#CPHC Chat 1/22/2013 Employee Wellness ChronicPainGPS Join today at 1pm EST #hcsm MT @GailZahtz: #cphc with @giasison

n Employee wellness and prevention. Also her work with @WHO ElinSilveous @GailZahtz I don't understand what the car pool healthcare #CPHC is all about?? GailZahtz @ElinSilveous LOL Vision/mission at http://t.co/vfwuMYRe #cphc is only in 3rd weekgrowing. Chat is 1 needle changing initiative/week. GailZahtz @ElinSilveous Surely #CPHC is totally grassroots- you of all people may remember how hard to start/support community in the beginning! TY ElinSilveous @GailZahtz @lttlewys @giasison Decades ago I was product manager for the thennation's leading health promotion/med self care prod line #CPHC GailZahtz @ElinSilveous Considering this is only the 2nd and we await our guest- a fabulous free for all is just fine! #CPHC GailZahtz First off- rather than just introductions- we also love when people self promote health initiatives, projects and concerns! #CPHC lttlewys Morning!! First time here, on the tail end of #BreastCancer treatment and invloved with @TheTutuProject & @TheCareyFoundation #CPHC ChronicPainGPS Patti here! Developing Patient Enrichment Program for chronic pain patients. Empower, educate, enrich lives! :o) #cphc sandyhubbard My focus is on temporary or recurrent illness that requires adaptive technology, design, lifestyle while honoring dignity and needs. #CPHC ElinSilveous Hi everyone. Elin here, checking out this #CPHC chat on employee wellness/health promotion. MandiBPro Hello, all! Hope you're enjoying your Tuesday. Mine's wild and wooly thus far. :) #CPHC Dlschermd @GailZahtz @lttlewys @giasison I'm here #cphc Danmunro Sorry - just joining - what's the hashtag focus? #CPHC GailZahtz @dlschermd @lttlewys @giasison Great to see you all! Feel free to talk about why you got involved with healthcare and projects! #CPHC nursefriendly Hello Everyone, Andrew Lopez, RN from #NewJersey :) #cphc GailZahtz @nursefriendly Goodness good to see you Andrew- folks this is new and grassroots...appreciate support! Today-employee health and WHO #CPHC Dlschermd #CPHC Happy to be here, seeing some familiar fellow ranters:) toughLoveforx Hello #CPHC Michael Josefowicz here in Brooklyn. I'm here to explore the synergies between primary health care and K-12 education. Kamiyamay #CPHC Hi Gail..so glad to tweet in...yes to the focus! menkris @GailZahtz Am here #cphc Radiologist working *primarily in KL (Mal) with a corp Hosp group.Setting up patient advocacy in India/Mal #cphc GailZahtz @MandiBPro Great to see you! I know you have been doing some #BigData work- feel free to share with #CPHC MandiBPro @GailZahtz Definitely. Finishing up a contract but will be jumping in the fray whole hog in 5m. :) #CPHC

Timbigfish Watching some healthcare pros make connections and discuss initiatives. Yeah, they're doing things that matter. #CPHC MargieClayman @sandyhubbard @GailZahtz Hiya ladies - can't chat long but thought anything you're involved in would be great :) #CPHC GailZahtz @danmunro Background is starting at http://t.co/vfwuMYRe Focus of # has moved to focus on highlighting healthcare initiatives. #CPHC StorkBrian #cphc @GailZahtz Promoting Muskegon & Grand Haven, MI Blizzard outside Fire alarms going off inside Is it Friday yet??? Nursefriendly @GailZahtz T1 People are looking to the Internet & Dr. Google for #Healthcare Info. Need to steer them in right direction ;) #cphc GailZahtz @nursefriendly How can we steer people- whether employees, other patients and/or family to right direction? #CPHC Timbigfish @GailZahtz @nursefriendly Easier to steer ppl in the right direction if destination is worth the trip. Content & connections, y'all. #CPHC MarksPhone @GailZahtz @nursefriendly not sure you can steer them these are adults and learn in response to problems they are trying to solve. #cphc GailZahtz @MarksPhone Is steer the wrong word? How can we help people make their own decisions that have good outcomes for all? #CPHC MarksPhone We need to understand the problems specific to the health solutions they are seeking and help them solve them. The is guide/steer #cphc Nursefriendly First step is to get online ourselves, see what is out there, what we as #doctors #nurses #healthcare #professionals trust. #cphc MandiBPro I've participated in several employer-sponsored wellness plans, w/ same concern: only fit(ter) folks seem to show consistent interest. #CPHC GailZahtz @MandiBPro Do you see a connection between the data filter and the human filter in trying to get engagement? #CPHC MandiBPro @GailZahtz Yes, & more access to data & ability/encouragement to APPLY insights, the wider the filter. Ease of access/application key. #CPHC Burgessct We could work to remove the paywalls on objective peer-reviewed research? Democratization of data and research? #CPHC menkris @burgessct Agree. The guardian had an article on that last week. http://t.co/9NlQYhOq #cphc burgessct Exactly - pub money for research & then pay-walled? MT: @menkris Guardian Article on that last week. http://t.co/j44ZIoH6 #cphc GailZahtz @burgessct I saw a statistic last week about patients getting paywalled. Often employers do that too?! #CPHC Burgessct Truly absurd RT @GailZahtz: @burgessct I saw a statistic last week about patients getting pay-walled. Often employers do that too?! #CPHC

