Medical records. Hospital owned or patient owned?

I had an “ah-ha” moment while sitting in the New Jersey Hospital Association’s annual meeting.   We were listening to Dr. Eric Topol – Director of the Scripps Translational Science Institute, cardiologist, and author – discuss the technology changes that consumers have access to today.

In some cases the technology he talked about is only available to people with huge resources, but his point in showing the crowd of 500 people these things is – “They are coming.” Not only will these new technologies be available to patients, but the access to the technology will change the dynamics of the patient experience and the relationship they have with the entire healthcare system.

The technology advancements that are on their way are not new to you. I have been saying these things at the employee meetings over the last 3 years. I have shared a number of times that we need to continue to find ways to bring value to the patients.

But, I had one of those aha moments during the presentation. Dr. Topol wrote a book – “Patients Come First,” and in his book he talks about when the patient will be able to eventually preform their own EKG or X-ray, there will be a lot fewer emergency department visits because they will not need the services of a hospital or person for urgent intervention.   

Ok no big deal there.

What really struck me was when he started talking about who owns patient medical records. In each state, the laws define the “ownership” differently.

For example, in New Jersey the law says the hospital owns and maintains the records and the patients only have access to them. Vermont is the only state in the nation where the patient owns their own records.

I can bet that most of you know how to read a medical record, right? Well, when I have read my own medical record, I’m convinced the doctor must have written it in another language – to me it is just gibberish.

So when Dr. Topol began talking about the translation services (my description) that are now available to explain to patients what their scans and medical records say in layman’s terms, I was so grateful for what that could do for our patients and families! Patients will no longer need to rely on the healthcare professional to make sense of the words; technology will do it for them.

I know what you’re thinking – that’s just one more piece of technology that will replace us! But it’s not, it’s an advancement that will help, and I’ll tell you why.

The new technology cannot replace the plan of care and the value of developing the relationship that we as humans provide. This technology can help to speed up a task that would normally take time out of your day, allowing you to use that time to see more patients.

I get ads for shoes all the time while searching on the Web (and always thinking “How do they know I love shoes?!”). When someone is searching specific health issues they are concerned about via Google or Bing monitoring their activity, we could use the same data sharing that Amazon uses in their marketing efforts to “market” to our patients the information that will help them with carry-over care, help them get healthy or remain healthy, and to take their medications. Well, it could help any number of things!

Yes, this could have some ethical issues but if the patient controls their own records, they could participate in any number of different apps that give them the tools they need to manage their lives and care in entirely different ways. We are trying to do this already with our new Parent PAL app, but the inner connectivity to other information could be the game changer.

Ok just breathe. I’m not trying to scare you, but instead to inspire all of us to think about what our patients couldn’t live without. Then, to develop the technology to remedy their issue and help it to become essential to them.

You know I love my FitBit. It truly does make me feel better when I hit my goals and keep track of how my friends are doing on their personal efforts to keep up their cardio. How could we help people manage the stress in their lives?

Would love to hear your thoughts!

You decide what the future looks like

I’m sure by now most of you know that I started my professional career working in Washington, DC and for the State of New Jersey. I was responsible for policies, and since my job was heavily impacted by politics it was important for me to learn the ropes.

So, with that said, watching this Presidential campaign has been both fascinating and frightening to me. Even more so, I believe it has parallels to the transformation in health care.

Let me explain…

Forget whether you affiliate yourself with the Democrat or Republican Party. It is very clear that most people paying attention to the debates and the campaigns for our next President are angry.

Why do I say this?

On both sides of the aisle, many of the policies that the candidates promise and put forward are impractical and can not be accomplished.

No, we aren't going to pay for everyone's college education — unless we raise taxes to equal 50% of what people earn. No, Mexico is not going to pay for a wall to stop immigrants from coming into our country. The Affordable Care Act may be modified; 10 million Americans including 1 million children now have insurance and it will not be repealed.

When I watch these debates and the political commercials I can’t help but wonder, “Why are candidates saying these things and why do people believing in them?”

Rapid changes in our economy and advancements in technology make it difficult for us to protect the “American Dream.” We can’t all be Mark Zuckerberg, creating Facebooks and making more money than we know what to do with. The truth is the state of our country is a harsh reality.

It’s not all bad and scary. I’ll be the first to tell you that some major improvements have been made in the last few years. The economy has turned around and unemployment is down to 5%. These are great! But, people are not better off now than they were in 2007 when it comes to their income.

We are all uncertain about our safety and our future employment. Our parents now know that we will not have the same opportunities as them in regards to financial security and independence. This can cause huge unrest and disillusionment.

So what is the answer?

The answer is that we hold the answer within our own world. It is up to us to continue to do our best to find hope and joy in our daily life.

Knowing that change is coming doesn't make it any easier to accept the change. We need to do for each other what we do for our families — find the joy and refrain from getting too far ahead of ourselves.

