Practical Steps In Improving One’s Health

Health is the general condition of the body and the mind. A healthy lifestyle is a manner or way of living that enables one to develop a general condition of the body and mind that is free of sickness and disease. Every activity that the individual undertakes and the decisions that he / she makes affects his / her lifestyle either positively or negatively. Therefore, there is the need for every individual to plan his activities and make sound decisions that would affect his / her health positively.

There are some activities that can tremendously improve the healthy lifestyle of an individual. These activities have been time-tested and have proved beyond all reasonable doubts to affect one's health positively. To assist in remembering them easily, we would rather use an acronym 'SPARKLE' to stand for all of those activities. Each of these initials stands for a vital activity in life that prolongs one's lifespan and improves the health condition of a person.

S – Sleep
P – Plan every day
A – Anticipate less
R – Relax
K – Keep your temper under control
L – Laugh more
E – Exercise regularly

• Sleep

Sleep has been recommended as the best antidote to restore the body organs to work more effectively and efficiently. Our bodies are like machines that need to be halted or stopped for a reasonable time. Doing this helps all the organs of the body to renew their strengths. It also prevails us from overworking our bodies which usually result in a breakdown which may be evidenced through sickness or even death.

It is recommended that the body should take a nap for not less than eight hours a day to help its organs to work well. It is wrong to strain the body if it gives signals that it needs to rest and it would even be a death blow if we try to induce our bodies to work an extra mile by taking in hard and unhealthy drugs and liquors like 'Caffeine' etc . just to stay awake all day. Let's allow the body to take its natural course of rest and allow it to rest since this would positively affect our health.

• Plan Everyday

Many sicknesses especially heartaches are as a result of poor or no planning of activities that one wishes to undertake in a day. The Bible even admonishes that 'the shrewd one considers or plans his steps (activities)'. If you fail to plan for your activities every day you put a strain on the brain and you push it to adjust to new activities without prior consultations. It also results in overworking of the body which can cause high fevers and headaches. Therefore, it is advisable to plan your activities for a particular day the night before the day. Although unforeseen events may arise, yet we can minimize it significantly and improve our health if we plan.

• Anticipate Less

Imperfect as we all are, there is the great tendency to anticipate the unfolding of events and the consequences of our decisions. However, it would also be wrong to expect too much of the future. This puts unnecessary pressure on the body and negatively affects the heart especially in situations where the matter at stake affects us and our business directly. It can also negatively affect our activities we need to do for the day. Experience has shown that some businessmen commit serious arithmetic mistakes as a result of extreme anticipation of past business transactions of which they have paid dearly. Others who work on machines in the industry have even lost control and endangered their lives. The candid truth is that our extreme anticipation can not overturn situations or results of our decisions. Think or expect less and leave matters to God and move on with the planned activities for the day.

• Relax

Relaxation is one of the activities that set the body in its right and perfect tone. If we relax our bodies by engaging in a recreational activity such as listening to music, watching a video or sport, sightseeing etc. refreshes our bodies. It will be as if we have charged our body 'batteries' new. It gives us a new 'spirit' or energy to work. As artists, we gain are able to brainstorm and generates a lot of creative ideas for the production of functional artifacts. Remember the old maxim that says 'All work and no play make Jack a dull boy'. Do not be too engross or busy in your work, relax and engage in a wholesome recreation to keep your body healthy always.

• Keep Your Temper under Control

Anger is like fire. If not erected under control can burn a whole house as it were. Therefore when tempers are high, exercise self-control or engage in activities that can calm your tempers down. Such activities include taking a walk off the scene, talking about the matter with a trusted friend or engaging in your favorite hobby such as drawing, painting or listening to music. In fact, if tempers are kept unchecked, they can cause serious health problems such as heartaches and other diseases related to the lungs. Also, because the victim is not thinking straight, he / she may take wrong decisions and act unwisely. It is advisable not to act in a provoked situation, just take your leave and remember that we all err against one another. Not making an issue out of what ensued between you and the one who angered you or harboring resentment will improve your health veryly.

• Laugh More

Laughter is a major tool that improves one's health. Studies have revealed that people who laugh always live long more than those who harbor resentments. Laughing helps in relaxing the muscles causing them to work more effectively. Health experts like clinical psychologists use laughing as a therapy in treating individuals with depression to help restore their emotional state. Therefore, laugh more and do not frown or always put on a serious look. This would improve your health.

• Exercise Regularly

Exercise is the activity of exerting one's muscles in various ways to keep fit. Exercise helps in strengthening the joints, muscles, and tissues of the body while improving on one's heart condition. It assists very much in the circulation of blood through the entire body. Exercising on a regular basis can help in avoiding stroke, a disease caused by a sudden loss of consciousness resulting when the rupture or occlusion of a blood vessel leads to oxygen deficiency in the brain. It is advised that a thirty minutes exercise on a daily basis can significantly improve one's health. Doctors even recommend exercise as a cure to thousands of ailments. Therefore, make time every morning to exercise your body and make sure you do it daily to improve your health condition.

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How Intelligent Care Improves the Patient Experience

Sam is in the hospital recovering from surgery. On his wrist is a high-tech remote wristband that can monitor his blood pressure, pulse oximetry, respiration, and temperature, and also send an immediate alert to his nurse if a problem arises. Suddenly, his nurse's smartphone app beeps, advising her that Sam's temperature just spiked to 101 degrees Fahrenheit, a sign that something might be wrong.

Meanwhile Debra, an at-home patient, receives a cell phone message that it's time to breathe into her respiratory training device (spirometer). The care coordinator at her doctor's office views the dashboard of data on Debra's results and is alerted if the result falls outside the safe parameter, instructing her on treatment.

And Linda, an elderly patient with mild dementia, has just woken up, and her alarm device reminds her to take her morning medicine. A sensor in her pillow dispenser confirms this and the alarm says: “We'll make sure your daughter knows you took your medicine this morning.

