Tuesday, July 28, 2020

Reopening elective surgeries after COVID19

At the start of the COVID-19 pandemic, many medical procedures were put on pause in order to prioritize the health and safety of both patients and medical staff. With resources focused on battling COVID-19, 72% of elective surgeries were canceled, resulting in a stark revenue loss for practices and inconvenient delays for patients.

Understandably, many patients remain apprehensive to reschedule elective surgeries due to potential fear of infection, and data shows that it may take anywhere from three to four months for practices to “catch-up” on surgical procedures that were canceled due to COVID.

But as the country is working to reopen and bring back some sort of normalcy, healthcare providers, too, can prepare their offices and practices. To ensure physician and patient safety and quality care when welcoming patients back for elective surgeries and other procedures, consider these tips.


Reopening Post COVID-19: Establishing an Internal Governance Committee & Plan


Before bringing patients back in person, practices should assemble a cross-functional internal governance committee to guide COVID-19 policies. The committee’s objective is to keep the practice abreast of any local, state, or regional policies, and help you gradually and safely expand access to care.

From front office administrative employees to surgical staff, this committee should cover all aspects of patient care, such as pre- and post-op procedures, providing a dynamic perspective and informing real-time decisions on practice protocols. With guidance from the committee, practices can more appropriately plan for staff coverage, assess facility capacity, solidify equipment resourcing and establish workflows, ensuring that the practice honors local guidelines while also remaining cognizant and sensitive to the needs of each individual patient.

Once the internal governance committee is established, its first step is to develop a written COVID-19 outline or plan that clearly maps out new policies and guidelines, both for internal (staff) and external (patient) audiences. This outline can also serve as a guide to be used during staff training, incorporating guidance from your local jurisdiction on current COVID-19 infection rates in your community, local testing protocols and sanitization procedures and more. The plan needs to clearly communicate how your practice is testing for COVID-19 -- and re-testing asymptomatic patients or false negatives. You can also calculate PPE, medication and surgical equipment needs with the CDC PPE calculator to ensure your supply chain can support practice needs.

As you map out your practice's reopening plan, it’s important that it continues to prioritize patient care. Proactively address the following questions to alleviate patient fear and confusion.
  • Are you checking in patients outside?
  • Using multiple entrances to avoid high-foot traffic entrances?
  • Designating certain dates and times for infected vs. healthy patients?
  • Removing waiting room chairs and asking people to wait in their cars?
  • Requiring the use of cloth or N95 masks inside?
  • Requiring social distancing procedures in the waiting room?

Addressing these questions in advance will not only ease patient apprehension, following these guidelines can also result in a more accurate, streamlined, and—most importantly—a sanitary check-in process. Practices may also find it helpful to space out in-person visits, fill in the gaps with telehealth visits to increase cash flow, and allow time for proper sanitization.

Once the plan is finalized, practices should begin communicating these new policies with patients and rescheduling previously canceled procedures. But, how should you prioritize certain procedures? That depends on your practice needs. The internal governance committee should guide the strategic plan for delivery of care and help prioritize the sequence of procedures. For example, a practice may prioritize the highest payout procedures in order to revive cash flow. Additionally, practices can block certain times for procedures to take place, bucketing high-risk patients or infected patients to visit the practice during separate times to ensure sanitation protocols are honored. Overall, it's important for the governance committee to define and establish what's best for your individual practice.

Communicating COVID-19 Procedures and Welcoming Patients Back In


As you begin to welcome patients back in, use digital tools such as online patient portals to inform patients about your new policies. Consider using secure messaging tools to answer any last-minute questions and to let patients know what they can expect during their visit, or when their appointment time has arrived.

Lastly, leverage your healthcare technology partners for support. Connect with their customer support teams and keep them abreast of your new procedures. Seek additional ways to improve the new policies or procedures to ensure patient safety and satisfaction during post-COVID visits. As we all are adjusting to new social norms, rely on the capabilities of technology to effectively educate, inform and communicate with staff and patients as elective procedures resume.

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Monday, July 27, 2020

3 Reasons You Should Become a Family Nurse Practitioner


In the United States, around 50% of licensed nurse practitioners choose to focus on family care. Family nurse practitioners serve as a lifeline for patients who have difficulty accessing care, offering cost-effective care.

There are a number of compelling personal and professional reasons to seeking advanced education as a family nurse practitioner. Below we look at three of the strongest reasons to consider becoming a nurse practitioner.


Increasing Your Autonomy as a Caregiver


The nurse who chooses an FNP career track gains autonomy over his or her nursing practice.

According to AANP National Database, 22 states plus the District of Columbia have approved “full practice” for nurse practitioners. “Full practice” means that family nurse practitioners are allowed to assess, diagnose, and prescribe medications independently.

