Disrupt Podcast #40: John Driscoll of CareCentrix

The 40th episode of our podcast, Disrupt, is now available!

For this episode of Disrupt, Home Health Care News sat down with CareCentrix CEO John Driscoll to talk about emerging health care trends and his company’s plans for 2021.

Originally founded in 1996 by major home health provider Gentiva, CareCentrix is a national at-home care organization that manages more than 26 million lives across over 8,000 provider locations.

Listen to this episode of Disrupt to learn:

— Why payer perceptions of home-based care are starting to change
— How CareCentrix plans on growing in the year ahead
— What consumers want from in-home care providers in 2021
— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!

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The Alderley Park Discovery Podcast: Life science skills, staffing and support

Episode two of the Alderley Park Discovery Podcast covers access to skills in the life sciences sector, with a focus on support for aspiring scientists and UK staffing trends.

In this instalment Dominic Tyer’s guests on the podcast are Sai Life Sciences’ head of global R&D Dean Edney, Joynes & Hunt’s managing director Steve Joynes and Dr Kath Mackay, managing director at Bruntwood SciTech’s Alderley Park.

Dr Mackay talks about why university connections are vital for a life science and tech cluster like Alderley Park and how the campus works to inspire the next generation of scientists.

From Dean Edney there’s a look at the expansion story of India-headquartered Sai Life Sciences and what the research development services company needed when it came to setting up its first European base of operations.

The podcast also features a rundown of recruitment trends in UK life sciences from Steve Joynes from specialist staffing solutions provider Joynes & Hunt. He discusses how recruitment has changed over the past decade and reveals some of the impacts from the COVID-19 pandemic on staffing.

The Alderley Park Discovery Podcast, produced in partnership with pharmaphorum, presents perspectives on UK and global bioscience innovation trends, with input from leading experts at Alderley Park in the North West of England.

In episode one of the podcast Dr Mackay talked about the challenges of rapidly building capacity to test thousands of patients a day for coronavirus at the Alderley Park Lighthouse Lab.

Alderley Park, a development by Bruntwood SciTech, is the UK’s largest single-site life science campus and offers bioscience facilities for R&D-focussed life science companies at every stage of their lifecycle, from start-up to global corporate.

Episode two of the Alderley Park Discovery Podcast is available in the player below, where you can listen to it, download it to your computer or find – and subscribe to the series, and other pharmaphorum podcasts – in iTunesSpotifyacast and Stitcher.


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How CommonSpirit Health at Home Launched a 27-Market Telehealth Program in 2 Weeks

For the home health industry, 2020 was the year agencies unquestionably embraced telehealth. Amid the COVID-19 emergency, virtual visits have become a key tool utilized in the delivery of care.

One company, CommonSpirit Health at Home, has long recognized the value of telehealth.

Prior to the COVID-19 emergency, CommonSpirit Health at Home had plans to roll out a major telehealth pilot. The public health emergency kicked those plans into high gear, pushing the organization to implement telehealth much sooner.

To learn more, Home Health Care News sat down with Trisha Crissman, COO of CommonSpirit Health at Home’s home care and hospice division, for a recent Disrupt episode. Highlights from the conversation are below, edited for length and clarity.

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HHCN: For our listeners who aren’t familiar with CommonSpirit Health at Home, tell us a little bit about the company.

Crissman: CommonSpirit Health at Home has been providing home-based health care for over 40 years through specialized home care, home infusion, hospice and medical transportation services across the country. We’re headquartered in Milford, Ohio, and we’re currently comprised of 70 locations across 13 states and nearly 3,000 employees.

In February 2019, CHI Health at Home transitioned to what we call now CommonSpirit Health at Home, as our two larger parent organizations aligned our ministries to form CommonSpirit Health. As a result of Catholic Health Initiatives and Dignity Health aligning, CommonSpirit Health became the largest nonprofit health care system in the country.

It currently operates more than 700 care sites in 142 hospitals across the country. The combined system has about 150,000 employees, and 25,000 physicians and advanced practice clinicians.

For most home-based care companies, the COVID-19 emergency has become the new normal, so to speak. What is CommonSpirit Health at Home experiencing on the ground, now almost 10 months in?

Patients and families have a heightened — and new — level of expectations for care in their home or their place of residence. We’re really seeing that they have become more accustomed to the role that technology plays in their care, which is refreshing. We’re seeing patients become more involved in their health and safety, and becoming more involved in opportunities to collaborate in their plan of care with providers. I think we’ll see this for quite a long time to come still, but we’re still having a difficult time and experiencing challenges related to accessing patients in congregate living environments.

I would also add that our clinicians are increasingly becoming more comfortable with the use of technology as well, understanding that remote patient monitoring and telehealth visits are powerful tools that can help keep our patients and our employees safe.

I’m really proud of the way that our teams have continued to say “yes” to their calling in this kind of new normal state. I think we’ve gotten beyond a place where we think it’s going to go back to normal. I think we’re kind of resolved that this is a new way of existing, and we’re continuing to lean into what’s happening across our country.

I’d also lastly add, in this new normal, our operators and our clinical leaders are responding more quickly to the day-to-day needs and requirements of the business.

What kind of results have you seen related to your telehealth efforts?

I would start off by saying that our rollout of telehealth solutions was incredibly rapid, but the preparation for it was really long. We’ve known all along, as an organization, that telehealth would be an important offering for the future. Our plan was to walk slowly into telehealth, with a plan to implement over the course of 18 months across all of our locations.

We were planning to do a pilot, work out the kinks over five months — and then COVID hit. So remarkably, my team did a phenomenal job responding. We altered our plan, skipped the pilot completely, and rolled out in 27 markets in literally two weeks.

Throughout this process, we’ve expanded our original inclusion criteria to allow for patients that did not want to have clinicians in their home due to COVID concerns. We’ve seen that we’ve had a really strong adoption of remote patient monitoring by both staff and patients. It’s taken us a little bit longer to adapt to the use of virtual visits. So we did spend a lot of time helping clinicians get comfortable with remote visits. We’re prepared for its kind of increased use as we see this resurgence.

Today, I would share that we’ve done over 3,700 virtual visits and have had 2,700 patients on remote patient monitoring since the beginning of the pandemic. This is just a little bit under a quarter of our overall home health census. From an outcomes standpoint, we’ve been able to decrease our in-person nursing visits and increase capacity to care for other patients — which is an outstanding byproduct.

Outcomes for our remote patient monitoring patients are better than those without remote patient monitoring, even though those patients have a higher acuity level, which is interesting to know. Related to patient satisfaction scores, our telehealth patients are 43% happier than those without telehealth. There’s some sort of ability to feel like you’re in control of your care and your environment.

We are constantly talking about this idea of the “cost of COVID-19.” What would you say has been the 2020 impact of the public health emergency on CommonSpirit Health at Home?

I would say the biggest impact that we have seen, of course, is our lost volume, particularly due to hospitals suspending elective surgeries back in the spring. The biggest impact was in states that did a statewide shutdown. In the states that did county-based shutdowns — for example in the Midwest, like Iowa and Nebraska — we didn’t see a significant impact in volumes as we did in other locations.

From a cost standpoint, we’ve seen increased spending for personal protective equipment (PPE), hazard pay, furloughs, lost productivity and costs due to workers being in quarantine.

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J&J and medical device innovation: the pharmaphorum podcast

In episode 27 of the pharmaphorum podcast I’m joined by Erin McEachren, who’s EU regional vice president at J&J Surgical Vision.

She talks about her priorities at J&J – having joined the company six months ago, the current state of the medical devices sector and some of the trends she’s keeping a close eye on.

Like pretty much every episode I’ve recorded since March this year the coronavirus features, and Erin tells me how she and her company have fared during the COVID-19 pandemic

There’s also time to hear about her time on the Canadian national skiing team and how competing at an elite level informed her subsequent business career.

You can listen to episode 27 of the pharmaphorum podcast in the player below, download the episode to your computer or find it – and subscribe to the rest of the series in iTunes, Spotify, acast, Stitcher and Podbean.


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Tay-Sachs and rare disease registries – the Health Heroes podcast

Episode four of Kantar Health’s Health Heroes podcast tackles pharma’s rare disease challenges, the role of patient registries and hears a moving story about the rare genetic disorder Tay-Sachs disease.

Joining me for this instalment of Health Heroes are Geneviève Bonnélye-Fesnien, global head of real-world evidence, research and consulting at Kantar Health, and Dan Lewi, co-founder of The Cure & Action for Tay-Sachs (or CATS) Foundation.

Dan’s eldest daughter Amelie was diagnosed with Tay-Sachs in 2011 at 15 months of age and he shares the emotional story of caring for her and how that led to setting up The CATS Foundation.

This episode of the podcast also looks at how the GM2 Disease Registry, managed by The CATS Foundation with support from Kantar Health, and it will help both patients and the pharma companies working on treatments for them.

The podcast finishes up with an overview from Geneviève on the current outlook for rare diseases.

