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Non-traditional Thinking Pays Off

July 19th, 2009
health_montageWho would ever consider having 24-hour ’round-the-clock family visiting in a hospital; beds for loved ones to stay overnight; deli-style counters on the patient floors to serve hot meals to loved ones, patients, and staff; popcorn machines in the lobbies; bread baking in the hallways; live music, massage, aroma, pet, humor, and drumming therapy; decorative fountains; and special mammography gowns for modesty? We did, and that was over 12 years ago. Our patient population tripled through the emergency room. The budget tripled, and the number of employees almost tripled.

At a lecture I once attended, Dr. Leland Kaiser said, “Give me the creative leader every time. They will always win over the traditional one.”

Well, yesterday, I met a creative leader. This young business entrepreneur was only about 34 years old. He owned a construction business that specialized in concrete. You know, poured basements, slabs, sidewalks, and driveways. When we discussed the current business climate, he smiled and said, “I’ve done okay.” Well, we all know that the construction business is literally on the skids right now and has been since the crash last year. NPR news ran a segment on Thursday about the 12,000 new government jobs being created in the Washington DC/Northern VA area. Seemed like good news until they said that these jobs represented only about a third of the more than 30,000 construction jobs that had been lost to date there.

When I asked our young rock star how he did it, he smiled and said, “I got this idea.” The number of times that those words have come out of my mouth is virtually immeasurable. Yet someone else has later described the related actions as an accidentally brilliant strategy. My response to him was, “So, what was the idea?” He smiled and said, “As soon as I got a bill, I paid it, that day, that minute, that instant.” As an employee of an accounting-type firm, my mind began to race with the traditional thoughts of “Oh, my gosh, how foolish. He could be getting interest on his money for 30, 60, or even 90 days, and he is paying his bills when they arrive?,” I thought to myself.

He then began to explain the outcome of his decision. “My suppliers love me, and because they don’t have to add in late fees, collection costs, lost interest, or simply lost money from late or uncollectable accounts receivable, this practice got their attention. Because they, in his words, “loved him,” he was able to negotiate better pick-up times for the concrete. This made him more flexible and productive as the trucks arrived at 8:00 AM with the morning’s first load of cement. The suppliers were also willing to negotiate lower prices for him than they could for the other contractors with whom he competed. Why? Because he paid them promptly every time.

He then went on to say that because his costs were lower than the other contractors, he could lower his prices to the builders with whom he wanted to do serious business, and, instead of the six or eight regulars that kept him going in the good times, he was now able to attract about 28 builders who wanted to work with him because he was on time, did good work, and, of course, was less expensive.

So, when he told me that he was doing okay, it meant that none of his employees had lost their jobs, his income had not gone down, and his business was virtually booming in an economy that has meant bankruptcy for more traditional construction oriented businesses. The really great news, however, is that this guy is a long lost, distant cousin about whom I had never known until just a month ago. So, I guess creativity runs in the family. Oh, yeah, and he’s a heck of a musician, too. Seems like Leland was right.

A Blueprint for Transformational Change: Nick Jacobs’ 2009 Graduate School address at St. Francis University’s 2009 commencement ceremonies

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Posted in Future, Healthcare, Hospital Administration, Leadership

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Don’t Drink the Water?

July 8th, 2009

Ever wonder about this whole water, nutrition, thrown-away-or-passed-through-pill thing?  I was talking to a friend who was explaining her box filled with powered, bio accessible supplements to me.   You know, the kind you drink in a milk shake in the morning.  She explained that her house had a septic system and that the annual visit by the septic maintenance truck was usually an occasion to discuss topics that the rest of us don’t get into on any given day.  Interestingly, she asked the septic  guy if things have changed “down there” over the years. (I know, I know. Too much information.)

His answer was terse.  He said, “Yep, all we see now when we start our work is pills, undigested pills.”  I’ve written blog posts about the lack of filtration capability built (or not built) into our water purification systems, and suggested that you move to Chicago if you have high cholesterol because there are so many lipids in the water.

