Sunday, August 12, 2012

Self Awareness - You Can Choose



The ability to Lead....to Create....to Empower Others.....These are the charactersitics of a dynamic Manager.  Whether you are the Boss, a Supervisor, an Administrator, a Divisional Director, a CEO, a Partner, a Physician, or part of a Team, you are managing. Even if you have no employees you are still managing.....yourself. One of the fundmental characteristics of a Manager is to process everything through the paradigm of "Self Awareness."

Are you self aware?  Stephen Covey possesses a wealth of character-centered strategies based on this dynamic and much more. 

If you haven't already read it, The Seven Habits Of Highly Effective People should be at the top of your list.  It could very well turn everything around that you feel is wrong with your practice or your life.  We all have power.  The power to choose..





Choosing Success





Become self-aware....become powerful.

Yesterday does not hold today or tomorrow hostage.

Healthcare Business Management is centered around The Seven Habits.
Help yourself be all you would like to be. Envision what we could do for you.

Saturday, August 11, 2012

Personnel Problems?




Do not let your fire go out, spark by irreplaceable spark,
in the hopeless swamps of the approximate, the not-quite, the not-yet, the not-at-all.

Do not let the hero in your soul perish, in lonely frustration for the life you deserved,
but have never been able to reach.

Check your road and the nature of your battle. The world you desired can be won.
It exists, it is real, it is possible, it is yours!
Personnel problems? Don't know what to do?  Healthcare Business Management can help you with your HR problems so you don't have to be the BAD GUY. 

www.HealthcareBusinessManagement.com

SERVICES WE PROVIDE:
  • Personnel Manual - Create and Update
  • Safety Manual - Create and Update
  • Personnel Task / Job Training
  • Initial and Annual Training for: Incentives, Operations, Computer, Personnel, Compliancy, HIPAA, OSHA, Financial and Safety
  • Payroll Account Setup - Service Interface and Report Hours
  • Acquisition - Replacement - Hiring
  • Hours, Vacation, Sick & Holiday Calculation
  • FLSA Personnel Documentation & Standards Compliancy
  • Benefit Package Development, Implementation, and Coordination as instructed for: Medical (including Psychological Recovery), Dental, and Life Insurance, Disability, Key Personnel, 401K or Defined Benefit Pension Plan, Vision, etc.
  • Initial and Annual Compliancy Assessment
  • Personnel Forms
  • Setup of Human Resource Compliancy Task Calendar and Tickler File
  • Customer Service Coaching and Training
  • Ergonomic Assessment and Implementation for OSHA Standards Compliancy
  • BiAnnual Reporting


Sunday, August 5, 2012

HEALTHCARE OPERATIONS MANAGEMENT



"Many experts believe that Operations Management has become one of the most highly intense and challenging roles in the medical industry."

The goal of Healthcare Business Management (HBM) is to ensure smooth operation of various processes that contribute to the production of quality services by your medical practice. Our role could be varied and encompass many operational areas depending on your needs.

The following are examples of five most common areas of Operations Management under which Healthcare Business Management might contribute:
  • Logistics Management
  • Budget Management
  • Operational Strategizing
  • Support Services Management
  • Third Party Relations Management

    Fulfillment of expectations that come from wearing multiple hats is the most challenging aspect of operations management. Many experts believe that operations management of the medical practice is probably one of the most challenging roles in the industry and it has now become greater within the context of HIPAA, Electronic medical records, Social Media Marketing and navigating the legal maze of confidentiality as it relates to the internet.

    With over 20 years of management experience, HBM can play a key role in chalking out the overall operational policy of your practice; and then provide your practice and personnel with a susinct and detailed operations policies and procedures manual to help you navigate compliancy and day-to-day business protocol.