We need to come together as a community where all people find the chance to succeed, where teamwork is encouraged and excellence follows.

What are your thoughts about this topic? Are you feeling the pressure and struggle? What are the ways you are coping?

Technology: Is it hurting or helping?

One of the many things that I have always appreciated about the employees at Children's Specialized Hospital is how many of you who show no hesitation to ask questions and allow me the opportunity to give you a different view on shared topic I’ve talked about.

This blog post is a result of the last State of the State. I know some of you showed concern that all of this new technology was going to "hurt" what we know as Children's Specialized; that it would in some way change our ability to stay close to the families.

First, let me begin by saying that when I started working here we had only five (5) locations. Today, we have 13 locations.

In each of our locations, families tell me that they feel connected to our staff. They are struck by how each of you takes them into your lives, and in turn you become part of their families. 

Let me tell you, that doesn't happen by accident. It happens because we live our values and we love what we do. You have set Service Excellence Standards that we all work hard tolive up to.

We have dramatically changed our hiring practices so we hire not only based upon your skills, but based on who you are and what kind of heart you have. These are purposeful, deliberate strategies that we set out. Yes, we always can do better to ensure we are all rowing in the same direction, but we have made significant strides.

Secondly, there are things we may not see every day, things that we shouldn’t necessarily be proud of that are an unfortunate reality that many of our families go through. For example, we have 5,000 calls coming into scheduling. No matter how many people we hire to answer the phones, there are no more appointments to give them. Our wait for physician services went up last year and we have wait lists for EVERY ONE of our services.

We continue to make great strides by using technology in registrations – reducing upwards of 5,000 hours of face-to-face time that parents have to wait to be registered by a person – creating a patient portal so families have access to their records, pharmacy refills digitally, and scheduling online in 2016.

But, we are still using modes of treatment that require families to come to us. Families have said that there are times in their lives that if they could do FaceTime or video treatment it would help them. If we had a 24-hour billing department that would allow people to chat online to understand their bill, like I can do with my cable company, that to would be easier for them.

We will hold to our values and continue the good things that we do have at Children’s Specialized. But we also have opportunities to better meet the needs of our families by the use of technology and pursuit of new ways to help their children meet their maximum potential that we must never stop striving for.

Disagree? Or did I miss your concerns? Let me know in the comments below.

Our partnership with China begins

First, let me begin by saying what a tremendous honor it was to for Michael Dribbon (VP Rehabilitation Services and Program Development), Chris Haines (Chief Medical Officer), and I to represent Children’s Specialized Hospital to begin our new consulting relationship with LIH Olivia’s Place. So many of you have asked about our trip, so I thought this would be a great place to share with all of you!

I’m going to totally over share on this one, but Michael over packed. Ha! Standing in the United Airlines line for check in, he had to take out ½ a pound of stuff from his suitcase. He was carrying presents and other materials for the people we were going to meet, but it ended up making his bag weigh a whopping 70.5 lbs! They wouldn’t let him pay to send the bag as is, so we had to do some luggage juggling.

The first thing we noticed when we arrived was the very tall apartment buildings. Inside entire, multi-generational families live together in 1,000 square feet homes. I can only speak for myself, but it really struck me how many people are in such a small space; everything is so compact.

I have a whole new appreciation for rush hour in New Jersey! In Beijing, it took us almost 95 minutes to go 5 miles. One of our hosts described driving in Beijing to me like a boulder in the middle of a stream. The water just makes its way around the boulder on the sides and isn’t deterred. People, cars, and bikes all move the same way. It just goes. I spent a lot of time in the back of the van with my eyes closed!

Beijing Children’s Hospital had just begun to institute appointments to their outpatient clinics. Prior to the week we arrived, people would just line up at the wee hours of the morning outside of the clinic doors and wait – just like you would at a department store. When the doors would open, people would be lined up by which physician they needed to see, and then wait again to be seen.

The physician would spend an average of 3 minutes with each patient and see 500 or so patients a day. It was hard for us to conceive how all of this functions.

The inpatient hospital is open from 9 a.m. to 5 p.m. on Monday-Friday. Just one nurse stays at night for the entire hospital. The families are expected to stay with their children to provide care over night and on the weekends.

Dr. Haines said he saw many children who had Guillain-Barre and other disorders that we also care for. There are so few surgeons so the things that we see as routine (e. g, feeding tube insertion) are not done because the clinicians can’t take the time away from the more traumatic surgeries that need to be completed.

Our role at Olivia’s Place is to provide expert advice as they open outpatient rehabilitation centers. Their first center was due to open the Monday after our arrival.

Their therapy staff was foreign trained and supplemented with therapy aides. The facility was beautiful and looked very much like ours. All of the patients are private pay, since the government insurance does not cover rehabilitation. It is their hope that they will be able to offer free care but that is an aspirational goal right now.