What is Intelligent Care? The emergence of leading-edge, patient-centered technologies and the innovative integration of those technologies are at the center of intelligent care. “To me, intelligent care means going beyond simple rule-based solutions (like crosschecking for allergies, or alerting patients when their medications are due), to actively integrating traditionally disconnected sources of data to take care of a patient,” says Naresh Ramarajan, MD, founder and chief medical officer of Navya, an organization that helps patients make cancer-treatment decisions using a step-by-step intelligent care system.

For example, smart-decision systems should be able to take into account a patient's preferences for a therapy with fewer side effects, as well as the best outcomes and potential costs. They should be able to integrate the best clinical-trial results and the most current international guidelines. “An intelligent care system might even search a database to find similar patients for whatever treatments have been successful,” says Ramarajan. “It would then synthesize all of these to come up with a ranked list of options with reasons behind each option.”

That data can then help patients make smart, informed choices. “As mobile app developers, we are often getting more requests from doctors and hospitals that include the need for ways to make their patient care more intelligent and innovative,” says Dulio Denis, a mobile program manager at Blue Label Labs, an industry leader in mobile, tablet, watch, and TV app design.

App developers work with healthcare clients who recognize that the alignment of consumer technology in mobile phones and the advance of new applications in what a hospital can do with cloud computing have reached a crossroads, where the providers can be more patient-centered. “I would not be surprised if we get to a place where medical care is functioning as seamlessly as the communication systems in social media function,” says Denis.

The Internet of Medical Things?

Just as the Internet of Things is now combining technology with life (turning on your thermostat, alerting you when the milk is gone), the Internet of Medical Things can do the same for healthcare. After all, women have been diagnosing their own pregnancies for three decades, so patients using our latest technology should certainly be able to swab their throat and send in the sample for a strep test without having to visit a doctor's office-then saving both the patient's and doctor's time and money. Intelligent care can also bring safer, more efficient patient care by streamlining procedures that produce smarter evidenced-based guidelines and provide improved safety, education, and service.

Roy Smythe, MD, cancer surgeon and founder of Valence Health-a company empowering healthcare providers with complete turnkey solutions for value-based care -says that “the devices we are going to be putting on and in our bodies in the future are going to be much more sophisticated and will be giving us insights that we never thought we would get. “

According to Orbita, a leader in innovative cloud-based technology for connected home healthcare, the intelligent health industry will soon feature ubiquitous wireless connectivity. The broad use of smart phones and a growing array of connected, sensor-enabled devices that measure and track personal wellness data, test results, and healthcare reminders now enable health scenarios that we never dreamed were possible a few years ago.

Intelli-health optimizes both social computing and data analytics, as well as content and experience management, improving the outcomes for patients globally.

Technologies include:

• In-hospital remote wristbands that monitor vital signs and alert staff to changes immediately
• Interactive systems that respond to hospitalized patient requests more quickly using smartphones and applications rather than the old-fashioned “call button”
• Smartbeds that can monitor position and comfort and alert staff to problems Hand-hygiene systems that can improve infection-control practices and alert clinicians to sanitize before entering every room
• Digital delivery of tailor patient-education information
• Apps enabling patients to fill prescriptions from their hospital bed before discharge
• Handheld ultrasound devices that allow patients to scan their own bodies and send results to a radiologist
• Self-tests for medical conditions such as strep throat, STDs, and elevated cholesterol.

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Understanding Population-Based Health Care to Engage Physicians

Wow, just writing this title excites me. Partly since I have such a passion for bringing together practitioners and patients for better health outcomes. But mostly because when we add a powerful mission that inspires real action that is based around population health management, I believe we can make some real progress in creating healthy and happier lives. To me, that's exciting because what it takes is us working together to implement a system that engages patients to become participants in their health. And this, my dear heart-centered friends, is where you as a holistic and wellness practitioner enter the traditional health care scene with your subset of skills and heart-centered characteristics that can lead health care teams toward new clinical benchmarks never before experienced in a clinical setting. Yes, that's a bold statement but one that I am convinced is not just possible but necessary.

So how does one undertake such a task? How can integrative practitioners not only be viewed as a viable part of the health care team but as a real contributor to the patients' health outlet?

I see population-based health care as a type of stone soup. If you remember the original folktale, villagers are tricked out of their greed and fear and into sharing and enjoying life with their neighbors. All thanks to a soup that did not even exist … until everyone, unsuspecting even to themselves, contribute their one and only ingredient; that alone would not amount to much. If each of us is really interested in spreading our mission in which we all share the same exit goals of healthy and happier people, then we must be willing to participate as a team. We must be willing to see, not only how our own “ingredient” brings value but how each member of the team brings value to the ultimate outcome of restored health and happiness. We must move past the “we against them” mentality that has plagued our health care system. We can no longer afford to see the split between social determinants of health and the physical manifestations of disease. The lifestyle medicine movement is already verifying the need to include what many holistic practitioners have known for decades, that individuals are not separate from their thoughts, feelings, beliefs, and habits which have a direct impact on health outcomes. We are not so different and clinicians are more open than ever to understanding all determinants of health.

There are several things that we must take into consideration first before we take on such a task and one of the biggest challenges I see from holistic and wellness practitioners is the willingness to speak and understand the same language as our clinical collections. It would be like moving to a foreign country without knowing the language. This most often happens because in our passion and excitation for giving witness to our mission, we tend to hyper focus on the techniques of our standards rather than on the intended health outlet. Can you imagine a surgeon giving the details and methods of using a scalpel to cut into our flesh? Ugh, who wants to hear that but another colleague? All I want to know is if I'll get better and how! Not the details of the technique. Focus on the health outlet that your modality offers which in turn is your mission!

