Category Archives: Information Technology Management

My Personal Statement…on my own terms

I was recently asked randomly to connect with someone on LinkedIn so he could cruise my content, for free, to get ideas he could present in his paid speaking engagements. Let’s see Nertz to that! I have had people connect with me again on LinkedIn and clone my profile. I have had unscrupulous recruiters download my resume and use it to get contracts on positions and to hound me for ideas that they capitalize on, all for free. I am not given credit, nor am I paid for what I am worth. My ideas and time are valuable, you better recognize! But, I wanted to share my personal statement I used and gained placement to the Healthcare Informatics program at University of San Diego.

 

Felicia’s Personal Statement

It has been approximately 26 years since I have been asked to write a personal statement and to do it in 500 words no less, so here we go. This will be my 3rd graduate degree I will pursue and complete, and my story is almost 3 decades in the making. Let’s take a moment to review the highlights of my experience and skills. I greet change and uncertainty as a call to action to innovate and rebrand if necessary. I have done this across my career as a provider and the CEO of my own company, Dale’s Angels Inc. I describe myself as a tech geek, pediatrician entrepreneur who thinks in systems or what can be added to provide efficiencies as well as cost savings.  I would love to see the next big thing in technology from the use of Surface 4 Pro, Virtual Reality, and Google Glass applications in healthcare delivery, safety, compliance, research, and Revenue Cycle Improvement. I believe with optimal usage of big data from these platforms healthcare will be transformed. I also believe there are many untapped business opportunities that should be explored.

 This degree will only add to my credibility as a healthcare consultant or Health Care Information Systems Executive. I understand the importance of aligning corporate strategic roadmaps and those of various technologic platforms that will yield safe patient care and at the same time yield profits. The combination of current clinical and business experience will make me immediately credible as I interact with healthcare system C suite officials, IT executives, and clinicians. I possess the exceptional interpersonal skills necessary to develop relationships with all levels of leadership in an organization and pride myself on my ability to facilitate open and robust dialogue between those levels.

 “Absolute Workaholic” describes my approach to any task.  I plan to remain medically relevant by continuing to practice eventually on a part-time basis and maintaining my board certification in both Pediatrics and Informatics. My most recent leadership experience in Health Information Technology gives me a distinct advantage and a unique perspective across a multitude of Acute and Outpatient platforms as well as being the Project Lead and Project Manager for the EHR Applications. I am the “Doctor Whisper” , I can translate tech speak, to standards of care automation and returns on investment to the C suite for the enterprise. I have actively participated in several think tanks, panel discussions, and discovery calls as it pertains to IDNs and Value Based Healthcare Delivery to vendor selection for an Urgent Care. I am fully versed in the dynamic regulatory environment, both state and national, and how that will affect our ability to practice and be properly reimbursed for what we do. I think information to providers, payers, and the C suite should be accessible and presented, in a pleasing manner, the issues, from regulatory to work life balance.

4 Steps T Write the Personal Statement

  • Stick to the number of words requested
  • Do not depend on spell check solely for proof reading
  • Give specific examples of your work in the area and what makes you unique
  • End with why you should be hired

I share these words of wisdom with hopes that it will help someone write their own statement. Please don’t plagiarize.

Diploma

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New Beginnings #WestWardFro

It has been a while since my last post, so what exactly have I been up to.

I have practiced as a physician, worked primarily as a implementation specialist on a government contract. In my job search I have completed over 100 different applications, caught recruiters trolling my resume for leads, using me to get contracts but never officially hiring me…I discovered that the job description I wrote for my old job was copied verbatim and posted to the new hire profile on LinkedIn necessitating me blocking this person and half dozen others, removing my resume,  and rejecting and blocking most cold contact recruiters. Someone actually attempted to make my going back into practice full time as some type of setback, and if my experience was somehow equivalent to theirs, when in fact we were light years a part. I have witnessed the election of the dumbest individual to the US presidency and the last installation of the Star Wars franchise being disappointing, but through it all I have not caught a case.

