Thinking About an In-Home Caregiver? Read Our Quick-Start Guide

in-home caregiverRecently I had a nurse colleague reach out to me to find a Patient Advocate in the Chicago area.  As part of the conversation, she mentioned that she was considering getting an in-home caregiver(s) for her mother.  I thought about this and decided that many people are in this quandry about how to care for their parents.  There are several choices when it comes to elder care– in or out of a nursing facility. Many seniors would prefer to receive care in the comfort of their own home. No matter what level of medical or personal assistance, home healthcare is readily available and can be customized to your needs. In-home caregivers can be a great solution for maintaining our parents’ independence.  Here are just a few things to consider when looking for an in-home caregiver:

Agency or Private Caregivers

Do you want to hire privately or through an agency? Hiring through an agency gives you additional support (i.e. by providing a substitute when your main caregiver is out sick or on vacation.) Hiring privately may be a little cheaper. If you do hire privately, make sure that you do a background check on your future caregiver.  I have had several clients who had issues and regrets because they didn’t check out the caregiver ahead of time. This is also essential if you don’t live locally because you cannot drop in from time to time to observe mom or dad’s caregiver.

Caregiver Education, Training and Title

What is the education of your caregiver? Is he/she a certified nurse’s aide (CNA), Home Health Aide or licensed vocational nurse (LVN)?  This may seem incidental, but it really is important criteria to evaluate. Remember- this person will be spending several hours per week with your parent (maybe more than you!) Are they trained by the in-home care agency? IF trained by the Agency, what does the training consist of? This is perfectly within your rights to ask. If you hire your in-home caregiver through an Agency, is there an RN or LVN  who oversees the development of your parent’s care plan? The roles of the RN and LVN in the development of care plans for your family member may vary from state to state.  In California, it is within the Scope of Practice for an LVN to develop care plans for situations that involve ‘Activities of Daily Living’. This would most likely be the same case for in-home assistance. However, RN &  LVNs can give medications. However, non licensed in home care givers can only provide medication assist and remind patients to take their medications. Some care facilities, such as some Assisted Living facilities have Medication Assistants with LVN or RN oversight.  Medication Assistants are limited within their scope.  Ask the facility what the training is for the Medication Assistants.  Ask the agency what is permissible for their caregivers and who will be handling the skilled nursing responsibilities. You can see it can get confusing but it is important to know who the caregivers are and what their scope of practice is for you to be comfortable.

Non-medical vs. Skilled Care

It’s important to establish your parent’s level of independent living. Some people can handle daily activities very well, while others need assistance with mobility, medications and nutrition. Start by determining your needs:

  • Do you need the caregiver to run errands?
  • Do you need them to take your parent to their appointments?
  • Do you need the caregiver to do food shopping and meal preparation?
  • Bathing/getting in & out of bed?
  • Will they be handling money?
  • Are there pets in the home that will need care too?

Cost of In-home Care

Cost will very from state to state.  How will this be paid for? A Patient Advocate can help you determine how much your loved one’s care will cost, what’s affordable and how much your long-term care insurance will cover. In-home caregivers are usually private pay or through long-term care insurance. There are special circumstances in which Medi-Cal/Medicaid will assist. However, generally this is paid for privately. In many cases, Medicare does not cover in-home assistance.

Make sure that the following are in place for your parent:

  • Healthcare Power of Attorney
  • List of Emergency Contacts
  • Financial Power of Attorney
  • Advance Directives
  • POLST (Physician Orders for Life Sustaining Treatment)

These steps should help you begin deciding what is the best path for your loved one and whether an in-home caregiver will be beneficial. If you would like more detailed information, please contact a Patient Advocate at MVLNC.


“Navigating Your Way Through Our Healthcare System”

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RN HEALTHCARE ADVOCATE CASE REVIEW: Prescriptions, Your Pharmacist and Best Ways to Avoid Mistakes

Rx imageIf you’ve ever gotten the wrong prescription, you know that it can be costly and a nuisance at the very least. But did you know that medication errors can cause harm and even be fatal? Medication errors that cause harm are called “adverse drug events.” This can be due to reactions from medications that are not supposed to be taken together, incorrect dosage instructions or allergic reactions. Overdoses and adverse reactions to prescriptions are the worst case scenario. There are a sea of other scenarios that involve non-life-threatening problems or are simply time-consuming to correct.

