Wednesday, July 15, 2015

Thinking about the end…

According to his book cover biography, Atul Gawande is the author of three best-selling books, including Complications, Better, and The Checklist Manifesto.  I have read all three and was quite excited to read his most current publication, Being Mortal.  Mr. Gawande is a surgeon, professor, and writer.  His books cover complicated and controversial topics in a calm and uncomplicated manner.  He introduces us to real people, with real medical issues while adding a human view to the sometimes sterile medical world.

In Being Mortal, Mr. Gawande tackles end-of-life issues.  He provides a historical perspective of end-of-life care, as well as current issues facing our society.  For example, he asserts that our medical community is still confused on the best methods for providing care for patients with long-term illnesses.  He states:

               “People with serious illness have priorities besides simple prolonging their lives.  Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete.  Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars.”

Mr. Gawande considers how “we can build a health care system that will actually help people achieve what’s most important to them at the end of their lives”.  He states, “People die only once.  They have no experience to draw on.  We need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come – and escape a warehouse oblivion that few really want.”

Overall, Mr. Gawande uses real-life stories to teach his readers the importance of compassion and facing reality.  He asserts that encouraging patients to think about and plan for the end of their life is just as important as preventative care.  In fact, some studies have shown that simply having a conversation about advanced directives (e.g., living wills) can reduce depression and confusion at the end-of-life.

This is not an uplifting book, but it is an important one.  I encourage everyone to discuss end-of-life choices with their loved ones.  It is not an easy conversation, but it can save heartache and provide peace.  Mr. Gawande supports this notion and provides an excellent guide to help begin those difficult conversations.



Contributed by Valerie Connor, SJC instructor, law and ethics courses.

Sunday, July 12, 2015

New Continuing Qualification Requirement (CQR)

Are you prepared to meet the new CQR   directive to maintain your certification?  The American Registry of Radiologic Technologists (ARRT) has been working with multiple constituents in the profession to develop a pathway for continued education.  Certification is now time limited to 10 years. Recertification will require the completion of the new CQR process.


The first CQR deadline is set for 2021. However, this will impact those who earned their certification in 2011 (effective January 1, 2011) and subsequent years. According to the ARRT website, the compliance phase will begin in 2018, which allows three years to complete the professional profile, the self-assessment section and targeted continuing education component by 2021.  The professional profile is a reflective exercise that compares clinical experiences to others in the discipline. Next, you must complete the structured self-assessment process, which is a learning tool designed to evaluate knowledge and skills on the qualifications that are expected of those who are certified. From this, a report will be generated with the results of the assessment and whether or not standards have been met. If standards have not been met, the ARRT will identify the necessary components that will be required for completion in order to be recertified. Please visit www.arrt.org/registration/CQR for additional information.

Submitted by Brenda Rice, Program Manager, Radiologic Science Administration

Friday, May 15, 2015

Emotional Intelligence?

An article was recently published in The Health Care Manager - a journal that 
provides practical, applied management information for managers in institutional health care settings - that was written by Dr. Twila Weiszbrod, Program Director.  The article is titled "Health Care Leader Competencies and the Relevance of Emotional Intelligence."  The article describes the relationship found between emotional intelligence and competencies identified being important for healthcare administrators!  You can read the article at: 

Friday, May 08, 2015

New Course!!

Scott Campbell, one of our adjunct faculty members, is currently completing the development of a course titled "Healthcare Delivery Models."  This highly interactive and completely relevant course will be available fully online in a 12-week term starting in October!!!

As Scott stated, "Health care delivery systems are evolving with new models that cut across the continuum of care being developed.  This evolution is being driven by a number of factors including the implementation of the Affordable Care Act, continuing pressure to provide care in a more cost-effective model, a growing emphasis on managing the health of a population over time rather than through episodic care, and an understanding that maintaining and improving health status is the key to the future of health care.  There is a need for a course that looks at these evolving systems and the forces that are changing health care delivery.  Health care administrators in the future will be expected to operate health care organizations in response to these changes."

Watch for more information to come about this new course!


Tuesday, April 07, 2015

What is the IMPACT Act of 2014, and Should It Be Affecting Your Operations?

The IMPACT Act of 2014 was signed into law on October 6, 2014.  IMPACT stands for “Improving Medicare Post-Acute Care Transformation” and this is indeed what this Act has begun to do.  In summary, what the Act does is that it reforms how post-acute assessment data is collected across different Medicare settings.  There was a resounding need not only for a standardization in data, but also for the instruments which collect it.  Obviously, as this is specifically geared towards Medicare, this Act will streamline their processes first and foremost, and it will enable several beneficial things overall regarding the services which they oversee.  The Act will allow for the collection of data which will further allow for quality comparison, for improvement of hospital and post-acute care discharge planning, and for further scrutiny towards Medicare payments for post-acute care (United States Senate Committee on Finance, n.d.).  This Act will also benefit from the upcoming ICD-10 implementation we can look forward to in October, 2015.  The increased number of codes available at this time for not only diagnoses, but also procedures, equipment, services, etc., will allow for a much easier transition towards implementation of the IMPACT Act.  The ICD-10 implementation will be a huge step towards easier compliance from post-acute providers of all specialties.