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In the past 9 months I have truly established myself as a Dallas Cowboy Superfan with the clothes, accessories and tricked out Cowboy Ops Truck…File May 09, 3 24 03 AM.jpegBeastLa in Redwood Forrest

 

I bought said truck in Dallas TX at Autoflex, Terry Hill and his crew are the bomb!! Went back on line bought a used travel trailer for scrap plus taxes, hitched it to BeastLa and pulled it to Oregon to start as the new Pediatric Nocturnist at Bay Area Hospital. Yes, I pulled it and drove all 3000 miles white knuckling it through Donner’s Pass(yes of the cannibalism story) April Snowstorms?? Chain Advisory??I am from the South we buy tires because they are big and cool not for this weather…File May 09, 3 25 57 AM.jpeg Me, the black chick with a ‘Fro drove through tip warnings and flood warnings all across the Midwest.

My best friend told me I am like a family of 10 Jamaicians because I always have 3 jobs, and it’s true, not to long after I started with Bay Area, I received and accepted a CMIO position.File May 09, 3 18 15 AM

Deja Vu as we approached Seattle Washing May 2017

My team went to Hollywood for dinner and did the touristy thing. By visiting Graumann’s Chinese theater

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The ‘Fro in front of  Graumann’s May 2017

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Star Trek Original Series Cast Member Cement Plaque, Graumann’s May 2017

 

I really love Ramen and will eat it any chance I get

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Best Ramen, Pasadena May 2017

I realize multiple things about myself, management of information will always be part of my life and I can make a career of being a practicing provider and Lead for EMRs. It will be my lifeblood. But I also think as technology evolves, providers that are current and can truly leverage experiences across the continuum of medicine and technology will be needed. In this economic climate no one, vendors or health systems, can nor should they justify large staffs that make no tangible contribution to the IS departments or efficient and meaningful usage of technology.

I think I have more adventures awaiting me as I settle into my new found home state, and I can’t wait!

 

Live from DC it’s Felicia!!!

So I’m here a full day early and what a day it has been!! I am going to go on record to say I am still salty with American Airlines in spite of getting here on time and getting from DCA to hotel on Metro was a solid experience!! These little brown birds are psychotic, they are so mean to each other and have no fear of humans.

During this post, I can’t be as chatty, because I am in the M Lounge at the Marriott Marquis and I don’t think the other guests would appreciate geek speak into my Dragon Anywhere app…I am looking forward to the first actual day of meeting and will plan to attend classes next meeting. I discovered how jammed packed and distracting this entire area is. I had an amazing lunch at Ping Pong. There is a whole new area with Hermes, Dior and LV surrounding an eternity pool…The Smithsonian, Martin Luther King’s, and the Washington Monument all very close. Blackboard, American Medical College, the VA Administration are all on the same block. I have had my iPad Pro a little over 1 month and I have already lost that blasted pen. I went to find a replacement at the ATT store in Chinatown and the manager and I grew up in Virginia Beach and graduated from Bayside High!! 6 degrees of separation wow!!! There is so much here, where do I start?

Well first things truly first…I came here for this…

http://www.physicianleaders.org/classroom/Course/L-SUMM-04-2016/

I have to complete Social Media Training and my CAPM Bootcamp…ugg!!! I am so far behind. Well I am signing off for now. Off to the Smithsonian to hit the spots I didn’t hit during my last time here…I wonder if there are any cherry blossoms left?

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Physician Mobility?

Distracted practice

In my day to day, I am Queen Multitasker. I look like the guy in the photo trying to balance phone calls, note taking, and all the multimedia gadgets required of someone in my administrative position. Unfortunately, I know a fair number of colleagues look like this guy instead of the fitted one button coat, they are in their lab jackets in a hospital or office near you.

So what should happen to reduce the juggling of the gadgets? Can we balance accessibility and still practice efficiently? Can we foster 2-way patient interactions and still respect provider downtime? Yes, Yes, and Yes.

