American Well, a Web service that puts patients face-to-face with doctors online, will be introduced in Hawaii. Its first customer, the Hawaii Medical Service Association, will make the Internet version of the house call available to everyone in the state, the company said. The service is for people who seek easier access to physicians because they are uninsured or do not want to wait for an appointment or spend time driving to a clinic, said Roy Schoenberg, co-founder and chief executive of American Well Systems.
The two leaders in a conspiracy to defraud Miami's Kendall Regional Medical Center for about $7 million were Jorge de Cespedes, the No. 2 official at Pharmed, and Sylvia Oramas, who worked in the hospital's housekeeping department, a federal judge has decided. U.S. District Judge Patricia Seitz's decision that the two were "organizers and leaders" could mean she might give them stiffer sentences.
Patsy Metheny, an independent community benefit consultant, talks about the role of hospital and health system marketers in reporting community benefit activities.
Trustees at Phillipsburg, NJ-based Warren Hospital have selected Thomas Litz as the next president and CEO. Litz will succeed Jeffrey Goodwin, who retired. Litz began work at the Roseberry Street hospital this week. Litz has worked around the country, including stints as chief executive of hospitals in Rochester, NY, and Birmingham, AL. Most recently, Litz served as corporate vice president of Integris Health in Oklahoma City. +
HCA's Northside Hospital & Tampa Bay Heart Institute have named Stephen Daugherty as CEO. Daugherty joins the Northside team from South Bay Hospital in Sun City Center where he has served as CEO for nearly three years. His career with HCA spans almost two decades. His new role as CEO at Northside Hospital & Tampa Bay Heart Institute will establish his responsibilities to include medical and professional staff development, budgetary oversight, organizational strategy improvements and day-to-day facility operations. +
Longtime hospital employee Bob Miller has been appointed COO of St. Elizabeth's Hospital in Belleville, IL. He first began working at the hospital part time as a housekeeping aide in 1974. He returned to the hospital in 1987 to work as a supervisor of Central Services. In 1998, he was named director of human resources and was promoted to administrative director of human resources in 2003. +
It's that special time of the year when people managers across the nation and in every industry face millions of holiday-bloated employees requesting weight-loss programs and diet-friendly cafeteria options.
Lexington Medical Center in West Columbia, SC, hopes to capitalize on employees' resolution-fueled demand for healthier, lighter fare with its "Better Choices" nutrition program. The program is several months old and already has registered better-than-expected participation from employees opting for healthier, less-fattening food when given an informed choice.
Better Choices uses the hospital's intranet to post daily menus for employee cafeteria fare that includes a breakdown of fats, carbohydrates, sugar, and other dietary information. A little green apple icon is attached to food that is either less than 500 calories per serving, or derives less than 30% of its calories from fat, or represents one serving of fruits or vegetables. Posters on the walls in employee areas, hallways, and the cafeteria provide useful hints about proper nutrition. Little paper pop-up tents on lunch tables provide quick "Did You Know" tips on healthy foods.
Steve Howell, director of nutrition services at the 384-bed community hospital, says Better Choices was created at the behest of employees. "They contacted us and asked for help to know what to eat," Howell says.
That's not as easy as it sounds, as Howell quickly determined. The hospital has plenty of full-time and part-time employees, and at any time any number of them could be on any number of diets; low fat; low carb; low or no sugar; Atkins; South Beach; the Zone; and Hollywood, to name a few. In addition, there are plenty of physician-crafted diets for employees with special health concerns.
"So many of these people are on different diets and we felt there was no way we could comply with every single diet that was out there," Howell says. "They were trying to eat healthier but they didn't know how. So, we tried to get the educational piece down and set some parameters to help them and educate them."
Coming from the Midwest, Howell says he was taken aback by the Southern diet. "I had people asking me if fried okra and french fries were a vegetable," he says. "You try not to laugh because you don't want to embarrass anybody, but it was just a real eye-opener."