The next thing is that we must step up and position ourselves and our scope of practice so it's aligned within the standards of care for a specific disease state. For example, if you are a certified or licensed massage therapist and you have additional certification in lymphedema treatment then you would focus on chronic conditions that are known to cause lymphedema such as cancer treatments or diabetes among others. Obviously, your scope of practice must align with the chronic conditions in which you are certified. I'll be discussing in greater detail how to position your scope of practice to build stronger relationships with clinicians in future postings. But for now, it's important to know that not being clear on how your scope of practice aligns with standards of care for a specific disease state, may be the reason for your difficulty in obtaining clinician referrals or partnerships.

Lastly, we need to get a clear understanding of the “lay-of-the-land” of not only within the clinical health care setting but the new payment system that rewards doctors and hospitals for improving the quality of care. Pay-for-Performance is a term for initiatives aimed at improving the quality, efficiency, and overall value of health care. These arrangements provide financial incentives to hospitals, doctors, and other health care providers to carry out such improvements and achieves optimal outcomes for patients.

Pay-for-performance has become popular among policy makers and private and public payers, including Medicare and Medicaid. The Affordable Care Act expends the use of pay-for-performance approaches in Medicare in particular and encourages experimentation to identify designs and programs that are most effective. I see this as another opportunity to expand your mission by demonstrating how you can help increase quality measures, efficiency in care, diminish gaps in care, and provide value in optimal health outcomes.

Therefore, in part 2 of this posting, I will clarify what we mean by population-based health management within the constitutions of an integrative health practice. In fact, we may need clarification on several terms that are now being used in the health care settings such as integration, quality measures and how understanding these key components within clinical settings can help establish you as a viable member of the health care team and secure your position as the expert in your field.

Until then, be well my friends as you help move people towards the truth of well-being with hope, love and laughter!

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The Meaning Of Quality In Health Care

The process of receiving health care services at the correct time in the appropriate way and to get the best possible exit is defined as quality health care.

Six attributes of health care quality

• Safety – Care should not harm any patient.
• Patient centered – Individual needs should be taken care of when providing care.
• Timely – Care should be provided exactly on time.
• Effective – Care must be based on evidence.
• Efficient – Wastage of time should be reduced.
• Equitable – Equal care should be provided to every patient.

What is quality health care?

The meaning of quality health care is not the same for all people. According to some patients, quality care is to consult a doctor, to get proper treatment from the staffs of a hospital and to have a physician who can spend much time with the patient. But all these things are secondary. Clinical quality of care is the most important thing because more lives can be saved by providing evidence-based and high quality care.

Does quality equal safety?

Yes, quality equals safety. The quality of care is to be improved by the health care providers because it can save more lives of the patients.

How is health care quality measured?

Outcome indicators and process indicators are the two ways of measuring quality of care. Timelines and baseline practices are measured by process indicators. Complication rates, mortality rates and infection rates are measured by output indicators.

These indicators can be looked at by the consumer to compare the hospitals. National accreditations, recognitions and state of the hospital should also be looked at by you to measure quality.

What are quality measures and quality indicators?

The process of converting the medical information of a patient into percentage or rate to analyze the quality of care provided by the hospitals to their patients is called a quality measure. You will be given information by quality measures about how the patients are provided care by the hospital. This quality information can be used by you to compare the quality care of different hospitals.

What role do nurses and doctors play?

A very important role is played by the doctors and nurses. Quality care should be provided by all the nurses and doctors, clinically and satisfactorily. All the staffs in a hospital such as the receptionist, scrub nurse, hospital administrator, physician and the X-ray technician are responsible in providing quality care to all the patients.

Remember all these features when you will go to get quality health care from any hospital.

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Changing the Face of Medical Images Through PACS

PACS stands for radiology picture archiving communications systems and laTely, you may have seen a lot of PACS system installed in the health radiology departments across the country. This system comes very handy to the medical professionals as one can capture, store, send and display medical images from one workstation to another workstation.

It has totally transformed the working of the radiology department as it has simplified scheduling, patient tracking and generation of reports and that too in time. It also allows X-ray and CAT-scan images to be electronically stored and then view them on the computer screen. PACS not only creates film less images but also improves the diagnosis methods as doctor's get full access to compare multiple images by the click of the button through PACS.

PACS has improved the working of the hospital by increasing the efficiency of diagnosis and reporting. Every hospital and healthcare center wants to deliver best services to their patients, to simplify the process, and to meet the demands of the patients; hospitals have opted for PACS.

There are various reasons why in these days medical centers are going for PACS, but one out of them is speed as we all are aware that earlier, images were taken on the film and then they were developed and this was very time-consuming process. Moreover, if consultation was required, then these films were sent by post to the physician for consultation. But now images can reach a physician who is far away in seconds through PACS.

Why every radiological department needs PACS:
• It's affordable and images are in digital form therefore, it eliminates the possibility of losing the images.
• Image is much clearer, and this helps to improve the diagnosis methods.
• Doctor's can easily manipulate the images and get full detailed image on the screen.
• Multiple clinicians can view the images simultaneously.
• PACS has helped a lot in training process and has provided better teaching experience to the medical students who got exposure to the various digital images through web.

Once you have decided that you want PACS for your healthcare and center then the first question that strikes will be where you will get it then, let me tell you can trust Allengers. It has 30 years of medical experience, and its PACS system is highly effective and easy to use and its been installed is many hospitals and historically improved the working of the various departments.

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Caregiver Wellness, Burnout, Stress Prevention, and Quality Of Life

Quality of Life Verses Caregiver Burnout

Yesterday you were a father, mother, son, daughter, or a blood relative. Suddenly, and without warning, circumstances have placed you in the role of caregiver for a loved one. Some caregiver training will be made available to you and other family members.

Nonetheless, this transition process can be daunting and seemingly overwhelming, but it's not mission impossible. When unexpected circumstances put a family member into the role of caregiver, quality of life takes on new meaning.

When the quality of life for a caregiver sufferers, the effectiveness of the caregiver is reduced. In my three decade professional nursing career, I saw burnout destroy careers of many a good nurse. Burnout zaps the effectiveness of a caregiver.

