I've never really thought much about shopping around for an x-ray, ultrasound or CT scan. But it turns out that being a proactive consumer can make a difference. 

Sometimes insurance companies will to sway patients with respect to where they have their test done. The rationale is that the patient will pay less toward his or her deductible at certain facilities -- and that also means the insurance company will pay less for the procedure. What isn't stated is that the quality of the equipment used at a facility that charges less may not produce the best scan for the radiologist to read, which can lead to a retest (more money out of the patient's pocket) or a missed diagnosis.

 pelvic scan taken with a 4 slice machine (lower quality)

 pelvic scan taken with a 64 slice machine (higher quality)

Where you get your scan can also impact the access your physician has to the image. Community imaging centers are electronically integrated, so network physicians have direct access to the images. They can compare scans that have been taken over time to identify any changes that may have occurred, and they can have the image on-screen during a procedure in the operating room.
 
It's worth investigating why you may pay less at one imaging center over another. There may be an important reason!

We have been working on adding additional features of Community Health Network's Personal Health Record (PHR) and a question occurred to me.

What is the expectation of privacy a patient has about the data they enter into a PHR on a health care provider’s web site?

If we used the information to help with providing patient care, do we need to ask the patient's permission before viewing the information?  Or is there an assumption that we can use the data because they have entered it into a health care organization's PHR as long as we follow the requirements detail in HIPAA?

Google, Microsoft, Revolution Health and the other non-health care organizations offering PHRs do not need to follow HIPAA guidelines as far as I understand because the law was only written for health care entities.

I think I'm leaning to that we should ask for permission but it is not required for us to view it.  Or we should detail in the PHR terms of use that we can use the information to help provide patient care and that we will not sell the information.

What do you think?

When creating a mobile website, several adjustments or considerations need to be made.  Obviously, you don’t just port your current website, optimized for a monitor, over to a mobile site.

You need to build the site as if you were building a site for dial-up users.  The download/upload speeds on smart phones are not yet comparable to the speed of a broadband connection.  Image sizes need to be minimized and html simplified.

The page layout needs to be more vertical than the page design for display on a monitor.  The user on a smart phone will be scrolling up and down to look at the page and the screen resolution is not very wide.  Also, the page length should be kept as short as possible to avoid long, endlessly scrolling pages.

Applications need to keep this rule in mind also.  The forms should only contain a few fields of data entry because it is more difficult to enter data on a phone than a keyboard and the load times will be slower.

The most important consideration, I feel is to make sure that what you put on a mobile makes sense for the user to use.  An obvious example is that you wouldn’t put an application on a mobile site that requires the user to print a page.  Less obvious is applications that can be built with all the other requirements in mind, but don’t consider whether the user will use them or not, don’t consider the process.  We can build a mobile site that has the full features of our Find a Doctor application, including the ability to compare physicians and request appointments, but we realized that a patient would not be doing that on their phone.  A patient would be looking up a doctor’s phone number, location, office hours, etc.  

So that’s what we built:  http://mobile.eCommunity.com.

Take a look at the site and see if you agree or disagree with what I’ve said here, or have comments about the site.

Community Health Network’s Car Safety Seat Program has been a part of Safe Kids Worldwide’s efforts to check child safety seats for proper installation through the Safe Kids Buckle Up program. Recently, the Safe Kids Buckle Up program celebrated the inspection of its one millionth car seat.

“Today’s milestone of a million child safety seats checked for proper installation is a prime example of the power of Safe Kids. Coalition coordinators, lead agencies, sponsors and literally thousands of volunteers coming together in pursuit of a common goal—to reduce the number of kids who are buckled up the wrong way or even worse, not at all,” says Mitch Stoller, president and CEO, Safe Kids Worldwide. “This celebration belongs to those of you in the field and the million children who have traveled more safely because of your efforts. Countless parents have slept more soundly knowing that they have learned the right way to secure their children in their car seats, booster seats and seat belts.”

“It has taken 11 years of hard work and unwavering dedication to get us to a million seats checked. To those of you who have spent your weekends crunched into the backseats of hundreds of vehicles, to those of you who have driven new car seats to the site of a crash so that a child would not be exposed to more risk by riding in a potentially damaged seat, to those of you who have made emergency installations at all hours of the day and night. This is your accomplishment and your legacy to the children of your community,” Stoller says.