    SPECIFICS
  • Electronic Scheduling,Recordkeeping and Billing compliancy deadline by 2012-2015
  • Document Management System Setup
  • Backfill and Index Records (Scan, Database)
  • Auto Update EMR via current system interface
  • HIPAA Certification of EMR System
  • Expired Paper Document Calendar Setup and Destruction / Shredding
  • Inventory Management of Asset List, Office Consumables and Controlled Substances (see "Compliancy")
  • Task/Project/Compliancy Calendar Creation
  • Whole Office Tickler File System Setup and Use Training
  • Compliancy File System Setup and Use Training
  • Vendor, Contact, Business Associate Info List Setup and Merge To Attestation Signature Form
  • Ongoing Update and Filing System Training and Upkeep
  • Forms Creation and Implementation
  • Workflow assessment
  • Office Presentation and Seasonal Decoration
  • Ergonomic Physical Facility Assessment & Recommendation
  • Grandfathered Chart Archiving as necessary
  • Develop Relationships and Contract with Third Party Entities PRN to Setup a New Practice
Are you a new graduate MD?  www.HealthcareBusinessManagement.com can help you navigate the mirade of regulatory and compliancy issues governing your new practice.  Call us at (949) 478-5821 to discuss what Healthcare Business Management can do for you!

Saturday, June 16, 2012

Social Media Mistakes And How To Protect Yourself



 
Social media was once considered a realm for teenagers to tweet about what they had for lunch, but now it has become a ubiquitous platform in the healthcare field. With the increasing amount of physicians using social networks for professional reasons, in 2010, the American Medical Association (AMA) established guidelines to prevent physicians from online misconduct.

According to a survey published in the Journal of the American Medical Association, common violations have been: inappropriate communication with patients, cyber-prescribing medication without an established patient relationship and misrepresentation of credentials online.

Guidelines that help prevent this type of unethical behavior is certainly important, however with the massive amount of physicians (or so-called “physicians”) exercising their free speech in the vast network of blogs and social media sites, who is responsible for monitoring the healthcare community when their activity extends beyond the hospital walls and into the gargantuan World Wide Web?

As it stands, the responsibility lies in the hands of doctors themselves. As a physician, if you’re not policing your own online behavior, a fellow colleague may report any misconduct to the appropriate authorities and you could face serious consequences for your actions. Take heed and follow the four tips below to avoid the possibility of jeopardizing your medical career.

Keep your patient’s ailment to yourself.


As a common rule, do not discuss a patient’s condition online. Even if you do not disclose the patient’s personal information, you may unintentionally violate your doctor-patient confidentiality privilege. In a recent case, a Rhode Island emergency room physician had detailed her patient’s ailment on Facebook, and although she did not explicitly mention the patient’s name or demographics, the characteristics of the injury were specific enough so that a colleague was able to identify the individual. As of April 16, 2012, the physician’s clinical privileges at the hospital have been terminated. Let this incident serve as a lesson – respect your patient’s privacy and preserve the public’s trust in the medical community.

Keep all comments professional – even your personal posts.


A physician’s reputation is very important and it’s not worth undermining your career by publishing negative or inappropriate comments that you would never utter in the workplace. Even if your social media account or blog is limited to a group of friends and family, it’s risky to have the mentality of thinking that the public can never trace the content back to you. Social media privacy settings are fickle and with the ability to archive public information, the Internet rarely forgets. Even if you realize your mistake and remove the content afterward, there is no telling how many colleagues have already witnessed your inappropriate behavior or how much damage it has already caused to your reputation in the healthcare community.

Do not prescribe medication online.


Social media platforms are no doubt an excellent resource to find information about current health topics and to connect with colleagues in similar specialties, however, it is not a place to practice medicine. Among the most cited infracts reported by medical boards is internet prescribing without having established a face-to-face relationship with the patient. In rare cases, this violation has even led to the death of innocent consumers. Aside from already having a real-life relationship with your patient, other factors that separate misconduct from legitimate online prescriptions differ significantly from state to state. To see a breakdown of regulations by state, click here to read the National Clearinghouse on Internet Prescribing established by The Federation of the State Medical Boards (http://www.fsmb.org/ncip.html). In all cases, a physician should already have a good understanding of the patient's problem, medical history and current health status before issuing a prescription online.

