The decision will require most Americans to obtain minimum health insurance coverage. CLEVELAND CLINIC President and CEO, Dr. Toby Cosgrove, says the law will ultimately change the face of healthcare.
CG: Dr. Toby Cosgrove/Cleveland Clinic
“I’m really pleased that we’ve seen the healthcare law held up. I think that what this means is that we’re moving ahead, we’re continuing on a journey of reforming healthcare in the United States . We’re addressing access for people who haven’t had access before. We’re beginning to address quality and developing a more efficient healthcare delivery system. I think one of the things I’d like to see more of however is more emphasis on wellness and reducing the incidence of chronic diseases that we see, secondary to behavior.”
“We started out with a healthcare system that was really designed for the 1950’s, a different set of diseases, different things we could do for patients and a different level of sophistication that we can bring to patient’s problems. All that’s changed now. We have a bigger population. We have an older population. We have more things we can do for people. Now we have to change the system in order to accommodate those changes.”
DR. COSGROVE HOPES TODAY’S DECISION WILL HELP TO CLEAR UP SOME OF THE CONFUSION OVER THE FUTURE OF HEALTHCARE.
CG: Dr. Toby Cosgrove/Cleveland Clinic
“I’m delighted we finally have a decision. It’s taken one more unknown out of the equation. For a long time we haven’t known what the rules of the game are, now we’re starting to know the rules of the game and that’s going to continue over a long period of time as we understand the law better, but we’ve got the first steps.“
Today, I’m talking to Dr.Corenthian “Corey” Booker.
Corey Booker, not to be confused with the mayor of Newark, is a physician. He received his undergraduate degree in Neurobiology and Physiology at the University of Maryland College, and his medical degree from Creighton University.
Thanks for talking to MedCrunch. What is OnPulse?
OnPulse is a new healthcare product designed to get you, the patient, on the same page as anyone involved in your healthcare. It’s an online environment allowing providers to communicate to one another and their patients. Not only physicians, but staff members –anyone who owns a piece of patient care. With instant online access through the product’s patient profile, connected health teams can view and share relevant information, no matter what EMR they use, or whether they’re at the office, at home or on the road.
Who should use OnPulse?
Any healthcare provider who is currently communicating by email or any specialist trying to manage a large team with email should love OnPulse. Also, any patient who emails their provider should use OnPulse.
How do patients access OnPulse?
It’s web based now (mobile app will be available this summer), so they would log on at http://www.onpulse.com and enter a username and login. Right now, it is by Invitation Only. You can request an invitation at our website. We will release it to more people next month. It can be accessed on iPads and will eventually be available on mobile phones.
What makes OnPulse different from anything else out there?
What makes OnPulse different is we allow the individuals who have an account to own their information. The difference is whenever you stop receiving care somewhere and close an account, you no longer have access to that information. With OnPulse, if you end a relationship with a doctor or provider, you own your information and you can share it with another provider anywhere or anytime you want or the next time you need to access care you can share it with that provider. As a system, multiple providers from different organizations can communicate. It’s based on 4 things: 1. Simplicity. 2. Access. 3. Peace of Mind. 4. On-line teams communicating in one place.
What regulations exist concerning ownership of patient health information?
Multiple state statutes, regulations, and cases govern the ownership of health information and the information contained in medical records. The classic statement of the rule concerning ownership of medical records is that the provider owns the medical records maintained by the provider, subject to the patient’s rights in the information contained in the record.
But,under the federal Health Insurance Portability and Accountability Act (HIPAA), every person “has a right of access to inspect and obtain a copy of protected health information.” The Meaningful Use regulations require that outpatient providers give patients clinical summaries within three business days for at least half of all office visits, if requested. Hospitals have to provide an electronic copy of discharge instructions upon request.
The stage two meaningful use places a much greater emphasis on patient engagement and set high standards for making data electronically available to patients. Physicians should think about these requirements as they work to implement a new EHR system. The new rules state that a professional must make electronic records available to 50 percent of their patients. Furthermore, 10 percent of a physician’s patients must actually view and download these records.
