Physician practices thrive on a continual stream of new patients for their long-term survival. Historically, a patient chose a primary care practice based on the proximity to their home or by recommendation from a list of providers given by their insurance company.
These are unprecedented times in the construction industry and even more-so in the healthcare construction industry. The early days of the pandemic saw construction material costs soar as a record-setting building and remodeling boom hit the residential side of construction, fueled in part by so many people spending more time at home.
Mental healthcare in Alabama is changing. And it’s about time.
For too long, an Alabamian facing a mental health crisis had two primary options: the hospital emergency department or jail. Neither option is ideal, and neither fully addresses the deeper mental health or substance abuse issues at hand.
Each day, we are learning more about the social impacts of COVID-19 and the mitigation strategies, and it should be no surprise that these impacts are deleterious. Over a few months in early 2020, most of our lives became completely reoriented in an effort to manage the unknown effects of the new illness. Families with schedules that were structured around school activities, sports, and church suddenly found themselves sequestered at home indefinitely. When schools reopened, they did so with disjointed schedules subject to the randomness of positive COVID cases. While families felt increased stress, people without children or partners experienced an even more crushing isolation. With remote working, holidays cancelled, churches closed, community activities suspended, and restaurants carry-out only, individuals endured this period through Zoom and social media.
“The Only Constant in Life Is Change.”- Heraclitus
As a healthcare administration professor with the recent global healthcare-related events in mind, I often think about the future of our healthcare industry.
The Alabama Pediatric and Congenital Heart Center at Children’s of Alabama continues to achieve unsurpassed results and bring the latest technology and procedures to children and adults with congenital heart disease in Alabama and throughout the Southeast. Despite the challenges of the COVID pandemic, the volume of patients has remained steady, demanding adaptability among the 300 members of the Heart Center.
The 21st Century Cures Act is a landmark bipartisan healthcare innovation law that went into effect on April 5, 2021. Cures includes provisions to promote health information interoperability and prohibit information blocking by “Actors,” which include health information networks, HIEs, health information technology developers of certified health IT, and health care providers.
Diabetes is the epitome of “an ounce of prevention is worth a pound of cure.” That was the driving force behind our division’s advocacy efforts that led to a change in Medicaid coverage requirements for continuous glucose monitors (CGM) for children with type 1 diabetes.
Nasal obstruction is a significant source of decreased productivity, decreased quality of life, and disruption in overall sleep and restfulness. There are many possible causes of nasal obstruction, including allergies, viral upper respiratory infections, nasal/sinus infections, or even very rarely sinonasal malignancies. Primarily, nasal obstruction is a factor of three sites that work together within the nose to create resistance to nasal airflow.
Obesity is no longer considered a cosmetic issue caused by overeating and a lack of self-control. The World Health Organization (WHO), along with national and international medical and scientific societies, now recognizes obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.
In its latest report, the Centers for Disease Control and Prevention (CDC) estimates that 42.4 percent of U.S. adults were obese with 9.2 percent of these severely obese, which is the highest incidence ever recorded in America.
Why do physicians leave their employment with a practice group?
There’s no single reason for such a separation. A physician's leaving might be planned well in advance, or might be an unplanned, precipitous event.
Mogul, mogul, mogul, drop off. It didn’t take long for the widowmaker, a black diamond trail on Snowshoe Mountain, to send me to the emergency room of Pocahontas Memorial Hospital. Snowshoe Mountain in West Virginia has some of the best snow east of the Mississippi and as a first-time
Children’s of Alabama marks an important milestone with the celebration of its Asthma Clinical Pathway’s 10th Anniversary. The quality improvement initiative began in March 2011 with an aim to reduce inpatient asthma length of stay through the delivery of evidence-based excellent acute asthma care.
With the imminent emergency of the Covid virus subsiding, discussions have shifted from the physical dangers to concern about its lasting psychological effects. Healthcare organizations report alarming levels of stress, burnout, anxiety, and depression in employees, especially clinicians. This sharp rise should bring another equally troubling issue to the conversation: substance use disorders and addiction among healthcare providers and professionals.
When the Birmingham Medical News asked me to write a blog, they told me I could write about anything. Anything? Anything.
