A small group of hospitals in western Wisconsin is providing a lesson in innovation for rural hospitals everywhere.
The Rural Wisconsin Health Cooperative Information Technology Network will get $1.6 million over the next three years as its share of the FCC's $400 million Rural Healthcare Pilot Program. The first-of-its-kind grant will be used to offset the cost of building a collaborative information system and electronic medical records initiative.
While the FCC pilot is providing funding for the telecommunications upgrade, the federal Health Resources and Services Administration is providing another $1.6 million for software and EMR hardware, says Louis Wenzlow, chief information officer for the Wisconsin project. The funding is expected to underwrite about 85% of the cost to establish collaborative broadband networks that will support telemedicine services for the cooperative's four small critical-access hospitals, and two physician clinics in the traditionally underserved rural areas. The cooperative members will pick up the remainder of the costs through monthly fees.
Wenzlow says the collaboration will allow the hospitals to negotiate better discounts from vendors, reduce datacenter costs and software licensing fees, and tap into a pooled technical support staff—services that might otherwise be prohibitively expensive for one small hospital acting on its own. "It's really extraordinarily expensive for a hospital to implement a full EHR system. By creating value that way, they are better able to spend more money on telecommunications down the road," he says.
The four hospitals in the cooperative are now live on a shared system that was implemented over the summer and includes financial systems, and departmental systems like lab and radiology, order entry and scheduling. Wenzlow says the cooperative is preparing an "aggressive" roll out of advanced clinical systems that are scheduled to go live early next year.
Philip Stuart, CEO of Tomah Memorial Hospital, located about 45 miles east of La Crosse, in western Wisconsin, says his 25-bed hospital had already implemented many of the IT upgrades the cooperative was promoting, but decided to join because of the potential savings. "The advantage to us is the savings on the back end in terms of software licensing fees, being able to participate in grants for our interconnectivity with telecommunications lines, and computer redundancy for data storage. That's now cost-sharing for us."
Stuart says that Tomah could save about $80,000 over the next five years by joining the cooperative. The pooled technical resources also allow Tomah to leave unfilled a technical support position that was recently vacated. "We view the ROI as being very positive," Stuart says.
Even though Tomah was upgrading its IT system on its own, Stuart says he wanted to be involved in a cutting-edge project that is serving "a common good." He says small hospitals shouldn't be intimidated by the idea of joining together on such a project without the help of a bigger health system, because the formula for success is the same.
"I don't think it makes any difference if it's a critical-access 25-bed hospital or a 615-bed academic medical center," he says. "To make it work, the infrastructure has to be in place. You need to have the right mix of people with the technical savvy to do it."
"The up-front work saves you problems on the back end, too," Stuart says. "Anybody that gets into this needs to understand what it means and make sure the medical staff and the end users are part of the planning processes and are intimately involved or it won't work."
The other members of the cooperative are: Boscobel Area Health Care; Memorial Hospital of Lafayette County, in Darlington; St. Joseph's Community Health Services, in Hillsboro; and two physician clinics in Wonewoc and Elroy.
John Commins is the human resources and community and rural hospitals editor withHealthLeadersMedia. He can be reached at jcommins@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.
In look and feel, hospital ads run the gamut from slick to sloppy. The main culprit for ads that look less than professional? Bad photography.
And, oh! There are so many different kinds of bad photography that shows up in healthcare advertising. There are the photographs of buildings—great if you want to put your audience to sleep. There are the photos of medical equipment—great if you want to intimidate your audience. And then there are the photographs of people standing stiffly in formation as if posing for a police line-up—a terrific choice if you want your creative to be about as uncreative as it can be.
But to my mind, the two worst offenders are the snapshot and the stock photo.
Look, mom, I made it myself!
Sure, you save money when you take your own campaign photographs. Not many people would try to pull this off for a print campaign, but you see it a lot in internal campaigns, such as employee newsletters. The fact is these home-spun photos aren't half bad. But they're not half-good, either. The result is almost always vaguely reminiscent of a child's macaroni craft project.
Everybody thinks they could be a marketer, right? Well everybody thinks they could be a photographer, too. Just as the head of OB should not write marketing copy, you should not take your own campaign photographs.
