Applying Logic Models to Medical Care

Logic Models are a standard industry tool in the non-profit management realm for program evaluation. The concept forms the basis of new demands for "meaningful use" in the medical industry. This ten minute tutorial will help you think about how you might apply logic models to clinical care for your patients.

Adjusting to Outcomes Measurements

Ever wonder why you have to click so many boxes just to finish a patient note? In this post, I reflect on "outcomes measurements" from my experience in the non-profit charitable world and how it relates to the current state of medical practice.

Gratitude Reduces Stress

Research shows that grateful people are more resilient to stress, but in a time or profession when we're all pressed to do more with less, how does one cultivate this discipline in their life. Here's a few thoughts to kick of the week of Thanksgiving.

Ten Ways to Become More Grateful

Hacking Your Company's EMR #4

"This EMR is BROKEN!" you scream as you dash your laptop against the exam room table. Well, maybe it is and maybe it isn't. Let's talk today about what might be broken and what to do about it.

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Hacking your Company's EMR #3

Documentation seems to be the bane of existence for a physician, related to their stress with Electronic Medical Records. Here's a couple of quick tips to help you cut down on the time you spend documenting your patient interactions.

How to Hack your Company's EMR #2

In the second of this four part series, I want to encourage you to brace yourself to be in learning mode with EMR. You surivived - no you CRUSHED residency - so this should be a snap, right? Today's tip is about how to utilize the training resources you have available to you, both formal and informal.

Thanks for watching

Steven Reames, Director

How to Hack Your Company's EMR #1

In this four part series, I want to provide a few tips on how to "hack" your company's EMR, which besides ICD-10 right now, might be the most frustrating part of your practice. In today's podcast, I'll tell the first and most important step you must undertake. Fortunately, you have complete control of this.

ICD-10, 9, 8, 7, 6, 5, 4, 3, 2, October 1

I'm hearing groans from across the Valley as we move into the last week before ICD-10 implementation. Many have wanted to avoid this day for a long time to come. Some have even set their retirement date for September 30 (I won't mention any names.)

But, it is finally here and I wanted to share some tips that Teresa Cirelli, IMA's reimbursement director, and I have put together to help make sure you are ready for this big change.

There's lots of detail in the video, but for those who don't want to take 8 minutes to watch, here's the bullet points and the resources I promised you.

Teresa Cirelli's IMA Presentation
 

#1 Don’t approve any vacation time in October, for billing staff especially
#2 Consider opening up a line of credit. Two resources:

• Mountain West Bank VP Commercial Lender, Lyle Cook, lcook@mountainwestbank.com, 208-989-7930
• Washington Trust Bank VP Private Banking, Joey Perry, jperry@watrust.com, 208-333-9422

#3 Finalize all ICD-9 charges in September
#4 Practice your coding documentation in ICD-10

• Index and Tabular ICD-10 Lists (PDFs)
• Android ICD-9 to 10 Converter 
• iPhone ICD-9 to 10 Converter
• ACP's Most common ICD9 Diagnoses Comparison 
• IMA will create a chart of your 10-15 most common diagnoses for $25

#5 Identify Documentation Gaps

• Journal of AHIMA's Documentation Gaps analysis

#6 Categorize Your Denials

• Denial Tracking Sheet

#7 Create a Denial Action Plan
#8 Check out Idaho Medical Association's ICD-10 Resources

• Public ICD-10 Resources
• Members Only ICD-10 Resources and Online Forum (Call 344-7888 if you need a logon).
• CMS Road to ICD-10

#9 Plan a Celebration - Gamify

• Gamification in the Workplace

#10 Keep Your Head in the Game 

I
Can
Do
10 x Better
With a a Great Attitude

Seven Things Your Team Needs to Hear from You #7

This is the last in our series reviewing David Dye's management presentation on the Seven Things Your Team Needs to Hear from You. This is one of my favorites: encouragement. Find out an easy and powerful tip on how to encourage people that you can immediately put to use.

