iPad Launches: Can it Help Healthcare?

Greetings All,

My colleagues at Medical Software Advice are curious to know if you think a new technology like the iPad, just launched today-A Steve Jobs classic-can assist healthcare providers.

They want to know from you. Please share your thoughts in the survey below:

Which Tablet Computing Device Will Rule the Halls of Healthcare?

There is no obligation and neither Amri Johnson or Diversity HealthWorks were compensated for promoting the survey. We simply would like to get your response. For many years there have been a variety of devices that healthcare has used to collect data. Some have been great, others not so functional. Some say the iPad's functionality can be potentially revolutionary.

Let Medical Software Advice know what you think and of course. . .

Make it a great day!

Will short-term thinking's results ever jolt us into reality?

When I started this post it was late Tuesday evening January 5th, and I wanted to simply get on-line and finally say Happy New Year to all of you who have been so tremendously supportive of this blog and our network and the mission that Diversity HealthWorks believes is absolutely critical to healthcare being all that it needs to be for this country.

Thank you for your support. I cannot fully express my appreciation in a writing, but know that the conversations generated, and the movement made towards creating what I feel is "REAL and ROBUST" healthcare reform (vs. financially-driven political health insurance reform) is greatly appreciated.

It was hard to get it all out when I started because I have had a heavier than usual sense that we are moving more and more rapidly away from our capacity to empathize. It is being replaced by blame, fear, and a mindset of scarcity. I understand it and I sympathize because I know that folks are struggling to different degrees. My concern is that the struggle is not making us more progressive as a nation. Frederick Douglass said: "If there is not struggle, there is no progress." My worry is that struggle is resented and as a result progress is thwarted.

I expressed in the last post that I am concerned that Americans don't have anything we agree on that connects us. Perhaps my Utopian sensibilities seem unrealistic, but it occurs to me that without any common bond, we are not a United States, we are simply a bunch of individuals focused on, as Janet Jackson stated in her song and Eddie Murphy repeated in a later comedy special, "What have you done for me lately?"

We are so wrapped up in the moment that we have no vision beyond "what I get more of" and/or "what they will take more of" and/or "if I get less of anything, it is wrong". Now, this is not a universal sentiment. Some feel blessed to have or have ample amounts and are willing (at least for now) to contribute a little more of what they have for those who have little to nothing.

Of course, since I talk about and explore facets of healthcare more than anything, I have seen this response to various health insurance reform bills proposed that suggest that those with more will pay a little more in some cases. So, I applaud those who are okay with this. Personally, I cannot say that they are right or wrong for thinking this way, but I think it is honorable and anyone willing to give gets a nod from me. I dare not question their intention, it is not my job.

On the other hand, there are those adamantly opposed to anything that speaks to addressing social issues that seemingly affect a few, but in reality affect us all. There is a belief that "those people" who could be the uninsured in the case of health insurance reform, "don't deserve care if they cannot afford it".

There is no consideration of what happens to a society that thinks like this, no consideration of how they are and will increasingly be directly and indirectly negatively affected, no consideration of the future of a nation that does not care for its people.

So, why this rant from a blogger that has traditionally been very much committed to presenting as balanced a perspective as I try to have in my consciousness?

Well, my conscience is speaking to me. My intuition is clear that where we are going, under the guise of making America strong, has very little to do with preserving the integrity of these not so United States and everything to do with individual preservation and in my opinion, our rapid demise.

I feel compelled to simply express my concern that we stand in the space of exploration about who we are choosing to be, more so than perhaps we ever have in our history. And for the most part we are not going too deep in this exploration. In fact, we are not even truly exploring anything beyond short-term dynamics that historically when focused on, have lead us to another short-term dynamic with less than ideal results.

Now, I am not saying to stop questioning our political system or the possible draw backs of spending taxpayer money to fix social problems, like health insurance reform, or even the dynamics of the economic recovery. By all means, say what you feel.

My issue is that as much as we scream and as much as we disagree because of concerns for self-preservation, is it possible to simultaneously consider a longer-term reality that transcends the individual and speaks to connectivity?

The time we are in speaks to a new reality of connectedness that we have not experienced in the world we are in prior to now. What this connectivity speaks to is a necessity to consider that win-loss dynamics in any capacity will no longer work.

So, there isn't an environmental policy that is good for one and bad for another. There isn't a healthcare solution that benefits one person and harms another. Yes, there are temporary situations that appear beneficial to one vs. another in a situation with apparently dichotomous variables; however, when we go beyond the short-term we will see that they won't work for long and "for long" is a lot shorter than it once was.