The Health Heroes podcast series aims to inform and educate life sciences companies on ways for getting closer to patients to help drive improved health outcomes.

Previous episodes have covered the impact of a rare disease, learning from China’s COVID-19 experience and the coronavirus pandemic’s effect on mental health in the US.


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Disrupt Podcast #39: Trisha Crissman of CommonSpirit Health at Home

The 39th episode of our podcast, Disrupt, is now available!

Formerly CHI Health at Home, CommonSpirit Health at Home is a Milford, Ohio-based health care organization that provides home care, home infusion, home respiratory care, hospice and medical transportation services.

As with most home health providers, COVID-19 has become the “new normal” for CommonSpirit. Throughout the public health emergency, the company has implemented a number of measures to address COVID-19 including — most notably — the expansion of its virtual monitoring capabilities.

For this episode of Disrupt, HHCN caught up with CommonSpirit’s Trisha Crissman, vice president and COO of the company’s home care and hospice division, to hear firsthand about its on-the-ground experience with COVID-19. During the conversation, Crissman also touched on how the company is tackling flu season.

Listen to this episode of Disrupt to learn about:

— The financial impact of COVID-19
— Lessons from the public health emergency
— CommonSpirit’s 2021 goals
— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!
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Disrupt Podcast #38: Mark McPherson and Ruth Martynowicz of Trinity Health at Home

The 38th episode of our podcast, Disrupt, is now available!

Trinity Health at Home currently ranks as one of the largest home health providers in the country. It’ll be even bigger next year, thanks to an ongoing consolidation strategy to combine its national and regional locations.

Home health veteran Mark McPherson leads Trinity Health at Home as its president and CEO. Apart from the consolidation move, McPherson’s focus is on preventing “COVID fatigue” among his front-line health care workers while preparing for what’s likely to be a very challenging winter.

Home Health Care News caught up with McPherson for our latest episode of Disrupt to learn more. Also joining HHCN and McPherson was Ruth Martynowicz, interim COO of Trinity Health at Home and Mercy Home Health.

Listen to this episode of Disrupt to learn:
— How Trinity Health at Home is dealing with COVID fatigue
— Why the provider is executing its organizational-wide consolidation strategy
— What the public health emergency looks like on the ground for Trinity
— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!
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24 Hour Home Care’s Ryan Iwamoto: ‘We Wanted to Be the Trader Joe’s of Home Care’

Ryan Iwamoto co-founded 24 Hour Home Care 12 years ago, right in the middle of the country’s last major recession. Now, Iwamoto and his company find themselves operating through another economic downturn, with this one caused by the COVID-19 crisis.

Los Angeles-based 24 Hour Home Care is an independent, non-medical home care provider with 20 locations spanning California, Arizona and Texas. It employs over 10,000 caregivers and has been one of the fastest-growing companies in the U.S. for the past several years, according to Inc. Magazine.

Despite a lengthy list of challenges over the years, the home care company has managed to thrive. It has mostly grown organically since launching, though these days, it’s becoming more of an M&A player as well.

Iwamoto, who serves as the president of the company, credits 24 Hour Home Care’s success to its people — which he calls its “secret sauce.”

To learn more about that secret sauce and how 24 Hour Home Care has thrived in forming partnerships with Medicare Advantage (MA) plans, hospitals and other health care providers, Home Health Care News sat down with Iwamoto for a recent episode of Disrupt.

Highlights from HHCN’s conversation with Iwamoto are below, edited for length and clarity. Subscribe to Disrupt via Apple Podcasts, Google Play Music, SoundCloud or your favorite podcast app.

HHCN: 24 Hour Home Care has been recognized as one of the fastest-growing home care companies for eight years in a row. How have you managed to do that, year over year?

Iwamoto: When we started 24 Hour Home Care, we wanted to combine the professionalism of a large company with the personalization of a mom-and-pop business. And when we were thinking about what company did this well, in any industry, there weren’t really many that came to mind. But there was one: Trader Joe’s.

Everyone loves Trader Joe’s. They did an amazing job of being your grocery store, even though there aren’t many Trader Joe’s across the country. The store in your neighborhood, you probably identify that one as “your Trader Joe’s.” And their motto was brilliant, too, right? They’re not the cheapest. They’re not your 99-cent grocery store. They’re also not your Whole Foods. But they did a really good job of offering quality products at competitive prices.

Most importantly, the people that you deal with are their secret sauce. The people are super engaged, helpful, motivated and seem to be happy to work at Trader Joe’s. That was something we really wanted to emulate at 24 Hour Home Care. We wanted to be the Trader Joe’s of home care.

Is that the magic bullet that you think made 24 Hour Home Care successful — its people?

Absolutely, just like Trader Joe’s. It’s our people.

We actually have a motto here at 24 Hour Home Care, which is “Care and Compete.” Every employee has to have a little bit of both to work here, a dedication to caring and a sense of competition.

On the care side, you have to care for what we call the four C’s: your clients, your caregivers, your colleagues and, of course, the community. On the competition side, to be frank, we are a mission-driven company, but we are for-profit. So, you have to be able to compete.

This is not just competing in the traditional sense of competing with your industry competitors, but also competing with yourself to be a better version of yourself every day. I like to say those two values are the two threads that are interwoven to make the fabric of our culture.

Do you think you’d be able to launch in the same way you did 12 years ago?

To be honest, probably not. As everyone knows, home care is not easy. When I started the company with David [Allerby], I was 26. It was during the heart of the recession.

The one thing we didn’t have on our side is experience. But the one thing that we did have on our side is just this blind ambition. We really didn’t know any better. But we kept pushing forward. We would fail a few times, but “fail forward” and keep adapting to our circumstances.

And I think that’s what’s helped create the mentality that we have today, that with any challenge comes an opportunity. With COVID-19, I think we’ve seen the same thing. You just have to find that opportunity to rise above it. Once you get more established and more experience, I think you get a little bit more set in your ways, maybe more resistant to change.

It would be a lot harder going into home care with a little bit more experience now.

Most of your business comes from private pay, but you’ve also invested heavily in Medicare Advantage (MA). Why did you see that as an opportunity for growth, and how is that effort going?

We’re extremely bullish on MA. And one of the things that I love to see is the needle starting to move for our health systems — people seeing the benefit and value of home care. Medicare Advantage adding home care as a supplemental benefit a couple years ago, I think, was a huge leap forward.

As a company, we were truly honored to be able to work with some of the plans like Anthem Inc. (NYSE: ANTM) to help create a home care benefit.

Right now, MA is not a significant portion of our revenue. But being a part of this mission to show the value of home care is why we do it. Five to 10 years down the line, to see this as your standard insurance and Medicare benefit — that’s what keeps me going every day.

If you think about it, Medicare was established in the 1960s. For a while, outpatient physical therapy (PT) wasn’t a Medicare benefit at all. Then programs were put together, pilots were made to show the benefit of outpatient PT. Then in the late 60s, it was added. Hospice didn’t become a Medicare benefit until the 1980s. It was several years down the line before people really saw the value in it.

But people put programs and pilots together to show the value of hospice. Now today, people think differently. It’s just assumed as a benefit. I’m very confident home care will follow suit. We’re already seeing it start to happen with MA. I’m excited to be able to help pioneer this for the industry.

In terms of the presidential election, how are you looking at it from a home care perspective?

We’ve gone through three presidents — George W. Bush, Barack Obama and Donald Trump.

I think that with every election, there’s going to be some change, of course. And there’s also going to be change that you’re just not going to have any control over.

For me, I try not to get so bogged down thinking of what may or may not [happen]. Where my mind goes with any of this, whether it’s the election, crisis or change, is ‘with change comes opportunity.” You just have to find it.

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Disrupt Podcast #37: Ryan Iwamoto of 24 Hour Home Care

The 37th episode of our podcast, Disrupt, is now available!

In 2008 — amid the last recession — Ryan Iwamoto and his co-founders started Los Angeles-based 24 Hour Home Care with $160,000 total of investment cash from family and friends. The company is now one of the largest privately owned home care companies in the U.S. with 19 locations spanning three states and over $115 million in projected revenue in 2020.

The growth that 24 Hour Home Care has seen over the last 12 years has been completely organic. Iwamoto, who serves as the president, has seen his company make the Inc. 5000 list recognizing the fastest growing companies in the country for eight years straight.

That success is due to the company’s ability to make innovative partnerships, its team and its ability to adapt on the fly — like it did when COVID-19 arrived in California. The biggest, however, is its “secret sauce,” Iwamoto said.

For this episode of Disrupt, HHCN caught up with Iwamoto to discuss that secret sauce, as well as non-medical home care, Medicare Advantage and the company’s 12-year journey to the top of the industry.

Listen to this episode of Disrupt to learn:

— What company 24 Hour Home Care modeled itself after

— How it adjusted when COVID-19 hit and how it plans to keep growing

— How it wins partnerships with hospitals and MA plans

— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!

