Category Archives: Resources

How Can A Healthcare Informatics Professional Improve A Healthcare Facility?

As a medical professional with a masters in health informatics, one would be tasked with documenting, storing, managing and using the available medical data to improve the condition of healthcare facilities at an institution. In fact, their roles have now become indispensable in any modern facility as the systems associated with managing data are becoming more and more complex with each passing day. To understand how the health information specialists are instrumental in shaping a better tomorrow for patients and the healthcare industry as a whole, let us discuss the following points.

Diversity in Knowledge and Practice

During an online MSHI degree course, a student has to go through diverse fields of study which will include but are not limited to IT security, database management, information systems, medical coding and, of course, relevant healthcare studies. They use all of this knowledge and the associated training in combination with each other to locate, organize, store, interpret, secure, and utilize massive volumes of medical data on a regular basis. As one can imagine, this essentially makes an expert HI professional one of the most important people in any medical facility.

What Else Can They Do Other than Sorting Data?

Every good HI professional does much more than just sorting medical data, even though that in itself is a very demanding job. The following are a few examples of what else the Health Informaticist often brings to the table when they join an establishment.

  • Data analysis that help administrators take decisions
  • Suggestion and development of various new improvements in terms of patient experience on the basis of data interpretation
  • Suggestion and development of strategies to cut down on expenses based on intel, data, and collaboration from other departments at the facility
  • Development and implementation of systems that measure how effective the current system of patient care is, based strictly on data
  • Interpretation and communication of medical data across departments for smoother and faster workflow

Growing Demand

The demand for healthcare informaticists are at an all-time high as more and more positions for health information resource managers, clinical data analysts, IT consultants and Health Information directors are opening up. Hiring agencies mainly include government hospitals, private hospitals, clinics, government/private agencies, and consulting firms. Technology is now an inseparable part of medical science and without the people with knowledge in multiple departments, it is slowly becoming an impossible task to manage everything efficiently.

As healthcare informatics is an interdisciplinary field of study, most experts suggest that future professionals should opt for an online program as it allows them to complete the necessary training while completing another course in some other field. For example, a trained nurse who has also completed an online MSHI program doesn’t only have much better career opportunities in the future but he/she can also become an asset to any organization. The only thing to keep in mind is that the degree should always be completed from a reputable university with the necessary affiliations that ensure quality education.

Should My Clinic Have A Social Media Account?

In today’s world, it seems that everyone is on social media.  The potential audience is gigantic, and many organizations consider joining social media as a way to expand their reach.  Unfortunately, many do not realize that simply creating an account isn’t enough.
Instead, social media requires commitment. People are more likely to “follow” pages that have consistent posts with helpful information.  In your organization, someone will need to regularly manage and post to the account.  If the organization’s social media page looks incomplete or abandoned, visitors will move on.  Before committing to a clinic social media account, take time to identify the desired goals are.

How do your current patients find information?

Ultimately, you want to be active in spots where your patients are.  If your target patient population does not use social media to find their information, it may not be the right primary channel to invest in.  Instead, social media efforts could come secondary to other marketing efforts.

Who will follow your social media account?

Answer this question with as many specific as possible.  Healthcare organizations usually target their social media content either to patients or caregivers. It’s possible to have a successful social media account that targets patients or caregivers.  An internal medicine clinic may target patients directly.  A geriatric medicine clinic may target its social media content to appeal to the patient’s family, instead of directly to the patient.

How will this account benefit your practice?

Connecting with current and potential patients should always be the primary goal of clinic outreach efforts.  Social media could be the best channel to help accomplish that. Write down your specific goals for social media.  Are these realistic?  Do these make sense? Before creating an account, you should ensure that your organization is comfortable with the potential return on investment.

How will this account benefit your (potential and current) patients?

When done strategically, social media accounts have incredible power to connect and share information.  Describe what information your organization would share on its social media account.  Write down a list of subjects that you’d cover.  List how frequently your organization would post.

For people, businesses, and healthcare organizations, social media is a powerful tool that hold the promise of expanded reach and influence among target audiences.  Yet social media accounts take time and energy to maintain.  If you’re struggling to answer the questions listed above, it may be a sign to postpone creating an account.

5 Questions about the American Healthcare System

Healthcare reform is a contentious issue in American politics.  While a few presidents—Lyndon Johnson, Bill Clinton, and Barack Obama—have signed laws that changed the American healthcare landscape, the system is still imperfect.  With the new Trump administration, the future of healthcare policy remains unclear.  Some of the changes (i.e. Medicare and the Affordable Care Act) may be in jeopardy.Picture-1000words(442x400)

Below are answers to some important questions about the American healthcare system.  In order to play a part in the continuing conversation about healthcare reform, it’s important to understand the current status of the American healthcare system.