Nicholas D. Kristof, Pulitzer Prize winning columnist for the New York Times has always been one of my literary heroes.  His coverage of Darfur, his reports on the Iraq war, Afghanistan, China, and gender rights issues have all captured my attention and admiration.  His column last Sunday in The New York Times, It’s Time to Learn from Frogs, was deeply disturbing and raised issues that should capture not only our imaginations but also should tickle our most profound concerns.

three legged frog
Photo credit: Discovery Channel/TreeHugger.com

For those of you who did not read it, the basic thesis was one of caution as we see our amphibian friends sprouting extra legs and some developing stunted genitals, while some of their fish companions are devolving into intersex fish that display female characteristics and produce eggs.  The reason for these changes is being attributed to a class of chemicals that scientists refer to as endocrine disruptors.  Some are passed into the environment through the urine of human females on estrogen treatments.  Although these theories for the disruptive changes in nature are still only theories, we have also begun to see a serious percentage of male babies  (7%) being born with undescended testicles and 1 percent being born with the urethra exiting the penis improperly.  Obesity may also be impacted by chemicals that contributors.

As the founder and former CEO of a research institute, our scientists constantly reminded me that 75% of our cancers were produced from the environment.  As we saw completely substantiated reasons in our economy to add man-made chemicals to retard spoilage, discourage bug infestations, and produce larger chicken breasts, or more attractive fruits and vegetables, the cascade of potential consequences caused by these decisions were never really known to us.

Mr. Kristof ends his op-ed by stating that “Those deformed frogs and intersex fish – not to mention the growing number of deformities in newborn boys-should jolt us once again.”

Could someone pass the “Fresh Mountain Spring Water?”  Oh, yeah, the one that’s full of heavy metals from the acid rains.  You know, that Grey Goose is looking better every day.

For further reading:

What Are Endocrine Disruptors?

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Posted in Diet, Environment, Healthcare, Wellness

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Dr. London Said it on Sept 6, 2001…Reihan Salam Said it Today

June 28th, 2009

All week my search for pertinent topics for this blog were side-tracked by the deaths of numerous luminaries: Michael Jackson, Farah Fawcett, Ed McMahon, and even Billy Mays.  We’ll miss you all.

Then, during lunch today, the Pittsburgh Post Gazette reached out and grabbed me with this headline:  “The End of Male Rule.” The reason that this headline was so moving to me stems back to the Saturday of the week-end before 911 when Dr. Wayne London, an old metaphysical theorist friend of mine told me that:  1.) The American financial system as we know it would collapse.  2.) The center of the U.S. Military would come under attack, as would 3.) the patriarchally-controlled Catholic Church.  He then said, “All of this will happen as Mary Energy begins to lead toward the change, and women will take control of the world again.”  He went on to explain that this woman control is not a new phenomena, just one that has not been around for quite some time.

Pentagon 9/11 memorial service, September 11, 2008 - Photo credit: UPI
Pentagon 9/11 memorial service, September 11, 2008 – Photo credit: UPI

Well, after the Twin Towers were hit, our own American citizens did much more damage than anyone could have ever imagined possible to our financial system by setting up the elaborate mortgage and derivative schemes that nearly caused the entire U.S. financial system to collapse.

Of course we all remember the horrible hit that the Pentagon endured on 911, and now we face the huge financial burdens of continuing two wars and trying to rebuild a completely exhausted military that has been over-stretched and nearly wiped out emotionally by the last several years of redeploying both our all-volunteer army and their equipment over and over again.  When you begin to see more suicides than casualties of war, something is obviously very wrong with the System.

The Church went through what has come to be recognized minimally as a very difficult time with millions and millions of dollars in lawsuits and structural challenges over sexual abuse issues that had been closeted by numerous U.S. Bishops for years and years.  The celibacy thing seemed to have been much more destructive for the men of the Church than the women.

So, what was Reihan’s interpretation of this metamorphosis, this change in traditional male dominance?