Should people be concerned about privacy?
As a patient no one knows you have an OnPulse account unless you tell them. Under HIPPA they allow providers to do what they currently do and allow them to invite other providers to the health team. Everyone on the team knows who has access to information. The system is only transparent to those using it.
When did you develop the idea for OnPulse?
I was exposed to communication in our healthcare system during my first summer of medical school. Writing HEDIS measures for the National Committee for Quality Assurance (NCQA), as a Washington Health Policy Fellow intern, taught me that our system was fragmented.
My understanding of communication in healthcare matured in residency when I became responsible for confused patients, busy consultants and returning phone calls to referring doctors for unreceived faxes, but I didn’t do anything about it until my fellowship. As a resident, you learn to communicate with everyone involved, you manage the communication with among your resident colleagues, consultants, patients and the people who are training you. As a resident, you learn to communicate with everyone involved, you manage the communication with among your resident colleagues, consultants, patients and the people who are training you. As a resident I saw, how our means of communication can fail the provider team and the patient. I didn’t know what to do about it at the time.
Within the first six months of my fellowship, I had a patient who looked at me with tears because she had suffered financially, physically and emotionally –she said, ‘I thought you guys were all communicating.’ That was it. I realized that all the faxes, phone calls and emails had failed her and so did our team, despite our best intentions.
Mostly, I learned even more about communicating in healthcare when I became a patient after I ruptured both of my patellar tendons, which connects your knee cap to your lower legs. I realized how difficult it is to navigate healthcare and to have a choice. I also learned how difficult it was for all of the providers to communicate as they are trying to help you reach a certain outcome, especially when they are not in the same organization. For instance I had an orthopedic surgeon and two physical therapist all in different places. This experience really informed how important the asset a patient was to the health team and really improved the system.
How does a patient get started using it?
The patient can either be invited by their provider or they can open their own account. Adding providers is simple. We recommend they that they invite providers that they have an established relationship with, especially an electronic one. If they have multiple providers helping them on a single issue they can suggest to their primary provider to form a health team in OnPulse. Then, you’re able to exchange messages, create a task and share files. Whenever information is requested by you –you receive a text or email alert that something is available to you.
OnPulse spans the communication needs for across sickness, wellness and fitness . For example, some patients even use it to communicate with their fitness trainer, keeping track of a daily routine, and keeping all their health information in one place.
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Are there any costs involved for the patient or the provider?
It is free to an individual patients and individual providers. No fee for individual users either patients or doctors. There are subscription payments as a practice to include your business for independent practices or hospitals.
What are the benefits of using OnPulse?
Medical practices can share vital information with other providers and their mutual patients in an easily accessible, unified place. It gives providers and patients secure access to the entire team of healthcare providers. It gives both peace of mind that what they send is actually received by the right person. It helps streamline communication. And it provides personalized communication with everyone. And it’s free to an individual patient and individual provider to use.
Where do you envision OnPulse in 5 years?
My vision for it is to become the healthcare communication environment of choice for all providers and patients. OnPulse, the new on-line healthcare communication environment for patients and providers.
How did medicine and entrepreneurship meet?
My background is medicine with a consistent thread of entrepreneurship. During my fellowship I completed the masters program in clinical informatics at the Duke University’s Fuqua School of Business to better understand how to apply my ideas to clinical medicine. Prior to this time I dabbled in buying and selling houses, creating an online stationary company for my creative wife Kathy and forming a mobile application development company, but by far (besides my kids) OnPulse is the thing that wakes me up and takes me to bed.
“I believe in better communication in healthcare. That’s why I developed OnPulse, where everyone can easily contribute to the personalized best care for the patient and the patient will own 100 percent of their records, and be able to share them accordingly with their health team of choice.”~ Corey Booker, MD/founder, OnPulse
1. AWARENESS – Be mindful of the unhealthy eating habit. Think of WHY you reach for certain unhealthy foods. Then, exchange it for something healthy. See list below.
2. PLAN MEALS – If you have no time for lunch and that is when you grab something unhealthy, prepare a healthy meal the night before and bring it to the office with you. If you work from home, put it in the refrigerator for easy grabbing the next day.