Lexington opened the Better Choices campaign in August with a barrage of announcements and posters and the posting of dietary information on the intranet. Howell says it cost Lexington about $10,000 to set up the Better Choices program, with most of the money going toward marketing, a software package, posters, and other printed materials.
Howell found that an earlier attempt to provide nutritional information had not fared well, so he had to rebuild employee trust in the accuracy of the program. "We bought some new software to enter in our recipes and that has gotten the biggest response from everyone," he says. "I got flooded with e-mails the first two weeks telling me 'this is exactly what I need to determine what I can and cannot eat down there.' Now if I don't have the nutritionals out there every day I hear about it fast."
It's a time-saver too. Employees with only 30 minutes for lunch can access the daily menu at their desks and pick out what they want ahead of time, which also leads to healthier, better-informed selections. It's like going to the supermarket with a list drawn up beforehand.
At the urging of hospital senior management, Howell combed through existing recipes to make them healthier. "It's a lot easier when you have the administration supporting you. So, we've been able to make some changes in the recipes that weren't there to make the foods healthier, such as adding half turkey and half beef to the meatloaf, or making the cream sauces with non-fat milk," he says. "These are changes the public doesn't even realize we've done."
Howell says he's been pleasantly surprised by the employees' response to the program. "We are looking at 20% to 30% participation, which is a lot higher than what I was expecting, which was about 18% to 25% of total cafeteria sales," he says.
In addition to Better Choices, Lexington provides employees with an optional in-house physical assessment that targets health goals like weight, blood pressure, and cholesterol reductions. As an incentive, participating employees are given a small deduction from their health insurances costs, which amounts to $10 a month. Lexington also encourages Weight Watchers, Biggest Losers, and other weight-loss programs, and intramural contests to see which employee groups can shed the most pounds.
In May, armed with months of data, Howell says he'll review Better Choices to see where it can be tweaked, both in cost-effectiveness, and in employee participation. He says Lexington may look at incentives like lowering prices of healthier foods and raising prices of less healthy items to encourage better diets.
For anyone trying to entice employees toward healthier eating, Howell says be patient, because you're trying to alter decades-long, entrenched, lifestyle choices. "If you try to change a culture it's not something you can do overnight," he says. "You have to go slow and steady knowing that your goal is going to be attained eventually but it is going to take a long time."
(If you want more information about Better Choices, or you're thinking about setting up a similar program at your hospital, Steve Howell says he'd be happy to help. You can reach him at sjhowell@lexhealth.org.)
John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media HR, a free weekly e-newsletter that provides up-to-date information on effective HR strategies, recruitment and compensation, physician staffing, and ongoing organizational development.
Longtime hospital employee Bob Miller has been appointed COO of St. Elizabeth's Hospital in Belleville, IL. He first began working at the hospital part time as a housekeeping aide in 1974. He returned to the hospital in 1987 to work as a supervisor of Central Services. In 1998, he was named director of human resources and was promoted to administrative director of human resources in 2003.
HCA's Northside Hospital & Tampa Bay Heart Institute have named Stephen Daugherty as CEO. Daugherty joins the Northside team from South Bay Hospital in Sun City Center where he has served as CEO for nearly three years. His career with HCA spans almost two decades. His new role as CEO at Northside Hospital & Tampa Bay Heart Institute will establish his responsibilities to include medical and professional staff development, budgetary oversight, organizational strategy improvements and day-to-day facility operations.
Trustees at Phillipsburg, NJ-based Warren Hospital have selected Thomas Litz as the next president and CEO. Litz will succeed Jeffrey Goodwin, who retired. Litz began work at the Roseberry Street hospital this week. Litz has worked around the country, including stints as chief executive of hospitals in Rochester, NY, and Birmingham, AL. Most recently, Litz served as corporate vice president of Integris Health in Oklahoma City.
A new survey from the AARP has found that many Americans are reporting health problems that they're blaming on financial stress. In addition, many have had to either delay or cancel doctor appointments or put off or do without prescription drugs because of financial difficulties.