Imagine a gently winding forest path stretching out before you, in sight of a place that feels friendly and familiar. Subtle sounds provide the soundtrack as you take slow, steady steps through the path’s vibrant color, light and shadow, followed by a deep inhale.
It is the most complex cardiothoracic surgery performed in newborns, one in which surgeons literally construct a new, larger aorta for babies born with hypoplastic left heart syndrome (HLHS). Called the Norwood procedure, it must be done within the infant’s first week of life, followed by a second surgery when the baby is three to six months, and a third at age four or five.
It has been a difficult 2020 with the ongoing presence of COVID 19 exhausting frontline healthcare entities and stalling the outpatient services. The pandemic has been a devastating historical event, but it has brought sweeping changes for 2021.
Breast pain is one of the most common symptoms in patients undergoing breast imaging tests. Known clinically as breast mastalgia, breast pain is a frequent ailment in women regularly affecting their quality of life. In the mainstream, especially in the media and on the internet, breast pain is often associated as a symptom of cancer. However, breast pain can develop from a variety of different conditions.
Approximately every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies of a stroke. It causes about one in 20 deaths annually – making it the fifth-leading cause of death – and the primary reason for long-term disability. Moreover, Alabama has the second-highest stroke mortality rate in the United States, behind Mississippi, according to the Centers for Disease Control and Prevention (CDC). This high incidence of stroke has earned Alabama a spot in the stroke belt, dubbed so by the medical community.
The COVID-19 pandemic has challenged virtually every aspect of life, and for many of us, sleep has been severely affected.
Valentine’s Day was last month, and as usual, stores were filled with candy hearts while customers snapped up flowers and greeting cards. With Valentine’s Day now in the rear view mirror, while thinking about the holiday, I realized that we tend to overlook the opportunities we have every day to genuinely impact someone else. I found myself wondering how I could turn the seasonal attempts to show someone appreciation into a day-to-day routine. If I carried this mentality with me throughout the year, what downstream effects would follow? How would this impact not only my personal life, but my career and the culture of my organization?
Each year, the landscape for physician practices has experienced seismic shifts in the areas of reimbursement, regulatory requirements, technology, and competition. Meeting the challenges of such a shifting landscape is a formidable task for even the most sophisticated of physician practices. Doing so requires a keen eye on what’s ahead and careful planning. So, let’s look at a couple of trends that should be considered in the planning process for 2020.
Over the last four decades, there has been a tremendous reduction in mortality of patients with cardiovascular diseases. This applies to the entire spectrum of disease, including patients with acute myocardial infarction, heart failure, atrial fibrillation and arrhythmia.
With more healthcare organizations moving to VoIP (Voice-over-Internet Protocol) for their phone and communication needs, it’s important to understand the technology and how to make it work for your business needs. So let’s start with the basics.
Real estate is the second highest expense behind payroll for most healthcare practices. The benefits of capitalizing during lease negotiations can include a healthy raise through increased profitability, reduced debt, a nicer office and more. On the contrary, if negotiations are not handled properly, the results can be decreased profitability, resulting in the need to produce tens to hundreds of thousands of additional dollars just to pay the same bills that should have cost less.
While it’s easy to shop around for the best price on a car or the cheapest gallon of milk, it can be nearly impossible to predict what your medical bill will be following a procedure or hospital visit, regardless of your health insurance coverage.
There is no one simple solution that will eliminate all business security risks. However, organizations can build a robust internal culture of security that can profoundly decrease those risks. This approach starts from the top down.
The “just right” theme repeated in the classic fairy tale of Goldilocks and the Three Bears hits close to home at Children’s of Alabama’s Pediatric Imaging Center (PIC), where services are tailored especially for kids. Every inch of the PIC, located at Children’s South Pediatric Outpatient Center in Birmingham, is designed with children in mind to ensure their experience is “just right.”
Sound processes are essential to the success of any business. This is even more important in healthcare, where the ever-changing environment makes process improvement vital in order for a practice to prosper.
