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Kathi Browne
Healthcare Social Media Consultant & Glass Community Leader
Healthcare Social Media Consultant & Glass Community Leader


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Saving lives with drone-delivered defibrillators ... why not EpiPens, Narcan, etc...?
Hospitals could probably do this now, but it would blow safety protocol right out the window.

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The government-mandated “patient satisfaction survey” is meant to reward quality and effective care by giving bigger payments from Medicare and Medicaid to Hospitals with better scores. HOWEVER, one of the grades is “How often did the hospital staff do everything they could to help you with your pain?” without taking into account drug seekers who use this to their advantage.

What can be done about this?

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@PhysiciansPract recently held a Physician's Practice tweetchat with some interesting discussion. I grabbed some of the comments to summarize the discussion below. What are your thoughts?

May 17 2017

What are the biggest staffing challenges provider orgs are facing today?
• Staff performing dual roles.
• Need to replace static job descriptions w/contextually driven role-based facilitating of specific workflow-defined tasks
• Define ideal patient flow and workflow, Step 2 - Build roles and responsibilities that support the workflow
• Replace Job Descriptions" with Position Agreements that are based on roles
• Growing demand, shrinking supply!
• Training staff on constantly changing regs and customer expectations -- as soon as someone is trained, the regs / rules change.
• Some pharma reps can provide training sessions.
• In the recruiting world, getting good staff in the door is a huge challenge, and keeping them.

With practices more stretched out than ever, how can practices gain more efficiencies?
• Get More Out Of Practice Staff
• Large and cumbersome EHR's are bogging down the workflow
• Invest in the right EHR.
• EHRs need to be more than "meaningful use machines" & promote efficient patient care / physician productivity
• Eliminate procedures and patients that are low return for investment (surgical practice).
• Delegate everything possible down to the appropriate skill level and provide proper tools to do job
• Some practices turn to LEAN principles or other process improvement models to help – But tradition "Lean" models often fall short in small to medium sized practices
• 60% of respondents in the @PhysiciansPract Staff Salary Survey said they had to let staff go/maintain operations with the same # of staff.
• Hospital based practices are efficient when Inpatient and outpatient within walking distance.

Can advanced practitioners, such as NPs and PAs, replace some of the duties that a physician takes on at the practice?
• Being creative and open minded with your staffing is a must, you need to make sure your hospital bylaws allow flexibility
• With worsening doc shortage, many MDs should consider the orthodontist model of care oversight.
• Love NPs, but in primary care the math doesn't work. NPs earn too much and insurance pays too little.
• In a surgical practice, PAs dramatically increase revenue for everyone.
• in our surgical hospital-based practice, we keep our surgeon focused on what he loves.
• In surgery, we run a busy burn unit. The PAs keep the pre- and post-op care humming, manage consults, and admin. duties
• They are often left to step in and "carry the load". The lack of residency training puts them at a disadvantage
• You can bill out under location tax id as long as the Physician is providing oversight.
• It is imperative for physicians who practice with PAs/NPs on their team to understand regulation/Med staff rules.
• Advanced practitioners are being lured by retail clinics because they are not getting the mentoring they need at practices

What are areas that are vital for practices to train their employees in? Compliance w/ MACRA? EHR use? Customer service?
• MACRA is not going anywhere, if you have not begun training your staff for that reality, you should start.
• It's got to be MACRA for practices with large Medicare populations. Lots of money on the table.
• Strong, positive leadership / mgmt is key many issues discussed today - as well as to morale/work environment etc.

Should practices be staffing people to comply with MACRA?
• 87.2% of respondents to the Staff Salary say they won't be doing that.
• Staffing to support MACRA is unrealistic- Use a group organization like an ACO to support that- but get engaged!
• Hiring a good registry makes more sense than adding "Macranauts". That combined with effective training will suffice.
• On average with patient out of pocket costs rising and value care there is $125,013 per year on the table.
• Not JUST inertia, but IMO considerable backlash against #MeaningfulUse & #MACRA among physician EHR users.
• Yes & training current #medstaff on the intricacies of #MACRA, which will affect physician ratings & payments.

What are some ways to retain staff – other than financial incentives? Or are financial incentives the only way?
• Work / life balance is not the of purpose (lack of) is what causes discouragement

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Good information from +Neil Mehta on Antibiotic resistance.

WHO's list of 12 bacteria that pose high risk due to antibiotic resistance.

Just canceled my airbnb account ... the Super Bowl commercial was the last straw.
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Hey friends, a Retired Marine buddy of mine just told me about a 100% disabled vet that needs just a little help with repairing his HVAC system via GoFundMe.

Here's the story & link... please help if you can, please share it either way.

Thank you!
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A career alternative to clinical practice? Who saw this coming and will this give him more opportunity to also weigh in on Healthcare reform?

I'm involved with an effort to build a group of lay volunteers (not necessarily medically trained people) to help underserved get connected to community services. Does anyone have examples of:

Tools or Criteria to identify and evaluate people who make good patient liasons/navigators (personalities, skills, connections, knowledge)

Training and Education materials to prepare people to work with others who need social services and other help (whether communication skills, trust building, safety tips, barrier identification, etc.)

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What happened in our country that people think it's okay to lash out at those who protect us? Eventually we're all impacted.

Today Blount county laid to rest one of our own. Proud of how our local folks have shown support.

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Outside of journals and professional organizations, where do you get your medical news?
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