The Henry J. Kaiser Family Foundation cites studies that show nurse practitioners can manage 80-90% of the primary care provided by physicians. The ability to provide primary care services means an FNP has increased independence. As a result, an FNPs may set his or her own schedule and choose to work as an independent practitioner or for a healthcare institution.

This flexibility in terms when and where you may work can help busy RNs gain a more positive work-life balance.


Gaining Career Stability


The demand for family nurse practitioners has grown yearly with no signs of slowing down. According to the U.S. Bureau of Labor Statistics, more than 53,000 nurse practitioner positions will be required by 2028. This is a 28% increase in job growth, higher than the national average.

In addition, an aging population and a predicted primary care provider shortage provide additional job stability. The Association of American Medical Colleges (AAMC) predicts a shortage of up to 55,200 primary care physicians by 2032. With prescriptive privileges and advanced practice skills, family nurse practitioners can combat the primary care provider shortage.

The Kaiser Family Foundation notes that 90% of nurse practitioners are primary-care prepared. This skill set opens up a wide variety of employment opportunities. Family nurse practitioners can work where is a need for primary care services, such as urgent care facilities, hospitals, private practices, and more.


Financial Benefits


Forbes has ranked nurse practitioner as one of the top paying roles for women, and Monster.com ranks nurse practitioners as one of the best-paid jobs in the country. The earning potential for a nurse practitioner is much higher than a registered nurse with an approximate $36,000 a year difference (U.S. Bureau of Labor Statistics).

In 2019, the Bureau of Labor Statistics reported the median annual wage for a nurse practitioners is $109,820. The same year, the median annual wage for an RN without an advanced nursing degree was $73,300.

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Healthcare data sharing needs a major overhaul

Across all sectors of the healthcare ecosystem, there’s dire need for a technological advancement to improve data sharing. If any event displays this disparity in the healthcare system so clearly, it’s COVID-19.

Researchers have called out the challenges public health agencies face accessing disparate data from key participants in the pandemic’s management. But it’s not just a problem amidst coronavirus—it’s an issue across the board, even in our most mundane days on the job.

Every corner of the field—from physicians’ private practices to large medical groups, inpatient to outpatient care, genomics, labs, health plans, and beyond—exhibits a clear void in efficient data and file sharing technology. For example, today, a patient is often required to physically pick up a CD/DVD from their radiologist to share their records with the specialist. Not only does this old process cause a delay in patient care but also continues the path of fragmented care.

With the 21st Century CURES Act coming into effect, organizations are required to improve their interoperability. But how can they when so many healthcare professionals are still relying on outdated systems like the fax machine, which has long been phased out of virtually every other field.


HIPAA requirements pose a necessary hurdle for what technology can be implemented, but compliant solutions exist that can be applied right now. With so much change and progress occurring in medicine, health and wellness, our use of technology must follow suit, so we can better share research, resources, patient data and other vital information in a more efficient and effective way.

Beyond the CURES Act requirements, improved file sharing is critical for enabling physicians to empower their patients’ engagement. Safely and securely transferring data for imaging and rich-media files can be expedited, claims data can be streamlined between payers and providers, and research centers can be enriched by enhanced IOP.

One glaring element of caution to consider when implementing any new software application is “the cloud.” This ambiguous data storage experiment is riddled with security breaches, data leaks and potential risks that may expose confidential information or result in a total loss of files, especially if no backup is available. When sharing files over cloud-based tools, you’re essentially relying on a vulnerable third party to pass your data along. Furthermore Accurics, a cloud-computing security firm, found that only four percent of issues reported in cloud production environments are being addressed, highlighting a startling fissure if using cloud-based software. And researchers from the cloud security company DivvyCloud found that breaches caused by cloud misconfigurations cost companies worldwide an estimated $5 trillion in 2018 and 2019.

There’s also a need for better mapping on the back end of healthcare computer networks, which is an issue in the hands of many EHR systems. Almost all healthcare environments have been structured uniquely from one another, often making it difficult to effectively transfer files within their own healthcare networks. It’s up to EHRs to create solutions that improve these workflows, particularly with interoperability, so file sharing solutions can work seamlessly on day one.


With such disparate systems in place, the technology advancement healthcare workers desperately need may not seem like a simple task on the surface, but it can and should happen sooner rather than later. Proper efforts to strategize with IT teams and organizational leadership can result in significant improvements when better data sharing technology is implemented.

This is an evolution that can arrive now, at low costs, with minimal training needed. It’s time the healthcare industry stepped into the future to meet the standards of today’s patients and the rest of the working world.

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