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GSK and eosinophil research: the pharmaphorum podcast

GlaxoSmithKline’s Nucala (mepolizumab) last month became the first and only biologic treatment approved in the US for Hypereosinophilic Syndrome (HES).

It’s part of the company’s focus on eosinophil-driven diseases, and ahead of that regulatory milestone I spoke with Tiffany Robinson-Smith, global medical affairs lead for biologics at GSK, about eosinophils and why they’re an important element of her company’s research programmes.

We also spoke in this episode of the podcast about some of the research challenges GSK faces with eosinophils and where they fit into the pharma company’s current product portfolio.

You can listen to episode 25 of the pharmaphorum podcast in the player below, download the episode to your computer or find it – and subscribe to the rest of the series in iTunes, Spotify, acast and Stitcher.


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Wildfires, COVID-19 and PDGM: Growing a Home Health Business During Moments of Crisis

Home health agencies are used to operating during moments of crisis. That’s especially true for California-based Medical Home Care Professionals, which has had to overcome several over the past few years.

In 2018, for example, Medical Home Care Professionals operated during the historic Carr Fire that devastated nearly 230,000 acres across California’s Shasta and Trinity counties. This year, the agency has experienced the indirect consequences of more wildfires and the direct impact of the COVID-19 virus — all while transitioning to the Patient-Driven Groupings Model (PDGM).

To find out what it takes to stay afloat during such turmoil, Home Health Care News recently caught up with Elaine Flores, the COO of Medical Home Care Professionals, for its latest episode of Disrupt. Highlights from the conversation are below, edited for length and clarity.

Subscribe to Disrupt via Apple Podcasts, Google Play Music, SoundCloud or your favorite podcast app.

HHCN: Before talking about the 2020 wildfires and operating during moments of crisis, can you provide some background on your agency?

Flores: Medical Home Care Professionals is a locally owned and operated home health agency in Redding, California. We also do custodial-type care. Our owner, Kathy McKillop, founded the company in 1985. We’re celebrating our 36th anniversary this October. Kathy was — and still is — a licensed vocational nurse. She had a patient at one of the local hospitals who wanted to go home. She felt that she could make that happen, so she took him home and started caring for him, providing 24-hour services. That was just what our community needed.

We’re now serving over 300 patients, with about 120 employees. We’re a Medicare-certified home health agency as well as a state-licensed home health agency for California. We work heavily with the MediCal program. We service all age demographics, from infants to geriatrics. We even do end-of-life work.

Your agency has had to walk a rocky road over the past few years, jumping from crisis to crisis. You operated through forest fires in 2018, then a historic blizzard after that. Now, you’re facing more forest fires and the COVID-19 virus. What has that been like?

In July 2018, our community had a fire called the Carr Fire. It started at our beloved Whiskeytown Lake, which is about 15 or 20 miles from the center of town. It started by accident. A vehicle was towing a trailer. A spark started a fire or something along those lines. The fire was burning in the wooded areas by the lake, but then the wind shifted and everything got really scary. We started losing structures as the fire moved.

As an agency, we had to put our emergency preparedness plan into action. For some context, the U.S. Centers for Medicare & Medicaid Services (CMS) in 2015 announced it was coming up with new Conditions of Participation (CoPs) for home health agencies. We started evaluating ourselves and preparing for these different CoPs, which included stricter requirements around agencies’ emergency-preparedness plans.

That benefited us. Overall, we felt that we were pretty prepared. When that fire started encroaching upon residential areas within our community, we were able to implement our plan, quickly alerting patients and coordinating evacuations. We evacuated patients into the Chico, California, area. In some instances, we evacuated them into skilled nursing facilities (SNFs). Our rock-star staff worked tirelessly to coordinate care for, at that point, 275 patients.

We had our command post at our office. Our first priorities were identifying high-risk patients and alerting the caregivers. We had employees losing homes. We had patients losing homes. We had to reassign staff, reassign patients. It was quite challenging.

How does that situation compare to the wildfires now?

Right now, we’re pretty safe. Our fire season doesn’t end until December, though. Who knows what can happen between now and then. Right now, we’re dealing with bad air quality. I’ve had to send staff members home because they may have an underlying condition like asthma, which could lead to difficulty breathing.

There was one day last week where it was 9:30 a.m., but it was pitch black because of the smoke.

What have been the keys to staying afloat and delivering care during these disasters? Again, you also operated through a historic blizzard right after that 2018 fire.

Having the right team is the key to it. Everybody on our team has that “I will do whatever we need to do to ensure that our patients and our employees have what they need” menality.

In regard to the blizzard, we had tons of snowfall for our little town, this torrential downpour of just snow. My phone immediately started going off the morning we woke up to it. It was my staff. We had people who couldn’t get to work. We had patients who had caregivers that were on shift that needed to be relieved.

We started another “command central.” We found people with big, big vehicles to get us into the office. When we got to the office, though, we were locked out because the roof had collapsed onto our main door. We had to get real creative, real quick.

How are you doing in regard to COVID-19? That can’t be a good mix with the smoke and breathing issues.

Everybody’s just trying to remain calm, remain vigilant. In the office, we have specific procedures that everybody follows. We wear masks within the office. We’re protecting each other in that respect. We’ve all tried to make sure we’re wearing the appropriate personal protective equipment (PPE) when delivering one-on-one patient care. All of our clinicians are screened over the phone on a daily basis, asked very specific questions. That’s all documented. Do you have a fever? Do you have shortness of breath? In terms of the intersection of COVID-19 and the fires, we want staff to change out their masks more frequently because of the smoke.

I know a lot of home health agencies are at a new normal when dealing with the coronavirus. At what point did Medical Home Care Professionals start to feel the impact?

We felt it when Governor Gavin Newsom issued the emergency order to stay at home — the shelter-in-place order. I remember it vividly. It was on March 18. We felt the shift right then and there. The next day, we came into the office and called our CEO. She was so supportive and said, “You guys, let’s think of the best way to do this. Let’s figure out what the shelter-in-place order means for our team.” We started looking at working from home. So, early March is when we felt the shift from COVID.

Shasta County has not had a very elevated conversion rate for COVID-19. I think we’re sitting at maybe 650 to 675 positive COVID cases since March. We really haven’t had big time exposure like most bigger cities. But we took every precaution that we needed to take, knowing what we knew. About 75% of our workforce is at home. We started doing multidisciplinary Zoom meetings.

How is Medical Home Care Professionals preparing for the fall COVID-19 surge?

We’ve taken a look at all of the protocols that we’ve put in place for COVID-19. We are also really promoting flu shots. We’ll start calling patients maybe more frequently than once a day — maybe a couple times a day. The other thing that we are going to do is continue ordering our PPE as we can get it. When this first occurred, who would have ever thought I would need to send one of my clinicians into the home in full PPE? We didn’t have an abundance of gowns. We didn’t have an abundance of N95s or surgical masks. We had to create our stockpile from nothing. We went from purchasing a box of surgical masks for $5 to now $50.

Did you come across any fraud schemes or shady PPE experiences?

We did. We were following a lot of our colleagues that were in the southern and central parts of the state. They were giving us leads on different entities. We went ahead and purchased 2,000 surgical masks from a vendor at one point. Our friends at Kaiser had purchased 1 million, so we thought it must be a good, reputable company. Well, they never got their supplies. Actually, they got them, but three months later. So did we, which is frustrating. There was another shipment, I recall, that came in — and the masks were soiled. They had molded, so we had to fight to get a refund for those.

We’ve talked about wildfires, a winter storm, the ongoing public health emergency and PPE scams. On top of all that, you’re also facing the transition to PDGM. How has that gone?

It’s gone. We were prepared for it. A couple years prior to launch, we had been to numerous conferences through our state association. We felt that we had a good ramp up for it. PDGM really has the philosophy of how we run our business anyway. We are in communication with our clinicians and with our patients on a daily basis. Care coordination is amazing at our agency. Our nurse leaders really coordinate patient care from the beginning of care to discharge. We had just a few areas where we needed to pivot.

That was with, for example, billing processes and Low Utilization Claims Adjustments (LUPAs). We had to understand all of the new ways that we were going to get reimbursed, then share that with our clinical team so they were more aware of the financial impact. But we’re doing okay with PDGM. Yes, we have had some challenges, some curveballs in there. But we’ve been able to adapt and pivot while working together as a team.

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Disrupt Podcast #36: Elaine Flores of Medical Home Care Professionals

The 36th episode of our podcast, Disrupt, is now available!

Headquartered in Northern California, Medical Home Care Professionals is a small home health agency that has had to overcome big challenges over the past few years.

In 2018, Medical Home Care Professionals had to operate through the historic Carr Fire. Right after that, it had to deliver care through a record-breaking blizzard. Now, it’s battling through the COVID-19 crisis — and another devastating wildfire.

For this episode of Disrupt, HHCN caught up with Elaine Flores, the COO and administrator of Medical Home Care Professionals, to learn how her agency has survived what has sometimes felt like an endless wave of emergencies. During the conversation, Flores also touched on Medical Home Care Professionals’ transition to the Patient-Driven Groupings Model (PDGM).