There were some things I saw there that I found hard to get used to. The signs in the bathroom at the hotel state, “Do not drink the water.” We had to use bottled water to brush our teeth. Also, in the closet there was a face mask with aerator on the front – think gas mask – in case the air was too polluted.

We got a chance to visit The Great Wall of China! It was 100 degrees outside that day. I sweated so much that the dye from my purse bled on my white shirt. There were attractive purple stains all over the back of my shirt and on my shoulder. The sights were beautiful, but I’m not sure how great I look in all the photos since I was so sweaty!

To make matters even more humorous, Michael and I have a bit of a fear of heights, whereas Dr. Haines was fearless during our adventures! Not only were we sweating because of the temperature, but I’m sure our nerves from being so high had something to do with it.

Also, giving a speech with a translator was very tough. You all know that I very rarely use notes and if I have them, I don’t keep to them. Well when someone is translating they read word for word on the slides. So, if you use words that aren’t on the slides and the translator doesn’t know them, well you can only imagine what gets translated.

It is clear to me that we have a unique ability to improve children’s lives in ways we can’t even begin to understand. We are continuing to provide assistance to our partners and hope that they will take us up on our offer to train side by side, both here and in China.

My thanks to all who have volunteered and we will continue to keep you apprised.

It’s all about those apps

Earlier this month I told you about an invention that would make my life easier. Cell phones can really do it all nowadays, so I’ve been thinking a lot about smartphone apps.

I am fascinated by the different tools people have adopted to help them make their life easier; that one (or sometimes two or three) thing they have become so reliant on that it would be hard to imagine getting through the day without it.

I used the word "app," but the crutch can really be anything that has become necessary for you to get through your day.

I’ll share mine!

I don’t think I’m alone in sharing that the first and most obvious necessity is my iPhone. It truly has become the one thing I would turn around the car for if I forgot it at home. I have become so dependent on its uses and how connected it keeps me.

I often hear people say, "I have my life in there!" Since I’m always on the go, I can absolutely relate to that one.

So, what apps are on my phone? I have a few apps that are my go-to, but then others that I just think are really cool.

On the functionality side I guess it is those you would expect:

·         Google, - to get a quick answer to any question

·         Email, so I can stay on top of my email even when I’m not in the office

·         Fitbit, because you all know I’m obsessed with my steps

·         NJ.com, to stay up-to-date on news

·         Google maps, I’d be lost without it and love to check where I’m going ahead of time

On the fun side:

·         Shazam, so I can figure out what song is playing where I am and then purchase it immediately via iTunes (also another favorite)

·         Facebook, for obvious reasons!

·         Kindle app, so I can buy new books without having to lug them around

Amazon Smile is both a site and an app that I can’t live without. I am a one-click wonder. I get boxes every week from Amazon and it is has made my life so much easier when I don't have to worry about getting to the store to shop, but can order on line and from one vendor! Plus, I can justify my shopping habit with Amazon Smile since each order gives back to our kids!

The Asbury Park Press website has a data universe that will let you find any homeowner's address if they live in the State of New Jersey. It has been a huge help to me when sending notes to donors or some of you! I love not having to ask people for their address and keeping the element of surprise!

Before the end of this calendar year we’ll be coming out with two apps for our patients and families to use! Stay on the lookout for more about those two apps both here on Access Amy and through email and the huddles!

There’s got to be some things I’m missing, right? What are the items that you are you using that you would like to share? The apps or websites that you can’t live without!

This would make my life easier...

Think back on the last decade or so; think about how far technology has come. Portable DVD players and digital cameras were becoming popular. Today, we get both features in our cell phone!

I’m sure I don’t speak for myself when I say that I’ve taken a lot of these technological advances for granted over the last few years. For example, my iPhone!

With my iPhone, I can FaceTime all of my loved ones and relatives in a real-time way from anywhere in the world at any time. A few friends and I were recently recalling standing in line in college during the ‘80s to use the payphone! Can you imagine having to schedule a weekly call to your home from a payphone, instead of picking up your personal cell phone from anywhere and just tapping the screen?

I remember using FedEx for the first time and thinking it was insane that it could be sent over night. Today, we can “Zip” a document and send it anywhere in the world immediately. 

Ok, here is my point.

All this chat about technology got me to thinking: If I could invent anything to make my life a little bit easier, what would it be?

I think the one invention I could really use would be some sort of transportation magic that would allow me to either be in multiple places at the same time or travel quickly. You know, sort of a "Bewitched" wiggle of my nose and POOF I’ve gone from Egg Harbor to Clifton at the blink of an eye.

Another thing I thought of was to clone myself! Some days there is just SO much to do that I could really use another one of me. Could you imagine my shoecloset if that were possible?

If you could invent any one thing to make your work or personal life easier or more efficient, what would it be? 