The question becomes, how should this be effecting your operations at current?  The answer is not a simple one.  The Act requirements will be phased in over time which begins in October 2016, one year after the implementation of ICD-10 coding.  Our focus needs to shift towards the three broad aims that the IMPACT Act is working towards regarding quality which include better care, healthier people and communities, and affordable care (Centers for Medicare and Medicaid Services, 2014). Obviously, on the heels of doing this, we must also ensure that we are working towards the implementation of the required standardized forms into our operations, electronic health records, or other systems which we might use.  This information will need to be reported in some interoperable way when the Act begins to be implemented in earnest.  Many post-acute providers already have systems in place such as the OASIS (home health), RAI/MDS (skilled nursing facilities), IRF-Patient Assessment Instrument (inpatient rehabilitation facilities), and LTCH-Continuity Assessment Record and Evaluation (long-term acute care hospitals).  All of these required forms are in use today by providers, however the ability for them to be interoperable with each other is what we need to start questioning.  The main point here is to ensure that services are not being inadequately utilized and that there is no duplication of those services across providers.  This will force each of the different post-acute care types to ensure that they are using the same ICD-10 codes at that time as other providers, and that their information meets these new interoperability requirements.  Indeed, a tall order for providers who are already stretched in the area of resources.

Some important websites with further information:

Centers for Medicare and Medicaid Services. (2014). IMPACT Act of 2014 & Cross Setting Measures.  Retrieved from http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Post-Acute-Care-Quality-Initiatives/IMPACT-Act-of-2014-and-Cross-Setting-Measures.html

United States Congress. (2014). The Improving Medicare Post-Acute Care Transformation Act of 2014 (Full Text).  Retrieved from http://www.gpo.gov/fdsys/pkg/BILLS-113hr4994enr/pdf/BILLS-113hr4994enr.pdf

United States Senate Committee on Finance. (n.d.).  The Improving Medicare Post-Acute Care Transformation Act of 2014.  Retrieved from http://www.finance.senate.gov/imo/media/doc/IMPACT%20Summary.pdf

Pitts, P.W., Christy, D.S., and McCurdy, D.A. (2014). Analysis and Impact of the Improving Medicare Post-Acute Care Transformation Act of 2014.  Retrieved from http://www.reedsmith.com/files/Publication/a0c30fb6-81bd-4739-9be5-169e20aad8ae/Presentation/PublicationAttachment/1841b086-dd16-4a9c-a0fa-2cc2081dadb6/Analysis%20and%20Impact%20of%20the%20Improving%20Medicare%20Post-Acute%20Care%20Transformation%20Act%20of.pdf

  

Contributed by Dr. Michael Mileski, DC, MPH, MSHEd, LNFA, SJC Faculty

Wednesday, March 25, 2015

Health Information Professionals week!

This week is Health Information Professionals week! We are so excited about our new BSHIM program at Saint Joseph's College! We are continuing to add entry-level courses to our curriculum while we wait for the next step in the CAHIIM accreditation process. We submitted our self-study last October and hope to receive a response this month from the CAHIIM review of our material. We will then make necessary adjustments and hopefully have our site visit by summer!

So far there are about 18 students that have applied to the program, with a few students already enrolled in courses. The remaining applicants are providing transcripts so they can work toward BSHIM degree completion!

For more information about Health Information Professionals week, as well as some great articles, please visit the AHIMA site at:
  http://www.ahima.org/~/media/AHIMA/Files/ConferencesEvents/MX10214_HIPW15PlanningKit.ashx?la=en

Tuesday, February 24, 2015

Hot Topics in Rad Science

Healthcare administrators today are concerned with providing quality care in a safe environment. 

Patient feedback is an important aspect of implementing and monitoring health initiatives that are tracked in health facilities. Patient safety rates, infection rates, drug reactions, etc. are to name a few initiatives that are monitored with corresponding action plans to prevent infections and readmissions.

The Affordable Care Act will change the arena of hospitals regarding issues such as reimbursement rates, in how physicians will order tests, etc.

In addition, in an effort to stay competitive, administrators need to evaluate the benefits versus the costs of purchasing new medical technologies, as patients are researching and requesting them. Diagnostic Imaging departments have been transformed over the past decade, due to recent advancements, such as magnetic particle imaging, information technology systems, new digital imaging systems, etc.

Wireless and mobile radiology systems allow physicians more freedom and the ability to treat patients at their bedside, in rural areas, etc. Remote viewing systems have allowed multiple physicians, who are in multiple locations to simultaneously access and consult on a patient. The Cloud or web-based systems are used to access images outside the hospital’s system.


With reimbursements decreasing, administrators are looking for ways to improve the work flow in radiology departments by incorporating more automation and ergonomically designed equipment, while working on a fixed budget. This can be very challenging. Patient safety comes first.  