The reality of a short-term mindset will jolt us into reality. It is already happening and it will make itself more and more evident moving forward. Will we recognize the effect quickly enough to begin changing the tide?

I trust that some won't; I am confident and aware that many will.

Make it a great day!

Expanded Jobs, Streamlined Tools at IMDiversity.com

The IMDiversity.com Career Center and Multicultural Villages network are migrating to a new jobs database and tools format this month, featuring expanded network jobs listings in healthcare and other other sectors, as well as streamlined tools for creating a custom job tools account, searchable resume, and personalized email job alert agents. We invite diverse jobseekers to visit the beta at http://jobsearch.imdiversity.com.

Special Note for Existing Users: Please note that those who previously created accounts on IMDiversity's former jobs site will still be able to access their tools, resumes, and application histories for a brief time during the transition at http://jobs.imdiversity.com. However, as of June all new healthcare openings will now be posted on the new job bank, and all users are urged to create a new account at http://jobsearch.imdiversity.com/jobseeker/create as soon as possible. (Please note that your old username and password will NOT work on the new system.)

Following the final release, we will be restoring many of the additional quicksearch tools on the IMDiversity.com Healthcare Careers and Readings Channel at http://www.imdiversity.com/healthcare.asp.

Culture and Quality Part II

The idea of connecting cultural competency to quality is not one that is new. In fact, there are products and people who have been in this mode for a long time. For example Resources for Cross Cultural Health has hosted a conference entitled National Conference Series on Quality Health Care for Culturally Diverse Populations, which they have hosted since 1998.

In addition there are people like Joe Betancourt, MD, MPH who was one of the principal authors of the IOM report Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare published in 2002 who along with his colleagues and leading health disparities researchers, Emilio Carrillo, MD and Alexander Green, MD, MPH created the cultural competency educational tool, Quality Interactions. The name of this product, that teaches health professionals about cultural competency indicates that the creators aligned cultural competency with quality from the beginning of its creation. Thus, as leading researchers and thought leaders in the field they get that cultural competency goes hand in hand with quality healthcare.

So, the idea is not new. However, the idea of aligning quality with cultural competency is not commonly practices. It is not practiced in healthcare where one may consider it to be obvious since the bottom line of healthcare delivery is quality and efficacy. It is why we focus so much on evidence-based practice. Nonetheless, a conscious and consistent conversation aligning the concepts of cultural competency with that of quality has yet to come to light for the majority of healthcare organizations. more

Chain Reactions

I have been in California for the past week and traveling basically from DC to Chicago, NYC to LA to where I am now in San Francisco since January 14th.

My travels have given me a unique opportunity to compare the dynamics that are happening with the economic realities we are facing from a more intimate local perspective in the cities I have been in.

First off, everyone as expected is concerned about financial realities. It is a part of every conversation and in each business conversation that I have had both healthcare and non-healthcare related, it comes up in context or through more specific content. In each local paper I read, there is some semblance of the economic reality. Hotels are cheaper (good for me) and the appreciation I get for a tip seems to be acknowledged more so than I can recall from past experiences where I have given equal percentages for the service delivered.

Specifically, with my healthcare industry conversations, the over arching theme is the cutting of budgets by hospitals and healthcare systems. In NYC where I visited a hospital in Brooklyn, stretching the dollar for programs related to diversity and cultural competency is not a new thing. However, this particular facility has shown tangible results as far as ROI directly and indirectly through the efforts of its diversity lead; however, the budget to increase initiatives has remained flat and this year has threatened to be cut significantly. What is the rationale?

In Chicago there is a theme of cost cutting as well, but some of the healthcare organizations there are experiencing an increase in Equal Employment Opportunity Commission (EEOC) claims. This is to be expected since the EEOC reports that when the economy is down, discrimination charges go up. A recent Society for Human Resource Management article (January 2009, HR Magazine) quoted The Training Associates marketing director Jeanne Picardi stating that, "Not all senior leaders are familiar with employment law, and may see all training as 'discretionary spending' to be cut. This is a bad idea at any time, and especially in a downturn, because employment law claims increase substantially during a poor economy."

So, while I cannot speak for all of Chicago or all of anywhere for that matter, it is evident that claims will go up and some organizations are taking preventive measures to mitigate the potential circumstances that can result from the current economic reality.