3. REDUCE STRESS – Meditate. Reducing stress will also improve your sleep. Mediatating just twice a week can help with sleep problems. Turn off all electronic equipment and find a quiet place with no distractions and simply breathe and stretch. Nature is wonderful to quiet the noise.
4. TAKE IT SLOW SO YOU DON’T CRASH – Slow-and-Steady is best.
20 SMALL CHANGES YOU CAN MAKE THAT ADD UP in 60 DAYS:
For as long as I can remember my Dad always said, “You’re either IN or you’re OUT. Make up your mind.” When I was a kid, I watched him play Baci (Italian bowling on dirt outdoors) and I heard him yell this out when teams were being created. You’re either IN or you’re OUT. The tone was get out of the way if you’re out.
He would also say it if he was going somewhere and wanted to know who was joining him or if anyone in the family, including myself, was undecided about anything in life. Dad does not suffer fools and to him anyone who is wishy-washy or ambiguous as we say after college — is a fool. The way he sees it if you have one leg in the car and one leg out, you’re going to get crippled. Either put both legs in the car or get out of the car all together. He will not ignite the engine of the car until you make up your mind.
Later, I learned NBA Legends on Management and my Dad think alike. Pat Riley said, “You’re either IN or you’re OUT. There is no such thing as life in-between.” Dad could probably play Pat Riley in a film. Since Dad’s not an actor, they got someone who reminds me of Dad — Al Pacino. Pacino will star as Pat Riley in the tentatively titled “Showtime.”
What my Dad and Riley are really talking about is COMMITMENT. Goethe agrees with them too.
Goethe said, “Until one is committed, there is hesitancy, the chance to draw back– Concerning all acts of initiative (and creation), there is one elementary truth that ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then Providence moves too. All sorts of things occur to help one that would never otherwise have occurred. A whole stream of events issues from the decision, raising in one’s favor all manner of unforeseen incidents and meetings and material assistance, which no man could have dreamed would have come his way. Whatever you can do, or dream you can do, begin it. Boldness has genius, power, and magic in it. Begin it now.”
Michael Jordon knows about commitment. He said, “I’m not out there sweating for three hours every day just to find out what it feels like to sweat…I’ve always believed that if you put in the work, the results will come.”
We can rewind to 1835 to find John Anster saying, “Boldness has genius, power, and magic in it. Only engage, and then the mind grows heated. Begin it, and the work will be completed.”
On pages 214-30 in Faust, there is a passage that reads:
“When indecision brings its own delays, And days are lost lamenting over lost days. Are you in earnest? Seize this very minute; What you can do, or dream you can do, begin it; Boldness has genius, power and magic in it.”
Why so much hulabaloo about COMMITMENT?
According to Prism, Ltd., the most important single factor in individual success is COMMITMENT. Commitment ignites action. Turns out, Dad and Pat Riley know what they’re talking about.
To commit is to pledge yourself to a certain purpose or line of conduct. It also means practicing your beliefs consistently. There are, therefore, two fundamental conditions for commitment. The first is having a sound set of beliefs. There is an old saying that goes, “Stand for something or you’ll fall for anything.” The second is faithful adherence to those beliefs with your behavior. Possibly the best description of commitment is “persistence with a purpose”.
Many successful business people are hailed as visionary leaders. On careful inspection they are found to be individuals who hold firmly to a simple set of commitments, usually grounded in beliefs such as “the best product money can buy”, or the highest possible customer service“. It is the strength of these commitments, religiously followed, that led to their business success.
It appears that effective leaders hold dearly to a half dozen commitments. The first, and most basic, of these is a commitment to a set of values, principles or beliefs. These underlying principles define both the organization’s uniqueness and the fundamental direction in which it wants to head. This first commitment leads to a common vision and purpose within the organization.
The second commitment is to oneself, to how one acts as a leader. An effective leader possesses a strong sense of personal integrity and self confidence. This leads to a willingness to share the credit for success. Another side to this commitment is a deliberate emphasis on continual self-improvement.