Most prescription medication mistakes boil down to human error. Doctors may prescribe the wrong medication or sometimes the pharmacist mixes up the names of two medications and dispenses the wrong prescription. A doctor’s handwriting may be illegible and the pharmacist reads it incorrectly. There are also erroneous prescribing faults on the part of a doctor which can result in harm to a patient. According to the Mayo Clinic, mistakes in prescribing, dispensing and administering medications injure more than 1 million people a year in the United States. These incidents are preventable—and fortunately, you can take a proactive approach to make sure your prescriptions are written and filled correctly.

Today Amy is our guest and she is sharing with us her experience with receiving the wrong medication from her Pharmacy:

My Recent Experience with Wrong Rx—Doctor Error

Here is a scenario I ran into: I went to my primary care physician for a rash around my mouth—which was later diagnosed as Perioral Dermatitis. My PCP prescribed Metronidazole cream but cautioned that he wasn’t familiar with this condition and I would probably need to see a specialist. I realized after a few days that the “Metro” cream was not treating my rash. So, I was referred to a dermatologist. The dermatologist made a note of the ineffective treatment cream and proceeded to diagnose the rash and prescribe me Hydrocortisone ointment, 2.5%. This topical ointment cleared up the rash almost overnight. On my follow-up visit to the dermatologist, he advised that I could continue the ointment and he would email 2 refills to my pharmacy. I picked up the prescription from the pharmacy without checking the bag and assumed it was the Hydrocortisone cream. However, when I opened the bag to use the ointment later, I realized it was Metronidazole cream—the original ineffective cream!

The pharmacist explained that he simply filled the order the doctor emailed to him. I realized that the doctor sent this cream in error, so I called his office to inquire about it. I spoke to a medical assistant who told me that according to his chart, Metronidazole cream was the correct prescription. At this point, I sought the advice of Donna—MVLNC private healthcare advocate. She advised that I should go back to the dermatologist’s office and speak to the doctor himself. Donna also explained the importance of getting a physical copy of the prescription with the name and strength of the medicine as well as dosage instructions for my personal records. If I wasn’t able to see the doctor, Donna advised that I should speak to an RN about the mix-up as opposed to a medical assistant, who may not be able to assess medications and their differences. This was extremely helpful advice—as it was the only way to get to the bottom of the prescription error and correct it.

Make Sure you Receive the Right Medication Before Leaving the Pharmacy

  • Be sure you get a thorough consultation from your doctor about what is being prescribed, what the dosage is, how often you will take it and what you can expect from taking the drug.
  • If the doctor’s office plans to phone in your prescription to the pharmacy, ask for a written copy, too. Take the time to review it to ensure it covers the same prescription your doctor has described. Once you get to the pharmacy, a written copy will help you confirm you are getting the right medication.
  • Usually your prescription will be handed to you, bagged and ready to go. Before you leave the pharmacy—open the bag, and check to be sure your name is on the prescription.
  • Read the label and make sure it says what you expect based on the information your doctor gave you. Check to be sure you have the right drug, in the right dose, in the right amount.
  • If there are any discrepancies, ask to speak with the pharmacist. Donna advises: make sure it is indeed the pharmacist you are talking to! Pharmacists can question prescriptions and doctor’s orders. A pharmacy tech usually just fills the orders and may not be able to solve a problem or answer medical questions.

Medication errors are serious business—doctors and pharmacists need to be made aware of a mistake no matter how inconsequential it may seem. But more importantly, it is up to you (the patient) to monitor your medication usage. Not only should you question possible drug interactions at the doctor’s office and pharmacy, always keep hard copies of your prescriptions on file for your own records. If you have any questions about drug interactions, prescription errors or problems filling prescriptions, contact MVLNC to get private healthcare advocacy advice.