Do not “friend” your patients on Facebook (or other social media venues).


While the AMA does not explicitly prohibit physicians from “friending” patients on social networks, it's safer to keep your profile private in order to maintain a professional doctor-patient relationship. Although family vacation photos and wild snapshots of you at your hospital’s holiday party may be harmless, they may not project the professional image you wish to maintain in front of your patients. By allowing your patients to read silly wall comments left by your friends and family, you may have trouble influencing them with your authority in medicine if their view of your professional ranking has diminished. It’s best to keep clear boundaries between your social and professional life. Don’t worry about offending your patients by declining their friend requests – simply follow-up with a cordial private message that explains your policy of not linking to any patients in order to maintain professionalism in your field. Your patients will appreciate and respect this type of honest and direct communication and they’ll likely feel less awkward during future visits. Nevertheless, while it’s best to play it safe by abiding to the above rule, if you really have the determination to reach out to your patients using a social media platform, be sure to create two separate accounts so that your personal information can remain totally separate from your professional profile.

As a physician, it’s important to remember that you don’t just represent yourself online, but you serve as an example for the medical profession as a whole. Don’t let your online behavior taint the status of your colleagues or hospital. Be respectful of these guidelines and reach out to fellow physicians who may need a little guidance in their own online behavior. Social media has the potential to be a valuable asset to healthcare professionals, but it’s up to you to make sure that this technology is encouraged and not abused.

Marketing for Your Medical Practice www.HealthcareBusinessManagement.com


A MGMA Report from Matthew O'Donnell

ACHIEVING PROFESSIONAL ACCREDITATION

"Accreditation is a process whereby a professional association or nongovernmental agency grants recognition to a health care institution or facility for demonstrated ability to meet predetermined criteria for established standards of excellence."

To remain compliant to many state, federal and medical agencies, office based surgery facilities must maintain 100% compliance with each standard and basic mandate to achieve and maintain accreditation.  Each center must meet these stringent and ongoing requirements to ensure the safety & protection of all patients and medical personnel. Consistent physical facility inspection to update standards criteria establishes and continues standards and regulatory compliance, including requisite online data entry which ensures annual certification must be accomplished.

Remaining compliant with a professional organization or agency such as AAAASF establishes compliancy with and adherence to ALL applicable local, state, and federal regulations including but not limited to:
  • Licensure
  • Fire Drill - Emergency - Terrorist
  • Facility Inspection
  • Sanitation and Hand Washing
  • Building codes
  • Federal Law & Regulation Standards
  • OSHA
  • Bloodborne Pathogens
  • Hazardous Waste
  • American with Disabilities Act
  • Health Insurance Portability and Accountability Act - HIPAA
  • Continuous MSDS Update and Record Keeping
    Healthcare Business Management securely maintains your required credentialing support documentation and information current in file for all personnel providing clinical services in your accredited healthcare facility and provides periodic inspection and primary source verification where applicable for recommendation and confirmation of outside sourced medical personnel providing services in your facility.
    CERTIFICATION SERVICES
    Healthcare Business Management provides the following services to ensure your positive outcome to continued certification:

    • Peer Review Coordination
    • Meeting Setup for Periods I & II
    • Online data input including Unanticipated Sequelae and Infection Control documentation
    • Timely submission of correct forms and documentation to the medical board regarding any untimely event
    • Annual Self Evaluation Assessment Certification
    • Third Year Inspection Gear up & Assessment and Certification
    • Physical Facility Equipment & Quality Management
    • Human Resource Interface & Training
    • Receipted timely evaluation reporting
    • Coordination and assisting auditors during inspection
    Achieve Regulatory Compliancy with www.HealthcareBusinessManagement.com


    Lean Six Sigma Certification? - One Size Does Not Fit All

    “Six Sigma” originated as a set of practices designed to improve manufacturing processes and eliminate defects, but its application was subsequently extended to other types of business processes as well. In Six Sigma, a defect is defined as any process output that does not meet customer specifications, or that could lead to creating an output that does not meet customer specifications.

