facility that’s almost ready to go active.  We think Empowering Pages has a really bright future, because better communication breeds better outcomes, which is better business.

So, we think moving it over from the consumer end where we’re using our Patient PageSM to a business-to-business model makes a lot of sense, because it’s going to impact the bottom line of these businesses that use it.  They’re going to have happier patients and families, in addition to those who join and visit the page.  For instance, if you have a home care company, and Marcy down the street has a page up, and you’re one of her neighbors.  You find out about her page, and you go on it to send Marcy a message and see how she’s doing, and see if there’s anything you can do to help. Well, now you know the name of Marcy’s home care company.  And, now when you need home care or someone you know needs home care, you know a name.

Generally, if somebody has home care, we know they have a home care visitor.  We don’t know what company they’re with because they tend to travel in private vehicles.  So, for brand identification and spreading your brand name, we think that it’s going to be a really good tool.  So, that’s Hospital Companions and then how we spun into also supporting businesses with Empowering Pages.

Stillman: When you look at your experiences, from your grandfather and your own personal experience with your children, yourself in the hospital, what programs and services do you feel help make hospitals more competitive or more patient-friendly, more patient-focused?

Benner: What I know now is different from what I knew then.  The experiences that led us up to Hospital Companions, I didn’t really see any really good programs that made the hospital competitive.  Now, because of research and being exposed and being in so many different hospitals, I see more of that.  And, the patient-centered care push is amazing.  The Planetree hospitals, some of the things that they put into effect are similar to our philosophies with environment really being part of the healing and the overall attitude of patient- and family-centered care.  Some hospitals are really doing it, and some hospitals are saying they’re doing it, and other hospitals just haven’t gotten there yet.  But, I think it’s a great program and a great goal for hospital systems.

People who are now looking into medical home and using that, I think that that is going to be amazing, and that will be a competitive advantage if hospitals institute that appropriately and there really is a medical home and a good source of communication among patient,their home physician and any specialists, pharmacists, therapists, etc. .  When someone does have a more complex medical issue and you’re shuffled specialist to specialist, you’re almost in charge of keeping the communication line open and what did the specialist say.  You’ll go back to your regular doctor, and, “Oh, what did the specialist say?”  Now, it might be in the chart, but it might not.  The objective test results will be in the chart, but will the subjective impressions in conversation?  They won’t be.

So, medical home seems to be a real good step in the right direction because, again, it addresses the communication and support of one patient.  And, better communication, better outcomes, better business.  So it really is good for, not just the patient and the doctor but, the whole health system, because patients and their family docs are communicating more effectively with specialists and there is a great ‘point person’ in the medical home physician.

Stillman: It seems to be a theme, and obviously communication is such a simple, simple task – something we’re all given the gift of … being able to speak and write.  It is the easiest thing to forget to do well, and it can cost someone’s life.

Benner: Absolutely.

In our next post, you’ll hear more of our interview with Kathleen Benner of Hospital Companions and Empowering Pages.  Subscribe to the Best Competitor Blog to read stimulating ideas for improving the American healthcare system and ways hospitals, systems, large medical groups and healthcare product manufacturers can better compete in today’s marketplace. We welcome your suggestions for future interview subjects or topics. Simply leave a comment below. We’d love to hear from you!

Healthcare Innovation … Where Does It Exist?

Posted by ClearDirections on February 26th, 2011 in Accountable Care Organization, Communication, Innovation, Legislation, Patient Protection and Affordable Care Act | 1 Comment

“For innovation to be meaningful, it must always take the customers’ point-of-view. … Innovation simplifies your business to its critical essentials. … It should make things easier for your people in the operation of your business, otherwise it’s not innovation but complication.”

-Michael E. Gerber,The E-Myth Revisited

Innovation in an industry that is being rocked by the most wide-sweeping change since the advent of Medicare on July 30, 1965, is not only important – it is imperative. With the new and continual change on the horizon under the Patient Protection and Affordable Care Act (PPACA) signed into law by President Obama nearly one year ago, all product and service providers to the care of the human body need to examine all the leverage points for their businesses/organizations. These industries that help us keep our human chassis in top shape or attempt to repair them when they are “run down and broken” stand to offer value under the proposed delivery chain of the Accountable Care Organization (ACO).

According to Elliot Fisher, MD, MPH who is credited as the father of the term, ACO, defined an ACO as such in a 2010 article on he co-authored:

ACOs consist of providers who are jointly held accountable for achieving measured quality improvements [note that “measured quality improvements” is synonymous with report cards] and reductions in the rate of spending growth. Our definition emphasizes that these cost and quality improvements must achieve overall, per capita improvements in quality and cost, and that ACOs should have at least limited accountability for achieving these improvements while caring for a defined population of patients.