For more information about David Dye's book, visit his website.

Click here to subscribe to this blog/podcast

Seven Things Your Team Needs to Hear from You #6

Making Things Clear

Does your team know what kind of things will get them removed from the team? Do you know? Clarity brings amazing results for a team and as the team leader, it is your job to make things clear. When people know what kind of culture you want to establish (and what is forbidden in your culture), you will make it easier for the right people to get on the bus and to open the exit doors for those who don't share your values.

Thirty years ago, employees were asked what they would do if they were boss for a day. The survey was repeated recently and in both cases, the answer was the same.

THE #1 thing that people would do as boss for the day is to get rid of the slackers. You know who they are: complainers, barely pulling their weight, always coming up with excuses. I know for me over the years that I have been extremely long-suffering towards these kind of people, but it was always because of my optimism that they would "grow into their role." Ninety-percent of the time, they didn't. They didn't just need development - they needed discpline and their lack of it was demotivating the entire team. We would spend inordinate amounts of time trying to work around their issues.

When we let them go it, brought a collective sigh of relief and we could focus on getting the right people on board.

Finally, clarity also means knowing who does what, when and how will we know. This is something that should be very clear at the end of every meeting you have or task you talk about getting done.Yes, we all know that this sounds a lot like outcomes measurement - because it is. If you even dare to ask this question in a muddy meeting, most people will thank you for driving for clarity. In fact, you might even demand that it is put on your meeting agenda form so that you can fill this in as you go through a meeting - and then review it at the beginning of the next one.

So, get that leadership squeegee out and wipe off your windows. You'll thank yourself for taking the time to do so.

Seven Things Your Team Needs to Hear You Say #5

I'm Sorry

Please Forgive Me

I made a mistake

These are hard words to say, especially if you are a physician who is supposed to be almost god-like in your clinic. There's a lot of hubris that comes along with medical training.

But did you know that you can actually increase the amount of grace that your team gives you when you humble yourself after realizing you made a mistake? This pays great benefits for the long haul when you allow your team to see you as, gulp, human!

The Truth about Sarcasm

The Seven Things Your Team Needs to Hear You Say #4

How to Develop Critical Thinking

How do you help your team (and even your patients) become better critical thinkers and able to make better decisions on their own. The temptation when people come to us asking for help is simply to give them advice - it makes us feel good about our knowledge and intelligence and keeps us firmly ensconced in our position of authority. The problem is that the line always seems to grow longer every day.

Here are eight great questions to ask the people who look to you for leadership to make them a better leader themselves.

Taken from a presentation by David Dye who has written the book "The Seven Things Your Team Needs to Hear You Say."


Click here to subscribe to Pearls of Great Value Podcast

The Global Leadership Summit

The Global Leadership Summit

I had the stunning opportunity to attend the Global Leadership Summit with IMA staffers Susie Pouliot and Theresa Cirelli. This is my first chance to be with 250,000 other GLOBAL leaders, piped in via satellite, from the Willow Creek Association campus in Illinois. While ostensibly a church and faith-based leadership conference, this is a world class training with leaders speaking like Jim Collins ("Good to Great", "Built to Last,"), Horst Schulz (Founding President The Ritz-Carlton Group), Ed Catmull (co-founder, Pixar Animation), and Bill Hybels, founder of Willow Creek Church in Chicago.

I highly recommend the summit which for the price of less than $100 for 2 full days is the highest-value leadership training of any kind I've received. Take a look at next year if you're interested.

Watch my challenge to you about being a learning rather than an expert.

Click here to subscribe to Pearls of Great Value Podcast

The Seven Things Your Team Needs to Hear You Say #3

In July, I attended the American Association of Medical Society Executives in Portland which was very timely for me as I move towards the end of my first year at ACMS. One of the presentations was by David Dye who has written the book "The Seven Things Your Team Needs to Hear You Say."