Question: What makes the American healthcare system different than other healthcare systems?
Answer: The American healthcare systems offers a lot of choice for potential insurance coverage, private plans, and public plans including Medicare, Medicaid, Veterans benefits, and the Children’s Health Insurance Program.  Despite all of those choices, America is the only wealthy country without universal coverage.   Additionally, the American healthcare system has higher usage of expensive medical technologies—like MRI machines.

Question: Where does the American healthcare system rank on the list of world healthcare systems?
Answer: The World Health Organization’s 2000 report ranks the American healthcare system as 37th in the world—behind every other wealthy country.

Question: How much does the United States spend on healthcare every year?
Answer: In 2013, the United States spent approximately $9,000 per resident (or 17.1% of the gross domestic product) on healthcare costs.  France spent the second highest amount of money on healthcare, approximately $4,300 per resident and 11.6% of its GDP.  With the lowest healthcare spending levels, the United Kingdom spent 8.8% of its GDP or approximately $3,300 per resident.

Question:  Doesn’t higher spending means that Americans get better healthcare?
Answer:  Not necessarily.  The American healthcare systems provides quality care that is similar to the care provided by other wealthy countries.

Question: If the care is comparable, what are the higher costs for?
Answer:  There isn’t one answer to this question.  There are a range of contributing factors including: widespread use of expensive medical technology, the fee for service model, and higher volumes of patients.

Healthcare policy continues to be a contentious issue in American politics.  Citizens, experts, and politicians have spent decades debating what changes will reform the system.  Yet this is not simply an issue for the politicians.  Stay informed about the discussion surrounding healthcare reform.  These changes will eventually impact the lives (and futures) of many Americans.


Baribault, Maryann and Casey Cloyd. Health Care Systems: Three International Comparisons. EDGE: Ethics of Development in a Global Environment, 26 July 1999, https://web.stanford.edu/class/e297c/poverty_prejudice/soc_sec/health.htm. Accessed January 22, 2017.
Comparing International Health Care Systems. PBS News Hour, 26 October 2009, http://www.pbs.org/newshour/updates/health-july-dec09-insurance_10-06/. Accessed January 22, 2017.
Murray, Christoper J.L., D Phil, and Julio Frank. Ranking 37th—Measuring the Performance of the U.S, Health Care System. The New England Journal of Medicine, 14 January 2010, http://www.nejm.org/doi/full/10.1056/NEJMp0910064. Accessed January 22, 2017.
The U.S. Health Care System: An International Perspective. Fact Sheet 2016. DPE. Department for Professional Employees. AFL-CIO, http://dpeaflcio.org/programs-publications/issue-fact-sheets/the-u-s-health-care-system-an-international-perspective/, Accessed January 22, 2017.
U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries.  The Commonwealth Fund, http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective. Accessed January 22, 2017.
World Health Organization’s Ranking of the World’s Health Systems. The Patient Factor: Your Voice in the Health Care Equation, http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/. Accessed January 22, 2017.

4 Reasons Why You Should Share Financial Goals with Staff

There are two sides to the American healthcare system: financial and patient care. While most staff recognize the existence of both, few are aware of their organizations financial goals.  In almost all offices, there are at least two people—the clinic manager and the medical director—who know the organization’s patient-care and financial goals. Smart healthcare leaders share financial information with their clinic staff.  Failing to share this information is a mistake.FL83630

After all, it’s difficult to expect a clinic team to collectively work to accomplish goals when they aren’t aware of them.  Here are responses to some common objections to sharing financial goals with clinic staff.

Objection: What are financial goals?

Response:  Financial goals are the targets that your clinic is reaching toward. Is it a decrease in the no show rate?  Is it an increase in payments from providers?  The specifics vary between organizations.  Summarizing information on financial goals should be easy.  If it cannot be described in a few sentences, continue simplifying until it can.

Objection:  My staff don’t need to know about the organization’s financial goals.

Response:  Many medical directors assume that their staff are uninterested in the larger goals of the organization. That’s not true. Since staff receive paychecks, they already have a vested interest in the financial success of the organization.

Objection:  It doesn’t benefit the organization to share the financial goals.

Response: When managers don’t share information on goals, they actively prevent their staff from assisting.  Since goals cannot always be easily achieved, smart managers recruit their staff to help reach them. Staff suggestions won’t always work.  Frequently, a staff member offers a solution that the managers hadn’t considered.

Objection:  Our first priority is patient care.