When care giving for anyone, especially a loved one, you never want to lose your effectiveness. Quality of life for the caregiver is directly proportional to their effectiveness as a caregiver and the quality of life for their loved one. There is a better than average chance, research indicates about a 75% chance, you will be faced with burnout.

If you have the responsibility of caring for a loved one, compromising the quality of your life can put you on the road leading to burnout. You can avoid burnout by practicing a regular program of caregiver wellness with the use of hypnosis.

Pay it forward

The human and caregiver experience is anything but mundane. As a caregiver you will have good days, and disappointing days. There will be days your abilities and mental toughness are tested. Other days will be gratifying, with untold opportunity to learn valuable lessons.

When the litter occurs, pay it forward, or pass it on. In the long run, it is insight and knowledge which improves the quality of life for a loved one under your care. I considered it icing on the cake when I learned to manage my quality of life, and I am paying forward this lesson.

In 2010 I was rescued and honored to meet a hypnotherapist, author, and teacher named Beverly Taylor. She is the CEO and founder of the Easy Key to Life Institute, a provider of hypnotherapy services and hypnotist certification classes worldwide.

I completed Beverly's hypnotist course, learning my certification later that year. Honestly, I have not looked back since. Hypnotism is no parlor trick. Its uses have been accepted and approved by the American Medical and Psychological Associations for over a half century.

What's most exciting for me is the acceptance of hypnosis by the medical community for its many medical uses. The National Center for Complementary and Integrative Health has clearly recognized and defined the use of this amazing complementary integrative health intervention called hypnosis.

Note the difference between complementary and complimentary. Complementary refer to the use of a recognized intervention along with conventional medicine. It complements a conventional practice.

Complimentary referers to someone saying nice things to another, Egypt, complimenting, someone.

Become a RUDE Caregiver.

The acronym I came up with which supports increasing quality of life, comfort, and safety, is to be a RUDE caregiver, in that, you practice your profession with;

• Respect

• Understanding

• Dignity


These words foster a healthy care environment. They reflect the essence of a caregiver practice which fosters increased quality of life for clients, and reduces the chance of burnout for the caregiver.

Imagine the harmony that is created by implementing this acronym. There may be times when clients or patients are unable to verbally express their gratitude and appreciation for your service.

There is no need to feel unappreciated or bad about the thank you, which sometimes may not be communicated. Keep in mind the importance and impact you have on the life of those you care for. You become an integral element in providing quality of life and care, so always;

• Respect yourself

• Understand the situation

• Dignity is practiced

• Empathy is practiced

This is the essence of the caregiver profession.

Hypnosis Can Improve Your Career and Life

Hypnosis is a completely natural process which is just a state of deep relaxation which allows for greater concentration and focus on any issue. With hypnosis, you typically relate yourself to perceptions and beliefs which negatively affect how you perform your duties.

It takes practice, but hypnosis can improve self-esteem and remove unrealistic limiting beliefs affecting your work performance. Harness the power of your subconscious mind and reduce work related stress. Stress is the main ingredient of caregiver burnout.

I have a passion for teaching and for alleviating the suffering that occurs as a result of disease. In combining the two, the caregiver learners and benefits, as do loved ones under their care. I urge caregivers to educate yourself about what you can do to avoid burnout.

If I can prevent burnout, through education, for just one caregiver, I view it as a contribution. Taking care of yourself makes you an effective caregiver for your loved one. Take care of yourself by limiting work hours and share the care giving responsibility with other family members.

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Engaging the New Healthcare Customer

The healthcare industry business model has transformed in fundamental ways and is now driven by consumerization. Healthcare providers have started aligning organizational focus to the patient using digital transformation methodologies.

Healthcare organizations are looking at new ways to leverage technology to improve costumer engagement and experience. Digital transformation not just contributates to greater health outcomes for patients but also benefits the bottom line of healthcare providers.

The new healthcare customer is highly informed, engaged and involved. When a differentiated customer experience is provided to them it can lead to satisfied customers and this in turn results in creating more potential market share and revenue growth.

The connection between revenue growth and customer satisfaction is becoming increasingly clear. Failing to live up to the expectations of the customer has an impact on the bottom line of the healthcare providers.

Reputation, brand, revenue growth and market share are all at risk if the customer has a negative experience. In today's digital world poor customer service and bad experiences can have a significant impact on the customer's decision regarding where to obtain healthcare.

Attracting and retaining new customers is no longer restricted to hotels, banks and retailers. Healthcare providers also need to focus on the ability to attract and retain customers. Customer expectations have evolved over the years and only those providers that cater to this change will succeed.

Innovative Digital Transformation Initiatives

Patient Management Initiative

Define opportunities by enhancing patient access process, improving data integrity and reducing insurance denials. The data and observations need to be synthesized to form insights.

Customer focus can help in concealing themes that are usually not obvious. The journey map to define the capabilities required for customer focus can be identified with thoughtful exploration.

Discover Needs of Customers

Digital tools can be used to satisfies the desire of customers for engagement. Most organizations do not know which tools to use.

Organizations need to clearly articulate goals by engaging with customers and observing their behavior, challenges, needs and opportunities. A proper patient engagement strategy can help in determining the right tools that you need to use to transform customer experience.


It is important to understand what improvements clinical effectiveness, drives customer loyalty, health outcomes and improvements patient engagement. Involve customers to co-design solutions and develop concepts that can be tested on real users. Define the key operating model changes that are necessary to support the organization in the future.

Decide on Initiatives

When market competition is considered, it is important to have a strategic plan that caters to patient engagement. This is essential for achieving performance related results. A roadmap is required for delivering services and products. This can also help in prioritizing customer needs and preferences.

Enhance Customer Experience

The ongoing benefits need to be monitored to enhance customer experience. The initiatives need oversight. If customer expectations are not met, technology can help pinpoint the issues. This can help get the initiatives back on track.