Listen to this episode of Disrupt to learn about:

— Keys for running a home health agency during times of crisis
— Best practices for ensuring continuity of care
— Medical Home Care Professionals’ transition to PDGM
— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!
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Alnylam, gene-silencing and biotech in 2020: the pharmaphorum podcast

Alnylam’s Brendan Martin joined the pharmaphorum podcast for episode 23 to talk about his company’s work in gene-silencing and how it could offer a route to target the current coronavirus pandemic.

Brendan joined Alnylam in 2016 as one of the company’s first Europe-based employees and has helped to build and establish a presence in the region that now includes 11 offices.

Now acting head of Europe, Middle East and Africa, and Canada for Alnylam Pharmaceuticals, as well as general manager at Alnylam UK and Ireland, he also discusses just what it means to be a biotech in 2020 and his own approach to biotech leadership.

With the impact of COVID-19 still inescapable in so many ways around the globe, we also touched on its impact on Alnylam and how the company works.

You can listen to episode 23 of the pharmaphorum podcast in the player below, download the episode to your computer or find it – and subscribe to the rest of the series in iTunes, Spotify, acast and Stitcher.


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Disrupt Podcast #35: Dr. Clive Fields of VillageMD

The 35th episode of our podcast, Disrupt, is now available!

In 2013, co-founder and CMO Dr. Clive Fields helped launch primary care provider VillageMD as a 13-physician practice. Seven years later, VillageMD has grown to a 2,500-physician practice — one with an innovative care model partly shaped around the home.

As one of its leaders, Fields has a vision of going “back to the future” by returning to home- and community-based care. He’ll have plenty of firepower to accomplish that vision moving forward, as Walgreens Boots Alliance recently announced plans to invest $1 billion in equity and convertible debt into VillageMD over the next three years, including a $250 million equity investment completed in July.

For this episode of Disrupt, HHCN caught up with Fields to discuss everything there is to know about the future of home-based care, value-based payment models, primary care and more.

Listen to this episode of Disrupt to learn:

— How Fields and his team grew VillageMD to where it is today
— Why home-based care is so important to the future of health care
— How VillageMD leverages home health and home care providers 
— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!
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[Podcast] How Cleveland Clinic Helps Employers Create a Safer Workplace During COVID-19

Photo of James Merlino, MD

Dr. Jim Merlino, Chief Clinical Transformation Officer, Cleveland Clinic

Despite having entered the US eight months ago, COVID-19 remains a topic enshrouded in confusion, conflicting information, hyperbole, and even conspiracy theories. Everyone, informed or not, seems to have an opinion about the coronavirus pandemic.

Fortunately, health systems, hospitals, and medical providers are  uniquely qualified to fill the educational void and assert a leadership position within their communities. 

In this week’s podcast, my friend and frequent guest, Dr. Jim Merlino shares how Cleveland Clinic’s free advisory service, COVID-19: Creating a Safe Workplace, helps employers and employees, “return to work, safely and confidently during the coronavirus pandemic.” 

Listen to the podcast or read the transcript to discover:

  • Why educating the public is such a vital responsibility for providers to embrace
  • How Cleveland Clinic was able to leverage its expertise and preparation for COVID-19 into an effective educational program for employers
  • Why executive leadership is essential for larger missions like these
  • Surprising new insights about how the coronavirus spreads
  • How large and small institutions can take similar leadership positions within their communities

Finally, please help educate the public by sharing COVID-19: Creating a Safe Workplace website with employers, patients, coworkers, colleagues, friends, family, and social media. 

Other streaming services: This and other episodes of the Healthcare Success podcast are also available…
iTunes | Spotify | iHeartRadio | Google Play | Pod Bean | Tunein | Radio Public | Stitcher

Podcast Transcript

Note: The following ‘How Cleveland Clinic Helps Employers Create a Safer Workplace During COVID-19′ podcast transcript is computer generated and edited for clarity.

Stewart Gandolf, MBA:
Hi everybody, Stewart Gandolf here with another podcast featuring absolutely one of my favorite guests and personal friend, Dr. Jim Merlino. He is Chief Clinical Transformation Officer with Cleveland Clinic, now back at the Clinic after some excellent time with Press Ganey. Welcome Jim, first of all.

Dr. Jim Merlino:
Thanks Stewart. Always great to talk with you.

Stewart Gandolf, MBA:
In preparation for this meeting, we spent some time talking about, catching up how the world is very different than the last time Jim and I spoke. Last time we talked was pre COVID, pre Jim moving over to Cleveland Clinic. Things have changed quite a bit since then, obviously. And I think today we’re going to talk about a topic that I think is really, really important, which is getting the word out, leveraging the pulpit of healthcare providers. As the most trusted people in America, doctors, hospitals, health systems have a unique opportunity to educate the public. And I was talking offline with Jim prior to doing this, how during the very, very early days of the pandemic, some of our blog posts were about this topic. Back when everything was absolutely uncertain, and the world was going crazy. Our firm went virtual about a week or two ahead of everybody else, right about the same time that Stanford went virtual, before it became mandatory.

Stewart Gandolf, MBA:
I was telling Jim, we have some friends that sent us predictions on what this pandemic was going to look like. So we went virtual really mostly for public good at that stage, even though some of my employees thought I was crazy, and we spent a lot of time writing in our blogs of how you can, as a provider, be part of the solution, get the word out. Can you post on social media? Can you talk to your patients? Can you send emails? How can you be a voice? And that was before any of this stuff had widely happened within our surrounding communities. We just had a sense there’d be a need for authoritative information to supplement what’s happening in the more official channels.

Stewart Gandolf, MBA:
So anyway, Jim and I were talking about this and in true fashion with Cleveland Clinic, with the leadership role that the clinic takes in terms of public health, began an advisory service. And so that’s what we’re going to talk about today. And Jim, I’d love to hear from you, how this all began, the mission. This is your format. Let’s just talk. Tell me about the advisory service and maybe the history of it to start.

Dr. Jim Merlino:
Sure Stewart. Well, again, it’s really great to be doing a podcast with you again, and I really always enjoy our conversations and the insights that you bring to the industry through your work as well. It’s interesting. Healthcare obviously is on the front lines with the pandemic response and taking care of people who are affected by COVID. But we actually, I think, have a bigger responsibility and that is to help society reactivate and also function safely in the era of COVID because we clearly are in an environment now where COVID is with us. Whether you believe it or not, it’s here. It’s not going away until there’s a treatment or an effective vaccine. It’s just going to be a part of what we do.

Dr. Jim Merlino:
I think one of the things that we’ve learned in healthcare, and it’s not just true for Cleveland Clinic, it’s true for healthcare across the world, is that we understand how to keep people safe. And for the most part, I think healthcare has done that and you see different statistics on healthcare worker infectivity, but there are a lot of organizations across the country that have kept their workers safe. We had over 1100 caregivers infected with COVID. We’re confident, because of the contact tracing that we’ve put in place, that we can say we don’t believe any of those caregivers received COVID from taking care of a COVID positive patient, but that’s not without effort. It’s because of the safety measures that we’ve put in place, the teams of people that we’ve had together since the beginning of this pandemic that have really studied these issues and really debated about what are the best things that we need to do, or the safest things that we need to do.

Dr. Jim Merlino:
So with all of that in mind and understanding that the tsunami was coming towards us very quickly, we did a lot of preparation. We were very fortunate, in Northeast Ohio, that the tsunami didn’t hit us like it did in other parts of the country like New York or Washington. But nevertheless, we did see COVID, we did take care of a lot of patients, we’re still taking care of a lot of patients, but we learned a lot.

Dr. Jim Merlino:
And as we saw that the tsunami wasn’t going to hit us as hard as we thought it was going to, we were able to now take the information that we’d prepared for our organization and actually retune it or reformat it so that we could push it out to the public; to businesses, to churches, to educational institutions, so that others could use it. We started getting a lot of incoming early from different businesses and other organizations that needed help, and we wanted to be helpful. Cleveland Clinic has four cares, care for community, care for organization, care for caregivers and care for patients, and we very much see this as part of our responsibility to help care for the community.

Dr. Jim Merlino:
And I’ll just add one more thing, and that is that it’s interesting that if you think about managing diseases, for most diseases, we’ve had decades to study them. For COVID, everything we know about this disease has really come in the last six months or less, and we’re learning new things every day. We’re clarifying things every day. And so the most important resource that we’ve been able to provide to partners outside of healthcare is really interpreting what’s going on and translating that information to what they do every day so they can keep their employees, their customers safe. It’s been interesting work. It’s been fascinating to be a part of, it’s been an honor to be a part of it, to help others. We think it’s really meaningful and impactful.

Stewart Gandolf, MBA:
The Cleveland Clinic, as I mentioned earlier, the idea of being in your community, a thought leader, a healthcare thought leader, and Cleveland Clinic clearly does that not just in its community, but from a world scope. Is that part of the clinic’s DNA? How has that evolved, this idea of we’re trying to be something more than just the provider? We want to really be a thought leader. How did that evolve and how does that sustain?