So, if PPACA and ACOs stand the test of Congressional time, gone are the days of finger-pointing on why a patient’s health status doesn’t improve, and finally patients and their family members might have a prayer of a chance of better “hand-offs” (as I like to call them) through stronger accountability and communication between care providers. In fact, just this morning I helped a group of MBA students at Kellogg Graduate School of Management review their business plan for a cool new communication tool that would help hold patients and their post-acute discharge caregivers more accountable for compliance with their prescribed regimen. It’s these types of business innovations that will create the proverbial win-wins for American healthcare. So, we know healthcare innovations are emerging from America’s top business schools. Where else does innovation exist?

Few likely know that Don Berwick, MD, head of the Centers for Medicare and Medicaid Services, is overseeing the new Center for Medicare and Medicaid Innovation. The Innovation Center claims it will “consult a diverse group of stakeholders including hospitals, doctors, consumers, payers, states, employers, advocates, relevant federal agencies and others to obtain direct input and build partnerships for its upcoming work. This dialogue will center on three areas of emphasis consistent with the Innovation Center’s goals.

* Better Care for Individuals: Improving care for patients in formal care settings like hospitals, nursing homes, and doctors’ offices, and developing innovations that make care safer, more patient-centered, more efficient, more effective, more timely, and more equitable. The Innovation Center will also promote the use of “bundled payments,” a more efficient approach to paying for care where providers collaborate to manage multiple procedures as part of a single episode with a single payment, rather than the current fee-for-service method of submitting separate bills for each procedure, which leads to higher costs.
* Coordinating Care to Improve Health Outcomes for Patients: Developing new models that make it easier for doctors and clinicians in different care settings to work together to care for a patient. Examples include identifying and widely deploying the best advanced primary care and health home models, and supporting innovations in accountable care organizations.
* Community Care Models: Exploring steps to improve public health and make communities healthier and stronger. The Innovation Center will work to identify and address major public health crises and the appropriate interventions for areas of great concern, such as obesity, smoking, and heart disease.”

Sounds wonderful, right? Well, if the “freshness” of the site for The Innovation Center is any indication of how innovative this new entity will be, I’m a bit concerned. The events page doesn’t even display a February calendar and it’s nearly March. And, the latest blog post is dated Nov 16, 2010. If those like us who deeply care about the healthcare system we leave to future generations abdicate the charge for innovation to the government, this sweeping change will not happen. And, the business thought leader Michael Gerber’s definition of innovation just becomes another jargon-ridden alphabet soup served by Congress. As Gerber said, it will not be “innovation, but complication.” Innovative business leaders in this country absolutely need to step forward to help create the new American healthcare system. Maybe Michael Gerber will join the conversation with us?

A Stick in the Arm is the Easy Part

Posted by ClearDirections on February 4th, 2011 in Communication, Inconvenience, Lack of Coordination, Outpatient Lab Testing, Time Waste | 6 Comments

You would think obtaining a standard, fasting blood draw for a 9-year-old before school would be simple, right? Wrong. After spending the morning today hearing complaints about not wanting to go to the lab to endure the prick of the needle, I successfully ushered our son out the door for a blood level check required after taking a new medication for a month. Driving through the slippery, bitter cold streets of southwestern Chicago just two days after being buried in a blizzard, we found our way to a community hospital-owned outpatient lab on the way to our son’s school.

When we arrived, we were thrilled to find just one solitary person waiting in the room to be called for his test so we could be certain to avoid being late for school. However, when we presented our lab order to the registrar, she wrinkled her nose at the order from our specialist at Children’s Memorial Hopsital. Because the order had been generated by Children’s EMR and did not have a physical signature on it, the registrar’s policy said she could not accept it. I explained that the order is just as it was when I received it from our physician, however that was not sufficient for her policy. So, we left without the test as I groaned about the wasted angst for our son. The other half of this equation is that my husband had to delay his arrival at work to take our daughter to school (who would never be ready to leave earlier than necessary for school!). What a waste of his time, as well.

After this disappointment, I called our specialist’s office and the staff member there said “we don’t have this problem with any other labs.” I apologized and asked her to track down our physician to get her to physically sign the paper and fax it to our testing facility that is geographically convenient for a fasting test tackled before school during the week. She also recommended we could have the test performed in the western suburbs at a Children’s facility 35 minutes away without question. By this time, I calculated that one testing facility’s outdated policy had cost three people (the registrar, our son and myself) 20 minutes of wasted time at the facility this morning plus my husband’s lost 30 minutes at work this morning. Couple that with the Children’s staff member who took the call I wrote about and a few others in between (add 10 minutes X 2) plus the time to bother the specialist for a signature (3 minutes) and we have at least 113 minutes of life due to lack of electronic seamless discussion in healthcare.

We need to prevent this waste within the system and create a better outpatient registration experience through a higher level of coordination and communication. I invite you to share your ideas and suggestions for improving these types of situations as I know I am not the only person who experiences these. Clear Directions for Healthcare is dedicated to destroying this inefficiency in the U.S. heatlhcare system.

If you have ideas for improving America’s healthcare, I invite you to continue the dialogue here or send us a 2-minute video response that we’ll review for our video podcast. Let’s “crowdsource” our way to better healthcare for all of America. Join us!