Being capable

Ok, so I don't want to sound like I have become my mother (trust me, that’s a whole other blog post), but I want to share with you some reflections. Our employee engagement survey starts on Monday, and one of the questions asks about the tools you need to do your job.

I grew up with my mother reminding me about how fortunate I am to have grown up both when I did and how I did. She loved to tell the story about walking miles to school through feet of snow, uphill, both ways etc. I bet you’ve heard the same from your parents.

I would just roll my eyes every time the story would start again. Yes, I too had that nasty habit and I’m not proud of it. Even as I write this post, I can hear my mother’s voice telling those stories.

Some of the questions you will be asked during the employee engagement survey (which begins on Monday!) will be about having the tools you need to do your job. I have a few things to share with you guys today about this one.

I remember vividly being in Toms River Main Street during one of my first employee meetings and our colleagues begging for new space—bigger gym and better space. I also remember the need to have better equipment at Stevens Road and the need to redo the North Wing in Mountainside.

Over the last decade we have invested over $100 million into our organization. We built a new inpatient hospital, opened or renovated 6 of our facilities – including our Long Term Care unit in Mountainside.

Let’s talk about the technological advancements! We created an electronic medical record (EMR), a scanning system, an electronic pharmacy tracking system, new billing systems – including electronic payment from insurers. We have implemented the use of the VGo with our babies and introduced new clinical programs to meet the needs of our patients.

When it comes to staff, we have added improvements in support of staff by improving the at-home sign on and the reimbursement tracking and payment processes at your requests. You have driven our clinical improvements, and we have continuously expanded and invested as you all have told us about new things.

While I know we will continue to evolve, I am so very thankful that we have done this with the tremendous support of our Foundation and donors who have funded most of these investments.

One of the most important things we have invested in is training for staff and by staff. Expanding your access to the experts among all of us and featuring you in the work that we are doing. From Clinical Rounds to Leadership Learning Retreats, we are all continuing our learnings and striving to grow. Many of you have presented at national and international conferences, sharing your expertise and featuring the hospital as one that showcases you and your great work!

Guys, I know we’re not perfect. And yes, there will always be more things to do and more needs, but it’s important that we take a look at the big picture. We continue to look for new and different ways to improve our services for our kids, understanding that we have to make our investments prudently to serve the most kids. THAT is what’s important.

I am so very proud of the work we have done and excited about the continued success that I know is before us.

What improvement has helped you to do your job better?

Confession: I’m obsessed with tracking my steps

You may have already heard that I am hooked on my Fitbit – an activity tracker that you wear to track your steps, count your calories, and even help you see how well you sleep.

I’m VERY serious about making sure I hit my goal in steps each day. I park farther away from the front door of wherever I’m headed and take the stairs whenever possible.

If I haven’t completed my goal of 12,500 (you can set your goal to whatever you want) at the end of the night, I stand by my bed and march in place to get the steps in. See? I told you I’m serious about it! Some might say obsessed… but it’s for a good reason. 

Since I have got my Fitbit in March, there have only been 5 days that I missed my goal. The Fitbit is such an easy way to say “wait, this is important for me to do.” Plus, it’s fun to watch the step counter go up as you climb to your goal!

I don’t think my goal of 12,500 steps is going to change the course of my life but it is one thing that I do each and every day that is just for me. No one else cares whether I do it or not, but to me it is the time I carve out for myself and because of that it’s important to me. Plus, I feel a sense of accomplishment as soon as I reach that goal!

There are times when I can’t make it to the gym because of my schedule or the snow has sucked the life out of me and I just can’t slug through. I’m sure I’m not the only one feeling the effects of the weather! But I always have my trusty Fitbit on my wrist saying “Don’t forget me; you’re so close to your goal!”

Is there something you do each day to take care of yourself? Maybe meditation, a walk around the block – something that is just for you, and while it might not change the course of your life, you still do it because it matters just to you?

The pros and cons of disruptive innovation

A lot of the healthcare trade journals have been printing stories about innovation. You have probably heard me say that I am truly concerned that disruptive innovation – something that will change how we use the healthcare system – will come from outside of the healthcare market place.

Just an example, the iPhone we know today evolved from the work of 3 guys in their garage – not at IBM or Hewlett Packard. Those companies will never hold the place they did in the marketplace before the disruption simply because they were not ahead of the curve – they will always be playing catch up. 

That is my worry for our hospital and for hospitals in general. We are a trusted place for families – a facility they come to filled with people they rely on. If technology evolves to a point where it can provide the same care they came to us for, how can we ensure that we can continue to be of value to our families?

I noticed something at the bank when I went to the ATM. I now have the option to “save” my most common transaction on the main screen when I log into the system so I don’t have to re-enter it every time. In addition, they give me my card back before they give my money because people were leaving their cards in the ATMs and causing a lot of risk, rework, and havoc.