Value and not volume is the guiding principle of the new healthcare system. The shift focus has had a significant impact on how patients are cared for and how healthcare providers are paid. This has led to increased patient choice with the focus on outcomes.

The new digital technology has created an innovative patient and provider contact mechanism. This unconventional communication channel has enabled on demand access to personal health data and scheduling.

Creating Value for a New Healthcare Customer

When it comes to creating value for customers, healthcare providers need to extend their focus beyond quality of care and price. They need to focus on engagement, convenience and other intangible factors like culture. Multiple strategies need to be designed to guide the digital transformation initiatives that are necessary to meet the customer demands.

Success in providing optimal patient experience is demonstrated through increased market share and enhanced brand value. The priority should be to engage with tomorrow's patients. Customer engagement platforms create innovative ways to expand customer relationships.

When patients are the primary focus of healthcare providers they are most likely to report, better experience compared to other providers. In order to provide better support to consumers, healthcare organizations have undergone phenomenal reorganization and transformation that has helped establish processes that facilitate changes by keeping the customer at the center.

Digital transformation should not be done without direction. Technology should not be used in haste to improve engagement. Customers want an experience that matches their expectations and preferences. It is important to define a vision and develop a strategy for digital transformation.

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What Makes a Good OB/GYN?

A lot of people have never given much thought on what makes a good OB / GYN despite the significance or importance of the concept. However, the need to know what makes a good OB / GYN gains significance when a woman is trying to conceive or take care of a baby. Knowing what makes a good OB / GYN might be the difference between having an easy time dealing with the issues of child birth and taking care of a baby, and having sleepless nights or negative outcomes. Therefore, it is vital for every individual to comprehend what makes a good OB / GYN. Below are the characteristics and practices of a good OB / GYN. Although they are not exhaustive, they offer critical insight into what a good OB / GYN should look like or behave.

Good credentials and affiliations: credentials such as licenses are a primary way to show that the individual is qualified to work as a health care provider. Be wary of a practitioner who has not met state licensure requirements. A license that acts as a seal of approval. This should be the first sign of a good a good OB / GYN. Also, know the hospital the practitioner is affiliated to. The hospital should have a good reputation mainly because it is where you will seek services from. Here, avoid GYNs who are affiliated to hospitals with poor or bad ratings / reputation. A bad rating is a sign of poor services being offered at the facility. Also, consider the reputation of the OB. It should be good or positive since he / she will be the one taking care of your baby or yourself.

A positive and friendly attitude: a good GYN should have a positive, empathetic and caring attitude. A doctor who has a caring attitude is more likely to pay more attention to your problems. Additionally, he / she is more likely to make follow ups to know how you are progressing. As George LeMaitre (author of How to choose a good doctor) said, “If you are looking for a good physician, start by looking for a human being who cares about people”.

A listening and responsive trait: a good professional should have the ability to listen to you as well as responds to your concerns and questions. Listening is a critical part in diagnosing the problem correctly. Also, a responsive professional will give you the needed information about the issue. This will help you make an informed decision.

By using these trains and characteristics, you will be able to easily know what makes a good OB / GYN.

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What Will and Will Not Happen If/When the Affordable Care Act (ACA) Is Replaced

It is true. The Affordable Care Act (ACA) is on the chopping block. As interesting as that may or may not be, the miss-understandings regarding its effect on medical practices is huge.

Repealing the ACA will NOT change Meaningful Use (MU) requirements or any associated deadlines. MU has transitioned to MACRA (Medicare Access & CHIP Reauthorization Act). There are a host of changes in MACRA which will affect medical practices. Those changes in MACRA have deadlines for compliance and penalties associated with non-compliance.

Navigating the murky waters surrounding these two topics can be difficult, possibly treacherous. The first step is to separate them into two camps. Attack each camp on its own merit allowing for any overlap that may exist between them.

These constantly changing governances require more time and expertise to understand and implement to their full advantage than most medical practices have available on staff.

The best use of management expenditures is to engage outside consulting services. Use an ACA qualified consultant for expert guidance on the “what ifs” regarding its repeal / replacement and how to prepare. There will be changes, small and / or complex. It is just a matter of time until they are enacted. An informed consultant will educate the practice on what matters most in their business. The best qualified consultant will have hands-on experience working in a medical practice.

The author is not an ACA expert and therefore offers no specific ACA advice. Rather, it is the author's determined opinion that seeking qualified ACA counsel is the business-prudent approach.

What is heard through the news media and software vendors should be used as a source of questions-not answers.

Turning our attention to MACRA, the terminology, the laws, the pending changes, the two methods of payment (MIPS and APM) and their combined effect on running an efficient and profitable practice decidedly different from the Affordable Care Act. Do not use the same consultant. You will pay more for a supposedly multi-topic qualified consultant who in fact knows less about either topic, and you will probably get less than the best advice.

MACRA compliance requires significantly enhanced software. Changes in MACRA require commensurate changes in the software. Old data from a previous Electronic Medical Records system will be vital to quality care and successful reporting going forward. This is especially true based on announced changes and those planned but not yet scheduled.

All this speaks to the need for a highly qualified consultant, independent of any software vendor which skill is also essential but separate. A MACRA Qualified Consultant will have hands-on experience working in a medical practice and is not committed to any particular software vendor.

Locating a qualified software vendor is a different task. Size and volume of sales are only one measure. References are one other source for qualifying a vendor. A live demo is essential. Be wary of a vendor who “does it all in-house”. Data conversions for example are better done by an outside firm which specialty is data. Training is the opposite. The functionality of software is of less value when effective training and after-training-support is not available or is cost prohibitive. Trainers need to have experience in a medical office. They need to practical experience of using software in a live environment.

Changes are coming across all aspects of patient care. It is easy to confuse ACA and MACRA given the political and business landscape and constant deluge of marketing hype. Prudent medical practices will engage knowledgeable consultants to help navigate these changes and turn challenges into better patient care and improved profitability.

