Issue link: https://beckershealthcare.uberflip.com/i/644565
74 THOUGHT LEADERSHIP Even many hospital executives who have worked hard on ER effi- ciency know they can do better. When I told the chairman of a major pharmaceutical company my story about waiting in the ER, he was ready with his own. He sprained his ankle while playing tennis, and friends drove him to the closest hospital, where he also happened to be the chairman of the hospital's board, but he didn't pull rank and was treated like any other patient. He was told to sit down and someone would be with him soon. Well, "soon" turned into 2.5 hours, and by that time, he said, his ankle felt much better. So he simply got up and walked out of the emergency room — another patient "LWBS." His story doesn't end there. A few days later, he attended a hospital board meeting in which the CEO of the hospital made a presentation on how the institution was becoming more efficient — especially the emergency room, where wait times had been cut from 1 or 2 hours to 30 minutes! e board chairman waited until aer the presentation to take the CEO aside and tell him his story. e CEO was embarrassed, even though this was a hospital that actually did have one of the shortest waiting times in the Chicago area, according to the Crain's survey. More than ever, unhappy patients in the ER can affect your bottom line. The HCAHPS survey assesses ER patients' attitudes. When consumers decide which ER to go to, they can access online tools such as the ProPublica's ER Wait Watcher, which shows wait times for individual ERs across the country, based on federal data. In 2015, online consumer site Yelp started using ProPublica's data on wait times in its assessments of hospitals. e experiences that people have in one part of the hospital can affect how they feel about another. CEOs should always be aware that the problems that exist in the ER serve as a window to the community on how well the hospital operates. n The Key to Population Health: Know Your Chronic Disease Patients and Coach Them By Nick van Terheyden, MD, Chief Medical Officer, Dell Healthcare I n my column last month, I talked about the need for a new physician interface that sits on top of the EHR and integrates data from multiple sources. This interface could also help us make use of the vast amount of consumer-generated data headed our way, via fitness trackers, smart watches, and phone and tablet apps. But only if we integrate it carefully. Few physicians are eager to have that data pouring into their EHR. What are we supposed to do with this stuff? How do we make it useful? We don't need to know every step recorded by a Fitbit, and we don't need all the data from healthy patients. That said, there is a place for some of this data within our efforts to create a healthier nation. U.S. ranks low because we don't manage chronic disease well Population health is critical to the future of healthcare in the U.S. Compared with other developed nations, the U.S. has ranked poorly on cost and outcomes. This is predominantly our inability to effectively manage chronic disease, which shortens people's lives, degrades their quality of life and costs the U.S. healthcare system enormous amounts of money. If we learn how to effectively manage chronic conditions, and avoid hospitalizations and serious complications, we can improve life for patients and greatly reduce the ballooning cost burden we all share. Caring for patients with chronic conditions is one of the toughest jobs we face as physicians, because these pa- tients need help every day, not just in the clinic. We need to coach them toward better health behaviors. To do that, we need two things: frequent contact with the patients and accurate data about their health and activities. Using remote monitoring and telehealth The combination of remote monitoring and telehealth can give us the power to really change lives. To use this new technology efficiently, though, the data needs to be a part of a physician's regular workflow and the most relevant data needs to be presented in a clear, easy-to- use dashboard. If the data is hard to find, it won't be used. Physicians are too busy already, and they don't have the bandwidth necessary to work with a new system or deci- pher poorly presented data. We also need to be cautious about the source and quan- tity of data we integrate. We don't need every step from a Fitbit, and we don't need all the data from patients who are in great health. They currently don't need our help and coaching. What we need is precisely targeted data from reliable, medical-grade monitoring devices used by patients who need coaching. There is a place for data from activity trackers within the system, but it needs to be appropriately filtered and integrated with data from devices that monitor glucose, blood pressure, weight and other vital signs. There also needs to be a carefully thought-out program of feedback and coaching to make this data meaningful to the patient. Ideally, the physician's team should include a well-trained health coach to design a feedback plan for each patient (with the physician's input). The coach doesn't have to be on the physician's staff, as there are plenty of options for delegating this task to an outsourcing company that specializes in telehealth and health coaching.