By Brenda Rice, Program Manager RSA

Sunday, February 01, 2015

Value Based Payments and the Physician Quality Reporting System

One of the newest provisions of the Affordable Care Act which went into effect on January 1, 2015 was the provision which ties physician payments to the quality of care that they provide.  The main idea behind this system is to move the physician practice from the model as it was where volume of patients was the focus.  This system had physician practices running to see huge numbers of patients in a day, sometimes double or triple booking to meet this end.  Value-based payments are beginning to be instituted this year to allow these same physicians to slow down and provide more meaningful care to patients than what has been furnished in the past. 

As of 2015, this provision will only apply to practices of 100 or more eligible professionals and is focused only on Medicare providers.  The value based payment model includes an opt-in payment adjustment for those practices which have reported satisfactory measures of quality under the newly instituted Physician Quality Reporting System (PQRS).  The PQRS will quickly become a method by which practices will be able to receive incentive payments, or negative adjustments, over the upcoming years of continued expansion of the Affordable Care Act.  As it stands, the PQRS allows for reporting of different measures by providers such as clinical conditions treated, types of care, settings where care is provided, quality improvement goals for the practice for the year, and other measures yet to be defined.  Physician practice payments will not be affected by this reporting as of this fiscal year, however, they can receive incentives or penalties in the future based upon what they report currently.  As such, those physician practices that do not provide information to the PQRS system in FY 2015 will see only penalty adjustments in the future. 

Forecasting the future is a very important part of what practice managers do.  Realizing the impact of this new system of reporting in current forecasts, budgeting, capital management, and marketing should be at the forefront of operations today.  Doing nothing now will hurt your practice in the future! 

Some important websites with further information:

American College of Physicians. (2013). Value based payment modifier.  Retrieved from: http://www.acponline.org/advocacy/where_we_stand/assets/vii2-value-based-payment-modifier.pdf

Berenson, R.A. (2010). Moving payment from volume to value: What role for performance measurement? Retrieved from: http://www.urban.org/uploadedpdf/412344-moving-payment-volume-value-performance-measurement.pdf

Centers for Medicare and Medicaid Services. (2014). Medicare FFS physician feedback program/Value-based payment modifier.  Retrieved from: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Background.html

Centers for Medicare and Medicaid Services. (2013). Physician quality reporting system (PQRS) overview.  Retrieved from: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/PQRS_OverviewFactSheet_2013_08_06.pdf


Contributed by Dr. Michael Mileski, DC, MPH, MSHEd, LNFA, SJC Faculty

Friday, January 16, 2015

High Deductible Healthcare

Background on high-deductible plans or otherwise known as “consumer-driven healthcare.”
According to the Leapfrog Group, 1 in 5 are now utilizing plans that are high-deductible or consumer-driven healthcare plans. One of the characteristics of these types of plans are that the patient is responsible for the first $1,000 or more. As stated on HealthCare.gov, the annual out-of-pocket maximum/limit can go up to 6,600 for an individual or $13,200 for a family. The benefit for a higher out-of-pocket is a lower monthly premium, but even with the best planning, one cannot truly prepare for the costs associated with an unexpected illness that may require a hospitalization or outpatient services.
What is this doing to the healthcare consumer? How do they pay for services that fall into this valley of co-pays and deductibles? Well, there are an increasing amount of finance options to help out. For example, there is one called Healthcare Finance Solutions that can offer short term loans for as little as 0% for the consumer and the provider can be paid within 48 hours. In addition, they offer infrastructure that will support the registration clerks and admissions staff as they are meeting with a patient or their family that will enable them to access the system and process their application in no time at all. Everything is integrated into the EMR or as a stand-alone that has easy access for the registration clerk or admissions staff. Now, the facility can collect upfront these large deductible plans, give the patient peace of mind that their financial responsibility is taken care of, and their focus can now be centered on getting better. More importantly, this can take the question of should I get this procedure done to when do I want to get this procedure done.
Most people, if not all, sign up for the high-deductible plans base on the monthly premium. I hope that over the next year a more robust education process is afforded to the purchaser of healthcare so as to avoid, this seemingly, one dimensional decision process.

HealthCare.gov. 2014a. Out-of-pocket maximum/limit. Retrieved from https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
Leapfroggroup.org. 2013. High Deductible Health Plans & The New Era of Consumerism in Healthcare. Retrieved from http://www.leapfroggroup.org/media/file/AnnualMeeting2013Program.pdf  


by Kevin (Michael) Harrington

Monday, December 01, 2014

Saint Joseph's College Cares

Saint Joseph's College is an integral part of the local community here in Maine.  Each year the college prepares pies to be given out at local food pantries. This year the staff took it up a big notch and made 1,548 pies, breaking the existing Guinness World Record for pie-making!  The finished pies were donated to over 100 area food pantries!  Click the link below for more detailed information and pictures:

http://www.sjcme.edu/content/pearson%E2%80%99s-caf%C3%A9-volunteers-aim-and-exceed-goal-most-pies-made

We are proud of our college and proud to be part of this college community!!!!