PTA President Charles J. "Chuck" SaylorsPTA President Charles J. “Chuck” Saylors

Before we go there, on NPR this evening, I heard about Chuck Saylors, the first male president of the National Parent Teacher’s Association since its inception in the late 1800′s, and it all started to make even more sense, a guy in a predominantly female organization deserving to become president because so many men have assumed more house dad roles.

Reihan’s article started with the line:  “The era of male dominance is coming to an end.  Seriously.”   He went on to describe the fact that the Great Recession has turned what was a quiet evolution into a revolution…a mortal blow to the macho men’s club.  He quotes the fact that 80% of job losses or over 7 million jobs have been lost by men in this recent massacre, and the predicted number of male jobs lost by the end of 2009 is estimated to be around 28 million worldwide.  He adds to the fact that soon there will be three women for every two male college graduates in the U.S.

One of his most interesting revelations was that Iceland threw out the entire men’s club in their last election, as did Lithuania.  Could this be the beginning of a trend?

Of course the article went into much more depth, had numerous other examples to support these claims, and was compelling in its support of Dr. London’s theme.  The bottom line, however, is not easily denied.  We macho, risk-taking, aggressive guys have done a lot of damage over the years, and it will be fun watching this predicted shift in the next decades.

I’ve always felt that a world run by women might have a little better chance of having less warfare. Let’s hope that the female leaders of our future will have the attributes that will make them better than the men that they are replacing, and the world will be a better place.

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Posted in Current Affairs, Future, Healthcare, workplace

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Healthcare Reform? Blow it up, and Start from Scratch!

June 20th, 2009

Healthcare Reform? The premise and the incentives are wrong.  We treat sickness (which can be a good thing), however, we do it to the almost total exclusion of encouraging and incenting wellness. While in the Netherlands a few years ago, I asked a very comfortably-situated business person why she and her entire family all rode bikes. She smiled and explained that the millions of bikes in the Netherlands are a way of life because they keep people healthy.  Of course, we don’t have to ride bikes, but why not?  “It is much less costly.  It gets us where we want to go, and it is so much better for our bodies,” she said.

Photo credit: Amsterdamize
Photo credit: Amsterdamize

After going to doctor after doctor in my early thirties and then again in my early forties for a recurring and seriously painful back problem, someone suggested a Chicago-trained chiropractor.  After a very quick, one time manipulation, he said, “Follow me, please.”  When we descended the stars of his office, in front of me was literally an entire homemade work out facility.  This particular center seemed to emphasize strength training.   The Doc walked me over to a row of three machines and said, “If you use these three machine or their equivalent, just the way I show you, you will never have to come back here again.”  Then he said, “Oh, and if you drop fifteen pounds, you may be able to get off those blood pressure pills, stop taking that stomach medicine, and feel better about yourself in the process.”

The Dr. Dean Ornish Coronary Artery Disease Reversal Program is completely about health and prevention.  It is about wellness; treating yourself with the love and respect that you deserve, being kind to yourself, yet being disciplined enough to get you where you need to be in order to enjoy a healthy, pain free life.

We spend only 4% of our health care dollars on prevention.  That may sound like a lot to some of you, but do the math.  Take 4% and multiple it times $2.2 trillion …or possibly soon $3 or $4.0 trillion.  Every physician should endorse a workout facility and work to send you there, and every physician should receive bonuses for having you use it.  A primary care physician in Britain can make about $320K a year, which includes incentives directed toward encouraging healthy living for their patients.  Our primary care docs make, what, $130,000, $150,000, $180,00 in comparison?   Would you really care if your physician could make almost twice as much if you were living a wonderful, healthful, reduced stress life?

There is absolutely NO DOUBT in my mind that the reason I’m typing this here today and not deceased at age 58, like my father, is because of the work of people like Drs. Ornish, Benson, Jonas, and Weil.   It is not because of my old donut shop, the nachos and cheese, the automobiles, my Lazy Boy, or the grueling work habits that we Americans think of as normal.