Stock syndrome
Photos purchased from online warehouses look pretty and are easy to use, but the generic images also scream "fake." If you're looking for a picture that matches your target audience—say, a young Hispanic woman—you're likely to find a photo of woman who could be Hispanic, but also might be Asian and kind of looks vaguely Indian, too. That's not representing your unique audience—it's representing every audience.
Stock photographs are meant to appeal to the masses. That is why, by the way, you sometimes see ads for different products or companies that feature photos of the same model. Not exactly the best way to differentiate yourself.
Pictures speak loudly
Think about these two kinds of photographs—stock and snapshot—and what they say about your organization.
Snapshots suggest you don't care about your work. They hint that you take short-cuts. They make you look unprofessional. And they say that you don't care enough about your audience to make an effort to look nice.
Slick but sterile stock photos make you look good, but they also create a distance between you and your audience. It says you don't think of them as individuals. It says you don't really know or understand them. They make your organization look standoffish and cold.
Hiring a professional photographer might be the most time-consuming and expensive option. But of the three options, it is by far the superior choice. Your photos will look genuine. They'll look professional. And assuming you use a local photographer, you can use actual customers or employees in your ads. That shows that you know and care about your internal and external communities.
One caveat, lest you think that I'm completely unbendable on this issue: if you must take photographs yourself, at the very least invest in a good digital camera. And find someone at the hospital who has at least hobby-level experience taking photographs—you might make an announcement in the employee newsletter, for example, that you're looking for help.
Maybe you'll discover that head of OB is handy with a camera.
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.
Ellsworth (KS) County Medical Center wants to convince its patients to walk across the United States. And most will do so without leaving Kansas, or even Ellsworth.
The hospital is promoting a program called WOW, or Walking off Weight, which aims to encourage locals to become more active and healthy. Dough Stefek, community outreach coordinator, says the hospital came up with the program after a health assessment survey revealed that 33% of county adults are overweight.
The hook—the hospital is encouraging participants to walk the equivalent of a cross-country trip.
"What we originally were going to do is walk the mileage across Kansas," he says. "I think with the response that we've had—and we've had a pretty good response so far—we're thinking that since Kansas is only 400 miles across, we're thinking that we're going to go ahead and walk across the United States—see how far we can get."
The hospital will display participants' progress on a bulletin board in the lobby and on its Web site. After the first day of registration, 56 people signed up and 20 came to hear more information about the program. Stefek says he hopes 300 will participate.
The program began on October 5 and will run through April 24. On April 25 the hospital will announce the winners—those who walked the farthest and those who lost the most weight—at the local health fair. The top winners will receive prizes.
All participants will receive Walking off Weight T-shirts featuring the program's logo—the word "WOW" with tennis shoes on the bottom of each W. The logo was conceptualized by one Ellsworth's nurse managers and designed by one of its dieticians.
Stefek says that developing a healthier community will ultimately benefit the hospital.
"We're hoping this is going to be a preventative type thing," he says. "With people actively involved in physical exercise [we hope] that they won't be coming into the hospital as much."
"Nano-niche" marketing—targeting very small but engaged groups of consumers—is one way to weather a recession. How can you do nano-marketing if your brand is designed to be sold to a wide audience? It's more work for the marketing team but often far less investment in media buys. So, you may spend a bit more on salary, but a lot less on ads. That’s because you're relying on content, blogs, search optimization, and reaching out to extremely small (but ripe for the plucking) lists and media outlets.
You probably have one of those piles on your desk that keeps being moved from one corner to another. You know, that pile you need to get to but avoid because it will take some real effort to tackle? For many marketing professionals, marketing accountability, analytics, and ROI are in this pile.
Two-thirds (65%) of CMOs and marketing execs say their ad budgets will decrease because of the troubled economy, but more of their money will go toward digital/interactive marketing than before, according to a survey from Epsilon.
A Massachusetts Medical Society (MMS) report released this week answers in the affirmative, but health plans think differently.
The MMS report shows that 12 physician specialties are operating under severe labor market conditions. Not surprisingly, internal medicine and family practice are listed as critical shortages. Long wait times continue to plague the primary care system; the average wait time for internal medicine is 50 days, and the average wait for family practice is 36 days, according to the report.
Twelve of 18 specialties surveyed were deemed to be operating under shortage conditions, including three—dermatology, neurology, and oncology—that were added to the shortage list for the first time. The number of shortage specialties in the state has doubled in just three years, according to researchers.