Physical health, mental health, and substance abuse problems often are more apparent in prisons than in the community, and many incarcerated men and women are often only diagnosed with these problems after receiving care from a correctional health provider. Correctional health care is also tasked with providing experienced management, technologically advanced services, and programs that control costs while ensuring quality of patient care.
The field of oncodermatology has emerged as a result of remarkable advances in cancer treatment. Unlike traditional chemotherapy, targeted anticancer agents such as epidermal growth factor receptor (EGFR) inhibitors are associated with decreased systemic toxicities.
The numbers tell the story.
Two years ago, the Children’s of Alabama Community Healthcare Education Simulation Program, or COACHES, launched with a mission of improving pediatric care in community hospitals throughout Alabama.
During my 30 years in healthcare consulting, I have seen several reform initiatives come and go.
In many cases, the initiatives have enhanced the ability of consumers to access insurance coverage and ultimately healthcare. In 1993, President Clinton proposed legislation that led to growth in Health Maintenance Organizations (HMOs) and also the HIPAA privacy standards which are still in place today. In the 2000s, President George Bush proposed changes to the Medicare program that led to the implementation of Medicare Part D coverage.
A look at the calendar tells us that we only have a short time left in 2018. That means many practices will be looking to complete their Security Risk Assessments in order to either qualify for the 2018 Merit-based Incentive Payment System (MIPS) or to simply fulfill their obligations to comply with the HIPAA Security Rule.
I work with Chris Heck, MD an orthopaedic spine surgeon. We have developed an interest in treating osteoporosis, as a result of patients with have seen with broken bones.
2017 was the first year for participation in the Merit-based Incentive Payment System (MIPS), a Quality Payment Program (QPP) implemented by CMS, to award or penalize participating clinicians with regard to future Medicare reimbursements based upon reporting under four categories:
Many Alabama providers participated in the Quality Payment Program in 2017, under MIPS (Merit Based Incentive Program). A handful participated in a MIPS APM (Alternative Payment Model), which is a baby step towards alternative payments, but still left the participants free from downside risks. As we pass the half-way point for the 2018 performance period, exploring risk bearing programs is on the rise.
Is your EHR application in the cloud or are you considering moving to a cloud based provider? If so ensuring that you know the providers processes for data backup, disaster recovery and overall security are extremely important.
One of the greatest challenges facing the healthcare industry isn’t a political issue, it’s a geographic issue. What if I told you that approximately 50 million Americans (17 percent of the total population of the US) have limited access to high quality healthcare because they live in rural communities? Rural healthcare has a unique set of challenges including not only geographic but also economic and lifestyle factors.
Other than skin cancer, prostate cancer is the most common cancer in American men. Although it is common, it is still one of the least well-known cancers and a diagnosis can cause confusion about treatment, symptoms, and potential side effects. In search of a minimally-invasive treatment for your prostate cancer? Through our partnership with Vituro Health, Urology Centers of Alabama is the first and only in the state to offer High Intensity Focused Ultrasound, or HIFU treatment.
I recently visited a specialty practice at a major health system. As I approached the registration desk a posted sign directed me to a standing kiosk to sign in. The family member I accompanied to the visit was unable to stand at the kiosk, so I provided the needed information and signed her in. Although it was a quick and seamless process, I was concerned because if I needed assistance, there were no employees to ask. Many practices have implemented kiosk sign-ins and have someone to assist a patient with the process if needed. Practice administrators have made the decision to implement kiosk to assure verification of the current insurance policy and prompt the patient to pay any out of pocket expense before they see the doctor. Many of the kiosk solutions allow a pre-registration via email to allow the patient to populate data and upload information from their own device at their convenience. Benefits of Kiosk Sign-ins include: reduction in the staffing at the front desk, decrease in patient wait time, and most impressively is the increase of time of service collections.
According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.
Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners! Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.
Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women1. While the disorder was originally described in 19402, lipedema remains under-recognized and underdiagnosed in the United States3. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.
Almost everyone has seen the ads for the new anticoagulants at this point. However, many Americans still remain in the dark regarding what atrial fibrillation (Afib) is and it’s potentially devastating consequences. Despite increasing efforts to improve the awareness for atrial fibrillation, many still do not know it’s signs and symptoms or that it is a progressive disease. Afib is the most common arrhythmia in the world affecting 3-6 million Americans with projections of up to 16 million by the year 2050.