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The Internet of Things and Medical Records Archiving

When the question is asked “should we archive our medical data records?” one could simply say “Of course you should. After all, it is your data”. Then stand by and expect providers and hospitals to line up for data archiving services. However, let's do not be too hasty.

True, there are many benefits from archiving medical records, whether they are static records that are needed for long term reference or patient active records that are needed in ongoing patient services. Either way it is important to remember that potential risk companies are potential gain.

When new technology is being considered it is especially important to evaluate the risks. It has always been true that our technology potential surpasses our proven, time-tested skill to exploit that potential. Among the benefits of new technology are increased processing speed and ease of access. So mistakes can be made faster and more people will be given opportunities to make them.

Specifically consider the Cloud for storage of archived records. There is still much discussion about long term security of data held in the Cloud. We have a well documented track record for implementing and maintaining security on host servers. What that really means is that we have a greater understanding of the risks associated with storing data on host servers than we do for staring data in the Cloud. Which storage method will prove to be the better choice remains to be seen.

Every archiving project begins with a data conversion. Extracting medical records and then converting them to a format compatible with the data archive structure.

With IoT, more services are becoming available faster than we can reasonably adopt them. That is not a reason for avoiding Medical IoT services but a warning. Providers should do their homework, make a plan with measurable steps for determining progress and proceed when satisfied with the plan and it's identified risks.

Most importantly, the safe storage and ease of retrieval for all your current medical record data, needs to be implemented. Do this before MIoT begins adding huge volumes of data to your existing library.

A personal example: Recently my daughter was given a fifteen page printed document with detailed information recommending changes to her diet relative to her long bout with kidney stones. The document could easily have been delivered electronically. Learning of this experience and reading about the Medical Internet of Things, it occurred to me that the medical profession may not yet be in a mode of actively adopting new technology. Considering that she is being treated at a prestigious teaching university in Texas, which I would expect to be more progressive in adopting new and useful technologies, it is probable that providers not connected with a teaching university may be even more reluctant to take up new tools .

That said, making good use of existing technology may be vital to the successful integration of MIoT.

Choosing to implement data archiving for your medical records would be a prudent step in preparation for new services as they come available via the Medical Internet of Things.

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Spinal Cord Damage In Children And Infants

After spinal surgery, in the rehabilitation period, you may need to manage soreness, pain, stiffness and limited mobility. Different kinds of spinal surgery involve the need to limit your exercises and activities. Therefore you may require assistive tools at home.
The rehabilitation process incorporates avoiding exercises like twisting, lifting, or bending for a few weeks or even months or more.

Regularly, you must be extremely careful about your return to complete physical activities after surgery, appropriate and completely restoration of bones may take over a year.

Advantages of Post Surgery Aid Items

There are many post surgery aid items intended to make the recovery procedure less problematic. Many are designed to provide mobility assistance and fall prevention and help you with consistent, reaching stretching, bending, turning, lifting and various other daily activities.

Here are some extremely useful items that will help you through the recovery period;

1. Swivel Cushion

Swivel cushions allow you to turn easily while placing less pressure on the healing part of the spine. It is normally used on chairs in homes and car seats. It is important to remember that swivel cushions will not work well in deep cushioned seats like recliners or some very soft seats. On harder, flat surfaced chairs and hard car seats it can work well. It allows you to rotate your body into the way you want to look or reach something.

2. Grabber

If your rehabilitation process requires limited activity, then you must invest in a grabber, also known as reacher. A well designed grabber will allow you to pick up things with ease without even walking. Some grabbers come with grip and grab convenience and are very light in weight to put less pressure on you spine when you try to reach any item.

3. Handrails

Handrails help you to get out of bed and walk in your house with ease and also prevent sudden falls due to stiffness and pain. You can ask someone to install handrails in walls, beds, and toilet so you can walk and stand up easily.

4. Quad Cane

A light weight quad cane will help you going for walks and standing up, that once was challenging after surgery. Some quad canes are foldable and easily transported everywhere. You can use it when you want to use toilet and to go for a walk as a workout in the end of your recovery period.

5. Heating Pads and Ice Packs

Alternating hot and cold compresses helps to heal pain faster. It is one of the essential items to have during recovery period. If your spreadsheet surgeon does not tell you, ask him or her how use alternating hot and cold compresses.

6. Extra Pillows and Cushions

Pillows and cushions add extra support for your spell. You can also place one under your knees to slightly rise when lying on you back to put less pressure on the spinal cord. Use firm pillows to prop up to a reclining position. If you sleep in a side lying position, you must tuck a cushion between your knees to keep your lower back at rest.

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ESR Blood Test – The Detector of Causes of Inflammation in a Human Body

An ESR Blood Test or Erythrocyte Sedimentation Rate Test aids in the detection of reasons behind the cause of inflammation in a person. The test does not really assist in diagnosing the existence of a specific disease or infection in the body but complements other tests ordered by a physician to understand the cause of inflammation. The tests ordered depend upon the types of symptoms experienced by an individual.

What does an ESR Blood Test Monitors?

The test helps in screening inflammatory conditions in the body, such as rheumatoid arthritis or systemic lupus erythematosus. It can be useful in detecting conditions that are a cause of inflammation, such as autoimmune diseases, infections and some types of cancers. A physician may also order this test if an individual sufferers from fever, has some type of arthritis, or experiences certain muscle problems.

How is an ESR Blood Test Performed?

As the name suggests, it's a kind of blood test wherein a sample of blood is drawn from one of the veins of the body, usually those nestled near the elbow or the back of the hand. Post the collection of blood in a test tube, the sample is sent to the laboratory for testing and analysis. In the case of an ESR Blood Test for cancer, it's quite possible that the patient may have to spare more blood samples than usual.