The combination of a strong, positive commitment to self and to a set of principles serve as a foundation to effectively maintain the remaining four commitments. These commitments are to: customers, results, employees, and the organization.
Everyone has a customer and is a customer to someone else. Customers are usually thought of as external to the organization who needs your product or service. A question worth asking is, “How much are others willing to pay for my work?” The price your customers are willing to pay measures its values in their eyes.
Besides serving customers, all organizations target specific results. Given the large number of demands placed on all of us, it is important to concentrate on achieving the most important goals and objectives. Commitment to results is largely determined by how clear priorities are, what actions get rewarded, and what risks are being taken to improve intended results.
The next commitment is to the people. The quality of the organization’s commitment to customers and results is largely based upon the quality of its commitment to people. The simple reason for this is that it is these people who serve the customer and achieve results. How are people treated in the organization? Commitment to people is largely the product of treating people with respect, challenging them, and giving them effective feedback on how they are doing.
The final leadership commitment is to the larger organization. Other departments, higher management, the organization’s overall strategy & mission are important. Communication is the key with this commitment. How people talk to, and about, each other greatly affects the quality of cooperation. How open are the channels of communication up, down, and across? Can management be challenged? Will people support management decisions and changes?
Balancing all six commitments is the key to well directed leadership. When management supports its employees, they will be able and willing to achieve intended results, When these results support customer needs and expectations, customers will support the organization with their business. A strong and healthy organization can then continue to show commitment to its people. The glue that holds this process together is the values and leaders in the organization.
HOW TO PRACTICE COMMITMENT
Effectively demonstrating commitment to others, to the organization’s basic principles, and to oneself is never easy. The truth is, demonstrating commitment is hard work. Wavering commitment is usually seen as no commitment at all. The only way to achieve a reputation for commitment is through determination and persistence. Genuine commitment stands the test of time.
Day to day, commitment is demonstrated by a combination of two actions. The first action is called supporting. Genuine support develops a commitment in the minds and hearts of others. This is accomplished by focusing on what is important and leading by example. It is not uncommon for people to be either confused as to what is important, or lose sight of it over time. Supporting means concentrating on what adds value, spotlighting what’s working, and rewarding others who are focusing on what is important and leading by example. A crucial aspect of true support is standing up to those who would undermine commitment, those whose words or actions show disrespect.
The second action underlying commitment is called improving. Improving stretches our commitment to an even higher level. Commitment means a willingness to look for a better way and learn from the process. It focuses on eliminating complacency, confronting what is not working, and providing incentives for improvement. The spirit of improving is rooted in challenging current expectation and ultimately taking the risk to make changes. These changes are based more on an optimism in the future than dissatisfaction in the past. It is embodied in the reply of car maker Professor Porsche, who, when asked which was his favorite model in the long line of Porsche automobiles replied: “I haven’t built it yet!”
It is the combination of both supporting and improving behaviors that makes up the practice of commitment. Separately neither action is capable of sustaining commitment. Promoting alone can come across as a shallow and pollyannish. Continuous improvement can be seen as “good is never good enough”. Together they provide a needed balance. Both are essential to commitment.
WHEN COMMITMENT IS MOST IMPORTANT
Commitment is most difficult and most readily proven during tough times. How someone weathers the storms most clearly demonstrates their basic beliefs. In antiquity, Epicurus stated: “…a captain earns his reputation during the storms.” When your competition scores big against you, when the money dries up, or when the glamour of success wears off, this is when it is easiest to compromise your commitments. The real test comes when you can hold the line against the easy route of compromise.
Fortunately, paying the price that commitment commands has payoffs worth the cost – a reputation for integrity and, even more important, the commitment of others in return. Commitment is a two-way street. You only get it if you are willing to give it.
Source: Prism, LTD
The above can be applied to other areas of your life. Commitment ignites action. Think about that. You commit first. Then, you do. Where does that begin? Your mind. Thought. It’s one of the reasons good things take time. Bad things happen fast. It’s because we “think” about good things before taking action. It’s not uncommon for people to get asked, “What were you thinking?” when something bad happens. The response is usually, “I wasn’t.” Take some time to think about what you are committed to and what steps (action) you need to take to ignite that goal. This can be applied to Business, Health, Fitness, Sports, Relationships, and Finances.