And what about death?  I have to tell you that death happens to all of us.  (Sorry.)  When it happens may depend a great deal upon our recognition of that fact, but it is not avoidable.  So, why is it that we, as a society, reject death as evil, and ignore its possible existence?  How could we cut billions and billions of wasted healthcare dollars?  Hospice is the answer.  Don’t commission oncologists for drug use when there is absolutely no hope that the patient will live.  Don’t pay radiologists for radiation treatments that will not work in preventing death.  Don’t reward hospitals financially for readmission after readmission for people who should have been told to mark  their DNR’s months earlier.  Face death as part of life.

healthy_food

Finally, look at the food and restaurant industry.   For every restaurant or food company that pulls a killer food and replaces it with the reasonable alternatives, reward them through the $3 or $4 trillion health budget.  You can buy veggie hot dogs on the streets of Toronto.  (Try Morning Star Farms brand veggie hot dogs.  They rock.)

In closing; diet, exercise, stress management, balanced lives, less capitalistic rewarding of killer diets, higher reimbursements in healthcare for the “right stuff,” and acknowledgement that this will eventually end, can make it all work so much better, so much cheaper, so much easier.  Did you have your pneumonia shot yet?  Well, actually, you may not need one if you start taking care of yourself.  I’m going downstairs to workout now.

Next time?  Tort reform.

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Posted in Healthcare, Integrative Health, Nutrition, Wellness, patient-centered care

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Who Let Us Down?

June 12th, 2009

Recent news:

WASHINGTON, DC — James von Brunn, the white supremacist who allegedly opened fire Wednesday at the U.S. Holocaust Memorial Museum in Washington, D.C., suggest that a lifetime of hatred had reached a critical mass. The 88-year-old is charged with murdering a security guard at the building.

LITTLE ROCK, Ark.  —  A Muslim convert charged with fatally shooting an American soldier at a military recruiting center said Tuesday that he doesn’t consider the killing a murder because U.S. military action in the Middle East made the killing justified.

NBC News is reporting that at Camp Liberty, the main U.S. military base in Iraq, which is located near the Baghdad International Airport, a yet unnamed serviceman walked into a “stress clinic” in the camp, opened first, killing at least five. Contrary to earlier reports, the soldier did not kill himself but is now in custody.

When things like this happen, we all stop and ask what went wrong?  In two of the three situations, we had relatives or friends nearby.  My daughter-in-law’s friend was working at the museum, and my son-in-law is stationed beside the stress clinic at Camp Liberty.

I’ll never forget when the Reagan administration began the movement to close down  mental hospitals.  A friend worked at the mental hospital nearby.  We had had a rash of threatening letters, some very upsetting encounters, and a several other incidents in the community when this friend said to me, “You know, we had 2,000 inpatients and 500 outpatients at the mental hospital.  Now we have 2,500 outpatients. Nobody’s left town, and when they don’t take their meds, there can be problems.”

Pfc. Joe Dwyer carried a young Iraqi boy who was injured during a heavy battle between the U.S. Army's 7th Cavalry Regiment and Iraqi forces near the village of Al Faysaliyah, Iraq, on March 25, 2003. Dwyer died of an apparent overdose at his home in North Carolina on June 29, 2008. Photo credit: Warren Zinn / Military Times file
Pfc. Joe Dwyer carried a young Iraqi boy injured during a heavy battle between the U.S. Army’s 7th Cavalry Regiment and Iraqi forces near the village of Al Faysaliyah, Iraq, on March 25, 2003. Dwyer died of an apparent overdose at his home in North Carolina on June 29, 2008. Photo credit: Warren Zinn / Military Times file

When you consider that there are about 6.5 billion people in the world, if only 5% of the total people living on this planet are suffering from some type of mental illness, we’re potentially talking about the equivalent of the entire population of the United States with some mental health issues. ( Sorry if  my math is slightly off.)  Point is, that’s a lot of people.  So, what are we doing for them?

The Rand Corp. released a study of returning service members and is estimating nearly 20 percent of the 1.6 million who have served since this war began will develop Post-Traumatic Stress Disorder (PTSD). That is nearly 320,000 PTSD sufferers – more than the population of Pittsburgh.