It's important to note that there are certain medicines which can hinder with the tests results and hence, must be stopped temporarily, but only after the consent of the doctor. Medications include: –

  • Androgens, such as testosterone, estrogens, etc.
  • Aspirin, when taken in high doses
  • Divalproex sodium
  • Phenothiazines
  • Valproic acid
  • Methadone
  • Prednisone
  • Phenytoin
  • Heroin

ESR Blood Test Results

The ESR blood test normal range majorly depends upon the age group an individual belongs to.

  • Women below 50 years – less than or equal to 20 mm / hr
  • Women above 50 years – less than or equal to 30 mm / hr
  • Men below 50 years – less than or equal to 15 mm / hr
  • Men above 50 years – less than or equal to 20 mm / hr
  • New born babies – less than or equal to 2 mm / hr
  • Children who have reached puberty – between 3 and 13 mm / hr.

Abnormal ESR Blood Test range, however, may be due to the prevalence of the below-mentioned diseases, conditions or infections in the body.

An Individual may have a high ESR level in case of: –

  • anemia
  • thyroid disease
  • disease in the kidneys
  • lymphoma
  • multiple myeloma
  • pregnancy
  • temporal arteritis
  • old age
  • Waldenstrom's macroglobulinemia
  • certain types of arthritis

On the contrary, a person may have lower levels of ESR in the blood because of the presence of conditions such as: –

  • hypofibrinogenemia
  • low plasma protein
  • congestive heart failure
  • leukocytosis
  • sickle cell anemia
  • polycythemia

How to reduce ESR in blood?

There are certain essential things that one can do to reduce the levels of ESR in the blood. This typically involves quitting smoking, taking up exercise on a regular basis, shrinking one's waist size, sleeping enough, steering away from stress and eating a healthy diet that specifically excludes foods that aid in escalating levels of ESR in blood.

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Voice of the Patient

Can you imagine having a farmers supply store in downtown San Francisco? It seems very unquestionably to me. There would be few sales. Having such a store there is an example of a business out of touch with its market. To be successful, businesses must supply the right product or services to the right customer in the right place and at the right time.

Should healthcare providers worry about such? Do they need to focus on the customer, the patient? While location is important for providers, does the delivery of services matter? After all, healthcare providers provide a service that is universally needed.

It so happens that the way services are provided makes a difference. With the right services provided in the right way providers will reap many benefits, including patient loyalty, better outcomes for the patient and better income for the practice. I believe that we can all agree that better patient engagement is one of the key factors to better health outcomes. But there is more than engagement between patient and clinicians that drives outcomes for patients and that improvements loyalty.

In a recent survey members of the Medical Group Management Association (MGMA) stated that several services helped improve patient satisfaction and engagement. Among them were flexible hours so that patients could have better access to clinicians, variety of communication styles, help with cost containment and management, and care management. Members stated that patients wanted other ways to communicate with doctors and staff, such as electronic patient portals and secure email. Since many more patients have high deductible policies they appreciate helping in managing their copays and deductibles. Letting a patient know before services are provided what their costs will be and helping with making arrangements for paying their share if need be put them much more at ease. Patients also like helping in changing their lifestyles if chronic conditions make it necessary.

I am not advocating that providers supply everything that patients want, even if 'saying' No 'to a request can be difficult. My own physician has said 'No' to some of my requests because it makes good financial sense to do so for the practice; his group is part of an ACO. For instance, recently when I asked if I could be tested for allergies to see which bees and wasps I was allergic to, he said 'No'. My reactions to stems was not severe yet and I should carry an epi pen with me when I am outside in the summer and spring in case I was stung and began to have a reaction. There are many instances when doctors should deny patient requests. For instance, recent research shows that 84% of physicians still prescribe antibiotics for runny and stuffy noses in spite of the fact that research shows this is the wrong thing to do, as it builds up antibiotic resistant bacteria.

It is important that medical providers find out what their patients want that will lead to better outcomes for all. It would be a waste of time and resources to provide services from a list such as those from the MGMA survey above if patients do not want some of those services. Perhaps almost all of the patients in your practice have easy access to services; they do not need more flexible hours. How, then, can you find out what your patients want that you are willing to provide?

There are several good ways to find out from your patients what new services they want or what services you provide that could be improved. Working with a team made up of various office and clinical staff, providers can use focus groups, advisory groups, surveys and patient feedback to staff to find ways to satisfy their patients. It is necessary to use teams to develop and implement these strategies to get patient input so as to get a good variety of ideas and questions.

A focus group is a good way to get ideas to improve your practice which you can then test to see if the suggestions are good. You can conduct a focus group using your own staff as leaders or you can hire a professional to help with this. A professional will definitely get better results but you can certainly conduct one yourself if you follow a few simple steps. One, have a goal for the focus group, such as, “How can our group help improve our services so as you (the patients) believe your needs are better met?” Then, your staff team can help create a set of questions and inquiries that can be used while conducting the session. Then, choose a moderator to move the session along and a recorder to write down the response of the patients. Finally, invite some of your patients to be a part of the focus group. I would use no more than 8 or 9 in the session. You may want to provide a reward for their participation.

Another way to find out your patients needs is to create a survey. Your team should help develop the questions for the survey. You may have your patients fill out the survey when they come in for a visit. If you want a broader group of responders, you may take time to do a phone survey of your patients. One member of the MGMA reported recently that his group has staff members call several patients each day over a period of time to collect responses to a survey.

Another effective way to get some insights is to collect feedback from patients during their encounters with your staff. Patients will sometimes let members of your staff know what could be better at your practice. Staff should be trained to write down these suggestions or have the patient write down the suggestion and hand it back to the staff. These suggestions can then be reviewed later at a staff meeting so that the suggestions can be further explored and the staff member who collected the suggestion can add further details. Such suggestions can be used in focus groups or in future surveys.