“There is a difference between interest and commitment. When you’re interested you do it only when circumstances permit. When you’re committed, you accept no excuses, only results.”
“Whatever you can do or dream you can, begin it.
Boldness has genius, power and magic in it!’ ~Goethe
“Commitment doesn’t mean you never fail. It means you commit to a specific outcome, so you continue to take actions until you get desired results. The actions you take may change, but your commitment to the result never wavers.” ~Maria Dorfner
Want a healthy company? Start by focusing on yourself.
For many entrepreneurs, it’s easy to ignore the warning signs that you’re unhealthy–much less take notice if your business isn’t well. When you’re so busy that you can’t remember the last time you read a book, sat down for a meal or spent a night watching useless TV, then your health may be the last thing on your mind.
But ignoring your unhealthy habits and their subsequent risk factors is dangerous–not only to you, but also to your business. Lack of sleep and exercise, unhealthy foods and high stress won’t keep you performing at your best. Your business is only as healthy as you are.
“I can’t be effective [as an entrepreneur] if my body isn’t as healthy as possible,” says Jonathan Fields, a serial entrepreneur who started New York City-based Sonic Yoga in 2001 following a frightening emergency surgery brought on by the stress of his career as an attorney.
With sales approaching $1 million and two locations, Fields, 41, now incorporates yoga, meditation and breathing exercises, as well as mountain biking and other outdoor activities, into his routine four or five days a week. He also keeps his diet well-rounded, eating plenty of fruits and vegetables and avoiding red meat and pork but allowing the occasional indulgence.
For his instructors, Fields promotes wellness beyond their own yoga classes. Although the majority of his instructors are part-time, independent contractors, Fields gives them all unlimited memberships to Sonic Yoga so that they can enjoy the benefits of yoga and meditation on their own. As a result, he’s witnessed heightened productivity and morale.
“I encourage them to make sure they’re making time for themselves,” says Fields. “As their boss, I’d like to see people work hard and give me everything they’ve got, but I also know that to get the most out of people, they need to be healthy.”
And while you may not be in the business of offering a healthy product or service, you can still take some lessons from those who do. Consider Bear Naked founders Brendan Synnott, 28, and Kelly Flatley, 27. The partners’ $20 million granola company is all about natural, healthy ingredients–not only in their products, but also in their company kitchen.
“Our refrigerator is always stocked with fresh fruit, cartons of yogurt, cheese sticks, baby carrots,” says Flatley, who co-founded the Norwalk, Connecticut, business in 2002. “A healthy snack is always available.”
Adds Synnott, “I would never understand why you would want to feed your employees [candy bars].” After all, who’s more likely to be alert: the employee who snacks on fruits and vegetables, or the one who frequents the vending machine for greasy chips?
In the interest of staying healthy, don’t forget to make time for those quiet moments alone, even as you’re guiding your company and your employees toward wellness.
“For me, being healthy is a bigger picture than just eating well and [exercising],” notes Flatley. “It’s taking time to relax with a book or sitting on the sun porch.”
For Fields, it can mean just a few minutes of meditation, even when he’s at his busiest. And those few minutes can be golden.
“The thought of just sitting still and not doing something for 10 seconds is brutal,” he says. “But it’s hugely beneficial for clarifying ideas and having breakthroughs, so it’s worth the effort.”
Here are some things you can do to improve the health of your business:
Encourage employee wellness. Some companies even provide incentives for sticking to a wellness program, such as prizes and monetary rewards.
Provide healthy snacks. Even if all you have is a vending machine, stock it with healthy things.
Get fit. You’re a role model for employees. They look to you for direction within your company. Why wouldn’t they look to you as a model of healthy living?
Meditate and relieve stress. Even if it’s only for a few minutes a day, take time to do something you really enjoy that doesn’t have anything to do with your business. It can lead to moments of clarity, during which you unleash the creative ideas within.