These two small steps save me and the bank’s employees’ time and energy, and honestly I greatly appreciate the change!

Now does it make me stay with this bank versus another? Probably not, but I do appreciate the fact that I can see they are thinking about how to improve the customer experience.

The Tablet Registration, the Patient Portal, and taking steps to allow families to schedule their appointments online are all examples of how we are doing this for our families. They are all ways to ease how patients and families interact with us and ensure that if we aren't the place that develops this disruptive technology, we are actively working with our them to improve their experience as well as provide great care for their children.

I still believe the best place for the disruption to come from is from you. You on the front lines see and hear everything. Throw those ideas out there and you never know what may happen!

Shoveling the way to safety

My favorite post to share with you all is when we spotlight one of our employees who really shined. Today, I’m sharing a wonderful story about Justina Candelaria (LTC Unit Secretary, Toms River - Stevens Road).

Winter weather is brutal – between the freezing temps and the inches upon inches (or sometimes feet upon feet) of snow – some of us may not be our usual “bubbly” selves.

One of the major storms back at the end of January – you remember, the major blizzard that really wasn’t, but still was pretty bad – Justina really stepped up to make sure everyone was safe.

The snow was starting to pile up, really coming down hard, and Justina knew the area in front of the hospital needed to be shoveled to help our patients and families get into and out of the site safely. Security wasn’t able to leave their spot at the front of the site, so Justina put on her boots and got to work!

She found a shovel and shoveled the entrance to Long Term Care, then salted the area to make sure it would stay as clear as possible. She did this because one of our families from LTC was out in the community with their child and would need to be able to get safely back inside!

This was not technically in Justina’s formal job description, as part of her role at Children’s Specialized Hospital. She wanted to ensure the safety of our patients and visitors and figured out a way to do it.

Thank you, Justina, for anticipating the needs of our patient and their family, as well as staying on top of getting the job done! You are a great team player.

Here’s to hoping the snow is slowing down! How many more days until Spring?

Do you know someone that should be recognized on Access Amy for something they’ve done at Children’s Specialized? I’d love to hear! Share below in the comments or send an e-mail to Megan Muller at memuller@childrens-specialized.org. 

Smartphone – what will it think of next!

I recently read a Wall Street Journal article discussing the transformation of the healthcare system with technology.

You may have heard me use the expression that it is my hope that the transformation comes from us, inside the healthcare system. The likelihood that the transformation will come from outside the system is great because we often get caught in the trap of knowing how the process works and find it difficult to imagine how it could be different or better.

I know I have given you this challenge before, but if the sky was the limit, how would you use technology to change healthcare?

For me, my healthcare technology fantasy is related to time.

There are many times that I know something is wrong, but I don’t feel it is “wrong” enough for me to take off from work and make a doctor’s appointment. My doctor is not close by and in order for me to see him, it requires at least a 3-hour block of time between 9 a.m. and 5 p.m. during the week. So, unless I am hacking up a lung, I am not taking the time to see him.

I haven’t crossed over yet to the minute clinics, but I am starting I might give it a try. I wish I could e-mail my doctor and tell him my symptoms, or send him a photo of a rash and see if he can diagnose it just by looking at the picture. Then he could help me work through it without having to come in.

It might sound bogus to you now, but over time it’s definitely something that could happen in health care! After all, we use the VGo robots now with some of our patients so our doctors can check on them remotely.

So what is your technology wish?

What are your intentions for 2015?

Can you believe it? The New Year is officially here and we are nearly through January already! If you’re like most people, you started off the New Year with a resolution – a promise to change a behavior or add a behavior in the New Year.

You’ve had about 3 full weeks to work on your New Year’s resolution. So, how’s it going so far? Have you stuck to your plan, or did you become distracted? 

Don’t feel discouraged. Instead, look at your resolution in a different way. Trish West-Low (PT – Toms River) once told me that we shouldn’t be thinking about resolutions which could be easily abandoned, but instead focus on intentions because if we get derailed, we can always refocus and reassert our intention.

Now, that’s really something isn’t it? An intention does not seem to carry the same weight if you end up not following through with your resolution.

Intentions are best set when they are within reach—something you can see and touch; something you can create an action plan for. 

Perhaps your intention for the New Year is to become healthier. To help you set your intention, you should think of a personal memory of when you felt your best and focus on getting back to that feeling. In order to get there, you need to have a plan. It’s not going to happen overnight, but as long as you are moving in the right direction and focusing on the route it takes to get there, your intention can be fulfilled.

Many of you have already heard about my morning routine. For the last 14 years at 4:30 a.m. Monday through Friday I have met my now 85-year-old father at the home I grew up in. We chat about 15 to 20 minutes, just to catch up, and then in separate cars we head to the gym to get our sweat on!