Dr. Jim Merlino:
Cleveland Clinic has always prided itself on being an organization that’s innovative and trying to do things that benefit others, and that’s just part of our DNA. We’re actually coming up on a 100 year anniversary this year. It’s interesting the last pandemic was 100 years ago. We’re 100 years old, but it is really in our DNA, and it’s also part of the focus of our CEO, Dr. Tom Mihaljevic. He believes that we should be doing things as much as we can to really push hard and trying to figure out ways to evolve healthcare. And I think the work we’re doing with COVID response is part of that. And again, we don’t have the license on best practices. I think one of the benefits of COVID, if there’s any benefit, because there aren’t many for sure, is how people have worked together across the country. Other healthcare organizations across the world have come together to share information. And what we’ve been able to do is really just help package that so that we can help others understand what to do and be safe.

Dr. Jim Merlino:
It is interesting, one thing about the Cleveland Clinic, one of the things I think that makes the Cleveland Clinic unique, there’s a lot, I’m certainly biased, is that we have a network of hospitals and healthcare institutions across the world. And what was striking about COVID … And we were meeting every day. During the heart of the pandemic, we were meeting twice a day, and all of our sites were dialed in. It was the ability to learn from each other. So a truly integrated network where you’re getting information from Abu Dhabi, you’re getting information from London, from Florida, from Las Vegas, from Toronto, and all of that’s feeding into your decision making. And what was most fascinating is everybody was experiencing this a little differently. So for instance, our operations overseas was able to give us some early warning into some of the things that they were seeing and also how they were responding to it, and that directly impacted our responses in the States, both in Cleveland and Florida. So it was a very interesting time to be a part of such an important integrated delivery system.

Stewart Gandolf, MBA:
Jim that totally makes sense. I feel like obviously Cleveland Clinic has some amazing resources with multiple locations and a hundred year history and an incredible medical team and support teams. At the level of maybe a community hospital or a group practice or any level, but let’s maybe take a step, just one step down, a single hospital or a couple of hospitals, or just a large group, what would be important if they too feel like, “Okay, we’re not Cleveland Clinic. We can’t be, but we want to be that kind of a thought leader here in Topeka or Poughkeepsie or wherever.” What kind of recommendations, before we get into the specifics of your advisory service, but what have you learned they can use to … What would be the couple of things that you’d really want to have in place so that yes, raise your hand, be a colleague with us, help us get the word out. What kinds of things do you think would be important for that?

Dr. Jim Merlino:
I don’t think you have to be Cleveland Clinic to be helpful to your community. I think if you likely look across the nation and talk to healthcare providers in other systems, I’ve certainly talked to many of my colleagues around the country. For the most part, we’re all coordinating. We’re all driving the same things. When we think about changing a policy, for instance, around visitors, we reach out to our colleagues, my friends. I reach out to my colleagues, reach out to their friends. We really are trying to bring information together. I think that’s probably true for a lot of providers.

Dr. Jim Merlino:
But what I would say to smaller organizations, regardless of where they are and whether they’re a hospital or a practice, or a couple doc or a provider group that’s providing care, you know what to do. Likely you’ve been delivering care in COVID, and the information that you have available to you, how you think about this, the clarity that you bring to that process will be helpful to partners that are in your community, because this is complicated and it really requires a thoughtful approach to keep people safe, but an approach we know we can do.

Dr. Jim Merlino:
And I think that what I would say to anybody that’s listening that may be practicing in a smaller environment is talk to people in your community and ask them how you can be helpful, ask them how you can translate what’s going on around COVID to impact how they can keep themselves, their employees and their customers safe. They need us. They don’t just need us to take care of sick people. They need us to provide guidance. And this is such an opportunity for healthcare in the United States and across the world to really step into a role, to do much more than we’ve probably done in the past, relative to things going on in the community.

Stewart Gandolf, MBA:
You mentioned your CEO, and that’s so often the case, the idea of … Because I could see how you’re a busy hospital located in whichever town you are and you may not have the resources, but I think it’s more than just resources. It’s more of your vision of how you fit in the community because it’d be really easy and certainly forgivable. We’re just treating patients here. We don’t have time to do this high fluid and visionary stuff. We just have to take care of patients and I totally get it. But I guess it comes down to maybe the vision of the CEO and the leadership of what role, maybe a larger role than just treating patients. Does that makes sense Jim?

Dr. Jim Merlino:
Absolutely, and it also comes to getting back to the role of your hospital. If you think about the history of healthcare in the United States and how it evolved, a big part of it was community centric and most hospitals are community hospitals. And they were formed by municipalities coming together, putting money in to build a hospital to take care of people in the community. So it really is getting back to the roots. I remember one of my first roles in healthcare, I was a board member in a community hospital in the city that I grew up in, actually where I was born. And it was a hospital that was built in early sixties by seven communities coming together. One donated the land, everybody threw in some money and before you know it, you had a hospital. And today, that’s part of a big healthcare system in Cleveland. It’s doing amazing stuff, but that’s what we’re about in healthcare. So taking care of our neighbors, caring for the sick, but also providing information to the community on how to stay healthy, which is just, when you think about it, that’s noble.

Stewart Gandolf, MBA:
We’ve talked about in some of the other relevant webinars and podcasts I’ve been doing surrounding this topic. If you haven’t, first of all, it’s for the good, to get the word out, but also that’s the primary reason. We’re in this for healthcare. We’re in this to serve our community. But from a business standpoint too, it’s to take the leadership because if there’s a void in the marketplace to be a positive force, we’re not doing it for that, but that’s a good thing too. We want to be more than just that big building that people fear or may have had … Everybody has their own relationship with the community hospital. They’ve typically been part of the community for years, but to be that kind of thought leader, I think is important. And all the things we’ve talked about in the past like, and I’m going to dive into the advisory service in a moment here, but the social media, the emails, and talking to patients, the safety videos, showing them how you care, showing them how the heroes, the everyday stories, showing them how they’re going to be safe are all important.

Stewart Gandolf, MBA:
So from there, I’d love to segue to more about the advisor service. Tell me about how do you deliver it and what is it? How much does it cost, if anything? How do they deliver it? What the purpose is, all that. I’m fascinated.

Dr. Jim Merlino:
Thanks for asking. We are too in terms of how quickly it’s really grown into something. And first of all, it’s free so that makes it easy for people to consider it.

Stewart Gandolf, MBA:
You did it!

Dr. Jim Merlino:

Stewart Gandolf, MBA:
All of our listeners need to write this down, they can just write this down. Free is good. So yeah.

Dr. Jim Merlino:
Free is good. Well sometimes free is not good. You always wonder what the intent is or if there is something behind the curtain, but no, this is free. And it hasn’t costed us much because we really just take in what we do every day for our caregivers and repackaged it so it’s a little easier for people who are not in medicine to understand. So we have a website that on that website, we have multiple industry playbooks that we’ve assembled that break down in simple terms how to think about keeping people safe. So there’s one for restaurants, for instance, manufacturing, office environment. They’re on the website. They’re all free. They’re all downloadable. They’re all easy to read. They all have a basic template that talks about the basics of COVID and safety, and then that portion that deals with the specific environment. They’re not that long.

Dr. Jim Merlino:
We built a playbook around how to better communicate with people, your employees, customers during this time, how to communicate with empathy because certainly, healthcare workers aren’t the only ones that are being stressed. Everybody’s being stressed on something so we thought that would be important. We do weekly webinars with our experts. So infectious disease, epidemiology, testing, HR to provide insight, to help employers, organizations keep their employees mentally fit and exercising their minds and healthy at home. We have a long running list of frequently asked questions that are posted as new information becomes available. Again, translated into simple terms, what do you do if somebody in your office tests positive for COVID? What do you do if somebody has symptoms? What do you do if somebody has a family member? What do you do if somebody gets exposed? Again, it’s just breaking down on all the things that people worry about. And all of that’s on the website, which I’ll share with you. It’s clevelandclinic.org/covid19atwork. Once again, clevelandclinic.org/covid19atwork.

Dr. Jim Merlino:
And what’s interesting about the material and the reaction to it, as I said earlier, is that it’s been a service because people just want to know what is going on, what the information they need to be concerned about really is. Cutting through the media, the conflicting news reports, the things they read, and then translating it into what to do. And that’s been very rewarding because I think that’s the clarity that we’ve been able to bring in. And frankly Stewart, as you would suspect, in some cases we just don’t know and we say it, but everything is guided by CDC guidance, what the scientific evidence is demonstrating. And then if there’s no gold standard to go to, it’s the best clinical judgment based on a pool of experts. I’ll give you one example that’s very public, which is our relationship with United Airlines.