Nursefriendly @GailZahtz Employee #Healthcare :) Could spend a while on that, though I'd be interested in thoughts #mandatory #influenza vaccination #cphc GailZahtz @nursefriendly We are lucky to have some physicians who are helping us with the flu issue. A few are here today! Hope to get up soon #CPHC Nursefriendly @GailZahtz Yes, several have weighed in on the Mandatory #Vaccination and other issues. Had a spirited discussion on that on LinkedIn #cphc GailZahtz @sandyhubbard What can we do in the workplace and other public environments to encourage and support people of all abilities? #CPHC Dlschermd #CPHC Employees need incentives (lower premiums?) to get with employer driven wellness programs. Problem is lack of efficacy data for them. GailZahtz @Kamiyamay GREAT to see you! As we haven't heard from our guest- we are moving forward with the issue of employee wellness- thoughts? #CPHC Nursefriendly @GailZahtz T1 Steer them in the right direction by #1 Getting online, seeing what is out there. #2 Learn what information they need. #cphc Nursefriendly Then interface with #s4pm (Society for Participatory Medicine) and other patient advocacy groups, share our findings, peer review :) #cphc ElinSilveous @GailZahtz @danmunro What area of employee health/wellness/prevention is today's focus? Efficacy? Outcomes? ROI? TY. #CPHC GailZahtz @ElinSilveous Looking at initiatives that have been successful in the workplace- and what else we can do. #CPHC Dlschermd @ElinSilveous @gailzahtz @danmunro There is no efficacy work really being done. That's the problem. #CPHC ElinSilveous @dlschermd @gailzahtz @danmunro Check out research by @Wendy_Lynch #CPHC GailZahtz TY. Have a link? RT @ElinSilveous: @dlschermd @gailzahtz @danmunro Check out research by @Wendy_Lynch #CPHC ElinSilveous #CPHC RT @Wendy_Lynch new survey has some interesting suggestions why so few look for cost info http://t.co/lP3jLsYc ElinSilveous @dlschermd @gailzahtz @danmunro Efficacy, ROI & outcomes research was HUGE in 80s, then fell away. I did some online research in 90s. #CPHC Sandyhubbard @GailZahtz It would be eye opening for high school students to spend the day out in the real world in a wheel chair. #CPHC lttlewys @gailzahtz @sandyhubbard That is so tough, it's really needs to built into the culture and people need to be aware & empathtic #CPHC Kamiyamay Interesting this came up...if employees providing health aren't well....difficult to advocate wellness. Offer, support, advocate! #CPHC MarksPhone We make learning part of a larger MD centric (not WebMD) strategy where we are setting up long term chenage to HC behavior etc. #cphc

StorkBrian #cphc @GailZahtz With respect to employee wellness, I wish hospitals would serve healthier food Restaurants to for that matter GailZahtz @StorkBrian Food at hospitals is actually big issue- as is ability to sleep, and integrating access in environment. #CPHC StorkBrian @GailZahtz #CPHC Sleep, indeed Lots of science behind the importance of sleep Need for healthcare services, however, never stops Kamiyamay @GailZahtz Working in community too....fast food, why can't we have vegie, whole food fast places...dreaming! #CPHC GailZahtz @MandiBPro @StorkBrian @sandyhubbard How can we create environments that encourage sleep, good eating, etc? #CPHC Kamiyamay @StorkBrian As on call sure understand. So how do we get organizations and corp to accept and be involved? #CPHC ElinSilveous Must start w/CEO RT @Kamiyamay @StorkBrian As on call sure understand. So how do we get organizations and corp to accept... #CPHC sandyhubbard Great brains can surely create a safe and private patient sleep environment without noise, light, fear yet allow health pros to work. #CPHC MandiBPro @sandyhubbard Difficult question. Seems The culture of medicine, and residency as I understand it, glorifies sleep deprivation. :( #CPHC menkris @GailZahtz @MandiBPro @StorkBrian @sandyhubbard The menus in the cafetaria can be tweaked; maybe keep the healthy choice cheaper #cphc StorkBrian @menkris @gailzahtz @mandibpro @sandyhubbard #CPHC I my mind, hospital cafeterias should be leading the way w healthy eating choices w/o JF menkris @StorkBrian @GailZahtz @MandiBPro @sandyhubbard They do; but folk also complain about the terrible taste! :D Esp the ones on call #cphc GailZahtz @menkris Isn't the terrible taste complaint similar to universal design and other engagement- selling the better stuff? #CPHC nursefriendly @timbigfish @MandiBPro The most effective way to lead is by example. Need to have people walking the walk, not just talking. #cphc Kamiyamay @MandiBPro Excellent....lead by example and then incentives...take time to be fit at work programs #CPHC GailZahtz Really good points everyone: built into the culture, doing studies, helping employees advocate for themselves! Oh- carry on!! #CPHC Nursefriendly With both #patients and #heathcare professionals, doctors working together, we amass a large pool of resources fairly quickly. #cphc toughLoveforx @nursefriendly "doctors working together" fyi "the networked educator" is a growing understanding in edu #ecosys #CPHC MandiBPro @dlschermd Would incentives + competition help? I know competition would help those fringe who are alpha-oriented, but not other types #CPHC Dlschermd Im specifically referring to mobile health tools (portals, apps). No efficacy studies in workplace health programs. #CPHC