I don't need a crystal ball to tell you all that the tough financial times are likely to get tougher as we move forward into 2009. You could probably use an expert to explain all the ways this is true in healthcare so you can strategize for the new year, but you're stuck with me, so I'll do it.
OK, now for the disclaimers. If I was really any good at predictions, I wouldn't need to work for a living. But I take heart that no one else seems any better at it, because we're certainly not seeing a decrease in people who have to work for a living. Still, having covered healthcare for at least eight years now, I think I have at least some credibility on the soothsaying stump. With disclaimers that nothing is riding on these predictions, see if you agree with me.
Dozens, perhaps more, hospitals will close in 2009 due to financial insolvency. We've already seen the beginnings of this trend, with hospitals in New Jersey, Chicago, and other urban areas, mostly, closing in 2008. This is unprecedented in recent times. Despite the reluctance of politicians and the credit markets to allow hospitals in their representative areas to close in the past, we have reached a tipping point. Given the precarious nature of the financial crisis, many hospitals—especially those in big cities where the paying population is small and where there are several alternatives—aren't seen as necessities anymore. Debt is the lifeblood of nonprofit hospitals. If you can't borrow at cheap rates to fund new technology and improved infrastructure, you can't survive—and the pot of money is just too small to go around anymore. What will be interesting is whether 2009 will bring a round of closures in more rural areas that have no other hospital alternative. I happen to think it won't take long before we start seeing those.
Hospitals will continue to morph so that the traditional definition of a hospital will become obsolete: Many have speculated that there is only so much hospitals can do to remain competitive in a marketplace that is moving largely away from traditional inpatient care. Many leading hospitals and health systems have already effectively branched out from inpatient care by opening medical malls, and acquiring single-specialty physician practices and even ancillary businesses like imaging centers, as North Carolina's Novant did last year. Hospitals' business influence used to be measured in bed size. In the future, hospitals won't be the focus. The dominant business entity will be healthcare organizations—vertically integrated behemoths that dominate a state or region not only with hospitals, but with other necessary components of care that are as patient-friendly as they are profitable.
Hospitals will change their borrowing practices significantly: To be fair, a lot of this has already happened. There's no longer any significant market for auction-rate debt, and having been burned by it in the past, hospitals wouldn't use that option even if it was available. We're going back to basics with lending and borrowing, and even if traditional fixed-rate, 30-year bond offerings aren't yet the majority of hospital borrowing, there will certainly be less exotic options out there, and in the long run, CFOs may be thankful for that.
CFOs will become more strategic: Hospital CFOs used to just be numbers men. Now, they are increasingly more female, and increasingly graded more on their strategic, not reporting, acumen. Many large organizations are centralizing the main duties on which CFOs used to spend the majority of their time—essentially statistics and calculations. Today's CFOs are expected to spend more time executing the strategic priorities outlined by the CEO and board—taking an active role in finding new and better ways to finance a building or equipment purchase to wring the most margin out of these initiatives.
Hospitals will spend more prudently: In a related prediction, now that the orgy of cheap money is over, hospitals won't be so quick to order that new piece of technology that will be paid off with anticipated high volumes. With the pot of reimbursement money so stretched, those projections of high volumes can't be trusted anymore, and smart CFOs will really probe the potential revenue streams of technology and bricks and mortar before shelling out the dough to build or expand. Already, the equipment leasing industry is feeling the downturn.
I have a few more predictions that are a little more "out there," but I don't have the guts to actually put them in print. In the coming months, I suspect we'll all see some things that as of right now, don't even seem possible. Here's to an unpredictable new year.
Philip Betbeze is finance editor with HealthLeaders magazine. He can be reached at pbetbeze@healthleadersmedia.com.Note: You can sign up to receive HealthLeaders Media Finance, a free weekly e-newsletter that reports on the top finance issues facing healthcare leaders.