    The core of Six Sigma was “born” at Motorola in the 1970s out of senior executive Art Sundry's criticism of Motorola’s bad quality. As a result of this criticism, the company discovered a connection between increases in quality and decreases in costs of production. At that time, the prevailing view was that quality costs extra money. In fact, it reduced total costs by driving down the costs for repair or control. Jim Smith subsequently formulated the particulars of the methodology at Motorola in 1986. Six Sigma was heavily inspired by the quality improvement methodologies of the six preceding decades, such as quality control, Total Quality Management (TQM), and Zero Defects based on the work of pioneers such as Shewhart, Deming, Juran, Crosby, Ishikawa, Taguchi, and others.

    Like its predecessors, Six Sigma doctrine asserts that:
    · Continuous efforts to achieve stable and predictable process results (i.e., reduce process variation) are of vital importance to business success.
    · Manufacturing and business processes have characteristics that can be measured, analyzed, improved and controlled.
    · Achieving sustained quality improvement requires commitment from the entire organization, particularly from top-level management.
    Features that set Six Sigma apart from previous quality improvement initiatives include:
    · A clear focus on achieving measurable and quantifiable financial returns from any Six Sigma project.
    · An increased emphasis on strong and passionate management leadership and support.
    · A special infrastructure of "Champions", "Master Black Belts", "Black Belts", "Green Belts", "Red Belts" etc. to lead and implement the Six Sigma approach.
    · A clear commitment to making decisions on the basis of verifiable data, rather than assumptions and guesswork.

    The term "Six Sigma" comes from a field of statistics known as process capability studies. Originally, it referred to the ability of manufacturing processes to produce a very high proportion of output within specification. Processes that operate with "six sigma quality" over the short term are assumed to produce long-term defect levels below 3.4 defects per million opportunities (DPMO). Six Sigma's implicit goal is to improve all processes to that level of quality or better.

    Six Sigma is a registered service mark and trademark of Motorola Inc. As of 2006[update]Motorola reported over US$17 billion in savings from Six Sigma. Other early adopters of Six Sigma who achieved well-publicized success include Honeywell (previously known as Allied Signal) and General Electric, where Jack Welch introduced the method. By the late 1990s, about two-thirds of the Fortune 500 organizations had begun Six Sigma initiatives with the aim of reducing costs and improving quality.

    In recent years[update], some practitioners have combined Six Sigma ideas with lean manufacturing to create a methodology named Lean Six Sigma. The Lean Six Sigma methodology views lean manufacturing, which addresses process flow and waste issues, and Six Sigma, with its focus on variation and design, as complementary disciplines aimed at promoting "business and operational excellence". Companies such as IBM use Lean Six Sigma to focus transformation efforts not just on efficiency but also on growth. It serves as a foundation for innovation throughout the organization, from manufacturing and software development to sales and service delivery functions. Although a cumbersome change to institute, many hospitals and large healthcare facilities are now adopting this Lean Six Sigma culture, replacing the even more behemoth Total Quality Management (TQM) "ball and chain" that has ruled their world in the past.

    Six Sigma mostly finds application in large organizations. An important factor in the spread of Six Sigma was GE's 1998 announcement of $350 million in savings thanks to Six Sigma, a figure that later grew to more than $1 billion. Industry consultants like Thomas Pyzdek and John Kullmann dictate that smaller companies with fewer than 500 employees are less suited to Six Sigma implementation, or at the very least should adapt only the standard approach to see if it would work for them. This is due both to the infrastructure of the training belt hierarchy that Six Sigma requires, and to the fact that large organizations present more opportunities for the kinds of improvements Six Sigma is suited to bringing about.

    Also, it is the fact that smaller companies must truly change their entire culture and every single employee must be enthusiastic and willing to devote their entire working day and job tasks to Six Sigma goals; a time-consuming, very invasive and daunting task. If just one out of 10 employees is not continuously encorporating the process into their workday, the entire result would be eliminated. We can, however, take away the lessons learned from Six Sigma and apply them to small business operations; streamlining their business processes and work-flow.