Birmingham, AL – Behavioral Health Systems, Inc. (BHS), a Birmingham-based corporation administering national behavioral health programs since 1989, will be hosting a national economic and legislative forum on Wednesday, April 18, 2018 at The Club in Birmingham, from 8:00 am to 5:00 pm.
In the past few years, when we discussed patient satisfaction it pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as, plastic surgery who primarily practice on a cash basis. Consumerism is here to stay! Cost and quality will create a level playing field in healthcare. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website; I may also see online reviews.
When most people think of Spring they think of flowers blooming, birds chirping and sunny day ahead, but for millions… their thoughts turn to congestion, runny noses, itchy eyes or endless sneezes. They have what are known as seasonal allergies. Allergy symptoms are caused by a hypersensitive response to an otherwise harmless substance and not all allergies are the same.
In a world of rapidly accelerating technology, our lives have become a 24hr sprint of endless tasks to be completed within a certain timeframe. Doctor offices are inundated with patients many young in age presenting symptoms such as high blood pressure, racing heartbeat, headaches, chest pain, random sweats, insomnia, and gastrointestinal problems. With the increased volume of patients and the demanding time constraints experienced in physician offices, these physical symptoms are often treated individually. The physician may prescribe medication, make recommendations on possible lifestyle changes, yet the symptoms remain. Effective treatment has to go deeper. These patients could be simply suffering from stress or they could be dealing with a more problematic subset of mood disorders: Anxiety Disorders.
Physicians serve on the frontlines of our healthcare system, and by extension the many social programs guaranteed by the Social Security Administration. It’s a large responsibility and we owe them a debt of gratitude. These dedicated care providers, across many areas of practice and at varied levels within our medical system, help more than 57 million children and adults who live with disabilities across the United States.
We all recognize that healthcare is evolving at a rapid pace. With this evolution, the need to share patient information to positively impact quality care, provide a seamless patient experience, plus save time for your staff to coordinate care is of critical importance. By making the most of new technology, today’s office equipment can easily and securely, help you do just that.
Every year, new hearing aid technology is introduced to the market. New technology in hearing aids boasts updates and changes in directional microphones, sound processing algorithms, noise reduction features, amplitude and frequency compression, and audio data transfer between hearing aids, just to mention a few. What is often forgotten however, is that the primary objective of a traditional hearing aid fitting is to ensure that the patient is receiving the appropriate amount of amplification for their hearing loss at each frequency.
Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. There may also be significant liability and financial risks to a responsible healthcare professional treating this patient, particularly as patient outcomes increasingly become connected to quality indicators and reimbursement.
The Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama actively works toward the goal of a total cure through research and development of innovative therapies. More than a dozen prominent pediatric hematology, oncology and blood and bone marrow physician-scientists provide exceptional programs in patient care, education and research. Currently, the Center provides care or treatment for 90 percent of the pediatric hematology-oncology patients in the state.
Dr. Sunshine arrives in her clinic at 8 am. Her lobby is full of patients. Mrs. Jane, a 45-year-old widower who has been Dr. Sunshine’s patient for 10 years. Mrs. Jane has recently been complaining about reoccurring back pain, the inability to fall asleep, and indigestion problems. Dr. Sunshine is aware of the sudden passing of Mrs. Jane’s husband a year ago and treats her physical symptoms as they present themselves with analgesics, sedatives and reflux medicine. Yet, Mrs. Jane’s complaints remain. Although compliant with her medications, Mrs. Jane’s symptoms are a result of Major Depressive Disorder.
Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.
As we finalize 2017 participation in the Merit Based Incentive Program, most of us focused on improved performance in quality since the category carried the highest weight of 60%. Those who had previous success in Meaningful Use found the Advancing Care category easy to address. The Practice Improvement category is new and somewhat vague, but many practices were already performing tasks that qualified as an improvement activity. It is important to document the approach to improvement and track success because this category is subject to audit in the future.
Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk. A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.