Dr. Jim Merlino:
So Cleveland Clinic’s had a long relationship with United and it’s been our corporate partner. And during the worst part of the pandemic, the darkest days of the pandemic when New York City was being clobbered, we sent a team of physicians and nurses to help out, and United was kind enough to fly them there and fly them back. And we got into a discussion about what they needed because they were asking, “We’re trying to figure out how to keep people safe while flying, how to keep our people safe. Would you be able to provide some input to us?” And then we said, “Absolutely. We’re here. Let’s talk about it.”

Dr. Jim Merlino:
And so, and again, sharing with permission and we started going through the material and they were very sophisticated. As you would expect, it’s a big company, the airlines. When it comes to safety, they all talk to each other. They think about this all the time. They’re very sophisticated and they had a lot of great material and we provided input based on what we saw as the science around what they were doing. They adapted some things that we suggested that they didn’t think about. They changed some things that they probably didn’t need to do. But that, I think, has probably made flying safer.

Dr. Jim Merlino:
And what’s interesting about flying right now is so certainly airline travel has significantly decreased, but planes never stopped flying and they didn’t put in the safety precautions. And yet, we don’t yet think we have a confirmed case of, there may be one we don’t know of, but we haven’t traced the case of COVID through airline transmissions. It’s probably coming as community spread increases and flying increases. But I think right now, we feel comfortable that we haven’t seen it. But the interesting thing is that, relative to United, is they were the first airline to mandate masks, and that was one piece of advice that we had given them, and they were very, very aggressive about it. They said, “Okay. If you tell us that that’s important, we will do it and we will enforce it.” And as you know now, all the airlines are doing it.

Dr. Jim Merlino:
So I think that’s a good partnership because the last thing I would say, and then I’ll shut up, is that it’s not just what the businesses or the hospitals need to be doing to keep us safe. This is a social contract. We have to be doing things to keep ourselves safe. If we go onto an airplane, we should need to wear a mask. We shouldn’t refuse to do that. We shouldn’t protest like, “We don’t have to do that.” No, you need to do that. That’s your responsibility. When you go to an environment where you’re working, like a hospital, where we know we can keep you safe. When you go home, you have to think about how to continue to keep you safe.

Dr. Jim Merlino:
I have a colleague, Dr. Steve Gordon, he’s our chair of infectious disease. He’s internationally renowned. He says, “Listen, COVID gets in healthcare, for healthcare workers, COVID gets into the back door, which is they come to work, they have all the precautions, they’re safe. They go home, they do something they shouldn’t have done. They drop their guard, they get infected.” That’s the backdoor and that’s the thing we have to close by being very mindful. We all have a role. COVID doesn’t discriminate and everybody in the world right now, everyone, and think about that. Everyone in the world is susceptible to it. So we all have a responsibility in this. We’re all in it together.

Stewart Gandolf, MBA:
It’s fascinating when I think about that and it’s interesting too, because the idea of airplanes, and I didn’t know that. I didn’t know there’s no documented cases for airlines having COVID. So there’s so much fear out there, misinformation and what I really like about the idea that you guys are doing this is beyond it’s helping me us all safer, but curating it, helping people understand what’s real, what’s not, how do you do that? Is there any secret to that? Because that’s very … Just that one little anecdote I think is really important.

Dr. Jim Merlino:
We have a big team and we talk about things, and so I’ll give you an example. During the heart of the pandemic, one of the biggest concerns … Well, during the start of the pandemic. We’re in the heart of the pandemic. There was a big concern about PPE, personal protective equipment. One of the top concerns was we’re going to run out. The tsunami is coming, we’re going to run out and what are we going to do? But yet you can’t ration it because you can’t cut corners. You can’t say to people, “You don’t need it there,” or, “Don’t use it this way.” It just wasn’t an option. So we had a team of people, of about 10 people, probably a little more, that really were meeting every day to talk about how do you manage PPE? What’s the best way to do it? How do you account for supply chain issues? How do you model out how much you have, and what’s your run rate on PPE?

Dr. Jim Merlino:
But it’s a statement of how experts come together to really tackle the smallest of problems that are really huge problems. That’s been our approach for everything, is we’ve had teams of professionals that are really experts in this space that have worked on these issues.

Dr. Jim Merlino:
Is my dog barking?

Stewart Gandolf, MBA:
That’s part of COVID. It’s perfectly OK to have dogs barking!

Dr. Jim Merlino:
Einstein my labradoodle.

Stewart Gandolf, MBA:
Oh my gosh. When we go offline, I’ll put my camera so you can see my dog. I have a labradoodle too. He’s enormous.

Dr. Jim Merlino:
Oh, I have a miniature. Oh yeah! We got to do it!

Stewart Gandolf, MBA:
Going back to the curation and United in that, again, thought leadership, I fly on a different airline. I have about three million miles. As you know, I travel a lot as you do too. And at the beginning of the pandemic, there was news reports about them being very spotty with requiring masks. So they lost me for a long time because I’m not getting on a plane if this has become a political statement with the person sitting next to me. I want to be safe and that whole idea of we’re all responsible, I think is really important. And it’s great that you guys are doing that. I think also, I want to ask about this. You mentioned restaurants and I don’t know if you guys do bars, but even offices. So this is very real to me today.

Stewart Gandolf, MBA:
So literally last night, I mentioned we went virtual earlier and I’ve just been very conservative about this. And people who know me know I’m not doing this from a fear standpoint, I’m doing it from a public health standpoint. So we shut down early, not because I was paranoid about getting COVID, but more you don’t know who you’re impacting. And I have a bunch of a team and it turned out actually we could have had a near miss with COVID had we stayed open very much longer, which I won’t go into.

Stewart Gandolf, MBA:
What kind of response have you gotten? Because I know from our standpoint, that’s going to be fantastically helpful to have an authority because again, we’re not experts at this. Yeah, I market healthcare, doesn’t mean I’m a doctor. It doesn’t mean I don’t have any expertise in COVID. I read a lot, but I don’t feel comfortable with my employees safety and their relatives’ safety by making these decisions. So by guiding, having a sense of trusted authority to go to makes me feel a whole lot better. I don’t know if you have anything to add to that, and certainly what kind of reaction have you gotten from doing this?

Dr. Jim Merlino:
A good reaction. I think one of the biggest concerns of patients is coming back to healthcare for elective procedures or not urgent procedures is will they be safe? And the answer is yes, they will be. And I think that that’s the same thing that employees want to know coming back to work or staying working. Will they be safe? And the answer is, yes, you will. However, and it’s a but, and that is you have to follow the rules. You have to be thoughtful. When your employer executes on a mask policy, you should follow the rules and wear the mask. When you have the ability to sanitize your hands, you should sanitize your hands.

Dr. Jim Merlino:
Look, the way we talk about these protections, these layers of protection, is that there’s something called the Swiss cheese model. In safety science for the military, for the airlines or healthcare, we assume that events are trying to hurt people and we enact barriers, and each barrier is like a piece of Swiss cheese. It blocks some things, but it has holes and it lets some things through. But the more pieces of Swiss cheese, the more barriers you line up, the better protective screen you can build to prevent those things from hurting people. And so when we think about precautions that employers put together; masking, social distancing, hand-washing, disinfecting commonly touched surfaces, education about how to keep yourself safe at home. None of those are perfect. Some are better than others, but collectively, they create a pretty strong barrier.

Dr. Jim Merlino:
And again, going back to healthcare experience, we know that we can keep people safe if they follow the rules and they have to be mindful about it. Again, I think the message is that if we do the right thing and we execute on what we know works, we can keep people safe and that should be the message. But again, part of that message needs to be that you have a responsibility as well. So when you leave the workplace, you want to be concerned about what you’re doing, who you’re interacting with, how you’re behaving, because you want to keep yourself safe at home as equally as much as you want to keep yourself safe at work.

Stewart Gandolf, MBA:
My wife went through a procedure right when things started to open up again and I told her, “Hey, this is a window. It’s probably going to bad again pretty quickly. Jump on now.” So she got her elective procedure done whenever that was. And so she went through it and it was amazing. They really had thought it through the whole, from the start to finish, how they greeted her in the parking lot, how they did all the way through. And then my wife said, “But the one thing is one nurse looked down and said, “This mask is just stupid. We don’t really need this.” And so that one, and fortunately, she kept her mask on, but obviously, didn’t have total buy in at an individual level. And that’s really what this requires, is a bunch of individuals doing stuff right, and even it’s … Maybe I’ll just argue, okay, you don’t believe it, but just suspend disbelief for me. Would you please? Because at the end of the day, that’s what we need.

Stewart Gandolf, MBA:
And I think the other point that you bring up is the importance of responsibility because, okay, great. This is so insightful to me, the idea of, okay, we have all this PPE. Who thought that your most dangerous experiences are not at the hospital, it’s when you go home? If you’re not being careful? Is that what you’re saying essentially, that the most dangerous part of your day, if you were treating COVID patients, is if you’re going home and being irresponsible?

Dr. Jim Merlino:
Well, I think that the biggest opening for risk is that. I wouldn’t say it’s the most dangerous. If you’re an ICU physician or a nurse taking care of COVID positive patients, that’s dangerous work. But I think if you’re following the precautions and you’re using them, you can keep yourself safe. So you have to be very mindful about that. It’s no different than any other environment where the risk of getting hurt is real if you’re not following safety precautions.