I believe it’s a combination of having multiple platforms integrated and optimized for the use of a busy and efficient provider. So what’s out there? We are an iOS world for now(Apple Rules, Android Users just get over it) If most consumers are like me, Steve Jobs’ company has gotten lots of my money over the years. There is the Apple watch, an Apple phone, as well as a tablet either surface or iPad Pro(The gold Ipad Pro is pretty but the verdict is still out on its usage in-house) but do any of these devices make the physician more efficient? Which front end dictation tool should be utilized and optimized? Nuance ™  apps it particularly Dragon Anywhere™ which I’ve been experimenting with more in the previous several weeks is particularly useful input tool.  I found in comparison to previous forms of Dragon™, Siri on my iPhone actually worked better than the previous iterations of the front end dictation tool really previously released by the company Nuance™. But there has been a marked improvement with the release of the Dragon Anywhere tool™. For a nominal subscription fee you have a hardware light version of Dragon™ on your phone. It has a more robust command structure as well as powerful editing tools in which you can enjoy the accuracy in the hardware heavy version of this tool.  I find that my ability to transfer and copy text into a Word document and then easily save it to my cloud Dropbox is almost seamless and then I can actually update the text and repeat that within less than 30 seconds. It has made my ability to post my blog a lot easier. I  still have to go back to my laptop/tablet to make the final corrections and formatting just because I find it easier but it actually has been a godsend as far as my ability to be able to create this post. (FYI, I’m using Dragon Anywhere™ to create this post.) I would suggest that you number 1, have the latest updates on your phone, have a subscription to office 360, and you can ensure that the embedded mic within your phone actually works well. The microphone on the iPhone has excellent noise canceling capabilities however what I have found is my Bluetooth, the accuracy has been affected by the LG 750 even up to LG 760 with a Bluetooth device.  You may actually have a better chance with a wired Beats™ as well as the white earbuds that actually come with your iPhone. I would also ensure that your screen saver or power saver mode is set to a minimum of 15 minutes or so before the  screen locks.

I am a iOS geek through and through.  However, the Surface 3 with Windows 10 and Citrix 14.3 from a healthcare information systems perspective actually affords the end-user the best experience and will truly increase their efficiency. And is also necessary to have a tool either like Dragon 360™ medical or Dragon Direct™. When Windows 10 was released someone told me you will experience a loss of functionality, but could not tell me exactly why. If the device is correctly imaged, with properly formatted applications, and Office 2016, it will only enhance your experience not detract from it. I just wish people that don’t have the full story and can’t give you clear directions on how to change something,  they need to take Madea’s advice and go and sit down somewhere and be quiet. We providers are under pressure from a regulatory standpoint to document thoroughly to tell the full story and to allow proper charges to be created and submitted in a timely manner. And from a business stand point, we are tasked to see as many patients as possible but still provide quality healthcare.  We should have the properly configured tools to allow us to maximize our time interacting with our patients and fellow staff members,  not inputting data into the EMR. Futuristic Complex

 

CPOE Remix

One writes to seal knowledge in their brain.  Me, April 2016

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(Image from Making Computerized Provider Order Entry Work. 2013)

Working on my latest implementation I kept hearing about a methodology for #CPOE implementation. What was the most frustrating to me is I couldn’t find it anywhere. A successful methodology should be written down, clear, and easily obtain so the next time you have a major implementation of an electronic medical record, you don’t have to reinvent the wheel. If you’ve done this greater than 40 times it should be sealed in the brains of everyone. The only problem with that is in the intervening years many of the people have moved on to different roles, many more people have retired or they moved on to different organizations. So that the people that made up the principal team for implementation may not even be available anymore. Those that are left they remember only bits and pieces of their role and sometimes what they remember is not applicable in your current state.