Parkinson’s is recognized as the second most neurodegenerative disorder right behind Alzheimer’s. An estimated 7 to 10 million people have Parkinson’s disease worldwide, with 60,000 new cases of Parkinson’s being diagnosed just in the U.S. every year. Parkinson’s is known as a progressive condition and symptoms will affect patients differently. Typically, people diagnosed with Parkinson’s will portray some degree of difficulty with shaking or tremor, slowness of movement or bradykinesia, stiffness in movement or rigidity of the arms, legs and trunk and gait imbalance. Because of the loss of dopamine producing brain cells, patients will see their movements become slower and smaller, creating risk for falls and impairing their quality of life.
There is a lot of confusion about SSDI and SSI, the two types of disability benefits that can be received from Social Security. The definition of disability is the same under both programs, but that is where the similarity ends. The following is a very basic description of the disability programs provided under the Social Security Act, titles II and XVI.
Most people are aware that atherosclerosis can cause blockages in the coronary arteries, resulting in chest pain or heart attack, or in the carotid arteries, precipitating a stroke. But atherosclerosis can lead to another serious but often under-diagnosed condition: peripheral arterial disease (PAD). Defined as atherosclerotic obstruction of the arteries to the lower extremities, PAD causes leg pain and is associated with other cardiovascular disease. Although lower extremity PAD affects an estimated 12 to 20 million people in the United States, only four to five million of them are experiencing symptoms.
It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved. Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.
Every caregiver strives to expand the services they provide to their patients, while also improving quality of care and safety. These are certainly our goals at the Children’s of Alabama orthopedic clinic.
Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.
Most all medical practices are preparing a MACRA project this summer. Our healthcare team has had the opportunity to speak to many physicians and managers regarding preparation for the transition from volume to value based medicine and reimbursement. A large project can be overwhelming for any practice but this is more than a project, it is a culture change!
The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.
On June 20th, CMS issued its proposed rule for year 2 of the Quality Payment Program (QPP) under Medicare Access and CHIP Reauthorization Act of 2015( MACRA). Comment period ends August 20.
For years now, I have seen patient after patient frustrated with stubborn fat in areas that do not respond well (or quickly) to diet and exercise. Their concerns are very common, and certainly not something of which to be ashamed. Patients also frequently ask me for my recommendations on non-invasive cosmetic treatments designed to address these issues, like CoolSculpting®, Sculpsure®, Vanquish™ or Zerona™.
Summer is quickly approaching, a season that usually comes with warmer weather and, for many of us, vacation time. Vacations come in a variety of forms. You may prefer a staycation where you simply stay at home and avoid emails for a week. You may favor an once-in-a-lifetime trip to a place like Iceland, or you might head to the southern Alabama coast to catch some sun at the beach. While the travel possibilities are nearly endless, a contact lens wearer needs to be prepared for every situation.
As we approach the beginning of summer, our minds are likely not on summer vacation. The process of assessing our electronic medical record vendor, absorbing the details of MIPS, and making the decisions on how to prepare, is overwhelming for small practices. The transition to value based medicine has been evolving over the last 10 years in stages; adopting electronic health record, Quality Reporting, and Meaningful Use. Many administrators and physicians did not realize the importance of each project; from choosing the right EMR, to implementing it properly, therefore achieving best practice workflows.
As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age. I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well.
A colonoscopy is an endoscopic examination of your large intestine. The primary indication for the procedure is colon cancer screening. However, it is also an effective diagnostic tool for the evaluation of chronic intestinal symptoms including abdominal pain, diarrhea and rectal bleeding as well as unexplained anemia.
Devices that store information are now everywhere and used multiple times by most people on a daily basis. From PCs, to laptops, to phones and tablets, to USB keys and external hard drives – the amount of data that a person can potentially store has grown exponentially over the past decade. While the convenience of near unlimited storage is very appealing, it also introduces new challenges.
A common diagnosis patients present at HealthSouth Lakeshore Rehabilitation Hospital is stroke. One of the many deficits a stroke patient may incur is aphasia, a speech and language disorder that causes difficulty using or comprehending words during listening, speaking, reading and writing. Although symptoms may vary from patient to patient, the difficulties and frustrations people with aphasia and their families encounter are consistent.
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