In Los Angeles and in all of California, the talk is on the CA State budget. It is a mess and all Californians are feeling it. From the healthcare industry to retail, jobs are being cut, budgets slashed and consumers are feeling the effects. The effects are coming in decreases in public services (including cuts in public health funding/services), hospital personnel, infrastructure, etc. Not anything different from the rest of the country per se; however, in California there is a conversation in the media that illustrates the dynamics of how the State budget connects to the local economy connects to healthcare that connects to a more profound crisis of deeper, chronic (pun intended) proportions.

Again, I am sure this is happening in most States, but I am not sure about the dialogue being future-oriented given the challenges in the present and the recounting of rationale from the past.

So, where do these chain reactions leave us? First, I think they leave us with a need to turn inward for clarity about what those of us who have the privilege to contemplate the future can do right now to play our role in the collective betterment. This does not exclude concern for our personal and family well-being, but it does require us to look beyond a myopic sentiment of self-interest towards what will create long-term prosperity for many.

Second, we have to stay the course. The money did not "go away". Whatever comes from congress or whatever the banks at some point decide to loan again, we cannot quit moving forward with the focus on growth, not maintenance. Maintenance is death, you grow or you die. If we are maintaining to keep what we have, we will soon see it dwindle. So, whether it be money-wise, health-wise or otherwise, whether we profit, break even, or take a loss, growth has to be at the root of what we do.

If we miss the mark of fiscal profit or better health, we have to sow the seeds and reap profit from our learning about what we missed. If we profit, re-invest in future growth rather than hoard. Gather and store, but let the overflow return to the flow. If it sounds a little Buddhist in nature, so be it. We will see nothing less than the reaping of our labor's fruits of the next 6-12 months. It will seem to arise almost immediately on either continuum. Take note and do what we have to do to not create more suffering from the suffering that we are experiencing individually and collectively right now.

Thirdly, but not last (as I am only sharing snippets) acknowledge that this is temporary and if you act in temporary ways, we will have results based on temporary circumstances. This crisis was created and it can be transformed. It will take the efforts of many to do it. Act based on what you want, not based on what you don't. Either way, we will get what we act upon. Let's act on the greatness that we desire!

Make it a great day!

Foundations' role: Drive Change/Policy vs. Fund Research

I found this LA Times article compelling and I think the timing could not be better. Folks, the time for transforming health care is NOW. The window of opportunity has never been wider.

Despite "the finance crisis" and "the credit crunch" the conversation that we can enter into is bolstered by the inclusion of myriad perspectives, participation in the process, and hope that the campaign season created.

Regardless of what political affiliation you subscribe to, we all have a physical body and health affects us all. California is taking the lead we can make mistakes and learn towards new innovation with the most populous and arguably the most diverse state in the Union.

Of course, no one really knows "the solution" but we must do something and we must do something together. . .

“Whatever affects one directly, affects all indirectly. I can never be what I ought to be until you are what you ought to be. This is the interrelated structure of reality.”

Martin Luther King, Jr.

Foundations take active role on health policy

January 5, 2009

Reporting from Sacramento — Frustrated that years of financing studies and demonstration projects have not translated into widespread improvement in medicine, California philanthropic foundations and think tanks are shedding their traditionally detached stances to crusade for healthcare reform in the state Capitol and in Congress.

Several of the biggest foundations have established offices in Sacramento and staffed them with experienced former advisors to lawmakers, with the aim of educating legislators to embrace their ideas.

The approach is a notable change in the foundation world, which in the past has maintained an academic distance from the political arena. It is also a delicate endeavor because such nonprofits are barred under Internal Revenue Service rules from lobbying or engaging in partisan politics. With billions of dollars at their disposal, the foundations are seeking to become bigger players.

In November, the California Endowment, a Los Angeles-based foundation with more than $3 billion in assets, announced that it was hiring Daniel Zingale, a senior advisor to Gov. Arnold Schwarzenegger. When he starts later this month, Zingale will encourage policies the endowment favors, including ensuring that all children have health coverage and making doctors and hospitals focus more on disease prevention and the management of chronic ailments.

A onetime AIDS activist and HMO regulator, Zingale led Schwarzenegger's 2007 campaign to expand healthcare to all Californians; that $14.9-billion proposal was rejected by legislators last January.

"We really consider ourselves to be supporting positive change and not just making grants," said Dr. Robert Ross, the endowment's president.

The New America Foundation, a Washington, D.C.-based think tank underwritten by foundations, has crossed even further into policymaking since opening a California office more than four years ago. In 2007, its experts helped Schwarzenegger develop his proposal to expand coverage and promoted it publicly, even appearing at a news conference with the governor. New America's experts can have so much contact with lawmakers that the foundation requires them to keep track of their hours to ensure they do not exceed lobbying limits set on nonprofits.