Learn more about car seat safety >>
Register online for car seat safety inspections at Community Health Network >>

Mark Dixon, president and CEO of Community Hospitals of Indianapolis, recently became a Fellow of the American College of Healthcare Executives (ACHE), the nation's leading professional society for health care leaders. Dixon is privileged to use the FACHE credential, which signifies board certification in health care management and ACHE Fellow status.

"Because health care management ultimately affects the people in our communities, it is critically important to have a standard of excellence promoted by a professional organization," says Thomas C. Dolan, Ph.D., president and CEO of ACHE. "By becoming an ACHE Fellow and simultaneously earning board certification from ACHE, health care leaders can show that they are committed to providing high-quality service to their patients and community."

Fellow status represents achievement of the highest standard of professional development. In fact, only 7,500 health care executives hold this distinction.

To obtain Fellow status, candidates must fulfill multiple requirements, including passing a comprehensive examination, meeting academic and experiential criteria, earning continuing education credits and demonstrating professional/community involvement. Fellows are also committed to ongoing professional development and undergo recertification every three years.

"I'm thrilled to be recognized as Fellow of the American College of Healthcare Executives," Dixon says. "This is such an amazing honor and I am so pleased to be able to serve our patients and our organization at Community Health Network."

ACHE is an international professional society of more than 30,000 health care executives who are leaders in a variety of health care settings.

Indiana artist Debbie Reichard has completed the installation of an outdoor sculpture in the circle entry of Community Hospital North. This installation is an extension of the Community Health Network Foundation’s initiative to incorporate art into the healing process for patients and families.

Titled A Torrent of Pleasantries (in plaid), the installation is five feet tall and 15 feet long and is made of garden hose and steel. This installation is the first in a series of planned projects created by art students at the Herron School of Art and Design at Indiana University-Purdue University Indianapolis. Later this year, more temporary sculptures will be installed as part of an ongoing relationship with students and faculty. Visitors can enjoy this installation through October 2009.

According to Reichard, this installation is her satirical view of suburban life. “Sentimentally, we can be intrinsically connected to specific objects, colors, sounds and smells,” she says. “Even though many of these triggers seem unremarkable to most, everyone can think of an object that reconnects them to a memory.”

Reichard is a former visiting assistant professor of sculpture at the Herron School and has also taught at the University of Washington and the University of Colorado. She is known for creating unique sculptures and ceramics. “I want to change normal,” she says. She works in metal, wood and ceramic, found objects, castable polymers, and sound.

I just uploaded some new video from the Community Hospital South Groundbreaking, last night we pushed out the actual ceremony footage, and today introduced a new video album featuring employee videos about the new facility. 

Shuttle service launched at Community Hospital South this week. With the start of major construction just around the corner, some of the parking areas have been reconfigured. Parking in front of the hospital will be more limited while the new patient tower is under construction. To compensate for the spaces that will be blocked due to the expansion, additional parking is now available at the north end of the campus. Click here for a map.

Patients and visitors are encouraged to use the free valet service at the entrance to the emergency room or at the entrance to the medical office building at the north end of the facility. For those who wish to park their own vehicle, Community Hospital South is now offering shuttle service 24 hours a day, seven days a week. The shuttle stops at both entrances to offer convenient access to the hospital. To request a ride on the shuttle, call 317-887-RIDE (7433).

We just made an update to the Find a Doctor application on eCommunity.com, basically an update to correct some application flow issues.  One of the major issues was our attempt to stop users from using the back button because it was causing issues with the session and search results of the application.  It was causing several unintended effects like not being able to come back to a profile page or leave a profile page each occurred in a different set of circumstances.

Shouldn't have done this in the first place.

Attempting to stop back button use is a major usability must-not-do.  There are many articles and books and web pages discussing this usability problem.  Probably the most famous is Jakob Nielsen's "The Top Ten Web Design Mistakes of 1999" which still applies today.

I recently read his book "Prioritizing Web Usability" (written with Hoa Loranger) which was published in 2006 and many of the usability problems that he wrote about in 1999 are still relevant today and relevant for the future.  It shows how timeless design issues can be and that developers who don’t understand the past are doomed to repeat design mistakes of earlier developers.

Since Maggie beat me to posting about the new site for The Indiana Heart Hospital, I am going to get in on announcing the new Community Hospital South website.

Welcome! I'm Cindy, the Patient Representative at The Indiana Heart Hospital. What this means is that I visit with our patients daily to see how their stay is going and to make sure that we are doing all that we can for them. I also meet their family members and offer emotional support and will address any questions or fears that they may have. We strive to make every visit an exceptional experience.