White supremacists are such old news.  We have had to hear about their beliefs over and over during the past sixty years or so.  Maybe when they are arrested,  as James von Brunn had been more than once, it would help them to serve their time doing community service as tour guides at Auschwitz?

Our soldiers, however, are an entirely different story.  We have spent the past several years meeting with experts in mental health who do know what to do for them.  That’s the good news.  The bad news is that this care is not being rendered.    The military has strict guidelines on the treatment of PTSD, but, if you ask our returning soldiers how faithfully these guidelines are implemented, the general answer is that “There’s not enough money to provide this care for our Guardsmen and women.”

We don’t pay our school bus drivers a living wage, and they are in charge of our most precious loved ones.  We couldn’t afford to send armour with our early troops deployed to Iraq and have had more amputees than in any war since the Civil War, and now we don’t have enough money to treat PTSD.

That type of rationalization makes me tired.  We have enough money, we just don’t have our priorities and incentives in line.

depression female young woman african american black mental health Nick Jacobs

Did anyone notice that James was boiling over with insanity?  How about Mohammed?  Our PTSD patient in Iraq knew that he was in troble, but we busted him, and then put him beside a driver with a gun on his hip.  That weapon became his killing tool.

This blog was not intended to be depressing.  It is intended to reemphasize that we in healthcare should be about caring. It is about teaching caring, love and respect.  It is about helping those who need help, and detaining those who won’t accept that help.   We have drugs, but, as the Virginia Tech shootings demonstrated, in certain phenotypes the receptors are not there to allow those drugs to be absorbed into the body.

Mental health help has a long way to go, and we all need to be part of that journey.  Telepsychiatry, PTSD clinics, screenings for radicals?  Surely someone cares.

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Posted in Healthcare, Mental Health, Military Medicine

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In My Opinion, It’s Tinker Bell Dust!

June 4th, 2009

Everyone has seen the media reports on the $1.7 trillion of cost cuts being projected by health care leaders over the next decade, but does anyone really believe it? According to this group, the premises embraced that will lead to these cuts are based upon improving care for chronic diseases, reducing unnecessary care, and streamlining administrative costs. Included in this wish/promise list are cutbacks, commitments to permit fewer Caesarean sections, better back pain management, less use of antibiotics and a reduction in diagnostic imaging tests.

U.S. President Obama meets with health care executives at the White House on May 11 (Pete Souza)
U.S. President Barack Obama meets with healthcare executives at the White House on May 11 (Photo credit: Pete Souza)

The groups involved have made commitments to try to reduce medical errors, begin the use of common insurance forms, to initiate a reduction in patient re-admissions, to improve the efficiency of drug development, and to promote the expansion of in-home care. (The majority of the preceding information comes from an article by Janet Adamy entitled “Health Groups Detail Plans to Reduce Costs,” in the June 2nd Wall Street Journal. )

If you are reading this, and you are a health care professional, it may be reminiscent of listening to your three hundred fifty pound, five foot tall neighbor describing how he is going to get back into his size 34 Levi’s. It also reminds me of a conversation that I had about 22 years ago when a hospital vice president said to me, “We are going to begin putting  computers into the hospital, and they will reduce costs, lower the need for staff, and contribute to much higher efficiencies.” What part of this equation didn’t happen? Even at the little hospital from which I just retired, we went from two, to three, to four… to about a dozen experts in every aspect of computer technology, and IT has been a dominant part of the capital budget for over a dozen years. So, what’s wrong with this scenario? As the equipment became more sophisticated, more well trained experts were needed. The higher the cost of the equipment, the greater the overhead required for maintenance, and the larger the demand became for everyone in the facility to be computerized.