The gym opens at 5 a.m., and the group that is dedicated enough to work out that early is not very large – maybe around 20 people or so. Many people make a New Year’s resolution that focuses on health and fitness—losing a certain amount of weight, focusing on moving more and eating better, or what have you. So, we’ve seen our small group of morning gym go-ers really increase.

And yet, year after year, after just a few short weeks we see that number start to decrease again.  

Now, I’m not one of those regulars at the gym who complain about the “resolution starters” who start coming just because it’s a new year. Instead, I commend them! After all, everyone has to start somewhere.

If each of the new faces I see at the gym set an intention on January 1 instead of stating a resolution, they’d look at their goal in a different way. They’d plan what they need to do in order to reach that goal and be successful.

So this year, the intention I am working towards is to be a better person than I was yesterday. Some days it is harder to measure, but I am purposefully working every day on this effort.

Our intentions at Children’s Specialized Hospital are articulated in our vision to create a world where every child has a chance to reach their intentions – their best self. We know we are a big part of helping them take that first step, say their first word, or connect in a way you could only dream about.

That is what we do each and every day. We are working towards that vision – one step at a time.

What vision are you stepping into to? What do you wish for in this New Year, and how will you get there? I would love to hear what your intentions are for 2015! 

Skipping the line with the new tablet registration

In a perfect world, our patients and families wouldn’t have any wait time before their appointment. After receiving some feedback from patients and families, as well as observation from staff, about the registration process—we knew we had to figure out a solution to a very long registration process.

Drumroll please…

On December 15, 2014 our Mountainside outpatient center rolled out a new tablet registration process! And so far, the feedback has been terrific!

Here’s how it works—a patient comes in to register for their first appointment, we need to scan them in or double check their documentation before “clearing” them. We would work with this patient to clear all of their documentation before moving on to the next patient family – who is probably here for their weekly therapy visit.

So, if the next patient in line has already had their paperwork checked and is considered a “clean registration,” they’d still need to wait until we complete the registration for the first patient.

You can see the issue here.

This new tablet registration streamlines the whole process and decreases wait time. Now, each patient will receive a card that will allow them to check themselves in at the self-service kiosk. How cool is that?!

Let me explain.

Greeters wait in the lobby in Mountainside for patients to arrive. The greeter can see the patient’s appointment time as well as if there is any documentation that they need copies of or signatures for.

Each patient gets a card like the one below. This card allows them to breeze through the registration process with just a swipe! If there is any missing documentation, the system will alert the family (if using the self-service registration) or the employee that something needs to be completed.

The bonus? They get two cards – so if there are two caretakers who swap appointments they won’t need to worry about sharing a card – and the card can be used at any of our locations.

This new registration process is incredibly beneficial on many levels.

First, by allowing patients whose documents are up to date move quicker through the registration process, their wait time is decreased significantly, allowing for an improved patient experience. In addition, because each “clean registration” receives a card, families are able to check themselves in for their appointment and avoid waiting in line!

As any project that we begin, we need to ensure that the end goal is aligned with our corporate goals. As an organization, we have set a growth goal of opening 1-2 sites each year. With the addition of this tablet registration process, we decrease wait time but also increase the amount of patients we are able to see. With more patients, we are able to look into more sites!

And lastly, consistency is key! The tablet registration will help to streamline the registration process and create more consistency at all of our sites. Since the goal is to have a “clean registration” for each patient, the documentation process will be much smoother on the back-end as well. For example, Finance will be able to collect the necessary information for insurance claims, since each greeter will be ensuring all documentation is updated and in the system before the patient proceeds.

This project was a huge undertaking, and took a cross-departmental team of motivated folks to complete. I have to give major kudos to Darlene Carr, Jana Prokop, Carrie Snyder, Lindsey Marabella, Nicole Assante, Tamisha Bourne, Jessica Hall, Donna Provenzano, Chuck Chianese, Linda Waddell, Haig Minassian, and Taaliba Warden for working through weekly 2-hour meetings, and testing. Kudos to Patient Access, Strategic Improvement, and IT for all of their hard work in making sure the table registration went off without a hitch.

And lastly, cheers to the Registration Staff at Mountainside for being our pilot site to launch the table registration. They have been continuing to provide input to the team on modifications, and helped us to get into a better situation to launch this system to our other sites.

By Spring we hope to implement tablet registration in two other sites – Newark & Hamilton – with a goal of using the system in at least 85 percent of our sites by the end of 2015. 

Pediatric Primary Care at Mountainside

Children’s Specialized Hospital has offered a Pediatric Practice for well over 20 years. It was originally funded by the Robert Wood Johnson Foundation as a pilot for a medical home that would treat children with complex medical needs. It is not a separate building, house, or hospital, but instead a way to provide comprehensive primary care to children with special needs and their siblings.

