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While I Was Paying Attention to Other Things, a New Hoop Appeared for My Practice to Jump Through

©Pavel Losevsky/

©Pavel Losevsky/

Sometimes it’s hard to figure out what to pay attention to. There are projects, staffing, budgets, contracts, technology, Medicare cuts and on and on. While I’m trying to pay close attention to this stuff, along comes a program that I should have paid attention to and asked questions about before it launched, but I didn’t.

A local payer is requesting notification each time a physician orders an imaging study for a covered patient. In this case, the practice owns the MRI so practice staff are doing the paperwork. This advance notification is not DIRECTLY tied to payment, nor is it mandatory. I’ve been around the block a few times, however, and I know what non-mandatory means, and so I try to play nice when it’s reasonable to do so. But, I didn’t pay attention, and the next thing I know the practice is in a hubbub trying to insert the advance notification into a process that’s already unnecessarily complex. The reason it’s difficult is that the person who has the information the insurer wants, the physician, is two staff people removed from who actually is responsible for entering the data. As with most medical information, getting it from the physician to the insurer requires a series of hoops and a lot of dexterity.

The Wall Street Journal wrote about this type of advance notification program a few days ago, and I think it’s another interesting sign of the healthcare times. Read about it here.

Posted in: Medicare & Reimbursement

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Using What To Do What? Radiologists Use iTunes to…

©Ron Chapple Studios/

©Ron Chapple Studios/

Under the category of using existing software for new purposes, radiologists at Renji Hospital and Shanghai Jiaotong University School of Medicine are using iTunes to house and sort medical PDFs of images and research documents. Download Squad has the story here.

Posted in: Innovation

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5 Questions: A Deceptively Simple Performance Evaluation

©Dmitriy Shironosov/

©Dmitriy Shironosov/

Here is a VERY succinct performance evaluation that I’ve used for years. Called 5 Questions, the employee completes it, submits it to the manager, then they discuss and refine it together during the evaluation interview. Here are the questions:

  1. What goals did you accomplish since your last evaluation (or hire)?
  2. What goals were you unable to accomplish and what hindered you from achieving them?
  3. What goals will you set for the next period?
  4. What resources do you need from the organization to achieve these goals?
  5. Based on YOUR personal satisfaction with your job (workload, environment, pay, challenge, etc.) how would you rate your satisfaction from 1 (poor) to 10 (excellent.) 1 2 3 4 5 6 7 8 9 10

You do have to stress that question #5 is not how well they think they’re doing their job, but how satisfied they are with the job.

The great thing about this evaluation is that it’s one piece of paper and not too intimidating. Staff can use phrases or sentences and write as little or as much as they like. If it’s hard to get a conversation going with the employee, ask them “What was your thought process when you assigned your job satisfaction a number __.” Usually that opens the flood gates!

If you use a goal-oriented evaluation like this one, you’ll find that employees will grasp that you are asking for their performance to be beyond the day-to-day tasks, and to focus on learning new skills, teaching others, creative thinking and problem-solving and new solutions for efficiency and productivity.

For help with job performance words and phrases, click here.

Posted in: Human Resources

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On Having a BIG Birthday

I turned 50 Friday.

It was a BIG birthday. I wanted it to be BIG. I invited friends to the house. My husband ordered wine and practiced smoking pork three times to make sure it would be perfect for The Day. We hired a Yard Guy to clean us up. I bought potted flowers to make believe I can keep plants alive. Despite threats, I was given lovely wine, books, cards and a cane with a rear view mirror. My parents, all three of my brothers and both my kids contacted me to wish me happiness. We laughed in very large quantities. After taking aspirin, I went to bed at 1:30 a.m., a time I hadn’t seen in years. It was a blast (outdated boomer expression.)

I feel very thrilled with life. I am loved, life is more than a tad interesting, and I wish there more hours in every day to read, work on this site, sit mindlessly in the sun with appropriate sunblock, and talk to people. I only have one real regret in my life and that is that I didn’t take touch typing in high school.

I’m a little embarrassed to be so happy, but everything’s not perfect. We don’t live close to our kids or our parents, our retirement account is pitiful, and the rental house we live in does not allow us to have pets. People we know and love are sick and are suffering, someone just lost a job, we wonder how we will ever be able to live through losing any of our parents. We’re overweight.