It is not my intention to be a complete cynic, but isn’t it true that tens of thousands of people who have become used to a certain standard of living will be controlling these cuts? If we could have improved chronic disease care, why wouldn’t we have done that already? It’s all about the reimbursement system. We are still reimbursing for sickness rather than wellness. How do we line up the incentives so that statements like “we will permit fewer Caesarean sections or we will initiate better back pain management” will not ring hollow as words directed toward placating the new President? Nowhere in the equation is there any reference to initiating tort reform. As long as doctors, hospitals, and other clinicians have to practice defensive medicine, we will not be able to reduce tests. We will not be able to reduce unnecessary costs.

pixie-dustl1Yes, of course a reduction in medical errors would be great. So would common insurance forms, and fewer re-admissions. I’m sure we will see our peers work diligently toward those ends, but, unless or until incentives are aligned, the system will continue to roll along pretty much as is. I’m not sure why the President hasn’t called me yet. Maybe it’s because he knows how I feel about tort reform. Maybe it’s because he knows that I’ll say that the list articulated in the opening paragraph is filled with smoke, or maybe it’s because, like all government-touted initiatives, it’s not supposed to actually come completely into play until two and possibly six years after he leaves office. That philosophy certainly didn’t work for our former Presidents, and, unless someone gets really serious about changing the way healthcare is delivered in the United States, these pledges will be just what they appear to be, “Tinker Bell dust!”

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Posted in Healthcare, Public Health, Public Policy

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May Cause Dizziness, Osteoporosis and Slow Death…

June 1st, 2009

There were some very bright people involved who confirmed my suspicions, but it was my persistence, my explorations, and my perseverance that took me to those scientists, doctors, and pharmacists. You see, the prognosis that I was given involved a very much dreaded series of events that played heavily in the death of my paternal grandmother – kidney failure.  Okay, it was mild.  Yes, it was just the very beginning stages, but, like surgery, when it involves my body, it’s major!

drug interaction awareness education Nick Jacobs SunStone consulting

After an E-mail to a very well known and highly respected physician at one of the mostly widely recognized medical facilities in the world, my suspicions were even more intensified.  Phone calls to two different pharmacist friends resulted in me getting the information that I had been seeking.  There were at least three recent studies that confirmed that ARB’s (Angiotensin Receptor Blockers) could cause renal (i.e. kidney) dysfunction, resulting in the doubling of serium creatinine, leading to death.

“Reports in the medical literature reinforce the importance of recognizing that angiotensin-converting enzyme inhibitors should be used with caution in patients with bilateral renal artery stenosis . . . Clinicians should be aware that renal failure might occur when using ARBs in these patients”…

…read one website.   Like I said, I’m not a doctor, and I’m sure that there will be plenty of opinions about these studies.

From another website:

“Chicago, IL – The addition of an angiotensin receptor blocker (ARB) to ACE-inhibitor therapy makes treatment noncompliance due to side effects more likely and ups the risks of symptomatic hypotension and renal dysfunction, suggests a pooled analysis of four randomized trials [1]. The findings are consistent with current treatment guidelines that express reservations about routinely combining the two drug classes, the authors write in the October 8, 2007 issue of the Archives of Internal Medicine.“

Well, to add insult to injury, last year I had my upper and lower GI work up, just for old times’ sake.    At the end of that procedure, the doc suggested one of those purple pills.  Tonight on the news, right after the GM bankruptcy, the story went something like this: According to the Associated Press…

“Taking such popular heartburn drugs as Nexium, Prevacid, or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.”

Well, okay, it was Britain.  We all know that they are generally much more healthy than we Americans.  Maybe the study should have read:  “If you are healthy, you will break your hip in England.”

I know, I know.  We all have to die of something, but darn it, why does it have to be the result of stuff that is supposed to be helping us stay alive? I hate the thought of spending the equivalent of a Mercedes car payment each month to load my body up with chemicals that do more damage than Jack and Coke or Goose and Tonic.  Seriously, Aunt Martha really seemed to have it together:  Don’t take anything stronger than an aspirin.  For heaven sakes, don’t get a physical if you can avoid it, and live your life in moderation.  She’s still going strong in her eighties.

Oh, well, it’s time for my Niaspan, Plavix, Nexium, Lotrel, Toporol, Zetia, Crestor and fish oil cocktail …with a chaser of mulivitamins. To your health!