Now with the new implementation the roles of all the players need to be clear prior to any kickoff meetings. If you plan on going to a new electronic medical record and if you plan on completing this in a 9 month time period, rapid implementation, your methodology really needs to be on point. Readiness Assessment, Governance Structures, Policy Implementation and Review, Key Roles Definition and accountabilities all need to be in place even more so then the change management as well as the project management. As a medical director, I had a role, but it  was not made clear to me until it was almost too late.  If you want to take on a greater role you have to be careful that you know what the roles ar of key players in an implementation so as not to overstep. You can’t rely on the inconsistent verbal statements and archived emails from six or eight years prior that I recieved. (So-Not-Cool.) I did not get a clear project plan, education plan, or implementation methodology until after the go live.  The age of the large scale go live ir practically over, except the DOD EHR Modernization project  and the Greenfield Implementations in the Middle East,  this is the decade of realignment and optimization. So what methodologies are out there for general consumption and what should be modified? I will be exploring over the next few posts what I can actually find this active in the blogosphere as well as in the electronic instruction manuals. I will detail how clinical process improvement is as necessary to sucessful practice as passing the boards. I also plan on detailing how some slight changes and automating certain aspects of a providers workflow in its current state will improve efficiency and add to work life balance.

FYI Insurance Companies and Medical Providers: Medications, Prior Authorization,Insurance Review

aid1978379-728px-Use-an-Inhaler-Step-1Bullet1For the past year, I’ve worked as a third-party medical insurance reviewer.   I’ve reviewed a variety of cases for pediatric clients as it relates to  their hospital stays, therapies, and prior authorization for medications as medically necessary.  I have come in direct conflict with physicians, insurance companies,  and the reviewers for this company.  It was during my review of a pediatric case today I had the following thoughts.  Before I go on,  I wanted to thank the original provider’s office for having an electronic medical record! Big hugs, big thanks, and praise the Lord that I did not have to decipher reams and reams of handwritten notes. They performed a proper medication reconciliation so I could easily find the date that the medication in question was started and when the medication had been switched to something else. I could easily see all the cool new ICD 10 codes.

But what really confused me was how the insurance company did not leverage the information that was right at their disposal.  They have access to medication utilization and refill data. They also have access to unscheduled office visits, urgent care and ER visits, and inpatient admission data.

.  lungs-diagram-120926As a provider, I know that a mark of well-controlled for asthma is no nighttime symptoms, decrease or no utilization of rescue inhalers, only come in for follow-up visits every three months, no exercise intolerance, they can keep up with other children, no significant exacerbations requiring systemic steroids, and no inpatient admissions and definitely no intubation’s. I also am well aware of the standards of care surrounding this disease and if a patient is well controlled based on the previously mentioned criteria, it is not in the best interest of the patient  to change a patient’s regimen solely based on changes in insurance formularies.

For the insurance company,  if you were to evaluate the aggredated data as far as medication refills, unscheduled office visits, unscheduled ER in urgent care visits, you will find out that there are a subset of patients that are actually under excellent control you may want to offer them an exception to random formulary changes based on that data.  Also can you imagine the goodwill  you can bestow to the provider and family members  because you proactively present the providers a list of their patients that are not going to require prior authorization and utilization reviews because you’ve given them the information up front and they will not have to be interrupted for and utilization review? And also the goodwill bestowed on the families who will have peace of mind that the insurance company is not going to randomly stop coverage of a medication that keeps their son or daughter healthy? Why can’t the companies agressively and proactively reach out to the patients and the providers and basically say we’ve noticed that this patient has been on his medication and has exhibited really good control and here is an incentive honorable mention in the insurance plan newsletter, reduction in premiums or coupons for medications, or higher payment to providers or performance bonuses? I believe these small gestures cost less than payments for catastrophic illness and repeated ER visits. Also, if I were the insurance company I would try to find out and replicate whatever this provider is doing to keep his patients compliant, his practice in the management of these patients and distributing this information to other providers in your network. What if the insurance companies had a Goodwill metric that there are exceptions that take in health of a patient on a non-approved regimen and long term cost savings if they were to continue on that treatment? Although goodwill is an intangible asset, it still is a undeniable and underated contributor to the bottom line of healthcare institution. Goodwill-As-One-Of-The-Assets2