Although compensation is often cited as a causal factor in shortage conditions for lower-paying specialties (such as primary care), the newer additions to the list are some of the highest-compensated specialties in medicine (such as dermatology). Shortages in those areas reflect a growing disparity between patient demand and physician supply being seen nationwide, says Bruce Auerbach, MD, MMS, president of the Massachusetts Medical Society.
Auerbach attributes the broader causes of the shortage to trends that are being seen across the country: retention and recruitment challenges, the threat of malpractice lawsuits, high malpractice premiums, and rising medical school debt—issues that would affect the state regardless of its health insurance system.
"Clearly there is a link to the health insurance system we have, both in terms of administrative burden as well as the reimbursement levels it provides to physicians that live in high-cost states like ours," Auerbach says.
Massachusetts physicians complained about increased workload and low payments in the report, but Marylou Buyse, MD, president and CEO of the Massachusetts Association of Health Plans, says those are misperceptions. Physicians are not seeing more patients, and health plans increased physician payments by 10% each year between 2002 and 2006 and the healthcare reform law increased Medicaid payments for physicians and hospitals, she says.
"Doctors are charging more for their care, they are not seeing more patients, and their payments are going up 10% a year," says Buyse.
Auerbach mentioned that decreasing administrative burdens is one immediate step the state could take. That charge rings hallow for Buyse.
"If anything, these administrative requirements are not new. They have been around for at least a decade. And if anything, the health plans have reduced them, not increased them," she says, mentioning fewer prior authorizations as an example. Healthcare law consultant David Harlow, principal of the Harlow Group in Newton, MA, who writes Health Blawg, says the question is: How can Massachusetts create a more attractive environment for physicians immediately?
Harlow says even if residencies are increased that won't help in the near term. "It's not an immediate quick fix," he says.
Recruiting new physicians and helping prospective doctors pay for their college are long-term solutions, but there are ways to deal with the problems now, such as revamping malpractice environment and allowing for retail pharmacies. CVS/pharmacy recently opened its first MinuteClinic in Massachusetts and hopes to have 28 retail clinics in its stores by the end of the year.
Greater use of physician assistants and nurse practioners to provide basic healthcare services would free up physicians to work on more complex cases, Harlow and Buyse say.
"To a great extent, that can be a reliever of pressure of primary care physicians, emergency rooms in hospitals, etc. If those service settings are used properly, they can be helpful escape valves," Harlow says.
What about the 433,000 newly insured in Massachusetts thanks to the recent healthcare reforms? That must be contributing to overwhelmed physicians, right? Maybe not. A recent article showed that many of the newly insured are using emergency rooms for routine care rather than visiting primary care physicians.
If average wait time for internal medicine is 50 days and family practice is 36 days, no wonder why people are rushing to the emergency room for routine care. Massachusetts has made great strides through its healthcare reforms, but educating patients and removing barriers to primary care are still major hurdles.
State leaders will need to clear those barriers before they can contain healthcare costs. But what will all of those newly insured do to a healthcare system that MMS already suggests is in severe trouble?
Elyas Bakhtiari contributed to this report.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.
Many Michigan health systems are likely to delay new construction projects that pour jobs and money into their communities, in a fallout from Wall Street's credit crunch. Faced with paying higher interest rates on bonds that help finance hospital projects and refinance costly older bond debt, some Michigan health systems are holding off on debt-refinancing plans until they see more stability in municipal bond markets. Others worry that losses on their investments may stall needed renovations and technology purchases.
The U.S. Department of Justice has unveiled a guilty plea by a former employee of WellCare Health Plans Inc. who admitted he conspired to defraud the Florida Medicaid program out of more than $20 million. Gregory West pleaded guilty in December, but the plea was sealed, Robert O'Neill, the U.S. Attorney for the Middle District of Florida, said in a release. West faces up to 10 years in prison and a $250,000 fine, the release said.
Irvine (CA) Regional Hospital and Medical Center will close Jan. 15, about a month earlier than originally scheduled. Tenet Healthcare Corp., which operates the hospital through a subsidiary, said it would work to find jobs for Irvine Regional employees at other Tenet hospitals in the area. The hospital had been leasing space from a real estate investment firm, which wanted the hospital closed before the lease expires in mid-February.