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Posted in Healthcare, Hospitals, Medicine

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The Health Care Reality

May 15th, 2009

1979 was the year in Johnstown, Pennsylvania when I decided that it was time to leave teaching and transition into business.  For those of you who don’t remember that year, it was the beginning of some serious financial challenges for our country, but it was also two years after the Johnstown Flood of ’77, and there was an unemployment rate of 19.5% in Cambria County, PA.

1979 Rolling Stone cover Blues Brothers SNL Dan Ackroyd John BelushiIn 1980, when I accepted a job with a then bankrupt nonprofit organization in Somerset, PA, what had been a booming coal industry went into the skids. My house mortgage was about the same as the unemployment rate, 19%.  The job that I took was in the arts and Ronald Reagan was interested in cutting funding to the National Endowment for the Arts.

In 1985, my new job was with a tourism agency, and that was the year that then-PA Governor Casey cut funding to tourism.

In 1988, when I entered healthcare, it was clear that Johnstown could no longer support four hospitals, and the next decade and a half resulted in the closing of two (and almost three) of the four hospitals in that area.

Turn the clock forward to last October, when I announced my decision to become a healthcare consultant.  The stock market crashed, eight of every ten hospitals stopped, postponed, or scaled back needed capital projects, 58% of hospitals are now reporting  increases in uninsured patients using the emergency departments, 48% of hospitals have cut staff, and 80% have reported cutting expenses that include consultants.

As a consultant, the first thing I would tell anyone is that “No matter how bad things appear to be, you can do it.”

  • Our successes as a teacher continue to remain evident as former students ranging in age from 38 to 58 continue to remind me of great memories of our time together.
  • The arts organization became the largest and most successful rural arts organization east of the Mississippi.
  • The Convention Bureau went from almost closed to the fifth largest agency in the State, and most of you have tracked the successes that we experienced at Windber.

Not unlike the little engine that could, we focused on the positive, forgot about the negative, and never dealt with “Mr. In-between.”

roosevelt_action400

There are those who approach life cautiously, carefully, and very conservatively, and then there are those of us who drink from that same cup in big gulps and dream about how things could be rather than how they are.  There are those who are afraid of failure, and those of us who embrace failure because we know that it is getting us closer to more dramatic successes.

The only boundaries that we have are between our ears.

Because the future is a design function. Let me close this blog post with the ending from my commencement address to the graduate students of St. Francis University (with the help once again of Dr. Leland Kaiser):

  • Nothing has to be the way it is.
  • We can invent (or prevent) our future, because all limitations are self imposed.
  • We can empower ourselves to create a new world.
  • Reframe any limitations to become opportunities because…
  • Tremendous limitations breed success. They open doors.

So, as we design our future, remember that we should not work to create what people will like, but instead work to create what people will love!

…and we will know success beyond our wildest dreams.

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Posted in Healthcare, Hospital Administration, Leadership, Public Policy

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HIMSS

April 15th, 2009

HIMSS, Healthcare, IT, health, information technology

If you’re interested in finding about everything that happened at the HIMSS 2009 Conference and Expo, don’t read on, because I’m just going to focus on four or five companies that captured my imagination there. There were hundreds and hundreds of vendors attempting to do business in the massive McCormick Convention Center in Chicago, and most of the participants were clearly interested in attracting some bailout money. My host for the week-end was Apptis, and a special thanks must go out to them for allowing me to grace their exhibit as an observer.