Stay Tuned for More Tips on How to Prevent Errors

Unfortunately on a daily and weekly basis, I have been working with these types of scenarios. The purpose of moving to computer entry of orders was to help minimize these mistakes. However, humans make mistakes and computers have glitches. Check back with us for more tips on preventing medications errors at home.


“Navigating Your Way Through Our Healthcare System”

Posted in Clinical Corner, General, Nursing, Patient Advocacy, Private Healthcare Advocate, Senior Care Management, Uncategorized | 1 Comment

Heart Disease & Women: 7 Warning Signs You Should Not Ignore

Over my 25 years as a Registered Nurse , I have seen go_red_for_women_2_gifcases where women present signs of a heart attack, yet treatment is delayed.  This is often because the warning signs are more subtle in women.  Women also tend to ignore their own health in order to take care of their families. Another issue is that healthcare professionals will miss the signs as they often mimic other healthcare issues.  Don’t allow your healthcare professional to ‘brush off’ heart attack warning signs. Trust your intuition! You know your body better than anyone… If you can tell something is wrong, insist that your doctor, physician assistant, or nurse practitioner run more tests. It’s better to be safe than sorry.

February is American Heart Month. As we near the end of February, I cannot help but place some focus on Women and Heart Disease.  The American Heart Association launched the “Go Red for Women” campaign to raise awareness about the dangers of heart disease among women. So far, it is estimated to have saved more than 627,000 lives! Unfortunately, heart disease is still the leading cause of death in both men and women. Every year, about 715,000 Americans have a heart attack. The good news is—heart disease is preventable and controllable.

Regardless of your age or health conditions, be proactive and seek immediate treatment if you begin to experience symptoms that you are unaccustomed to. Below are warning signs women should pay attention to, as they could be signaling the onset of a heart attack.

7 Warning Signs Women Should Not Ignore

  1. Pain. Classic heart attack symptoms include chest pain, pressure, burning, and discomfort centered under the breastbone. Other aches and pains to pay attention to include the back, shoulders, arms, stomach and jaw. **Note: They may come and go and are often not as pronounced in women.
  2. Shortness of breath. Many women feel as if they are panting and trying to take deep breaths. This can occur days or weeks before a heart attack.
  3. Nausea or dizziness. It’s fairly common to vomit during a heart attack. Nausea or heartburn accompanied by light-headedness, dizziness, or fainting are signs of abnormal heart rhythms.
  4. Unusual fatigue. Many women feel extremely tired days or weeks before, or during an attack. This typically means feeling so weak that you cannot do any normal activity.
  5. Rapid or irregular pulse. A rapid or irregular pulse accompanied by any other warning signs can be a strong indicator of a heart attack, arrhythmia, or heart failure.
  6. Heavy sweating. If you are pale and covered in sweat for no reason, this may be an indicator of a heart attack. Feeling sweaty with cold clammy skin is also a common symptom.
  7. Swelling. Swelling, usually in the abdomen or lower extremities, is the result of fluids accumulating in the body during heart failure.

I recently had a patient where her only warning sign was nausea over several days.  It was almost passed up for the flu. She did not experience chest pain.  Fortunately for this woman, she took her blood pressure daily. On day three of nausea, her blood pressure was much lower than it usually had been. She went to the Urgent Care near her home  – still not thinking she had anything more than the flu.  An EKG  was done and she was sent directly to the hospital via ambulance.

It is important to know that  patients who are diabetic may not experience chest pain; and if they do, it may not be to the same intensity.  It is important to be aware of these other symptoms and address them immediately.

Reduce your Risk for Heart Disease

There are things every woman can do to reduce her risk for heart attack. According to the American Heart Association, women who have become aware of the dangers of heart disease say they have made healthy changes. More than a third report shedding excess pounds via diet and exercise. Other women say they have talked to their physician about developing a “heart health plan.”