Kamiyamay Gym membership and advocate wellness during work hours! #CPHC GailZahtz Okay- so can anyone name ONE initiative, no matter how small, that has or could make a difference in employee health/ workplace? #CPHC MandiBPro @GailZahtz Healthy dietary choices in vending machines, walking meetings, wireless headsets to pace instead of sit - all would help. #CPHC MandiBPro @GailZahtz Walking meetings. #CPHC GailZahtz I am glad we have back-end tracking-- these are fabulous ideas of small changes that would make a huge difference! #CPHC MandiBPro Corporate culture shift from seated keyboard jockeys to interactive motion machines. :) Encourage #healthyhabits w/ grassroots change. #CPHC Burgessct We have stand-up *update* meetings in our company @MandiBPro keeps everyone alert, brief and "healthy" #CPHC GailZahtz @burgessct How does the stand up update work? #CPHC Burgessct Stand in a room and updates their status reports - no sittng allowed RT @GailZahtz: @burgessct How does the stand up update work? #CPHC MandiBPro @GailZahtz Instead of sitting at conf table, all attendees stand. I do these 15 minutes, twice a day, with my dev teams. Effective. #CPHC toughLoveforx @MandiBPro I've seen same technique routinely used in software development. 15 minute Standups a couple of times a day. #CPHC @GailZahtz GailZahtz Question is- how do we encourage these 15 minute "stand-ups"? #CPHC MandiBPro @GailZahtz Good way: start w/ sticky notes on the wall as brainstorming exercise, w/ team. They're moving, they're engaged. Daily. #CPHC Nursefriendly @sandyhubbard No shortage of #chronic #illnesses out there :( #COPD #Diabetes #KidneyFailure #congestiveheartfailure #MH #cancer #cphc nursefriendly @ sandyhubbard That doesn't start to address the needs of #eldercare, #geriatrics which are a huge demographic as well. #cphc sandyhubbard @nursefriendly Helping to remove the stress of dealing with an unadapted environment would be useful for those illnesses, I believe. #CPHC nursefriendly @sandyhubbard Agree, with the #SilverTsunami approaching, keeping people in their homes alone is a gargantuan challenge #cphc nursefriendly @sandyhubbard It should come as no secret that there will not be money to pay for nursinghomes, or space for all our parents. #cphc sandyhubbard @nursefriendly You state these issues very well. I'm glad you are involved and advocating! #CPHC sandyhubbard @nursefriendly The Baby Boom is a Big Balloon of a demographic that will need to be healthy and in their homes as they age. #CPHC burgessct Yes we will :) @sandyhubbard @nursefriendly #CPHC - trying to line it all up before I need it burgessct #CPHC - Babyboomers need to be healthy at home and educated about med research/capability as we move to Individualized Care @GailZahtz Kamiyamay Not just Babyboomers....all Gen's please! #CPHC GailZahtz @Kamiyamay Agree it's all generations! Access, ease of life, and having patients have dignity at home and in the hospital! #CPHC

sandyhubbard @burgessct We must be safe in home as we age and able to advocate from position of power, financial stability and dignity. #CPHC GailZahtz @sandyhubbard @burgessct You know I agree 100% that design and health are now 1 issue- should not be separated anymore! #CPHC MandiBPro @sandyhubbard Sadly, supporters 4 empowerment through info are the ones who already KNOW how to use it, & we're minority population. #CPHC Burgessct Agree - those in the pews don't need evangelizing - @MandiBPro @sandyhubbard #CPHC Nursefriendly @sandyhubbard #the #babyboomers are here, and making their presence known in #healthcare, we are not prepared for them in the least :( #cphc sandyhubbard All of these points really boil down to removing barriers in every category to promote understanding, access and advocacy. #CPHC burgessct @GailZahtz @sandyhubbard - I would add - and make it easily accessible today and tomorrow for the common man as well as the researcher #CPHC toughLoveforx @sandyhubbard My thought is we need trusted people on the ground to interpret or frame as barriers are removed. #CPHC sandyhubbard @nursefriendly Great point. The whole point of universal design is that it is truly universal. #CPHC @GailZahtz GailZahtz So interesting, as many of you know Universal Design is a Big issue to me- we start with work- and move quickly to good environment #CPHC Nursefriendly @sandyhubbard Making the changes now, remodeling, building new houses with #parents #eldercare in mind has to be a priority #cphc menkris @sandyhubbard @burgessct Absolutely. Critical to that is patient-friendly home design. Structural and assist devices #cphc nursefriendly @MandiBPro Have to wonder, if they were made more attractive, how #employee #wellness programs could reduce #burnout #attrition :( #cphc GailZahtz Good question HOW? RT @nursefriendly wonder, if more attractive, how #employee #wellness programs could reduce #burnout #attrition :( #CPHC nursefriendly @MandiBPro In #healthcare & #nursing specifically, #burnout, resulting #substanceabuse, #depression, etc is costing billions :( #cphc MandiBPro @GailZahtz @nursefriendly Increased productivity w/out increased hours (via brainpower output w/ healthier self) = job sat increase? #CPHC Nursefriendly @MandiBPro @GailZahtz In #healthcare I think we are getting stretched to the breaking point, dangerously - risking #patient safety #cphc Kamiyamay @nursefriendly I agree Andrew...stretched often...feel like a rubber band about to break at times! #CPHC TechurSelf @kamiyamay re: working to breaking pt. Yes, I think of the Japanese work-life balance part of the Happy movie. http://t.co/Qxyy5wcd #CPHC ElinSilveous @GailZahtz Check out work by Don Vickery, MD on Taking Care Program/Take Care of Yourself. Certainly work needs done on #mHealth. #CPHC