Response: Perfect.  Healthcare organizations should focus on providing high-quality patient care first.  The two goals are not mutually exclusive.  Staff can provide high-quality patient care and also be aware of the financial goals of the organization.

Finances and patient care make up the two sides to the American healthcare system. One cannot exist without the other.  Staff realize this, yet many managers still fail to share financial goal information with staff.  Reaching goals takes concentrated effort.  Smart healthcare leaders will share this information with staff to ensure that there is as much brainpower as possible working to achieve goals. Managers who fail to share the information intentionally limit their chances of success.

How To Quickly Capture Health Insurance Changes

Jobs change; marriages happen; children are born; open enrollment starts. Throughout the year, a patient’s health insurance coverage can change via these four options or many more. Although most organizations focus on updating insurance information each January, it’s important to do it year round. Capturing accurate insurance information ensures smooth clinical operations and medical billing. Use these five resources to prioritize catching health insurance changes as they happen.

Image by Wellness Corporate Solutions (www.wellnesscorporatesolutions.com)Front line staff: Staff the front desk with smart, well-trained healthcare administrative employees.  Since they frequently talk with patients, these staff members play a vital role in capturing a patient’s insurance. Instruct these staff to ask the patient to confirm their insurance when scheduling appointments and at check-in.  Train these staff members on how to properly update a patient’s insurance, either in the patient’s file or in the electronic medical record.  Also teach these staff members how to use resources to

The patient: Most patients come to the doctor’s office prepared.  They should be able to tell you which insurance they have, and what their identification numbers are.  If they are unable to provide proof of active insurance (i.e. a health insurance card), front line staff should be aware of the preferred course of action.  For example, some organizations will allow the patient to check in with the promise that the patient will update it later.  Other organizations will instruct staff not to check in the patient without proof of insurance.

The patient’s insurance card: Although they like to change things all of the time, there is one thing that healthcare organizations can count on.  And that is the fact that a patient’s health insurance card will be a treasure trove of information.  Typically, this is where you can find information about a patient’s member and group identification numbers as well as the billing address to send the bills to the insurance company for processing.

An updated list of health insurance changes:  Create a list (or another tool) that captures the insurances that an organization is contracted with and the ones that the organization is not contracted with. This tool should be available to all staff members who update or work with a patient’s insurance.  Since changes frequently happen, regular updates to this tool are required.

Access to an eligibility portal: Investigate if there are online eligibility portals that staff can use to confirm eligibility or referral authorization.  These are time saving tools, because it minimizes the number of times that staff have to call a patient’s insurance.

Regardless of size, it is important for all organizations to quickly capture any insurance changes for a patient.  After reading the list, take a moment to consider what is working well and what could be better.  Adjust as needed.

The Role of the Social Worker

See Social Worker Openings Here!

Social workers play an important role on care teams, because they can do psychosocial assessments for patients.  Often these assessments identify outstanding challenges that a patient is facing.  Then social workers can work collaboratively with the patient and provider to provide guidance and education to improve patient experience and outcome. For those who do not regularly work with medical social workers, here is an overview of their role.

Social Worker

What Settings Do They Work In?
Depending on the organization, social workers can be found in outpatient and inpatient settings.  One social worker may be on staff at a clinic with a vulnerable population.  Other social workers may work with a variety clinics to support patients as they move between departments.  Precise staffing of social workers depends on the needs throughout the individual health care organization.  Nursing homes also have social workers who support the facility residents and their families throughout their stay.

What Do They Do?
Usually, social workers only see the patients who have been referred to them.  During the first conversation with a patient, a social worker typically does a psychosocial assessment.  The results of this assessment help to determine what support the patient needs from the social worker.  Although patients will need different levels of support, social workers will usually assist with care coordination and behavioral health services.

Care coordination needs vary.  Some patients will seek continuing care within the same organization.  Others will return to their established provider.  Another group of patients will need to identify new providers to transition care to.  While specifics differ, social workers can help coordinate a patient’s care in each of these scenarios.  When needed, they will guide the patient through the organization’s medical records release process.  Additionally social workers may contact outside organizations to discuss a patient’s medical care or identify appropriate providers to transition care to.

After an initial assessment, a social worker may offer continuing behavioral health services to a patient depending on their needs.  As a part of an interdisciplinary medical team, social workers will work collaboratively with other providers to identify and address issues that need continuing support.

What’s Their Educational Background?
Social workers in health care settings typically have a master’s degree in social work.  To provide clinical care, they must be licensed with the state’s department of health.

 

By providing psychosocial assessments, social workers can identify challenges and support a patient as they navigate the health care system.  The insights from a medical social worker can help patients achieve better outcomes.