The “Go Red for Women” campaign encourages strength in numbers—it promotes women coming together to fight heart disease. A spokesperson notes that “women have the power to save their own lives.” Don’t take a chance: if you have one or more of the symptoms discussed in this article, take a few hours out of your day to get checked out. It could be the best decision you ever make

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What are Accountable Care Organizations- the Short Version

Is the term “Accountable Care Organization” doctorspopping up in your conversations about health care and insurance? Accountable Care Organizations (ACOs) are on the horizon, so it’s important to know what they are. Accountable Care Organizations are groups of doctors, hospitals, and other health care providers, who are coming together voluntarily to give coordinated care to their Medicare patients. An ACO agrees to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years. The goal of ACOs is to avoid unnecessary duplication of services while delivering quality care. Health care providers can assemble their own ACOs.

This concept is part of the new health law—born from the Medicare Shared Savings Program. This Program encourages cooperation among providers to improve the quality of care for Medicare Fee-For-Service beneficiaries. It aims to reduce unnecessary costs associated with the traditional system (i.e. doctors and hospitals are typically paid more when they order more tests and do more procedures). ACOs will create savings incentives by offering bonuses when providers keep costs down. However, there is more to the equation: the focus must be on prevention and carefully managing patients with chronic diseases.

What are the Proposed Benefits of ACOs?

According to the ideal model, ACOs should benefit patients and providers. For patients (or beneficiaries), ACOs are designed to improve outcomes and increase value by:

  • Promoting accountability for care given by all providers
  • Requiring coordinated care for all services provided
  • Providers would get paid more for keeping their patients healthy and out of the hospital

ACOs will need to prove that the overall health care product they’re delivering works well and costs less to encourage patients to participate. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, the Shared Savings Program will reward them monetarily.

Can Patients Still Choose their Own Providers?

Yes. Patients are still free to see doctors of their choice outside the network without paying more. Primary care doctors are required to tell their patients if they are part of an ACO. Most likely, physicians will refer patients to hospitals and specialists within their ACO network.

What are the Cons?

According to health care industry experts, ACOs sounds a lot like HMOs—which limit patient options and created a consumer backlash in the 1990s. Economists fear that the race to form ACOs could have a negative impact by encouraging hospital mergers and provider consolidation. As hospitals become integrated, many are joining forces and purchasing physician practices. This leaves few independent doctors. In a nutshell, the greater market share can drive up health costs. Legal concerns have been raised that ACOs could violate antitrust and anti-fraud laws, while driving up health care prices.

Forbes Magazine on the subject of ACOs: “A rapidly emerging health care delivery system that rewards doctors and hospitals for working together to improve quality and rein in costs is serving roughly 10 percent of the U.S. population.”

Stay tuned to our blog  for the latest developments on Accountable Care Organizations. We will keep you updates as health care and legal experts weigh in on this new health care delivery model.

Centers for Medicare and Medicaid Services

NPR- Health News & Analysis (National Public Radio)

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Affordable Care Act- 2013 Timeline

ImageWith President Obama at the helm for another term, you can be sure that the Patient Protection and Affordable Care Act is here to stay! Action by the federal government, hospitals and providers is underway to fully implement each phase of healthcare reform. With that said, you may be wondering what changes are on the horizon for the 2013 calendar year. There are four main directives of the Affordable Care Act that are set to be launched this year. Take a look at the key features for 2013 according to the timeline published by Learn how these healthcare changes will affect the U.S. patient population.

  • January 1, 2013: Improving Preventative Health Coverage

To expand the number of Americans receiving preventive care, the law provides new funding to state Medicaid programs so they can provide preventive services to patients at little or no cost. States are being given the option of whether to extend Medicaid benefits to all non-Medicare individuals under 65 with incomes up to 133% of the federal poverty level. You can check to see whether your state is expanding the Medicaid program or not.

  • January 1, 2013: Increasing Medicaid Payments for Primary Care Doctors

As Medicaid programs and providers prepare to cover more patients in 2014, the Act requires states to pay primary care physicians 100% of Medicare payment rates in 2013 and 2014 for primary care services. There is reportedly $250 million in new funding provided by the Affordable Care Act to expand the primary workforce. This funding is intended to help prepare the health system to meet the demand for health care workers as well as adding initiatives to train and support thousands of new doctors, nurses, and physician’s assistants. That’s good news…opponents of the Act are concerned about a physician shortage. Experts question if we have enough doctors to take care of a potential influx of 32 million American people.