GailZahtz @toughLoveforx How can we look at other models- like struggle in education- to compare health outside of doctor's office? #CPHC ElinSilveous Did #CPHC folks see this? --> RT @Health_Affairs Is It Time To Re-Examine Workplace Wellness Get Well Quick Schemes? http://t.co/pzU2SVWk MandiBPro @ElinSilveous There are free alternatives that simply require paradigm shift: standup/walking meetings, employee support groups #CPHC menkris @GailZahtz Walking groups that walk together everyday at a fixed time they decide on. Has improved interpersonal relations for one #cphc GailZahtz @menkris Walking groups! Fabulous idea. Why don't we have more meetings that encourage general health? @bacigalupe Great to see you! #CPHC Timbigfish @MandiBPro @nursefriendly Yeah, makes sense. But it starts at the top. Recently read of female CEO who does walking (hiking) meetings. #CPHC Kamiyamay @timbigfish In hospitals and facilities would like to see initiatives trickle down to people out there working the long shifts too! #CPHC MandiBPro @GailZahtz SO difficult in medicine, I know. Corp culture must commit to embodying these values, and establish principles to support. #CPHC menkris @GailZahtz In a hospital environment; not many interested. But lots of takers for exercise incentives and initiatives. #cphc GailZahtz Must start with the top everywhere yes? So how can we help? RT @ElinSilveous: Must start w/CEO RT @Kamiyamay @StorkBrian #CPHC menkris @GailZahtz Yes; a very hard sell #cphc GailZahtz So we are talking about how universal design and access to healthy choices can make a difference at work and everywhere. #CPHC toughLoveforx @GailZahtz Health care outside the office... might be interesting to look at the homeschool movement in #ecoys #CPHC sandyhubbard @MargieClayman HI Margie - we're identifying common themes in healthcare that are frustrating and targeting a few to discuss. #CPHC ChronicPainGPS Resources assisting employers/employees/practitioners 2 implement/develop programs w/employee health activities http://t.co/cwRleEg3 #cphc ElinSilveous I am a huge proponent of medical self care and preventing medically unnecessary visits to ER/Doc. Keeps people healthier, contains $ #CPHC toughLoveforx @ElinSilveous "medical self care " yes. Any experience with "self-diagnosis" to make judgements about when to see the Doc? #CPHC nursefriendly @toughLoveforx #healthcare can no longer be conducted as a one-sided conversation. All parties need to be involved, engaged. #cphc lttlewys @nursefriendly @toughLoveforx Totally agree, need to have open & clear communications with everyone! Share info/records #CPHC nursefriendly @lttlewys @toughLoveforx We've become such a "closed" culture, trained to keep #patients in the dark for liability purposes :( #cphc

lttlewys @nursefriendly @toughLoveforx Agree!! Really need to get the Drs to understand it's about sharing data & info! Patients need help #CPHC nursefriendly @toughLoveforx We need to emphasize that #doctors #nurses #healthcareprofessionals don't have all the answers. Need #patient input :) #cphc toughLoveforx @nursefriendly One problem is usually a patient wants the doc to have all the answers. Then doesn't trust they do. #CPHC toughLoveforx @Kamiyamay My thought is patients need to know what querstions to ask and what info docs need to know. #CPHC @nursefriendly MarksPhone @toughLoveforx @Kamiyamay @nursefriendly and this can be reversied where the MD helps idendify what the patient is seeking to solve. #cphc GailZahtz @MarksPhone Great point- how can physicians identify better what the patient is seeking to solve? #CPHC MarksPhone @GailZahtz Needs assessment at visit what do they want to know where to they learn how active R they in their HC, etc. ? #cphc MandiBPro @GailZahtz In the not-so-distant future, I hope physicians will have TIME to TALK to the patients to uncover their real concerns. #CPHC MandiBPro @ChronicPainGPS AGREE. We need to give docs time to truly evaluate patients as individuals, not CPT codes. #CPHC toughLoveforx @Kamiyamay "physicians will have TIME to TALK" wud patient diaries and stories before meets help? #CPHC @MandiBPro @GailZahtz MandiBPro @toughLoveforx Patient narratives would be helpful, but time-consuming to prep for both. If only >5 min could be spent in conversation #CPHC Nursefriendly @toughLoveforx #doctors #nurses #healthcareprofessionals don't like admitting "They Don't Have All The Answers" - #FactOfLife #cphc toughLoveforx @MandiBPro I was thinking for some even an informal - or question asking diary done by patient before meeting wud help. thgts? #CPHC nursefriendly @ toughLoveforx #Medicine, #Healthcare are not perfect or exact sciences. There are no "money back guarantees" #Newsflash #cphc GailZahtz @nursefriendly For the other side- how much do patients today work with physicians to get answers they do have? #CPHC MandiBPro @GailZahtz We as patients and individuals lie to ourselves and our providers CONSTANTLY, to our detriment. It's human nature. :( #CPHC MandiBPro @toughLoveforx Ah, yes! If patient uses self-exploration to prep for appt, absolutely. But honesty is key - and HARD to attain. #CPHC TechurSelf @MandiBPro @toughLoveforx Yes, we think there is a place for self-tracking & reporting on health & #wellness to share w/ HC provider. #CPHC GailZahtz @TechurSelf can you talk more about self tracking and reporting? Seems there is a disconnect with those who want and docs who read. #CPHC MandiBPro @GailZahtz Currently VERY limited way to automate integration of self-reported data into EMR/HIS. Hope to address in 2013. #CPHC toughLoveforx @TechurSelf Any experience, research or links to self tracking and reporting that you know about? #CPHC @MandiBPro TechurSelf @GailZahtz Yes, def a disconnect. HC sys needs to integrate self-tracking & sharing of personalized #bigdata in form useful to docs. #cphc