Healthcare Social Workers. United States Department of Labor: Bureau of Labor Statistics, 30 March 2016, https://www.bls.gov/oes/current/oes211022.htm. Accessed February 10, 2017.
Medical Social Work. Wikipedia, 7 December 2016, https://en.wikipedia.org/wiki/Medical_social_work. Accessed February 11, 2017.
Social Workers. United States Department of Labor: Bureau of Labor Statistics, 17 December 2015, https://www.bls.gov/ooh/community-and-social-service/social-workers.htm. Accessed February 11, 2017.
Social Work Profession. National Association of Social Workers, https://www.socialworkers.org/pressroom/features/general/profession.asp. Accessed February 11, 2017.

How to Understand 3 Types of Health Insurance Changes

Open enrollment, contract negotiations, and documentation changes impact a patient’s health insurance.  Sometimes the changes are big; sometimes they’re small.  Since healthcare organizations see hundreds or thousands of patients, it’s important that to understand and prepare for each type of change on a large scale.

Open Enrollment:  During open enrollment, patients can change their insurance plans or coverage levels through an employer sponsored plan or through a health insurance exchange.  Employers may also announce that they’ve changed the company that provides benefits to their employees.  In this scenario, the patient is aware of the voluntary or involuntary change.

Contract Negotiations: Annually, many healthcare organizations may renegotiate contracts with insurance companies for the following year. These discussions frequently relate to changes in reimbursement rates and patient coverage levels. Proactive patients will often be aware of the upcoming changes, but other insurance plan members may not be aware of the changes.  When organizations and insurance companies terminate their contracts, it’s important to identify all affected patients as soon as possible.  Although this is rare, it may mean that the patient needs to transfer their care elsewhere in order for the insurance company to pay for it.

Minor Documentation Changes: Although the biggest changes happen early in the year, insurance companies regularly make changes.  These minor changes often impact a slim percentage of patients in a particular situation.  With these month-to-month changes, the insurance companies are typically requesting more or different documentation from healthcare offices before the company will authorize a particular aspect of the patient’s care.

Responding to these Insurance Changes

Front line staff can capture most insurance updates by asking the patient about their insurance information.  Anyone who schedules or checks in patients should routinely confirm the patient’s insurance coverage with every visit.  If possible, staff should also copy the insurance card to store in the electronic medical record or in the patient’s file. Generally, staff should copy a patient’s insurance card at least once per year or more frequently if it changes.  A few organizations copy the insurance card at every visit.  Since patients won’t be aware of contractual or documentation changes, offices should have a resource to track monthly and annual insurance changes. This system should be easy for front line staff to use in real time. Also, it should be detailed enough for billing or pre-authorization staff to use as a resource. Larger organizations may choose to go with a searchable web resource while smaller offices may choose to create a simple list.  Organizations will tailor the resource to fit their institutional needs.

8 Steps to a Successful Referral Process

Every day outpatient clinics write and receive dozens of referrals. Staff will spend a significant amount of time processing these referrals and contacting patients.  A simplified system that considers organizational requirements and technological limitations can save staff hours and ensure quicker processing turnaround.  Here are 8 steps to take to craft a successful referral process for your clinic.

More than 100 openings for admin staff!

Step 1: Organizations often have referral standards that clinics are expected to meet.  These standards should be easily accessible.  If you can’t find them, ask your clinic manager. As leaders in the organization, they should know the standards or where to find them. .

Step 2: All systems have technological limitations.  Identify what is realistic with your current resources. Does your clinic receive referrals electronically, via fax, or via mail?  After the referral is entered, are physical files kept?  Or is the information uploaded into an electronic medical record?

Step 3: Consider how referrals flow through your clinic. Are there any bottlenecks in the current process?  Talk with other clinics to ask about their referral process and any associated challenges.

Step 4: Ask the employees who currently work with referrals for their feedback on the current system.  These employees can identify challenges and potential solutions that will assist you in creating a new system. .

Step 5: Reflect on what you’ve learned, and draft a new process.  Instead of delegating it to another staff member, try the new system out for yourself.  If that’s not possible, sit with a trusted staff member while they try it out.  Collectively work to identify and solve any immediate challenges. When ready, share with the rest of the staff.

Step 6: In many organizations, clinical and non-clinical staff both handle referrals.  Ask for feedback from each staff member.  Adjust accordingly.

Step 7:  Begin entering referrals and contacting patients using the new system. .