The California Health Care Foundation, based in Oakland, has taken a less blunt tack since opening its Sacramento office, where it employs a former legislative health expert who helps ensure that the foundation's research topics are relevant to legislative agendas.

"Our view is the Legislature is not facing a shortage of recommendations but a shortage of reliable information," said Dr. Mark Smith, president of the foundation, which has assets of about $640 million.

In 2007, the foundation paid for Jonathan Gruber, an economist at Massachusetts Institute of Technology, to appraise the costs and effects of the healthcare proposals being considered in the Legislature. Lawmakers and their aides relied on those figures in their negotiations.

In an interview, Smith said that the governor and Legislature last year adopted an idea the foundation has supported through grants to ensure that nursing homes and hospitals always know patients' directives about what kind of life-sustaining treatments should be taken when they are seriously or terminally ill.

Sally Pipes, president of the Pacific Research Institute, a conservative think tank based in San Francisco that favors market approaches to healthcare, said foundations risk undermining the credibility of their research by wading into policy deliberations.

"I think that's a bad move for them, because I think they will be really tarred as lobbyists," Pipes said. "I don't think lobbyists have the respect of economists or researchers."

Foundation leaders emphasize they have no interest in direct lobbying and that they promote ideas that are based in evidence, not ideology.

Advocacy is risky for foundations, since most are categorized by the IRS as 501(c) nonprofits, which restricts them from direct lobbying or participation in partisan politics. In the 1990s, Republican senators castigated the New Jersey-based Robert Wood Johnson Foundation, one of the nation's oldest philanthropies, for underwriting a series of forums in which First Lady Hillary Rodham Clinton discussed the Clinton administration's plans for healthcare reform.

But a new generation of healthcare foundations has arisen since then, explicitly charged with advancing more activist missions than those of the older philanthropies started by wealthy families.

"There's been a sea change in thinking," said Leif Wellington Haase, director of New America's California program. "People will realize over time what a big deal that is."

Nationally, 99 new foundations were created when nonprofit healthcare insurers like Blue Cross of California were converted into investor-owned entities, according to the Foundation Center, a New York City-based nonprofit that studies philanthropy. As a condition of regulatory approval, these companies had to set aside a portion of their initial stock sale to endow foundations devoted to improving healthcare.

More than $4 billion in foundation money was devoted to healthcare issues in 2006 by both older and newer philanthropies, according to the Foundation Center

Said Paul Brest, president of the William and Flora Hewlett Foundation in Menlo Park and author of a book on philanthropic strategies: "What I've seen is foundations moving from thinking all we needed to do is support good research in the field and the rest will happen to realizing that unless we are going to support organizations to take the research and try to turn it into policy, then the research is going to sit in the bottom of a pile somewhere."

The California Endowment's entry into Sacramento has been driven by disappointment that many of its pilot projects have shown impressive results yet been ignored by lawmakers, said Ross, its president.

Those include ventures to keep the mentally ill off the streets, extend medical care to children from poor families and help gang members avoid returning to prison.

"We have data and evidence that these programs work," Ross said.

Over the last few years, the endowment has tried to be more sophisticated in how it influences state policy.

Along with four other foundations, including Hewlett, the endowment has financed California Forward, a nonprofit explicitly charged with changing the "outmoded" political structure of the Capitol.

The nonprofit backed Proposition 11, the successful November ballot initiative designed to make legislative elections more competitive and lead to more moderate officeholders.

Now the endowment employs Jason Kinney, a prominent Democratic political strategist, for advice.

In an effort to boost public support for healthcare reform in 2007, the foundation spent more than $10 million on a statewide advertising campaign, community organizing and public forums.

"We are growing weary of experiencing failure on this front," Ross said. He said the employment of people like Zingale "is a trend you'll see more of from our colleagues in the field."

jordan.rau@latimes.com

Healthcare, Cultural Competency, Diversity Live Here. . .

Greetings All,

Welcome to our new Blog. Diversity HealthWorks has created this blog to share relevant health care information and editorials to you on a regular basis. Our intention is to create a space that allows you as a healthcare professional, consumer, or advocate to gather and share information about healthcare, cultural issues affecting healthcare, and the myriad diversity-related issues that impact our health that we are aware of and those we are not.

The fact is, all of us are aware of something. Given this fact, PLEASE SHARE what you know. We welcome you and if you are blogosphere or someone that is not and has something to say, please pass it along and we will do the same.

Stay tuned for what we are hoping is the #1 blog focused on the opportunities, challenges, and overall elevation of the diversity/inclusion and cultural competency conversation in healthcare.