I will be blogging about my everyday experiences with patients and their families: the compliments, the concerns, the good days and the sad days.I feel lucky that I personally to get know our patients and hear so many inspirational stories that I want to share these stories with you!

 

We have redesigned and reorganized the Web site for The Indiana Heart Hospital. We will continue to build it out and add more functionality over the next week. Take a look and let us know your comments!

www.HeartHospital.com

P.S. Coming soon...a new Web site to commemorate the Next Evolution of Community Hospital South. Look for it around the groundbreaking on June 17 at www.eCommunity.com/south

Community Health Network was a presenting sponsor for the inaugural Race Around the Reservoir Geist Half Marathon and 5K, which occurred on May 17.

Dan Hodgkins, vice president of health promotion and community benefit called the event “an incredible success.” In all 4,500 people participated in the event—the most ever for an inaugural race in the state of Indiana.

One of the largest successes was the involvement of children. Last year, Community along with The Lawrence Township Foundation started the Kids Up and Running program in the Lawrence schools. The goal was to combat sedentary lifestyles and get children and their families moving. More than 1,200 students raced in the half marathon and for more than half, it was their first organized race. “I think we had more success than anyone ever thought about,” Hodgkins says.

All proceeds raised from the race will go to support the Up and Running program as well as other similar programs in the Metropolitan School District of Lawrence Township and Hamilton Southeastern School District.

“This is a great example of how our Community Health Network contributions “pay it forward” to the broader community,” Hodgkins says.

Community programs awarded for addressing childhood obesity
The U.S. Surgeon General, Steven K. Galson, M.D., has singled out two model programs in Indiana to be awarded for successfully addressing the issues of childhood obesity. A news conference was held Wednesday, May 28, at Douglass Park in order to present the awards to Lawrence Township Foundation’s “My Community Gets Healthy” program and Indianapolis Public Schools Howe Academy’s “Fit4life” program.

Both of these programs have been supported by Community Health Network. “I am very proud of the work my department staff has provided to make both of these programs a reality, especially Karen Shirey, Lutrell Lauderdale, Todd Williams and Marcia Plant Jackson and others,” Hodgkins says.

The Surgeon General asked some of the student runners from the Geist Half Marathon, including a student at MSD Lawrence, who came in 14th out of the entire field of 4,500 runners, to be present at the awards ceremony and press conference. He was able to compete in the race with the support of the school clinic staff including, Denise Schnell, family nurse practitioner at Brook Park.

I am responding to a comment posted on my last entry:

"Didn't you just argue against your own point? The constant communication is already happening, and will continue to happen, the filtering has nothing to do with Web 3.0, or Web 2.0, or anything. I am in constant communication with everyone i know, via email, blogs, SMS, etc., and filter out simply by not checking, and only allowing certain communication methods to reach me when I choose them to. I'm not clear what your not buying."

I decided to respond with another post.

First of all, no one today is in the constant level of communication with user generated content that is described in the book.

Second, I disagree that filtering is not part of Web 3.0 (or whatever you want to call it).  Web 3.0 is also sometimes referred to the Semantic Web which means that web documents will be more structured and machine readable.  I believe this will be part of the evolution of web technologies and will ultimately create a vast world wide library of information.

Consequently, information retrieval algorithms will be more refined and filtering will be part of this refinement or users will not be able to find what they need when there are trillions and trillions of web documents.  I have observed friends and colleagues with information overload issues in e-mail and other communications.  I have experienced it myself and have set up rules in Outlook to filter e-mails into categories, generally consisting of ones to ignore, ones that are urgent and ones that don’t need immediate attention.

This information will consist of friends, family, etc. and businesses, marketers and other organizations vying for your attention, just like there are issues with e-mail spam today.  The spam will come in many different forms in the future and will use these new social networking/user generated content technologies.

This need for filtering will just grow in the future as the expanse of information exponentially increases.

A Community clinical nurse specialist and the network director of epilepsy/pulmonary DRG management, are featured in an in-depth video about Community Health Network’s world-class performance in preventing ventilator associated pneumonia (VAP). All of the network’s seven ICUs have gone at least one year without a VAP.

The video serves as a VHA Inc. Leading Practice Blueprint that maps out all of the steps that have been proven to lead the most effective and efficient care for VAP. Produced by VHA, the video was developed after VHA recognized Community Hospital East as a leading practice hospital for its work in preventing VAP. The video will serve to educate and encourage 1,400 VHA member hospitals nationwide to adapt and adopt these practices into their patient care patterns.