Step 8: Remain open to criticism.  All systems will require periodic tweaks to make sure they remain relevant and helpful. Recognize that many electronic medical records systems track turnaround times between receipt of referral, processing, and contacting the patient. If this information is available, use it to determine if you’re meeting the desired goals.
Referrals play an important part of the American healthcare system.  Creating a system that works for your clinic while also meeting organizational standards is challenging and possible. Use these 8 steps to identify standards and limitations, and then craft a successful referral processing system. Commit to continuous improvement of the system to ensure that patients are being contacted as quickly as possible.

Four Qualities to Look for in Interviewees

Managers know that interviewing, hiring, and training to fill open roles takes significant time and investment.  In most healthcare roles, staff are required to interact daily with vulnerable and agitated patients. Given this daily reality, it’s important to determine as quickly as possible how a candidate will handle stressful and unexpected situations. Here are four qualities to look for during the interview process to help with hiring decisions.

Punctuality: Regardless of industry, all managers want their employees to be ready to work on time. Tardy employees create more stress for their managers and co-workers.  For interview candidates, this should be the easiest standard to meet. Allow extra time to get to the interview. If something unexpected happens, call the hiring manager to inform them. Most hiring managers will allow candidates to arrive late if circumstances are outside of their control.  Candidates who are late without prior notification or apology should be considered cautiously.  It may be a one time occurrence, or it may be a pattern.

Communication: Successful healthcare employees should have strong oral and written communication skills.  Arranging interviews over email allows managers to see firsthand how candidates use written communication.  During the conversation, managers will have clear examples of how the candidate communicates orally.  In both cases, consider the tone, efficiency, and professionalism of the communication. Most adults should already have a firm understanding of how to communicate in the workplace.  If the candidate doesn’t already meet organizational communication standards, then consider whether or not this would be the right person to fill the open role.

Response under pressure: Healthcare is an unpredictable industry.  Patients arrive with a need and medical providers and staff need to respond.  These general scenarios can be urgent, escalated, routine, or unexpected.  Before the interview, consider the environment of the organization.  Note any frequent stressors and ask how the candidate would respond to these stressors during the interview.

Problem solving: Some healthcare organizations exclusively use behavioral based interview questions that require candidates to provide examples in their answers.  Regardless of the type of questions, any hiring manager should ask the candidate to provide examples.  Then listen to their answer.  If it’s still unclear how they arrived at a decision, continue to ask follow up questions.

 

Healthcare hiring managers should use these four qualities and other organizational requirements to determine whether or not a candidate will be a good hire. Eventually managers will learn to recognize strong candidates during the interview process.

Four Situations To Prepare For At Clinic Front Desks

Working at a clinic front desk is challenging.  The patients see these staff members first, and the front desk is where patients ask questions and express frustrations. Often patients form their first impressions of an organization based on these initial interactions with these staff.  Here are four situations and how clinic staff can prepare for them.

Late Patients
Situation: Life happens.  Sometimes people have the best intentions to arrive early, and it doesn’t happen.  Other times, there was no chance that a patient could have made it on time. In both cases, the patient comes to the front desk first for guidance.

How to Handle: Staff should know the clinic policy.  Organizations vary widely.  Some allow patients to check in 15 minutes after their appointment; others require an early check in. Ask what your policy is.  Are there any exceptions?

Traffic and Parking
Situation: Traffic is unpredictable. Parking isn’t always available or free.  Depending on the clinic location, some patients drive for hours to reach their appointment.  Unexpected traffic or parking problems are additional stressors.

How to Handle: Clinic staff members don’t control traffic or parking.  Patients know this, and will still express their frustrations.  This cannot be completely avoided.  To minimize the confusion, tell patients about specific traffic challenges or parking availability when scheduling appointments.  On the appointment day, if a patient shares their frustrations, listen.

Paperwork
Situation: Doctors ask patients to fill out paperwork.  Patients are frustrated by seemingly repetitive paperwork. Staff at the front desk provide the paperwork and encourage patient to complete the forms.

How to Handle:
Some patients will come prepared. Others won’t.  Advise patients about what additional information is needed at the time of scheduling.  Will they get a new patient packet?  Do they need to bring medical records? Stock extra copies of required forms, so staff can provide additional copies to unprepared patients.

Phone Calls
Situation: Patients call with requests ranging from routine paperwork questions to urgent medical needs.  In many organizations, the front desk staff answer a bulk of the phone calls.

How to Handle:  Always be polite. Ask patients to identify themselves early in the conversation. If needed, ask for clarification. Staff should be prepared to reply to a variety of different questions.  When asked a question that you don’t know the answer to, say, “That’s an interesting question. I’m not sure of the answer.  Let me find out.”

Although it’s challenging, working at a clinic front desk provides a variety of things to do and people to meet.  Preparing staff for these four situations helps ensure a positive experience for both patients and staff.