Dr. Jim Merlino:
But the need to be paying attention to safety doesn’t stop when you leave. And you don’t need to wear an N95 mask and gown at home, but you do need to be thinking about potential exposure opportunities, who you’re communicating with, making sure you’re avoiding large groups, quarantining yourself if you’re exposed to somebody. So that continuum of safety really stretches everywhere, not just where you’re working, regardless of what you do for a living.

Stewart Gandolf, MBA:
As we come into the home stretch here, I’d love to get any final comments you have, but I guess maybe starting with that would be to give you a place to start is what is the advice you would give to pastor of a church or the owner of a bar, or an office? All of us say to you with exasperation, “Dr. Merlino, I’m a pastor. I don’t know anything about this stuff.” What would you tell them? Obviously go to your side, but what’s maybe the philosophy or?

Dr. Jim Merlino:
I think the philosophy is to be cautiously optimistic. Number one, we will get through this. It’s not going to be without costs and it’s not going to be easy, but we will get through this. And I think it’s really important that as my boss, Dr. Tom Mihaljevic says, you have to keep perspective because we will get through this. The second thing I would say is to educate yourself and learn as much as you can. Pay attention to sites that are reputable. Don’t make your decisions based on what you’re hearing or what you’re reading on news outlets. Pay attention to medical sites and use that as your guidance. And stay up to date because the information changes. We’ve evolved a lot of our thinking on COVID. When the pandemic first started here in the United States, my wife and I were wiping down our groceries. You don’t need to do that.

Dr. Jim Merlino:
So pay attention to what’s changing and use common sense and be diligent about the procedures. A mask needs to cover your nose and mouth. It can’t just cover your mouth. It can’t be worn at your neck. It has to be worn the right way. You have to have precautions in place, or I’m sorry, protocols in place to think about what you do if somebody gets COVID in the workplace. Don’t wait for it to happen. Plan ahead. So those are the things that I would tell businesses. Those are the things that I tell businesses.

Stewart Gandolf, MBA:
There’s been times where I’ve been in situations here in California, which was at the beginning, was in the leadership position. Now, not so much, where nobody’s wearing a mask and it’s even me knowing what I know, there’s that social pressure to not wear a mask and I wear it anyway. And so I think that’s important to recognize there’ll be times that are probably challenging and do what the experts telling you. Not just because everybody else is not wearing it does not mean, “Well, they’re doing it.” It’s not safe.

Dr. Jim Merlino:
That’s right.

Stewart Gandolf, MBA:
Because that’s really what I think happens. They just said, “Well, nobody’s doing it. I guess it’s okay. It’s a sunny day and nobody’s sick.” And on the other hand, to not freak out and not be paralyzed because we have to go through life. And it sounds like, which is very heartening to hear the optimism in there that there are ways to get through this. And if we’re following the basics and I love, again, the Swiss cheese model, because that’s where I think … Maybe my last comment and then if you have anything else you can add up is perfection is the enemy of good. So in this case, if you’re thinking it’s just overwhelming. If I want to be 100% safe, I’d be lying in the sun, by myself with an N95 mask on, with the wind blowing at 100 miles an hour. It’s like, well, so then if you’re paralyzed and you’re afraid to do anything.

Stewart Gandolf, MBA:
But maybe the odds are, and maybe you can tell me this clinically, all right, if you’re having dinner outside, you’re six feet away or 10 feet away, it becomes like you overreact and just don’t have life and it becomes undoable. Do you have any comments on that? Because it feels like that’s where people get into trouble. They either, well, this is just too hard, they do nothing, or they end up with no health issues because they’re trying to do absolute perfection, which is maybe not as necessary. Any comment on that?

Dr. Jim Merlino:
Yeah. It’s like people who have obsessive compulsive disorder. People who suffer from that, they have to do specifically sometimes over and over again. That’s not what this is about. This is about really just understanding what are the few things that are capable of keeping you safe when they’re done together and just being vigilant about it. You can go to a restaurant that’s appropriately set up for social distancing and where people are wearing masks. You can sit at the table with your spouse and take your masks off if servers are masked. Those things are safe. I’ve done it. I’ve flown. My wife and I flew to Florida the first two weeks of July and we wore our masks. Everybody on the plane had a mask on. We went out to eat but we went out to eat in restaurants that we knew were following the precautions. And we were very, very careful about observing our environment because we weren’t going to walk into a situation that would put us at risk.

Dr. Jim Merlino:
But the point is you can do things. You don’t have to live in a bubble. You just have to be vigilant. And I would add, one of my closing comments would be the biggest thing we worry about in healthcare with any safety precaution or process is fatigue. People forgetting it, or people getting comfortable with it. We have to be mindful. We have to stay vigilant because that’s how we’ll keep ourselves safe. So we can’t relax our guard, so to speak, as we’re continuing to live with this pandemic.

Stewart Gandolf, MBA:
That totally makes sense, and for obviously the vast majority of our audience here is in health care. They live this every day and hopefully, some of those insights will help you communicate with your patients or your constituents and your employees too. We haven’t talked about this, and maybe just a second before we close here, your own employees at the hospital, they’re still people too and there probably is still some fear there. So any comments to the providers that are listening here or one final comments of how to get the word out to employees or to your patients?

Dr. Jim Merlino:
Well, to the providers, thank you, because I know that everyone in the provider space is working very hard to do the right thing, to keep themselves safe, to take care of patients, and it’s hard, so thank you. Again, I think it just comes back to emphasizing safety. We have to keep talking about it. We have to remind people about it. We have to reinforce it. That’s the message.

Stewart Gandolf, MBA:
Very good. Jim, as always, it’s been fun and fantastic talking to you, insightful. Love your thought leadership, love what you and your team are doing. Thank you.

Dr. Jim Merlino:
My pleasure. Thank you, Stewart. It’s always great to talk with you about these issues.

The post [Podcast] How Cleveland Clinic Helps Employers Create a Safer Workplace During COVID-19 appeared first on Healthcare Success.

Telehealth and COVID-19: Overcoming New Challenges for Providers and Payers

Anthem, Samsung, American Well Partner to Provide Plan Members Access to Telehealth Services

Telehealth has quickly transformed the healthcare industry. Rather than scheduling an appointment, waiting up to a few weeks, and going to a doctor’s office or another healthcare facility, we can now access many types of care from the convenience of our smartphones. 

However, telehealth has also brought in its own set of new challenges that must be overcome for it to be successful in the long term. Below, we explore five of the biggest issues telemedicine faces and offer insights on how they can be solved.  

Clearing Legislative Hurdles

The Centers for Medicare and Medicaid Services greatly lowered the bar for provisioning telehealth in the wake of COVID-19. Since then, providers have been allowed to deliver care through a larger range of platforms as long as they are not public-facing

However, this doesn’t address the widely varying state requirements for licensing and credentialing. In general, telehealth providers must be licensed in the state where patients receive care. Only nine states currently offer special telehealth licenses that allow providers to deliver telemedicine outside their state limiting their potential scope. 

Although we can expect deregulation to occur over the next few years, the timeline and the path it will take is very much up in the air. This means providers must develop platforms that are flexible enough to adapt to changing legal environments. 

Overcoming reimbursement issues 

Prior to COVID-19, reimbursement had been a key barrier to the widespread implementation of telehealth. Even now, reimbursement for conditions not related to the coronavirus can still be difficult. 

Each state has different regulations guiding the type of services and providers eligible for Medicaid reimbursement. For example, reimbursement policies often only applied to rural areas or those within certain geographic restrictions. 

Once the public health crisis has ended, many of the current flexibilities will end, putting a particular strain on smaller facilities. Overall, there must be comprehensive and holistic reform that ensures all providers get reimbursed, whether providing care in person or via telehealth. 

Addressing inequality in access to care 

One of the greatest benefits of telehealth is that it can facilitate care well beyond the walls of physical healthcare facilities. No longer limited by geography, mobility, or other factors, patients can receive care as long as they have an internet connection. 

However, many individuals around the country do not have access to high-speed internet and/or smartphones. For example, only 69.3% of rural areas and 64.6% of tribal areas have adequate access to high-speed broadband. This directly affects patients’ ability to participate in telehealth modalities, including consultation and remote monitoring. 

Likewise, many telehealth services are based on smartphone apps. Rural populations are also less likely to own smartphones compared to urban and suburban residents—71% of rural residents compared to 83%.  

While 71% may sound like a good number, we’re talking about tens of millions of people, and disproportionately elderly individuals with greater needs, who can’t use telehealth for these reasons. 

Providers must develop platforms that can support audio-only, offline, and alternative channels to compensate for these connectivity and device-access obstacles. 


Interoperability is fundamental for the long term success of telehealth services. While the large scale adoption of electronic health records (EHR) has been one of the greatest achievements of the past decade, even that has not been with its hurdles—particularly in rural settings. 

