With the U.S. economy officially in recession, a new report provides five useful tips for getting electronic medical record money for federally qualified health centers.
The white paper, written by consultants Audie C. Horn and Rhonda Metze, says that although times are tight, grant money is available for community health centers whose managers understand and state their needs carefully, are willing to persist through the arduous grant-writing process, and who are willing to pool resources with other CHCs.
While the paper is focused on EMR funding (it is underwritten by the EMR vendor HealthPort), Metze's and Horn's suggestions are commonsensical and applicable to most any effort to get grants.
First, community health centers in the same region are urged to team up with one another. That's because the federal government gives preference to networks of CHCs rather than individual CHCs, doling out grants of about $1 million or so to collaboratives to gain economy of scale and have a greater impact in a region. For example, the Mississippi HealthSafeNet High Impact EMP Project, representing seven of Mississippi's 22 CHCs, recently applied, received, and divvied up a $1.4 million technology grant from the feds.
Second, don't just look to the government for money. Private foundations and corporations are still handing out money for CHCs with savvy managers who know where to look and how to ask. Generally, private donors don't give as much as the feds, but they're usually quicker to act. If you don't know where to find a deep-pockets donor, Metze recommends browsing at foundationcenter.org/, which regularly posts contact information on any number of private foundations, endowments, and other donors. Metze says more and more private donors are learning about the value and the needs of CHCs, which makes asking for money a little bit easier.
Third, consider adopting a total cost of ownership model. It requires a little bit of work, but it has the potential to pay major dividends both financially and with respect to building community ties. Go to your local hospital and point out the savings that can be achieved by funneling non-emergency cases from their emergency department to your CHC. Go to your local Wal-Mart or other big employer in town and make sure they understand the work you are doing to keep their community and their workers healthy and productive. Make sure they understand the cost benefit and ask them to share in the cost. "That support can include help with marketing, or providing space for free clinics at their facilities, or by donations, or by volunteer work," Metze says. "The whole community needs to buy into the total cost of ownership for the care you are providing."
Fourth, get your message straight. You're asking for money, so you'd better be able to explain why you need it. Explain how your CHC provides care for the homeless or migrant and seasonal workers. Explain how the funding you're requesting will be used to ultimately benefit a population that nobody else is serving.
And fifth, focus on quality improvements. With the industry emphasis on preventive medical care continuing to grow, make sure to highlight the preventive care programs your CHC has undertaken. This can be tricky because of the patient mix at CHCs, where most patients are poor, uninsured, and seeking immediate care for an immediate problem. But you can show how the money you're seeking can have a positive impact on preventive care. For example, an EMR grant could allow your CHC to provide diabetes, dental, and body-mass screenings for the population you serve.
It's never easy to ask anyone for money. It's not supposed to be. But if you're organized, know what you want, and are willing to work with other like-minded CHCs in your region, the money is out there.
John Commins is the human resources and community and rural hospitals editor withHealthLeaders Media. He can be reached atjcommins@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Community and Rural Hospital Weekly, a free weekly e-newsletter that provides news and information tailored to the specific needs of community hospitals.
I'm going to come right out and say it: If you're in a market with a large Spanish-speaking population and your response is to publish a Spanish-language version of your hospital's newsletter or boast that you hablo Español at the bottom of your newspaper ads, you're wasting your time and money. And you're not fooling anyone into thinking you understand the needs of patients who come from "different" cultures, either.
In fact, I'm going to go a step further. If you serve a community with a large immigrant population it is not enough to hire a couple of customer service reps to answer the phone in their language. It's not enough to hire a few staff members and clinicians from the same ethnic or cultural group. Don't get me wrong. It's a start. It's just not enough.
In order to serve special populations you must understand them. And I mean really understand them. And that means taking the time to talk to them, to ask them what they want, to find out their needs. You must discover how they want to be treated—both medically and emotionally and culturally.