This is the third in a seven part series, and today I'll share with you why your team needs to hear you say "How Can I Help You?" so that they know you care.

Thanks for tuning in.

Steve

Seven Things Your Team Needs to Hear You Say #2

In July, I attended the American Association of Medical Society Executives in Portland which was very timely for me as I move towards the end of my first year at ACMS. One of the presentations was by David Dye who has written the book "The Seven Things Your Team Needs to Hear You Say."

This is the second in a seven part series, and today I'll share with you why your team needs to hear you say "TRY IT" if you're going to stay on the cutting edge of change.

Thanks for tuning in.

Steve

Seven Things Your Team Needs to Hear You Say #1

In July, I attended the American Association of Medical Society Executives in Portland which was very timely for me as I move towards the end of my first year at ACMS. One of the presentations was by David Dye who has written the book "The Seven Things Your Team Needs to Hear You Say."

In this seven part series, I'll share with you the seven things and provide my own perspective on each of them. In the first, you'll understand why your team needs to hear that you believe in them.

 

Thanks for tuning in.

Steve

July Conference Wrap-up

I just returned from ten days of travel to two conferences and all I can say is how impressed I am with our membership.

Coeur d'Alene - Idaho Medical Association Annual Meeting and House of Delegates

This was my first experience watching physicians engage in policy making for the IMA. Ada County physicians, including those serving on the IMA board, represented well more than 1/3 of the 90 physician delegates. What a great turnout of our physicians in statewide leadership.

If you have not attended a House of Delegates and know how it operates, it reminded me a lot of the mock United Nations or Legislature that we did in high school, but with a lot more knowledge of the real world. IMA members are allowed to propose resolutions in writing that will become policy, directives, and legislative focus for the coming year. Comments and amendments are made in the first session, the house breaks to two separate reference committees for cleaning up and recommendations, and during the final session, votes are cast.

A full resolutions overview is available on www.idmed.org, but here are some of the more actively debated issues:

• IMA Physician Directory to Contain All Idaho Physician - referred to IMA board
• Recognition of Comprehensive Advanced Life Support (CALS) Certification - adopted as amended
• Support for Equitable Reimbursement for Telehealth Service - adopted as amended

Thank you to all our Ada County delegates and IMA board members who traveled north for this event:
IMA Board Members: Kyle Palmer, Bruze Belzer, Kenny Bramwell, David Schmitz, Vicki Wooll, David Rice, Patrice Burgess, Crystal Pyrak
ACMS Board Members: Joe Williams, Michael Sant, Daniel Reed
ACMS MD/DO Members: Travis Kemp, Alice Black, Ed Newcombe, Suzanne Allen, Ted Epperly, Steven Smith, Thornton Bryan, Richard Rainey, Lisa Inouye, Ed Boese, Terry Ribbens, Mary Barinaga, Gregory Bross, Kurt Seppi, Stephen Montamat, Robert Friedman, Julie Foote, Vaun Archibald, Marian Zakarian, Duncan MacDonald, Steven Brown, Ronald Dorn, Nancy Keegan-Ovando.
ACMS NP Member: Tyler Watkins

Portland - American Association of Medical Society Executives
Following the IMA meeting and after a half day of riding the Hiawatha Trail with my family (VERY cool experience), I flew to Portland Oregon for 3 1/2 days of training with AAMSE. This was great timing for me 9 months into my job here and provided some key membership engagement strategies that will make ACMS even better.


But one of the things I finally had to stop talking about was how much I loved my job. I started getting on my new colleague's nerves by talking about our 71% market share, a balanced budget, a great partnership with our state association, an invested but not micro-managing board, and a membership that turns out. We really do have one of the premier county medical societies of the people I met and that's because of the support and involvement of our members. Thank you.

In future weeks, I will start pod-casting some of the material I learned that I think will make you a better physician. If you'd like to subscribe, please let me know here.

Steven Reames, Executive Director