MandiBPro @GailZahtz @TechurSelf Addressing self-tracking integration w/ EHRs & downstream entities will close crucial gap w/ patients who use. #CPHC Sandyhubbard Within hospital environment, there is still much work to be done in Universal Design regard, suprisingly. #CPHC GailZahtz @sandyhubbard I was just at hospital that had re-design last month- put up fancy wood on walls- no grab bars. #CPHC sandyhubbard @GailZahtz How many restrooms do you see with accessible stalls yet paper towel dispenser is at standing height. Insulting. #CPHC GailZahtz It is so interesting- I say self promote- Universal and Sensory design is topic of my upcoming book- wasn't going to mention ;-) #CPHC sandyhubbard I am so excited you are writing a book on this subject, Gail! @GailZahtz Universal and Sensory Design is topic of my upcoming book. #CPHC GailZahtz @sandyhubbard Thank you! A bit de-railed from this and other projects- but still planning a May marathon finish to publish! #CPHC GailZahtz @MandiBPro How can we not ingrain good health in medicine if the hospitals and physicians and nurses can't be healthy? #CPHC StorkBrian @GailZahtz @mandibpro @sandyhubbard #CPHC Really wish I had a good answer for that question MandiBPro @GailZahtz I think it can be grass-roots, emp-led - depends on the size/mgmt style of the org. I empower my teams to execute as works. #CPHC Kamiyamay @MandiBPro You said a couple of key words...Empower and Team!!! #CPHC GailZahtz Yes- so how? RT @lttlewys: RT @kamiyamay: @MandiBPro You said a couple of key words...Empower and Team!!! #CPHC ~YES!!! #CPHC toughLoveforx @GailZahtz imo Empower&Team connected off line and/or on line with a 100% patient health focus..#CPHC @lttlewys @Kamiyamay @MandiBPro Kamiyamay MandiBPro Employee support - excellent! Would improve attitude, environment, productivity! #CPHC MandiBPro @Kamiyamay Yes, and helps alleviate any Big Brother insecurity emps might feel from mgmt-led initiatives. #CPHC Kamiyamay I work in rural Texas...so many providing care in facilities and elsewhere smoke need incentives to stop.. #CPHC Dlschermd Took so long to fight (3 years and a threatened law suit) for my hosp to ban smoking years ago. I did it without hiring a lawyer. #CPHC GailZahtz @dlschermd Your hospital allowed smoking indooors? Thought that was a decade ago. #CPHC Dlschermd @GailZahtz Was outdoors. I had to cross campus and hold my breath. #CPHC Timbigfish @Kamiyamay Yeah, might be easier for grassroots there. Nobody's watching :-) #CPHC GailZahtz @timbigfish HA- first you're napping now point out everyone is watching! Think exciting conversation from no guest show! #CPHC

Timbigfish @Kamiyamay But how cool would it be to see CEO or Med Dir show up to walk-ntalk a shift? #CPHC TechurSelf Yes, I vote CEO-led walk n' talk meetings! at @timbigfish @Kamiyamay #CPHC #wellness cc @urwell_app lttlewys @gailzahtz @sandyhubbard I have my medical imbedded inside of me, only works if the Dr or hospital that has the equip to read it #CPHC GailZahtz @lttlewys Can you tell us more about your medical imbed and how it does (or doesn't) work with your physicians? #CPHC lttlewys @gailzahtz I have chip in my port-carries all my med records. Just needs to be scanned. When I switched drs, they didn't have software #CPHC GailZahtz @lttlewys How did you get the chip in your port carries? And why do your current doctors not have access? #CPHC Lttlewys @gailzahtz It's a SMART port, got it with 1st dx of #breastcancer to receive chemo treatments, tech hasn't been adopted by all drs #CPHC lttlewys Patients & Drs, need to work together to empower each other share records, information and data amongst each other, need to adopt tech #CPHC GailZahtz @lttlewys I am a bit shocked that you have this "smart port" yet offices not equippedmaybe you can write or speak on? Important! #CPHC Nursefriendly @lttlewys @toughLoveforx Far too many #TurfWars in #healthcare. Think it is by design to keep the professions 'at each others throats" #cphc ElinSilveous Other researchers in wellness/prevention/productivity space include Ken Pelletier & Dee Eddington. #CPHC GailZahtz @ElinSilveous Perhaps it will be of value to put together a list of good research and books? #CPHC ElinSilveous @toughLoveforx Yes. I did online research on this in '94 and '96. Will republish data/info soon. #CPHC toughLoveforx @ElinSilveous Cool. Please keep me in mind when you do publish. In meantime all 140 chrs or links wud be much appreciated. #CPHC ElinSilveous @toughLoveforx Will do, Michael. #CPHC ChrisCarrollMD Patient care preventing me from attending today's twitterchats! Sorry #cphc folks! #twiticalcareproblems GailZahtz @ChrisCarrollMD Patient care first! I told @nursefriendly docs would be joining soon about the flu! Just not today :-)) #CPHC GailZahtz I nursed at meetings when I was a CEO- best for my baby! RT @MandiBPro: RT @Kamiyamay: RT @timbigfish: @Kamiyamay #CPHC MandiBPro @toughLoveforx Now, you know MY world. ;) I think Agile methodology applies to many/most professional fields. #CPHC toughLoveforx @MandiBPro I know it's critical in software development and k-12 Education, I agree it applies to any service industry. #CPHC