  • January 1, 2013: Expanded Authority to Bundle Payments

The Affordable Care Act has established a national pilot program that encourages hospitals and providers to work together regarding patient care.  Under payment “bundling,” hospitals, doctors, and providers are paid a flat rate for an episode of care rather than the current system in which each service or test is billed separately to Medicare. For example, instead of a surgical procedure generating multiple claims from multiple providers, the entire team is compensated with a “bundled” payment. This payment incentive is intended to increase efficiently while maintaining or improving quality of care. Those delivering care need to work together; in turn, savings are shared between providers and the Medicare program.

  • October 1, 2013: Additional Funding for the Children’s Health Insurance Program (CHIP)

Under the new legislation, states will receive two more years of funding to continue coverage for children not eligible for Medicaid. The Children’s Health Insurance Program provides low-cost health insurance coverage for children in families who earn too much to qualify for Medicaid coverage, but can’t afford to purchase private health insurance. Children up to age 19 in families with incomes up to $45,000 per year (for a family of four) are likely to be eligible for coverage. In many states, children in families with higher incomes also qualify. Learn more about CHIP.


Timeline of the Affordable Care Act

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Nurses & Providers: Get to Know the HITECH Act


The Health Information Technology for Economic and Clinical Health (HITECH) Act is an important part of President Obama’s stimulus package—known as the American Recovery and Reinvestment Act of 2009. This act represents the first significant commitment of federal resources to support the widespread adoption of electronic health records, or EHRs. As of August 2012, 54 percent of the eligible Medicare and Medicaid professionals had registered for the meaningful use incentive program. Meaningful use is still in the process of being defined on a state-by-state basis. However, the overall definition of meaningful use of EHRs embodies:

  • Improving quality of health care, safety and efficiency of health care
  • Engaging patients and family to review and inspect EHRs for accuracy
  • Improve care coordination among hospitals, providers and pharmacies
  • Maintain privacy and security of patient health information

What are the Benefits of Electronic Health Records (EHRs)?

When properly implemented, the benefits of EHRs far outweigh paper records. Care coordination is among the biggest advantages of EHRs. When all provider team members can communicate efficiently, patients definitely benefit. In a crisis, EHRs provide instant access to information about a patient’s medical history, medications and allergies. One study found that many emergency medics said they greatly benefitted from access to pre-existing health information through electronic records. Emergency personnel reported that this information was especially helpful for patients with frequent emergencies or those who were unconscious or otherwise unable to provide information. Other benefits include cost savings and accurate and complete information about a patient’s health. The U.S. Department of Veteran Affairs was one of the first to adopt health IT and exchange; they report that savings from preventing adverse drug reactions alone total an estimated $4.64 billion.

How Does the HITECH Act Specifically Affect Nurses?

The security of personal health records has always been critical within the healthcare industry. As healthcare professionals, the protection of personal health information (PHI) is just as important as the patient care delivered. In 1996, HIPAA (Health Insurance Portability Act) set national standards for the security of electronic protected health data. The HITECH Act widens the requirements of HIPAA to include the business associates of covered entities and includes a Breach Notification Rule. In a nutshell, the Breach Notification Rule requires health care providers to notify patients when there is a breach of unsecured personal health information.

Since nurses are often involved in the transmission of PHI, they need a basic understanding of the new security rules as they pertain to the HITECH Act. All PHI must be encrypted prior to transmission. Here is just one example: an emergency room nurse must send medical documentation to a patient’s insurance provider to validate the need for additional tests to be run. When transmitting that protected health information, the nurse must ensure that the information is delivered in an encrypted form, so that it cannot be used by an unauthorized party.

So, what this means is that nurses and health organizations have to answer key questions when requests are made for electronic health records.

  • Does the EHR have the capability to comply with requests for electronic access?
  • How will patients receive an electronic copy of the data?
  • What security protections will be employed to secure the electronic access (i.e. encryption, passwords)?
  • Will it be documented and time stamped when EHRs are issued to the patient?
  • Will the organization instruct patients on protecting this electronic information?