That's what New York Downtown Hospital in Lower Manhattan did. With an Asian population that makes up more than 80% of its customer base, cultural sensitivity is at the very heart of its mission—and its market strategy. "We don't want to lose any patients to our competitors," Jeffrey Menkes, president and CEO of the 180-licensed-bed hospital, said in the November issue of HealthLeaders magazine (Who are the People in Your Neighborhood?).
The hospital didn't just throw together a few programs and hope for the best. It created a comprehensive strategy for how to best serve the Asian community based on market research, including the good old fashioned kind—talking to its customers.
The hospital didn't hire a few people who speak Chinese—more than 40% of the staff speaks a Chinese dialect. And it doesn't just wish and hope for the right applicants to appear at the door—it actively recruits them.
It's a whole-hospital, long-term effort, Menkes says. "One of the things we don't want to do is set up that mentality that everybody wears a yellow button that says, ‘We're being sensitive this month.'"
Hospital employees helped identify projects that would improve the experience of Chinese patients. Teams of employees chose the five that they thought would make the greatest contribution. One was staff training in cultural sensitivity as it relates to patient care.
"Many of the staff do have a good understanding of cultural differences, but our goal was to really develop a book of wisdom that could be disseminated to all of the staff to improve the consistency of their responsiveness to cultural difference," says Harriet Levine, president of Stuart Levine & Associates LLC, the consulting firm that worked with the hospital on the project.
Another area that staff chose to focus on: employee satisfaction. It sounds funny, at first—as if the staff put itself first. But, Levine says, new initiatives simply won't work if you don't have satisfied employees who will stand behind them.
Management must understand that to get your employees on board, your staff and the union need to be recognized, appreciated, and valued, Levine says. "And when that all works together, you can get great customer service."
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Marketing, a free weekly e-newsletter that will guide you through the complex and constantly-changing field of healthcare marketing.
The professionals and academic minds at Pitt County Memorial Hospital (PCMH) and East Carolina University (ECU), both in Greenville, NC, decided that it was time to bring technologically advanced, patient focused, integrated cardiac care to North Carolina in the form of a new facility. However, without an effective way to communicate the unique new approach to caring for patients, the success of this ambitious collaboration hung in the balance.
This all inclusive institute for care will include two new facilities, opening in early 2009, that will be called the East Carolina Heart Institute (ECHI). "The institute [will be a place] where research, education, treatment, and prevention all come together to benefit the people of this region and beyond," says Dan Dunlop, president of Jennings, ECHI's agency, in Chapel Hill, NC.
With so much coming together at once, PCMH, ECU, and Jennings needed to create an effective awareness campaign that would inform while bringing a sense of balance and clarity to all of the attributes and services the new institute needed to convey.
The campaign that was created to meet those needs communicates a balance between technology and treatment, achieved with a creative strategy using images that mirror each another with similar photographs placed side by side. One photo depicts the technology and the other the patient and the art of patient-centric medicine.
"The mirror image photography within the ECHI campaign graphically depicts the balance of leading edge technology and the best in academic medicine," says Dunlop.
The copy and overall message for each piece of the campaign was kept simple and concise to complement the images, balance them on the page (for the print pieces), and allow the images to stand out.
"One of the things we're working hard on is integrating the advertising with events marketing, internal communications and media relations, as well," says Dunlop. According to Dunlop, for a successful launch awareness campaign, you can't just be content to sit back and rely solely on the power of the paid media. Marketers need a fully integrated endeavor to create buzz.
Kandace McLaughlin Doyle is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kdoyle@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
Online social networking site Facebook has launched a new featured called Facebook Connect, an application that allows users to view what their other friends are doing and share their online actions with others. Supporters believe these capabilities may result in the emergence of a new social Web.
Many companies' paid marketing and advertising efforts are experiencing a loss of credibility with their target market. Advertising seems to have created a credibility gap with consumers, who often do not believe a brand's message just because it came in the form of an ad. Fortunately, a cohesive public relations strategy can close this gap between organizations and their brand.