Genova Technologies
The companies that grabbed my attention were rather unique; neither the largest, nor the most aggressive. Not the end all and be all of IT, but niche players that had their acts together. Dawn Ainger, the President and COO of Genova Technologies was the first to garner my complete attention. She and her people had come up with a software platform that is uniquely positioned to change the entire concept of Continuing Medical Education. Just log onto their product for somewhere around $100 a month, and voila, everytime you research a patient’s ailment online you get CME credits backed by a major university. Next, she plans to expand to nursing education as well. My oh my, will that change plenty of lives? Our typical employed physician used to get an automatic $4,000 a year stipend for CME in our little rural hospital and never got credit for the work they were already doing. Nice job, Dawn.

logo_aclaim
Not that all of the products that captured my attention were produced by companies run by women, but a-claim was, and their President and CEO Mary Dees Griffith had come up with a similarly low cost solution to a major, ongoing problem. Get your a-claim software, and prequalify your patients on line, have them sign the authorization prior to being seen, and then ask them for their check or credit card for the co-pay that you now know will be approved. Nice job, Mary. Every physician’s office in the world should spend $100 or so a month for that one, because it could virtually eliminate their accounts receivables.

logo_lifelinks
As I was walking by Lifelinks, I noticed a butterfly logo and was curious as to what they did. Once again, their basic, get-you-in-the-door fee was about $100 a month, and that will get you access to live human beings on your lap top who can perform sign language interactively with your patients, or, if need be, Lifelinks will get you live and online someone who speaks whatever language your patient needs. Okay, so that’s probably not a big problem in a small town in Western Pennsylvania, but I’m sure it’s perfect for those offices in highly diverse regions of our country. More importantly, their literature pointed out a case in New Jersey where a physician had been sued and the patient won $400,000 because the doc told her he couldn’t afford a translator. Good job, guys. Wesley Waite, the COO, actually hit the keyboard, and a woman came up on the screen to interact with me personally in sign language. Amazing.

Gemalto, health, security, Netherlands
Gemalto, a Dutch based company really grabbed my attention in the world of cyber security on a small, simple scale. Well, okay, not so small I guess. They have over 100 million of their devices already in use in the EU, but not too many in the US yet. The Gemalto team took us happily through the safety and security they can build into their smart cards to keep you from being hit with a major civil and/or criminal penalty for compromised information.

voalte_iphoneThe wildest display tucked in the back corner of one of the exhibit halls was a lime green and pink booth with the word, voalté across the top of their exhibit. A really nice guy named Oscar in pink scrubs and a black voalté teeshirt was my tour guide through I-phone heaven for nurses, techs, and other hospital professionals. What they have created with this system can only be described as remarkable. It shimmies, it shakes, it crawls on its belly like a reptile. Seriously, paging, messaging, dosing, you name it can all be communicated to your staff via the Apple iphone. No more overhead pages, no more, “I didn’t get that message,” no more I’m busy because if you are, that page keeps being passed along until someone isn’t busy. This Sarasota company is fresh, fun, exciting, and competent.

So that’s my little trip down HIMSS lane. Oh yeah and I got to have lunch with the brilliant Tony Chen of both HospitalImpact.org and SavvyDaddy.com fame. I encouraged Tony to follow his dreams, and he told me today in an E-mail that he is going to do just that. You go, Tony. And Neil Versel, the very talented free lance writer, journalist, and U2 fan nearly knocked me over at the entrance. I met Neil a few years back at a Web 2.0 conference in Chicago, and there were at least two or three other people there I had worked with over my 22 years in Healthcare Management. The biggest outcome?

My feet are still killing me.

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Healing and the Mind Revisited

April 8th, 2009

I’m working in Chicago right now, feeling a little overwhelmed by a phone call that I had from one of my very dearest friends about his impending future, about my son-in-law in Baghdad and his family who are living without him at home, and also about the challenges that we individually and collectively face both nationally and internationally during this time of economic crisis and overall unrest. During the midst of my thoughtful contemplation, I received an E-mail from a very dear friend, Savery, with a link to open. I was so moved by it that I decided to post the link on Facebook.

Almost immediately after it went out, my friend, Dr. Dean Ornish, sent me this follow up link from Bill Moyer’s show. For those of you who don’t know this about me, the Bill Moyers series, “Healing and the Mind” was my inspiration for the Planetree Philosophy that we implemented at Windber all those years ago. For some reason, he and I keep intersecting, and here we are again.

So, thanks, Savery, Dean, and Bill, but most of all, thanks to the amazing man who created this wonderful experience that you are all about to have.

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