    Time management, carving out excess waste and preserving the bottom-line pervades the mission of www.HealthcareBusinessManagement.com


    Wednesday, June 13, 2012


    MARIJUANA - SOME FACTS
    In The Healthcare Environment?
    To Test Or Not To Test - Benign OR Dangerous? 

    Millions are using (and abusing) marijuana every day. In fact, 1 out of 7 high school students smoke it more than once a day. Marijuana is thought by many to be benign and recreational, so it is one of the most highly used drug of choice. For this reason, society should know its short- and long-term effects on the brain.  Marijuana can affect these two areas emotionally or physically. Also, in some cases physical damages causes the emotional response. The brain is the most complicated part of the human body. To understand, let's explain certain parts and their functions to better understand our brain and thus the possibilities of chemical induced complications. The brain with its 15 billion neurons and nerve cells operates using chemical and electrical messages. This is how we perceive our senses. Differences in the way our brain translates these messages can impair perceptions. Hallucinogens prevent the brain from receiving all these messages in order. All the information that we receive is through millions of transactions of neurons, like a computer and marijuana alters these transactions.

    After smoking, or consuming marijuana, it is distributed in the brain. The concentration of marijuana in the brain may be governed by an active transport process in the choroid plexus network of blood vessels in the brain which regulates intra-ventricular pressure by absorption and secretion of cerebral spinal fluid. One scientific experiment gave an example of how the distribution of marijuana in the central nervous system could affect man. At a high dose of 30 mg./kg, marked sedation and pronounced motor in-coordination peaked at the one-hour interval subsiding in 8 hours when overreaction occurred to external stimuli; man reveals incapacitation of cognitive and motor function. High concentrations of marijuana are usually found in the following parts of the brain: the frontal cortex (the general association area), and hippocampus (short term memory and orientation). As a result, perception of time, mood and general coordination is impaired. Yes, marijuana intoxication affects neurological function, but what appears to disappear in 24 hours, can become a permanent malfunction. THC affects the limbic system which is vital to some everyday functions. The brain is made up of 3 basic cerebral types differing in structure, chemistry and organization (MacLean, 1970).

    These are:
    1) Reptilian or brain stem responsible for instinctive (survival) behavior (and regulator of vital functions of the body)
     2) Old Mammalian (paleo-cortex) or limbic brain surrounding the brain stem (like a lap or limbus) having an important role in emotional behavior and motivation (contains opiate receptors)
    3) New Mammalian (neo-cortex) brain (thinking cap) with the capacity for symbolic (written and spoken language).

    The 3 subdivisions of the limbic cortical system or ring are linked by 3 pathways to the brain stem. The lower part (hippocampus memory information) of the ring connected with the amygdala insures self-presentation (survival). The upper part is connected to the septum which is the area for pleasure. These 2 are connected to the olfactory that deals with sense. In addition, there is a third passageway dealing with sexual behaviors and visual activities. Any limbic dysfunction can result in emotional and mood disturbances, alienation, distortions of perceptions, and paranoid states. THC can reduce the blood flow to the hippocampus, which is the controller of short-term memory and orientation.

    To make a simple conclusion to all this confusing data, marijuana results in chemical damage effecting emotional, motivational and hormonal disturbances. After only 3 months of light, or moderate, or heavy use, evidence of irreversible damage can be detected. The effects of marijuana are mostly short term, meaning damages that can be restored to a seemingly normal state. Most symptoms from heavy usage vanish in about a year and a half of clean time.  But emotional and memory abnormalities are never fully restored. Since more evident and severe short-term effects take about a month of being clean to subside, one can see the potential for a problem in a weekend smoker. That means that consistent users (about twice a week or less) aren’t EVER sober.

    The brain is one third fat. Cannabinoids are fat soluble, and not only do they collect in brain cells, but they also accumulate in billions of other cells in the body and are consistently being released into the blood stream. In the case of moderate twice a week use, before half of the cannabinoids that are being stored are released, new cannabinoids are being introduced. The cannabinoids release process is very slow and if there is continued use, it can make the user always stoned! Maybe not all the effects of intoxication will be evident, but noticeable differences in thinking and talking are evident. It takes marijuana about 2 to 4 weeks to get out of your system. So, if you are smoking marijuana 1 to 3 times a week - think of the implications.