Earlier this year (2014), we recruited Dr. Matt McDonald, Section Chief - Inpatient and Special Needs Pediatrics, to lead a team to turn the “idea” of a medical home initiative into a reality. I’m happy to announce that yesterday, December 10, we officially launched Pediatric Primary Care at Mountainside.

Our Primary Care Practice has been highly praised by the families who have access to the care that we provide. Pediatric Primary Care at Mountainside is special in the way the team cares for children with complex healthcare needs. No other pediatric rehabilitation center across the country is implementing this type of innovative care coordination model.

In order for this program to be successful and approved by the National Committee for Quality Assurance – we “must pass” the six required elements:

1. Access during office hours
2. Use data for population management
3. Care management
4. Support self-care process
5. Referral tracking and follow-up
6. Implement continuous quality improvement

Pediatric Primary Care will offer same-day appointments, a web portal that provides better access to the patient’s medical information, the ability to handle more aspects of care remotely, and regular follow-ups.

We are examining ways to use technology more efficiently; to better support our families, and go beyond the service of primary care and service as the care coordination of ALL of the care needed by the child and family. This means linking all of the various clinicians (regardless of whether they are at Children’s Specialized or not) and share information to manage the whole child in one database that is actively managed by a care management team.

So many times our kids have to repeat tests, and because there is often so much to communicate about what is going on in the health of the whole child, things can be missed. 

Folks, this is BIG. This service is going to help us set the bar nationally in caring for children with special and complex medical needs. Teamwork is the most critical part of transforming our current practice and making it successful for our patients and families. It is a huge undertaking – to envision this program, then to build it both from a technology and clinical skill set.

Thank you to Dr. Matt McDonald and entire team who has made this happen.

Adding this service to our care is important to our families. It allows them to be certain that their children are receiving the best care. We are excited to offer this service at Mountainside now, with the intention of rolling out the program to additional sites shortly after. 

For more information visit http://www.medicalhomeinfo.org/.

For detailed information on recognition visit http://www.ncqa.org.

Patient Portal Empowers Families

One item that is a continuous source of frustration with our families is the inability to easily access their children’s medical information. From requesting reports or copies of their medical records to getting copies of test results, we know it is an area in which we can do better.

Our Strategic Improvement and IT Departments have been working tirelessly to provide a way for our parents to digitally access to their children’s information. And we’re excited to announce the launch of the My Children’s Specialized Patient & Family Portal. I’m happy to announce that the portal is live as of today!

This valuable tool was built in collaboration with our families and staff as a way to empower them to be able to continue to successfully manage their child's health care.

This patient portal tool is great. It will not only offer secure online access to the patient’s medical records, but it will also allow the families to review and pay their bills online.

Over time, we hope to introduce a feature to allow families to schedule appointments! This is a very exciting time to be able to meet the families’ demands in this way.

The team has worked diligently to ensure that this tool abides by current laws on what parents can and cannot see. Families will be able to:

• View their child’s physician and therapy reports, including discharge summaries and progress notes
• View information regarding their visits, including evaluations and discharge summaries
• View upcoming appointment dates and times as well as set appointment reminders and request cancellations of appointments
• View medications and allergy information
• View billing statements and pay bills online
• Share their health record with other healthcare providers or individuals in various formats, including e-mail and downloading capabilities

Although this solution will solve an issue for our families, it may cause unintended consequences that we will have to address.

For example, the notes that are put in the medical record –how we word things about their child's progress and whether or not we are putting things in the record that we haven't communicated to the family directly – will now be open for the family to view.

For some, this may cause concern. Perhaps you wrote something that was not communicated, or worded something in a way that could be misunderstood. We will work through these issues together. We need to ensure that we continually remind ourselves that we are responding to families’ needs and will ultimately improve the information flow and the patient experience.

This is a very exciting step in how we provide care and information to our families; it will help to minimize the amount of administrative tasks that employees are responsible for, allowing them to assist families in other ways. I wanted to make sure you knew both that this was coming to fruition and the “why” behind initiative and why it is so important or our families.

Help Our Families By Sharing This Resource

A few weeks ago you received an e-mail from me sharing our effort to assist families choose the best insurance exchange for their child with special needs. Choosing an insurance plan is a daunting task, even more so for a parent with a child that requires multiple specialists, dozens of therapy visits and expensive adaptive equipment. And, with these new private or public exchanges, it’s a whole new ball game.

We worked with our Family Faculty, Family Advisory Committee, and a consultant to help us create an online tool that our families could use to assist them in making this important decision. With six easy steps, a comprehensive explanation, glossary of terms, printable forms, and personal stories from families that have learned from their own experiences – we have seen tremendous traffic to this site! 

In just about a month since we launched this tool, we have had over 3,000 visitors to the website. That’s just incredible, and really shows you how useful this tool is.

We have asked SPAN and other advocacy groups to share it with their constituents. The NJ Hospital Association has shared it with their members and NJBIZ did an article about the tool when we unveiled it. The Star Ledger has posted a story online, as well as in the paper yesterday.