Learn more about the HITECH Act and the implementation of EHRs: Providers & Professionals resources

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Happy 2013! 10 Feel-Good Strategies for a Healthier You – Plus A Bonus Strategy

I do not know about you but around here December and the Holidays have gone by at warp speed.  Here are some ideas to decompress and start the New Year off with a little less stress:

Since the beginning of the millennium, scientists have been researching the connection between happiness and health. They can now conclude with a certain level of confidence that having a sense of peace, fulfillment, and purpose leads to a healthier and longer life.  One social scientist, Sonja Lyubomirsky, authored a book called The How of Happiness. She reveals that nearly every aspect of health seems to be affected by happiness (or lack thereof): physical and mental well-being, energy levels, immune function, relationships with others, and even our life-spans.

More and more evidence suggests that being happier can actually help you live longer! A study of 180 senior women revealed that two-thirds of the gloomy participants died before their 85th birthday, while on average the happy ladies lived 9 years longer. This small focus group may not be a predictor of the population and it’s obviously not the gospel. But, if it’s even possible that you can live longer just by being positive, isn’t it worth a try?

We put together a list of 10 simple strategies for a happier, healthier you. At MVLNC, we hope 2013 is your best year yet!

1.     Be an Optimist

Thinking optimistically is a very effective way to increase your well-being. Optimistic people are healthier, have more friends and are more successful at work. As the saying goes, it’s not the events in our lives that make us happy or sad—it’s our perception of them. Optimistic people see problems as temporary, which helps them to bounce back quickly after a hardship.

2.      Simplify Your Life

The “Simplicity Movement” is a newer way of thinking—it aims to achieve a less stressful, more meaningful life. To do this, we must slow down and be more balanced, deliberate and thoughtful.  This may mean de-cluttering your home, downsizing your career ambitions or not being so “connected” via the internet. Mental health professionals have joined the movement, focusing on how simple living can help alleviate tension-related reactions such as insomnia, nervousness, anxiety, neck and shoulder spasms and chronic fatigue. One of my favorite ways to simply is to take one day off a week from being “connected”  – it really makes a difference in feeling like I have taken a break.

3.     Develop Discipline

Manage your time and priorities because self-discipline creates happiness. Happy people tend to believe they’re more in control of their lives and take an active approach to solving problems. Using self-discipline can be difficult at first, because we don’t “feel like it.” If you wait to feel like it before exercising, working or paying your bills on time, it may never happen.

4.     Meditate

People who meditate often are usually happier than those who don’t. Not sure how to meditate? Choose a simple word such as “calm” or “peace.” Repeat the word to yourself for 10-20 minutes. Try to steer away from everyday thoughts and focus back on your repetition.  Meditation can also take place while walking or doing a favorite activity that allows you to not think about everyday stressors.  I find when cycling or running all of the sudden I find I am not thinking about daily life.  So be open to what can be considered methods of  Meditation.

5.     Change Your Breathing

When you are stressed out or angry, your breathing changes. Long patterns of unhealthy breathing patterns can cause a higher pulse rate and high blood pressure. When you feel stress or anger building, breathe in deeply and slower. Try the technique: in through the nose, out through the mouth. Within minutes, your bad mood will fade away.

6.     Laugh More Often

According to Dr. Oz, laughter can lower your heart rate and blood pressure as well as reduce the constriction in your blood vessels. It can also help with your mental health. We all know it’s fun to laugh and it feels good, but it may come as a surprise to learn that it has medicinal qualities. Studies have shown that laughter can help you work through emotional issues.

7.     Increase Sleep

It’s difficult to be happy if you’re constantly tired and struggling to find enough energy to get through the day. A good night’s sleep makes you feel energized and alert. Lack of sleep has been associated with worsening of blood pressure and cholesterol—risk factors for heart disease and stroke. Your heart will be healthier if you get between 7 and 9 hours of sleep each night.