nursefriendly @MandiBPro @GailZahtz #healthcare by design had buffers built in. With #ForProfit companies buying up facilities, losing buffers. #cphc MandiBPro @nursefriendly Yes, this is a HUGE concern. And what is root cause? Shortage of expert professionals? Cultural acceptance? #CPHC nursefriendly MandiBPro @GailZahtz #Fortune500 companies like clockwork, #MittRomney, buy companies, fired highest paid, stripped benefits, resold. #cphc nursefriendly @MandiBPro @GailZahtz Those #Fortune500 tactics are now being instituted in #healthcare, and it is costing lives, employees #cphc sandyhubbard @nursefriendly So you're saying that many of the limitations we perceive in big health care orgs are for profit motive and CYA. #CPHC lttlewys @nursefriendly @toughLoveforx That mentality is HORRID!! It's like some Dr's don't want their patients informed & What about family #CPHC nursefriendly @MandiBPro #RootCause? Trillions of dollars going into #healthcare annually, huge profits to be made like any other business. #cphc nursefriendly @MandiBPro Solutions will affect profits, will cut into the bottom line. In a #ForProfit system, it is cheaper to let problems persist #cphc nursefriendly @sandyhubbard Yes, and as more #investors move into the #SafeHaven of #Profitable #Healthcare, the problems are going to get worse. #cphc GailZahtz Interesting how we have connected the dots- from employee health to universal design to access at hospitals to Baby Boomers. #CPHC ChronicPainGPS Patient/Dr partnership built on MUTUAL trust and respect. Treat Pts as People - unique individuals, NOT cookie cutter diagnosis #cphc GailZahtz @ChronicPainGPS This mutual trust issue comes up everyday! The missing key to all. I am still amazed about @lttlewyns story... #CPHC MarksPhone @GailZahtz "Changing the Office Visit from Transactional to Value Driven" http://t.co/xcPMxngL Speaks to helping patients #cphc toughLoveforx @MarksPhone Big thanks for Transaction to Value Driven Post. Many same issues in education. #ecosys #CPHC @GailZahtz ElinSilveous Worksite walking programs, yoga & aerobics are easy, low cost programs to implement. often started by enthusiastic employee. #CPHC MandiBPro @ElinSilveous EXACTLY! Walking the building, itself, is helpful - no need to even go outside! Wireless headsets so you can pace helps. #CPHC Nursefriendly @lttlewys @toughLoveforx Bringing #patients #families #caregivers into the equation is going to require a major #CultureShift #cphc ElinSilveous @MandiBPro I noticed @fitbit is targeting employee benefits/HR for worksite wellness. Not sure of #ROI (health, productivity, cost) #CPHC MandiBPro @ElinSilveous I saw that, too. Good engagement tool for those who are already leaning towards device use, but for unhealthiest...not. #CPHC

Dlschermd @ElinSilveous @mandibpro @fitbit Will be interesting to see. They just partnered with Loseit. #CPHC ElinSilveous @dlschermd @mandibpro @fitbit Yes, it will. Await research for sure. #CPHC ChronicPainGPS @GailZahtz when I click on @lttlewyns handle, that page doesn't exist? #cphc GailZahtz @ChronicPainGPS Which click? #CPHC ChronicPainGPS @GailZahtz: I am still amazed about @lttlewyns story - I don't know that I'm familiar with that; tried looking up @lttlewyns not there #cphc GailZahtz @ChronicPainGPS She is here on the chat- do not know if @lttlewyns shared the story before of her smart port? Did you Brandi? #CPHC Sandyhubbard @ChronicPainGPS @GailZahtz Hi Patti - Brandie's handle is @LttLewys like little without the "i" #CPHC ChronicPainGPS @sandyhubbard: thanks! Got it now! #cphc GailZahtz Is there something tangible we can do to promote the walk and talk, universal design and other important ideas? #CPHC ElinSilveous What is meant by universal design? Thank you. #CPHC @GailZahtz GailZahtz @ElinSilveous Universal Design was started by Mace et al 25 years ago to promote 7 ideas of better environments for everyone. #CPHC ElinSilveous What were the 7 ideas of universal design? TY. @GailZahtz #CPHC GailZahtz @ElinSilveous I can get you link- the original book is at the University of NC website- search Universal Design co-authored by R Mace #CPHC Timbigfish @GailZahtz Most ppl, CEOs too, are followers. Would be cool to find fitness minded leader to live this. What would @CoryBooker do? :-) #cphc Dlschermd @GailZahtz We need to incentivize and also start ingraining in early school. Childhood obesity could be nipped in bud. #CPHC GailZahtz @dlschermd Incentivize the kids to eat better? #CPHC Dlschermd @GailZahtz Incentives to employees. Kids can be incentivized by literally showing them the effects of poor habits. Patient volunteers.#CPHC MandiBPro @GailZahtz I've bet my daughter $500 that she can't beat me in a 5K. It incents BOTH of us. #CPHC nursefriendly @toughLoveforx If the amount of #mederrors, #HealthcareHarm & #malpractice suits didn't make it clear. #doctors, etc are not perfect #cphc Kamiyamay @GailZahtz Different patients need and want different things...many don't know how to cut through the maze. Why make it a maze? #CPHC GailZahtz @Kamiyamay So how do we cut through patient mazes and dishonesty too? @mandiBPro #CPHC menkris @MandiBPro @GailZahtz For patients; keeping a daily journal helps. Keeps it real and there is a record. #cphc