But perfection is not what I’m looking for. I’m looking for satisfaction, meaning and an authentic life. I’d love to hear about your 50th birthday, and what you’re looking for.

Posted in: Headlines

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Every Ten Minutes is a New (or Lost) Opportunity

©Travis Manley/

©Travis Manley/

Here’s some information you probably already knew, but might have forgotten. After ten minutes of a presentation, the majority of an audience (your staff, your docs, your board, your referrers) tune out, or rather, their brains turn off. BusinessWeek’s Carmine Gallo recently wrote about John Medina’s book Brain Rules and the ten-minute rule.

If you want to hold people’s attention, I recommend you introduce some sort of engaging device at or shortly before each 10-minute increment of your presentation. This device doesn’t have to be complicated. A simple story will suffice, as will a review of the past 10 minutes. In my presentations, I often tell a relevant story, or better yet, show a video clip that is relevant to the previous discussion. If you’re presenting via Webinar software (BusinessWeek, 4/18/08), you can use a tool to push a poll or a question to your audience. Again, be sure to plan these exercises at 10-minute intervals. – Carmine Gallo

Some things I’ve used successfully to break up relatively dry information in staff meetings:

  • short dance break to wake everyone up ( James Brown’s ‘I Feel Good” is a classic favorite)
  • passing out party hats to everyone to announce a special event (can get silly)
  • visual interest slides at intervals – optical illusions (the gorilla on the basketball court is a classic but I don’t know if it’s available for groups unless you buy the DVD)
  • telling a tasteful joke if you can deliver it well – I personally can’t tell a joke to save my life
  • teach desk exercises to stave off stiff necks and sore backs
  • show pictures or movies from the last staff event, holiday party, etc.

Read the complete article here and let me know what you do to keep people from tuning you out.

Posted in: Human Resources

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What Does “Meme” Mean?

NOTE: This post won’t make a bit of sense unless I tell you that my blog used to be called “healthpromeme.”  A bunch of people told me they didn’t get it and couldn’t remember it, so I changed it!

A number of people have asked about the name of this blog. My mother wrote to me and said she needed filled in on this “meme” thing. Wikipedia defines meme (rhymes with “seem”) this way:

A meme consists of any unit of cultural information, such as a practice or idea, that gets transmitted verbally or by repeated action from one mind to another. Examples include thoughts, ideas, theories, practices, habits, songs, dances and moods. Memes propagate themselves and can move through a “culture” in a manner similar to the behavior of a virus. As a unit of cultural evolution, a meme in some ways resembles a gene. Richard Dawkins, in his book The Selfish Gene, recounts how and why he coined the term meme to describe how one might extend Darwinian principles to explain the spread of ideas and cultural phenomena. He gave as examples tunes, catch-phrases, beliefs, clothing-fashions, and the technology of building arches. – Wikipedia

When I was considering names for this blog, I was looking for something catchy, similar to Geeks Are Sexy, a favorite site of mine, or Execupundit, another favorite. After deciding on lots of excellent names, and finding none of them were names that were actually for sale, my son suggested healthpromeme, to describe the field I’m in and indicate some sort of hip factor. If you’re my age, you need your children to clue you in to things, and if you’re like me, you also need them to clue you in to when it’s time to stop saying stuff that isn’t hip anymore. It seems like I just got the hang of saying “jiggy with it” when my kids told me to stop it.

I hope you have kids to tell you when to stop it too.

p.s. Click on the Memes category to the right and see what memes are in healthcare.

Posted in: Memes

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Misys, iMedica and a Cast of Thousands: Interesting Interview Worth the Read

HIStalk (an interesting healthcare IT blog written anonymously) has a great interview with Michael Nissenbaum, President and CEO of iMedica. Nissenbaum speaks about his 10 years in the field with Millbrook, GE and now iMedica, talks about Misys leasing the iMedica EHR product under the name MyWay, and gives an interesting rundown of some players in the ever-changing field of medical practice software.

I see a cycle that’s been in healthcare for years. Right now, it’s hospitals providing software to physicians under the Stark exemption. A year from now, when we have a new administration, God knows what the new rules are going to be. You and I both have seen it. We have seen centralization and de-centralization. – Michael Nissenbaum

Posted in: Innovation

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