8.     Balance Time Alone & Time with Others

Research studies suggest that people who spend most of their time alone experience higher than average rates of depression. However, spending all of your time with others can be overwhelming. You should place value on your alone time as much as that with others. Everyone needs balance in this area.

9.     Increase Omega-3

New research shows that Omega-3fatty acidscan improve moodand well-being. Already well known for their ability to protect against heart disease, cancer, and diabetes, Omega-3 fatty acids may be highly effective in preventing and managing depression and cognitive decline, according to a growing body of evidence. Foods high in Omega-3 fatty acids include fish oil, flaxseed oil, cereal, basil and broccoli.

 10.  Exercise

Of course…exercise is on every list, right? We left this one for last, but it’s probably the most important! Daily exercise can have a big impact on how positive we feel. After demonstrating that 30 minutes of exercise three times a week is just as effective as drug therapy for relieving depression symptoms in the short term, medical center researchers have concluded that continued exercise reduces the chances of recurring depression.

BONUS STRATEGY: Spend Time With Fido

Spending time with your dog or cat can really help change your attitude and might help you accomplish some  strategies 1 – 10.  Walking your dog will give you exercise and time away from those electronics.  Simply petting your dog or cat can help improve your mental outlook for the day. Don’t have a dog or cat ? Visit a friend that does or volunteer at the local rescue that needs help with exercising and caring for those pets looking and waiting for their forever home.


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Your Personal Healthcare Information – “Blue Button® it”

“Blue Button®” & You: 24/7 Access to Your Medical Record

We covered an overview of the HITECH Act in our last blog, and now we will delve into how it affects YOU—the patient. HITECH stands for the Health Information Technology for Economic and Clinical Health Act. It aims to encourage all medical practices and providers to embrace health IT, or information technology. This includes implementing electronic health records (EHRs) instead of the long-standing paper files. President Obama is pushing this initiative forward; as it falls under the Healthcare Affordability Act. The sooner a medical entity complies by maintaining and providing health records electronically, the more financial incentives they will receive through the year 2015.
Electronic Health Record Access for Patients
So, how does this act affect you? For years, individuals have been able to inspect and obtain a copy of their protected health information. Well, HITECH extends the requirements so that patients’ health information is more secure and protected. And at the same time— entities must provide electronic health records (instead of paper files).
In the near future, all organizations will be directed to give patients access to an electronic copy of their medical records. Patients can also designate that a third party gain access. This is a significant change in our healthcare system. The development of health IT should greatly streamline communication between your doctors, pharmacy, hospital, and other organizations. Most consumers should initially be offered their electronic health records at their doctor’s office or hospital. In addition, the Act states that only a fee equal to the labor cost can be charged for an electronic request.

Introduction of the “Blue Button”
So, what exactly is the “Blue Button”? It is a new icon that universally represents access to individuals’ electronic health records. The Blue Button on a computer screen will be a clickable button which will allow you to download your health information on demand. Healthcare providers and insurance companies are already starting to utilize the Blue Button. The actual details of how its functionality will work are still being ironed out. Being able to access your health information 24/7 can be lifesaving in an emergency situation, prevent medication errors, and improve care coordination between your medical practitioners. Doctors and pharmacists will now have your data at their fingertips, such as current medications and drug allergies, claims, treatment and lab results. Patients can also plug their medical data into mobile apps and other tools.
Benefits of EHRs and the “Blue Button”
The roll-out of EHRs being linked to all of your health care providers is designed to offer many benefits. Here are just a few:
• Coordination of care among doctors. If you see multiple specialists in addition to your primary care physician, it is important that your care is coordinated. Doctors may prescribe different prescriptions which could interact in harmful ways. EHRs can warn your care providers if they try to prescribe a drug that could cause a negative interaction.
• Reduction of unnecessary tests and procedures. Repeating medical tests can be unnecessary and costly. This can mean a greater deductible for you and increased insurance premiums. With EHRs, all of your care providers have access to your test results and records.

• Direct access for review of your health records. It is crucial to identify wrong and missing information on your medical record—also to make additions or corrections. Providers who have already implemented EHR systems are beginning to give their patients access to their health information online. This should enable you to keep better track of your care. If you have a question about a past procedure, you will have the information at your fingertips instead of having to wait days.