    Pot not only seems to disrupt normal learning functions but also contains emotion altering properties.  een as psychiatric outpatients, showed a decrease in attention, logical thinking, personal hygiene, performance in school, and participation in physical and social activities compared with their pre-marijuana status. These changes revised when marijuana smoking stopped.  The effects of always being stoned even if they haven’t smoked that day at all, can still include poor social judgment, poor attention span, poor concentration, confusion, anxiety, depression, apathy, passivity and often slow speech.

    Most marijuana smokers also suffer from anxiety disorders. The most common among users is social anxiety disorder where the user is nervous around large groups of people. Some only can function on one to one basis. Isolation of users is also common. Many people with slight depression use the drug to feel better. Marijuana will do that at first then it can intensify the depression. So, they continue to use the drug at higher dosages’ which results in still more depression. One can see how cyclical use of marijuana to cure the depression that comes from using it begins!

    One of the biggest controversies in marijuana abuse is: Which is causal?  Are problems caused by heavy smoking of marijuana, or is it just that people with problems are more likely to end up using marijuana heavily?

    One last finding of note is interference with the maturation process. Yes, this deals with young people, but has also been found to have permanently stunted the maturation process in adults who not only ingested and smoked weed when young, but then also sealed the deal with vaping THC as an adult. Not only is the maturing process halted, it is known to make adults emotionally regress to a teen and even a preteen inability to make cognitively consequential choices. These noted symptoms of the usage of marijuana that take place can now be scientifically proven. Most findings conclude that it affects brain function, including emotions. This usually wanes in youth after approximately 3 months of being totally clean of cannabis. Unfortunately, in adults (long-term users) the regression can be permanent, and the more use continues, the less chance there is of any, much less complete, restoration.

    This is how marijuana can now be shown to have long term effects, with irreversible damage. Most damage can be seen in chronic smokers who have built a tolerance and a degree of dependency to the drug. Effects physically and mentally are also exhibited. Tolerance to a drug develops when increasing doses are necessary to obtain the initial effect of a lower dose. Dependence may be psychological and/or physical. Psychological dependence refers to a craving for a drug often leading to compulsive drug use. Physical or physiological dependence is a state whereby withdrawal of the drug leads to undesirable effects in mood or the physical body. Marijuana is used to experience a high and as a person continually introduces this chemical into the body, they grow accustomed to it. Hence, in order to get the same high, you must smoke more potent marijuana. Cells in the pleasure center of the brain are being damaged and as more are damaged, more marijuana is needed. Also, the natural high is harder to achieve.

    Many studies show how marijuana physically affects the brain. In one experiment, monkeys were used.  After making the monkeys smoke marijuana for 5 months, they then kept them clean for 3 months, and documented the differences in physiology and behavior with totally clean monkeys to compare to. Surprising abnormalities included (RER) chaos and synaptic vesicle clumping. RER or rough endoplasmic reticulum makes proteins so that each cell can function properly. RER is in neat strands in the cell’s interior. But, in the heavy smoking monkeys there was chaos in all the cells. Synaptic vesicle activity accounts for our thinking, feeling and doing. The heavy smoking monkeys had synaptic vesicles that were all clumped together. The vesicles were also filled with abnormal deposits of unknown material.

    The conclusion was that long-term cannabis use in any form will produce irreversible effects in the brain. It causes a degenerative “marijuana abused” brain; much like long term use of alcohol can cause what is called an irreversible degenerative “wet” brain. The permanent symptoms of a marijuana abused brain are lack of empathy, bad short-term memory, apathy, inability to perceive consequences, lack of motivation, depression AND surprisingly…. permanent physiological changes in the brain and DNA!


    Don’t fool yourself, marijuana in ANY form is not benign.