Changing your services, adding more services, will help satisfy your patients which will lead to better outcomes and improve patient loyalty. Loyalty is important as it is easier to treat a returning patient than a new one; it is also more cost effective to treat returning patients as it generally takes less time to treat them. Further, loyal patients will recommend you to their family and friends as well as provide good feedback on sites that measure patient satisfaction and on social media web sites. Using some of the tools that I described will help you find out what your patients want.

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Model the Process

Cooking is a process that involves specific, orderly steps with well-defined inputs. For some recipes slight variations are allowed but the basic steps and ingredients must be maintained for a good product. For instance, when my wife makes a marinara sauce, she uses crushed tomatoes, salt, onions, garlic, basil, red wine, fennel and parsley. I, on the other hand, use the same ingredients except the fennel but add a bit of sugar and oregano. The steps in making it are the same for both of us: brown the garlic and onion in olive oil and then add the rest of the ingredients and simmer for about a half hour to an hour.

In business, manufacturing and service industries such as healthcare most activities are performed with well-defined processes. In manufacturing there is no room for variation in order to produce a best quality product. In service industries, there may be some variations as in the slight variations of making marinara but the best results are achieved if each task is performed essentially the same. There is more room for variation in the clinical side of healthcare as an orthopedic surgeon may choose to use tissue from the patellar tendon or hamstring to repair a ruptured ACL. Neverheless, using standardized processes generally results in best outcomes and these processes should be modeled , according to the structure of Business Process Management, which I have been discussing in previous newsletters.

Modeling a process allows for standardization and identification of best steps to use. If each person in a process adopts the standardized process then outcomes will be predictable, then pleasing the clients and patients. It also eliminates waste, thus producing savings for the business or provider.

Modeling a process can involve paper and pencil or computer software. Most is done with software now. Two common ways to model a process are to use flowcharts or value stream maps, which are used in Lean process management. I have created a simple flowchart which models the process that I use to analyze data that has already been collected for a client. You can find an image of this map by clicking here .

Since I am the only one who employs this process there is no variation; I am consistent from one application to the next for different clients.

What are the components found in process models? Typically, there should always be a definite beginning and end point. Along the physical steps you may want to include some are all of the following: people involved in the process, information and data, materials, tools, and environmental factors. These are always used in value stream maps.

You may believe that the processes at your site are fairly standard but the 'present state' of a given process may be quite variable. This is especially true if a process has never been documented. For instance, when a medial assistant is escorting a patient to an exam room at an outpatient clinic, she may stop and take the patient's weight and measure her height before proceeding to the exam room. Another MA may take the weight and not measure the height.

To see if there is wide variation in a process that is unacceptable because it leads to errors or poor outcomes, a team of those involved in a process should work with a process champion (a person designated to own a process and optimize it) to ' map the current state 'of a process. It is during the mapping of the current state that the variations will appear. In fact, it may appear that there is very little standardization occurring at all.

I was working with a hospital group once and we were mapping the check-out process. In working with the administration and nurses we found that there was a wide variation in how the check-in staff was informed that there was an empty bed available. In fact, there were many workarounds for this process that had been developed by the floor nurses as the standard process did not work well. So, we made a present state map that represented the steps generally used by most staff. Then, we created a 'future state map' that represented the steps that all should use and that was best in notifying the check-in staff of the availability of beds on a unit. After creating the future state map, the process champion worked with the team to develop a plan to implement the new process and make sure that it was consistently followed by all involved staff. This included identifying indicators that could have measured to indicate the success of the implementation.

One of the important steps that a process champion must do before meeting with the process improvement team is to take a gemba walk. This involves the champion going to the place where a process occurs and patently watching it unfold. She should do this several times and with different staff involved. By observing the process unfold she will be able to assess the amount of variation in the current state. The champion should also observe a process after it has been successfully implemented to be sure that there is no backsliding to the previous state of the process which was probably highly variable and unsatisfactory.

As you can see, to get best results, a process should be explicitly mapped. From this map, a standardized future state map can be created so that all will carry out the process in the same way, thus providing predictably good results. Patients and clients will be happier, staff will be pleased and the providers will be rewarded with increased income.

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IVF: What It Is and How It Works

IVF has grown exponentially popular over the past decade with the advances in medical technology. It has given many couples hope in having a baby to complete their family. Although the term IVF is used so often, what is it and how does it work?

IVF is the abbreviation for In Vitro Fertilization. What that means is that the process takes place in a laboratory. The term In Vitro is Latin and means In Glass. A fertility specialist will unite an egg with sperm using specific techniques in a glass container or rather a dish. The popular phrase 'test tube' baby comes from this process, although it is a slightly skewed description. Thereafter, the embryos are transferred into the uterus. IVF was first successfully used in 1978 and since then thousands of babies have been born through this fertility treatment.

It may be a popular fertility treatment but it is only suitable for certain people. The factors that may deem IVF possible would be the following:

  • Where a woman has tubal problems and her fallopian tubes are blocked. In such a case the sperm can not travel to the uterus so intervention is required to make pregnancy possible.
  • Where a man has a low sperm count or he has problems with sperm motility and the sperm is unable to travel through the fallopian tubes. The sperm has to be removed and placed with the egg via IVF to make pregnancy possible.
  • Severe endometriosis can affect the fertilization of the egg. It can also affect the implantation of the embryo in the uterus so these steps need to be controlled with a fertility treatment.
  • Many women have ovarian issues which prevent the eggs from being released so the eggs need to be extracted in order to pair with the sperm.
  • Fibroid tumors and an abnormally shaped uterus certainly affect fertility so IVF can be considered in such cases.
  • Conditions where infertility is inexplicable may also warrant IVF as a relevant option for couples.

Once the problem has been identified and you wish to proceed with IVF , these are the stages.

  1. Ovulation induction is the first step in this process.
  2. Next, the egg is retrieved.
  3. Embryo culture and fertilization is the next step.
  4. Then finally, the embryo is transferred.

IVF is quite a personal and in-depth medically advanced process, and it has shown to be quite effective for couples who want to have a baby.

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