MandiBPro @GailZahtz I wrote a blog about this - the Healthcare Lie Detector, leveraging data to identify gaps b/w health perception & reality. #CPHC MandiBPro @menkris That would be extremely helpful, provided they keep don't omit, "Smoked 3 cigs on GNO last night. Slept in, missed gym." X 5. #CPHC toughLoveforx @MandiBPro Agreed. Honesty is hard. But often able to sense further questions to get to really helpful stuff. That means HCP time. #CPHC GailZahtz We need to talk about how we can help patients be better and honest communicators, not just providers. #CPHC menkris @MandiBPro :) If it is a personal journal; for oneself alone that none else reads; and if it will help with outcomes - even then? #cphc MandiBPro @menkris Patient has to share the info w/ provider AND change behavior if it is to help w/ outcomes. The truth hurts, but it's needed! #CPHC ElinSilveous If someone feels intimidated asking their M.D. questions, they need to find another provider, and FAST. #CPHC Nursefriendly @sandyhubbard #Thankyou Sandy, these are #healthcare #discussions that need to be had, and the sooner the better. #cphc sandyhubbard Regular people need to be empowered to discuss. RT @nursefriendly healthcare discussions that need to be had & the sooner the better. #cphc Dlschermd @GailZahtz @kamiyamay @mandibpro Need to get wellness out in open and educate. Make it part of vernacular. #CPHC GailZahtz @dlschermd How do we make wellness part of the veernacular? #CPHC Nursefriendly @toughLoveforx @Kamiyamay There is a strong need for #patient #advocates, #nurse #navigators, and assistance in navigating #healthcare #cphc Kamiyamay @nursefriendly They must be taught -I teach what to ask....how do people access that..not everyone offers..because teaching=time #CPHC ChronicPainGPS @GailZahtz @nursefriendly: I don't know that pts know that they CAN work WITH their Drs; many are intimidated by Dr; what to ask? #cphc lttlewys @gailzahtz Agree, patients need to learn it's ok to question the Drs and to ask others!! SoMe is awesome for that!! #CPHC ChronicPainGPS Many Pts afraid to ? Drs and then Drs get offended if they do. Correct that will take effort on BOTH sides to learn from each other #cphc toughLoveforx @nursefriendly From watching my 90 year old mom in hospital a Patient Advocate cud be a paying profession. #CPHC anyone do that? @Kamiyamay toughLoveforx @MandiBPro @nursefriendly @Kamiyamay Has anyone seen Patient Advocacy as a paying profession or job description? #CPHC lttlewys @toughloveforx @MandiBPro @nursefriendly @Kamiyamay I have, they are lowpaying & under utilized & considered glorified Social Workers #CPHC menkris @toughLoveforx @MandiBPro @nursefriendly @Kamiyamay Don't think it pays; (it is a pro-bono kind of job); but in job description, yes #cphc

toughLoveforx @lttlewys I know middle class people wud gladly pay a more professional compensation. #CPHC @MandiBPro @nursefriendly @Kamiyamay lttlewys @gailzahtz I had a wonderful woman, but she was so limited & I didn't fit into a lot of requirements she needed to help me #CPHC toughLoveforx @lttlewys I think, but don't know could be a significant help for HCP time attention demands. #CPHC @MandiBPro @nursefriendly @Kamiyamay ChronicPainGPS @toughLoveforx: Program http://t.co/YM4Avubr to certify RNs as #advocates #cphc GailZahtz @ChronicPainGPS How does this advocacy program work? #CPHC toughLoveforx @ChronicPainGPS Thanks! Checking now.. #CPHC lttlewys @toughloveforx It's also getting the drs & facilities to cooperate ;-) #CPHC toughLoveforx @lttlewys Can you explain "facilities?" Does that mean the hospital and nursing staffs? #CPHC ChronicPainGPS Patient Advocate Foundation http://t.co/llQq9Pks is also a great resource #cphc toughLoveforx @ChronicPainGPS " Establish your own practice as an Independent RN Patient Advocate (iRNPA)." so that is really interesting. #CPHC ChronicPainGPS @GailZahtz: I had one come to our Chronic Pain Awareness Expo last Sept; they advocate 4 U in all aspects of your healthcare #cphc GailZahtz @ChronicPainGPS Would love to hear about your chronic pain expo! (if not today- definitely soon!! sounds very interesting) #CPHC ChronicPainGPS @GailZahtz: Attend appts w/you; review bills to ensure accuracy; advocate 4 services. Charge abt $100/hr (some offer slide scale) #cphc lttlewys @toughloveforx Yes, and their staff! Treatment centers, anywhere medical care is provided #CPHC ChronicPainGPS They really are they to ensure that you fully understand your treatments, meds, every aspect of your healthcare. #cphc ChronicPainGPS I am advocate but not RN so I am really good at connecting people with info and resources but can't get into the medical advice/aspect #cphc GailZahtz RE babyboomers and numbers- 60 M currently disabled. 10k turn 65 daily to hit 70M in 8 years. Where are we? #CPHC nursefriendly @sandyhubbard What little savings #babyboomers have, houses, assets, won't last long in #nursinghomes. Government won't have funds #cphc nursefriendly @sandyhubbard Unless there is something in the #AffordableCareAct that covers nursinghomes, they will be out of reach financially #cphc GailZahtz On nursing home- we are currently short 40 million beds- that's now, not in a year. #CPHC toughLoveforx @nursefriendly Also keep in mind baby boomers on the whole are much more educated in health than previous gens. @sandyhubbard #CPHC nursefriendly @burgessct @sandyhubbard When that phonecall comes in, crisis hits, is not the time to be faced with life-altering situations. #cphc nursefriendly @burgessct @sandyhubbard It only takes one #fall, #stroke #heartattack #accident to change an independent parent, into a fulltime job. #cphc