“This is the ultimate jewel in our crown of safety and quality achievements. VHA thought so and blueprinted it for all of VHA,” says Glenn J. Bingle, M.D., chief medical officer and network vice president, medical and academic affairs.

Wellspring Pharmacy at Community Hospital North now has five designated parking spots for customer use on the first floor of the parking garage. Spots 154 to 158 are designated for short-term parking while you are conducting business at Wellspring. The spots are located at the south end of the garage, next to the green elevator.

“We wanted to provide an exceptional experience for our patients and customers who rely on Wellspring for their prescription needs,” says Julia Feeney, merchandising coordinator. “The good news is that employees can also use those parking spots when shopping at Wellspring. We would like to extend a thank you to all of the people at CHN who worked to make this happen.”

More about Wellspring Pharmacy >>

I’m going to go out on a limb here and make a prediction of the future of the Internet.

I recently skimmed through a book called "Groundswell", written by Charlene Li and Josh Bernoff.  The last chapter was an extrapolation of the current state of social software that they call the groundswell.

The future that they believe will be here within five years is one where everyone is in constant communication through blogs, ratings/commenting systems, social networking software and instant messaging.  You will get notifications from friends, work, entertainment, etc. all the time.

I’m not buying it.

With all the self publishing occurring, the amount of information on the Internet is growing exponentially and as a result of this trend, users will feel information overload.  This has been discussed since the 90's when there were fewer web pages.

The Web 2.0 trend is a bubble that's going to burst and be shrunk by users filtering out all the stuff that they don't want to see or sort through manually.  Just like e-mail spam filters, there will be self-generated filters on the information you search for on the Internet.

Search profiles stored in a search engine that automatically filter your information through a point of view, a set of criteria, your past viewing history or comparing your profile to results others have searched for and viewed (Wisdom of the Crowds).

Even following a single prolific blogger can be hard because everyone is very busy trying to cram more and more into a day.  Internet filters that filter through blog posts and other information will be coming soon.  And it will be delivered to the user like RSS feeds work today.

Information retrieval improvements and information filtering will be the next new big thing on the Internet, Web 3.0 if you will.  And boxes instead of rounded corners.


"We are all interested in the future for that is where you and I are going to spend the rest of our lives." --Criswell

Earlier this year, Community Hospital East demonstrated that its stroke care program follows national standards and guidelines that can significantly improve outcomes for stroke patients. The Joint Commission’s Primary Stroke Center certification is based on the recommendations for primary stroke centers published by the Brain Attack Coalition and the American Stroke Association’s statements and guidelines for stroke care. The Joint Commission launched the program—the nation’s first—in 2003.

A celebration was held Thursday, May 15. “As part of the celebration and in recognition of Stroke Awareness Month, members of the stroke team will host a stroke education table. The team will explain stroke risks, sign and symptoms. Give-away items and contest prizes will be awarded to individuals who participate in interactive quizzes and drawing. We hope to see many of our employees as well as visitors stop by to celebrate with us,” commented José Longoria, Vice President of neuroscience/pulmonary services.

Established in 2004, Community East’s Stroke team is led by clinical nurse specialist Deb Ferguson, M.S.N., R.N., C.C.R.N., C.N.R.N. and Doug Strobel, M.D., medical director for the Stroke Program. This team is comprised of multi-disciplinary clinical team members from throughout the hospital that care for the stroke patient along the path of recovery. It meets regularly to review, discuss and evaluate patient safety and quality goals, education and training, new policies and protocols to achieve The Joint Commission Accreditation as a Primary Stroke Center. 

Google Health is live and looking good. I'll be playing around with it for a bit.

Recently I was in a content workshop we held to share with other member of our department that are responsible for marketing and communications.  We were briefly explaining what RSS was and I said essentially that the most important thing about RSS is that a user does not need to visit your website to read your content, listen to your audio or view your video.  For people who don't use it and are accustomed to controlling the design and layout of content, this is extremely important to understand.

I gave the example of news organizations who will subscribe to RSS feeds from all the new release pages (if there is a feed) and this would allow the press to keep up with the organization's announcements without visiting several websites every day, which they are unlikely to do.  RSS pulls any updated content to them so that all they need to do is open their RSS reader.

This idea leads to the second most important thing about RSS:  The user is in control of the content they receive and are able to pull from sources, instead of the typical push marketing that is done with TV, radio, print and billboards.