New this week is a video that helps explain every aspect of the site, the key features, and why this is so important.

What I need is your help. You are the most trusted person in our families’ lives because you are an advocate for their children. Please help raise the awareness about this insurance tool; a few e-mails to contacts, a share on Facebook could go a long way to ensuring the children we treat have the best possible insurance coverage to reach their fullest potential.

Have you started the discussion with the families you treat about its benefit?

Technology allows our Docs to make house calls

You have heard me tell you that technology is revolutionizing how we will provide health care to our children. Children’s Specialized Hospital is fortunate to be the first pediatric rehabilitation hospital in the country to offer the telemedicine robot, VGo.

What is VGo? It’s a robot. A robot that uses HIPPA-secure technology to provide two-way video, audio and motor driven action. This is SO COOL! Thank you to Dr. Haines for being the driving force behind bringing VGo to our patients. 

Currently we are using VGo in two ways.We use VGo on our inpatient units where our doctors can sign on from their home computer and drive VGo around the unit to check in on patients and answer parent’s questions without physically being in the hospital.So Dr. Fantasia can sign on from her home computer without coming into the hospital.Talk about improving the patient experience – having a doctor available 24/7!

Now this is really great; we are currently sending home a VGo, with some of our infants and their parents, for the first week. For many of these patients this is their first time outside of a hospital setting and having access to the medical team that has helped them through what is probably one of the most challenging times in their lives is priceless. 

Dr. Burke and her team will schedule appointments to check in on the patient; with the home health nurse too. In a few cases, Dr. Burke has been able to avoid ED visits and readmissions because of these check-ins.One time, a baby’s trach came out during the visit and she was able to successfully talk the parent/nurse into reinserting it. 

Currently, we have two VGo robots in our New Brunswick site, as well as one at each of our LTC centers. But we hope to add more VGo robots to our inventory and help improve access to pediatric specialists and outpatient care to children living in medically underserved communities. 

Special thanks to Drs. Haines and Burke for being true champions of VGo and for embracing this new technology to its fullest. Thank you too to our facilities team who go to the ends of NJ to deliver our VGos, and bring them home. 

In the short time that we’ve been able to use these devices, VGo has offered endless opportunities to help our children in a way that we never thought was possible. Not only can our physicians check in on their patients at any point in the day from wherever they are, but we are now able to have our physicians consult with one another across our sites, right at the patient’s bed side by just dialing into the system from a computer or iPad.

We strive to help every child live in a world where they have every opportunity to reach their goals. Advances in technology, such as this, make it possible to save more lives and help our kids reach new heights.

I am excited to see the other opportunities the VGo system – or any other new form of technology – offers the children at Children’s Specialized Hospital.

Have you used the VGo system yet, or used any other form of telemedicine to help improve patient care? Do you have any idea on how we can use our VGos? I’d love to hear your thoughts.

Welcome to the family Warren!

Children’s Specialized Hospital is proud to announce the newest expansion of specialty pediatric health care services in Somerset County! The 13th outpatient center, located at 266 King George Road in Warren has officially opened. It was a common request by parents that we expand our locations. The Warren site was an existing therapy suite; therefore it was already known to the community and had steady traffic. In addition, the demand in Mountainside has been so great that we are hoping this expansion will provide more options in this geographic area.

The new facility is equipped with a large therapy gym, several break-out rooms for individual therapy sessions, 5 exam rooms for specialty physicians, and currently provide the following services: occupational therapy, speech therapy and physical therapy.  We hope to offer physician subspecialists and psychological services in early 2015.

Why Warren? Children’s Specialized Hospital is dedicated to serving children with all types of special needs and the leadership identified a growing need for expanded services within Somerset County, which is currently home to at least 15,000 children under the age of 18 years with disabilities.

We are thrilled to be able to bring therapy closer to home for many of our current patients. There are thousands of children in need of our specialized services, including children who have been diagnosed on the autism spectrum.

New Jersey has the highest reported rates of autism in the country. This means that 1 in every 45 children in the state is diagnosed with the developmental disability; a statistic that leaves many residents scratching their heads.

Experts attribute the high autism rate in New Jersey to earlier and more efficient screening methods practiced by school districts and medical facilities throughout the state. Such methods include red flag trainings for teachers and educators in early childhood environments, as well as advanced early developmental screenings provided by Children’s Specialized Hospital at no cost to the family.

As autism rates continue to climb, Children’s Specialized Hospital is proud to be the largest provider of autism services in New Jersey as well as a national leader in education, research and early diagnosis.

In addition, I’d like to share some exciting news with you.  The Board has approved of us to solidify space in Monmouth County, adding a 14th site to our growing list. We are working on a construction timeline and looking into fundraising to financially prepare for this next site.