Do you Blue Button?Image

When you think of searching something in the web you hear people say “Google it.” I believe “Blue Button it” will someday be synonymous with downloading your personal healthcare information. If you would like to “Blue Button,” (or download) your health information, check with your healthcare provider to see if their system is in place—and if not, when it will be. Remember, many healthcare systems are still working on all of this new technology. However, many do have EHR in place but may not have be up to speed with Blue Button. I recommend you ask your healthcare provider if they have a way for you to securely download your healthcare information – even if Blue Button is not in place. Please remember if you are not yet comfortable with using the computer for this type of information you can always request a paper copy.

To learn more about the Blue Button and EHRs, visit Specific information for patients can be found at: Patients & Families resources.

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Understanding Healthcare Reform: Electronic Health Record Access & the HITECH Act. How Does this Affect You in the Near Future?

The Healthcare Affordability Act will continue to move forward. If you have not paid attention to it in the past you may be starting to now. Periodically  we will take some time to explain key aspects of this law and how it affects you.  The HITECH Act is a good place to start.

HITECH is an acronym that stands for the Health Information Technology for Economic and Clinical Health Act. It is part of President Obama’s stimulus package—known as the American Recovery and Reinvestment Act of 2009. The HITECH Act is designed to fulfill a promise that President Obama made in a speech in which he said: “To improve the quality of our health care while lowering its costs, we will make the immediate investments necessary to ensure that within five years, all of America’s medical records are computerized. This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests. But it’s not only about saving billions of dollars; it will save lives by reducing the deadly but preventable medical errors that pervade our health-care system.”

To help accomplish this goal, the HITECH Act creates a system of incentives to encourage medical practices to implement electronic health records (EHRs) and penalties for non-compliance. According to, “This is the future of health care.” The Department of Health and Human Services has also implemented a campaign to educate providers, professionals, patients, and families on health information technology. They want providers to learn the basics of HITECH; they want to offer patients help learning the benefits of IT as well as how to protect your personal health information (PHI).

All patients (individuals) currently have the right to access their medical health records, but up until now we’ve been limited to a “paper format.” In the very near future, we will all have access to electronic health records. Some hospitals and healthcare providers have already rolled out a system of providing their patients with an electronic version of their protected health information. There are a multitude of reasons you should obtain a copy of your medical records! We will go into all of these in next week’s HITECH blog post about patient access to PHI and your rights. Have you heard of the “Blue Button?” Blue Button is becoming a universal symbol as a way to get easy, secure, online access to your health information. These are all very important developments in our ever-changing healthcare system, so be sure to stay on top of this topic! Read about the latest developments on the HITECH Act and upcoming milestones by staying tuned to our blog.

Check back  next week to read more information on the HITTECH Act:

  • Tuesday- Dec. 18, 2012: Blue Button & You: 24/7 Access to Your Medical Record
  •  Friday- Dec. 21, 2012: What Does HITECH Mean for Nurses and Providers?

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Anatomy & Physiology 101 for Attorneys

Brain injuries can be complex. They can be caused by falls, motor vehicle accidents, any situation that cause sudden stops, and medical conditions or treatments.  When treating brain  injury  it is important to accurately diagnose and have a treatment plan.  It is important to know how the patient presented at the time of the accident – were they conscious or unconscious?  What is the patient’s medical history.

Brain injury can be mild, moderate or severe.  Treatment for brain injury patients may be complex and have several healthcare disciplines involved,  The patient’s treating physicians can include: a Physical Rehabilitation Medicine Doctor, a Neurologist and a Psychiatrist.  Additionally  Physical Therapy, Speech Therapy  and Occupational Therapy are often needed.  A Nurse Case Manager to be assigned to the case to manage the complex needs of the patient.  All of these healthcare professionals work together to help assure the best possible outcomes.

Want to learn more? Myself and several other healthcare professionals will be speaking  at the  Anatomy and Physiology 101 for Attorneys November 29, 2012 in Las Vegas. The link above will take you to the details of the conference.

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