This year has not been kind to disease management.
Experts have increasingly questioned DM's effectiveness and CMS ended the DM-inspired Medicare Health Support demonstration, claiming that it was not successful.
Those who question DM say call-center based nursing programs are simply not cost-effective, which is causing many in the industry to find other ways to reduce costs and improve outcomes and quality.
Employers are also demanding services that reach all employees (not only the sickest), and DM companies have found that DM programs are not as effective for some chronic illnesses.
This combination has led DM companies to add wellness programs to their chronic care offerings and create an expanded industry now called population health, which has replaced disease management as the industry term.
Population health companies have moved beyond call-center programs and expanded into technology, remote patient monitoring, and automated call centers.
At the recent DMAA: The Care Continuum Alliance conference in Hollywood, FL, two industry leaders discussed another potential option: chronic illness self-management.
The healthcare system does not prevent illness and disease; empowering the individual patient to take control of his or her health could become the next frontier for DM, said Kevin J. Wildenhaus, PhD, director of behavior science and data analytics at HealthMedia Inc. The Ann Arbor, MI-based company, which was purchased by healthcare giant Johnson & Johnson in October, specializes in combining technology and behavioral science to emulate a health coach via the Web.
Chronic illness self-management programs move away from member education to empowerment and away from information to intervention, said Wildenhaus.
It's one thing to place health information on a Web site. It's quite another to make it informative and something that people can integrate into their lives. This can be accomplished by gathering information from an individual's health risk assessment and claims records, and then creating a member-specific Web page. Employers can help by giving incentives for employees to visit their pages.
"The information is out there. People are accessing it, but what are they doing with the information," said Wendy Vida, RD, clinical preventionist at Highmark Blue Shield in Pittsburgh. Highmark created the Blues on Call program that seeks to empower members through a 24-7 condition management program, interactive voice recognition telephonic outreach, resources for members and providers, self-management education, nurse case management, and online chronic condition program.
Vida said self-management is especially important given the growth of consumer-driven health plans (CDHPs). Having to take a greater responsibility for their healthcare bills, people must gain a better control of their health and self-management dovetails with CDHPs, she said.
Wildenhaus said self-management programs include:
Management of medical, emotional, and personal issues
Motivation and self-confidence associated in managing their conditions
Management of sleep, pain, fatigue, and depression
Improved doctor, patient, and pharmacist relationships, and communications
Medication adherence and overall treatment compliance
Social support
Setting goals and planning skills
Accepting personal responsibility for managing conditions
Wildenhaus said both Highmark and HealthMedia's programs get people engaged, improve patient conditions, and reduce medical and productivity costs. For instance, participants reported improved health, quality of life, self-confidence, self-management skills, provider relationships, and medication adherence as well as decreased stress and worry. A medical claims analysis showed that the Highmark program saved nearly $1,000 on medical claims per each member annually compared to projections.
HealthMedia has been successful in areas such as depression, insomnia, and eating disorders, but there are a whole slew of barriers to overcome if self-management becomes the norm across the population health landscape.
Here are just a handful of questions:
Will doctors view this as a direct attack on their autonomy?
How can you help at-risk populations self-manage their conditions?
What do you do with the millions who are not ready to commit to better health?
Will health insurers, population health companies, and technology vendors be able to create networks that effectively engage members?
How much will human intervention (i.e. nurse call centers) play a part in self-management programs?
The industry is interested in learning more about the idea as was evident in the packed meeting room when the two industry leaders spoke.
However, there are still many unanswered questions about how to make health a part of everyone's daily life. Integrating health into lives will take a coordinated effort from all stakeholders, including physicians, population health, health insurers, nurses, and most importantly the patients.
A person has to feel motivated before he or she is activated. That activation level for each individual will ultimately decide whether chronic illness self-management is a winner or another interesting idea that doesn't work.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.Note: You can sign up to receiveHealth Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.