burgessct Exactly - plan ahead, it wasn't raining when Noah built the ark @nursefriendly @sandyhubbard @gailzahtz @mandibpro #CPHC independence GailZahtz With 60M needing UD and access, we have only 15M homes/units that are safe in the U.S. today. #CPHC GailZahtz @burgessct You already have me talking with physicians- actually they get cost saving over new time/ideas. Interesting. #CPHC MandiBPro @burgessct I'd argue that patients are empowered to drive down cost faster and more significantly than any other variable. BE HEALTHY! #CPHC Kamiyamay @GailZahtz I start "You expect honesty from me, I need honesty from you for us to work as a team to get best results" communication #CPHC sandyhubbard We are having many great lines of thought here that we don't want to go to waste. I hope we can revisit these in future #CPHC chats. GailZahtz @lttlewys On one hand we have people here advocating for patients to engage and track- on the other your experience was opposite... #CPHC menkris @MandiBPro Sharing is hard, yes indeed. Self motivation is the key. Provider & family support is critical to that, I think #cphc menkris @MandiBPro Thank you ! Will read and revert. #cphc GailZahtz have only a few minutes for formal chat- though idea was to use the hashtag 24/7- what is tangible that we can do from today's ideas? #CPHC Nursefriendly @MandiBPro Unlike any other business, when you #CutCorners in #Healthcare, #patients die, #healthcareharm & errors increase #cphc GailZahtz @TechurSelf we have here @burgessct and @mandiBPro on big data and @lttlewys who shared about docs not having tech access to her embed #CPHC GailZahtz @menkris Thanks so much! @touchLoveFox also! Great to see you all! #CPHC GailZahtz Seems a tie-in with everything said is the big disconnect is information shared between physicians and patients (on both sides) #CPHC toughLoveforx @GailZahtz Yes. Information is important, but what I've seen in education is the importance of Shared Decision Making. Tricky stuff. #CPHC nursefriendly @lttlewys @toughLoveforx The dynamics are rapidly changing, #patients are starting to demand a seat at the table, bout time. #cphc GailZahtz @toughLoveforx Was just at a physician and payor led site that encourages shared decision making, only no patients on the board. #CPHC nursefriendly @lttlewys @toughLoveforx #medicine for a very long time was the private domain of doctors, shrouded in secrecy, they had all the keys. #cphc

nursefriendly @lttlewys @toughLoveforx That dynamic has to change, and doctors, nurses #hcps need to realize #patients need access #cphc nursefriendly @lttlewys @toughLoveforx It is a common #mentality in #healthcare. The less #patients know, the less they can complain about. #cphc GailZahtz OH- big news out of MN! Family #caregivers now to be re-imbursed same as non-family! #CPHC MandiBPro FANTASTIC!!! RT @GailZahtz: OH- big news out of MN! Family #caregivers now to be re-imbursed same as non-family! #CPHC Nursefriendly @lttlewys @toughLoveforx A persistent barrier is #HealthcareLiteracy and learning to navigate the #healthcare system. #cphc ElinSilveous thanks for an interesting #CPHC chat everyone. Need to prepare for a meeting. Have a fabulous week! MandiBPro @ElinSilveous Great to see you, Elin! See you next time. :) #CPHC Burgessct Thanks for the invite - this has been enjoyable - is anyone archiving the stream? #cphc GailZahtz @burgessct I am archiving- and got requests to publish- will get to that tomorrow definitely! #CPHC hronicPainGPS It was GREAT! Happy to share - great info for pts/providers MT @GailZahtz: Would love to hear about your chronic pain expo! #cphc MandiBPro GREAT chat today, guys, thank you @GailZahtz and all! Must run to next engagement, but have LOTS of ideas for "what NOW"... #CPHC TechurSelf @GailZahtz Thanks for organizing #CPHC. Looking forward to future chats! lttlewys @gailzahtz Thanks so much for inviting me, need to add this chat to my @Listly list!! http://t.co/Zju2glGF #CPHC SusannaJSmith @GailZahtz Maybe update http://t.co/Xabx1Mfd w/ 3 main ideas discussed on today & topic for next week for future participants? #CPHC GailZahtz @SusannaJSmith Yes, I think an update on http://t.co/vfwuMYRe of the main topics discussed would be great idea! I will work on asap. #CPHC GailZahtz @MandiBPro @nursefriendly Money is needed to pay the bills for all- difference in healthcare is there are many "buyers" #CPHC Burgessct .@MandiBPro Let's bust open paradigm of $$ driven-make it care driven by driving down cost connect & collect down? #CPHC @nursefriendly TechurSelf @mandibpro @GailZahtz Yes, agree. Would be so excited to see that happen, and it's coming. #CPHC Nursefriendly @lttlewys @toughLoveforx It makes it difficult for #patientadvocates (a #nurses #1 priority, directive) when it clashes w/ profits #cphc TechurSelf@mandibpro @burgessct Yes, and when the reimbursement/ins sys rewards #wellness, even better. #CPHC

toughLoveforx @nursefriendly 2me "A persistent barrier is #HealthcareLiteracy" shd be a central part of Literacy in the K-12 curriculum. #CPHC @lttlewys GailZahtz May I just say- this is 3rd week, our guest did not show- and this was amazing and informativetruly crowd-sourced! #CPHC sandyhubbard @GailZahtz For folks who need to get back to their day, does this chat happen every week? #CPHC GailZahtz @burgessct @MandiBPro @sandyhubbard TYSM and yes, chat is weekly on tuesdays at 1 ET and working on website and other platforms. #CPHC ICLNetwork See work of Dr. Jeff Belkora, Dir. of Decision Services @ UCSF. His methodology facilitates critical reflection btwn physician/patient #CPHC GailZahtz Thank you everyone as you get back to daily life! Too fast to mention all- website is http://t.co/vfwuMYRe and we need help ;-)) #CPHC GailZahtz Thank you everyone! When we do something for passion not pay- amazing when great people help Make It Matter! #CPHC