Taking this electronic health data and ensuring interoperability among disparate apps will require secure data exchange without special user effort. Second, interoperability needs complete access, modification, and use of all patient electronic health information. Finally, it must restrict information blocking or any “knowingly and unreasonably” interfering with the exchange of EHR data. 

To do all of this requires the development of core standards and practices, cross-training, and significant investment in data security for all telehealth platforms across the industry. 

Patient preferences 

Since the foundation of medicine, healthcare has relied on in-person interactions. COVID-19 taught everyone just how important remote care is, especially during times of infectious disease transmission. 

However, even with its clear advantages, some patients remain unconvinced. How do you still deliver effective and safe care to these individuals? 

As telehealth continues to expand and patients grow more familiar with it, some of this will disappear on its own. But, telehealth providers must take steps to educate patients about the specific benefits of telemedicine, explain to them how to use platforms and services, and ensure their PHI is secure. 

Of all the challenges to telehealth, this is both the most difficult, yet attainable. It’s entirely in the hands of telehealth providers how well and how quickly they’ll be able to overcome this barrier. 

Telehealth: Driving the Future of Healthcare

Now is the watershed moment for telehealth. As the world slowly returns to normal and some of the regulatory and reimbursements policy restrictions come to an end, whether the healthcare industry can maintain the gains that have been made the last few months remains to be seen. There is no guarantee that healthcare won’t return the way it was before the pandemic. 

Now’s the time for telehealth providers and those interested in joining the market to create solutions for the issues described above that will capitalize on all of telehealth’s benefits and ensure the long term viability of this effective and absolutely vital care modality. 

You can dive further into the world of telehealth in our Shine podcast. In our latest episode, four industry experts discuss the world of telehealth, the tests it’s facing, and where it’s headed in the near future. 

About Ed Adamson

Ed Adamson is a Director of Strategy & Insight at Star, a global consultancy that connects insights, strategy, design, engineering, and marketing services into a seamless workflow. Adamson has 19 years of experience of brand-led innovation for some of the world’s greatest CPG brands from companies including P&G, Kimberly-Clark, Coty, GSK, Bayer, Danone, Mondelez and McCormick Foods.

Novartis, company culture and COVID-19: the pharmaphorum podcast

Novartis’ Steven Baert joined the pharmaphorum podcast for episode 22 to discuss how COVID-19 will change the face of company culture, now and in the future.

We also looked at how Novartis’ own operations had to change in response to the coronavirus pandemic and the considerable challenges that presented him as its chief people and organisation officer.

It’s a role that sees him responsible for the physical and mental wellbeing of 130,000 employees around the world, huge numbers of which had to rapidly transition to new ways of remote working.

Steven also talked about how his company’s culture has already changed in response to COVID-19 and what he thinks the virus means for pharma’s future working practices.

You can listen to episode 22 of the pharmaphorum podcast here, download the episode to your computer or find it – and subscribe to the rest of the series in iTunes, Spotify, acast and Stitcher.

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Hospice Honors winner shares insights into using CAHPS to elevate patient care (podcast)

Listen to MatrixCare’s lastest podcast with HEALTHCAREfirst’s Navin Gupta who speaks with Cathy Conway, CEO of Hospice of Santa Cruz County. Find out how her team leverages CAHPS data to increase efficiencies and achieve the highest level of patient care. With a focus on the people they serve, hear how those changes helped them win HEALTHCAREfirst’s Hospice Honors.

Disrupt Podcast #34: Ken Albert, CEO and President of Androscoggin

The 34th episode of our podcast, Disrupt, is now available! 

Founded in 1966, Androscoggin Home Healthcare + Hospice is the largest independent, nonprofit provider of home health and hospice services in the state of Maine. On top of those core services, Androscoggin also offers palliative care, transitional care, virtual care and more.

At the helm of Androscoggin is CEO and President Ken Albert. Since the coronavirus began, Albert has helped his company overcome an array of challenges, including difficulties securing PPE and caring for patients in long-term care facilities.

For this episode of Disrupt, HHCN caught up with Albert to discuss those and other challenges, in addition to the future of telehealth and the home health industry at large. During the conversation, Albert also touched on the importance of supporting home health staff and helping team members cope through an incredibly difficult time.

Listen to this episode of Disrupt to learn:

— How Androscoggin navigated through the early days of the coronavirus while also recovering from an EMR-related crisis
— What providers can do to support their clinicians and caregivers during an emergency
— Why Albert believes “the telehealth toothpaste isn’t going back into the tube”
— And more!

Subscribe to Disrupt to be notified when new episodes are released. Listen today!
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The post Disrupt Podcast #34: Ken Albert, CEO and President of Androscoggin appeared first on Home Health Care News.

Androscoggin CEO Ken Albert: COVID-19 Has Caused a Complete Shift in Our Operational Paradigm

Founded in 1966, Androscoggin Home Healthcare+Hospice is the largest, nonprofit provider of home health and hospice services in the state of Maine.

In recent years, Androscoggin has also expanded into palliative care, transitional care and more, according to CEO and President Ken Albert. The provider has long been bullish on telehealth, too, signing its first contract for remote patient monitoring two decades ago.

Despite its ability to stay ahead of the home health curve, the coronavirus has caused Androscoggin to completely shift its operational paradigm, Albert told Home Health Care News in late May while recording an episode of Disrupt. 

Highlights from HHCN’s conversation with Albert are below, edited for length and clarity. Subscribe to Disrupt via Apple Podcasts, Google Play Music, SoundCloud or your favorite podcast app.

We’re going to jump into how your organization has adapted during the COVID-19 emergency shortly. Before we do, I wanted to talk about your background. You had a bunch of interesting roles before Androscoggin, correct?

I did. I worked on the regulatory side for several years ago. At one point, I assumed the responsibility of being the chief operating officer for the Maine Center for Disease Control and Prevention.

And on top of that, you had 17 years of clinical practice experience in emergency and intensive care settings. Has your diverse background been beneficial in running Androscoggin?

I think the nature of home health and hospice today certainly is becoming more and more regulated. And I think having the regulatory background as well as the clinical background leads to being a better leader.

I also had the privilege of practicing law for several years in Maine. I had some home health and hospice clients, too. So, again, that lends itself to a different perspective on our operations. When you can come in with more angles of “subject matter expertise,” I think it just makes you overall a better leader and provider within the communities you’re serving.

For our listeners who aren’t familiar with your organization, can you share a little bit of basic info? You came to the organization in 2016, right?

Correct. And the organization had been a client of mine before that, so my interface with the organization was both as counsel and, prior to that, as a clinician in the community. I had referred and engaged with many of Androscoggin’s employees. I always knew that if I had an opportunity to jump in at a leadership level, I would do so.

Androscoggin was founded in 1966. We’re the largest independent nonprofit provider in Maine. We’re the only home care and hospice provider that is not affiliated with a health system, though we do serve about six different hospitals throughout our geographic area while collaborating with other health systems as well.

You provide home health care and hospice services. What else?

We view ourselves as a health care company, not necessarily a home health care and hospice company. The location in which we provide care is in the home, but we really have diversified our clinical portfolio.

In addition to our headquarters in Lewiston, Maine, we have five regional offices throughout the state and a 14-bed hospice general in-patient (GIP) facility. We also provide an extensive array of palliative care services. Our medical staff has grown from one to about 11 over the past three years, working in hospitals and in the community. We have palliative care navigators to assist specialists and primary care providers with palliative care needs for their patients. We have a rapidly expanding telehealth program.

We’ve actually been doing telehealth for two decades. Looking back, our initial telehealth contract with a vendor was 20 years ago. We’re skilled at remote patient monitoring and have been viewed as a collaborator with referral sources in that regard for many years.

We also have a large transitional care division that works with third-party payers, including Humana Inc. (NYSE: HUM), Anthem Inc. (NYSE: ANTM) and others. Within the transitional care division, we have a large program called our “Community Care Team,” which is largely a Medicaid program where we case-manage the highest 5% of Medicaid utilizers for about 50 physician practices throughout the state.

Overall, how many people does Androscoggin care for on a daily basis?

On a daily basis, we’re navigating the health care needs of over 2,000 patients.

Shifting to current events and the coronavirus: How is Androscoggin doing as we’re talking here on May 28?

In November, we went into emergency command because we lost access to both front-office and back-office EMRs for three-and-a-half weeks. Our entire staff converted to paper. We had roving medical records departments. We never skipped a beat, never denied an admission as a result of that. We were kind of recovering from that when COVID-19 hit in March.

We were already at a heightened pace, if you will, for several months leading into the coronavirus. So, we just continued that work. It’s been a long journey. I think it’s given us a unique perspective about the stress of “change,” especially during an emergency. But we’re doing well. And I think that’s a real testament to our team. We do our work with almost 500 employees and about 220 volunteers.

Can you walk me through what the past couple of months have looked like?

As an overarching sentiment here, I would say that it was a complete shift in our operational paradigm. I’ve heard the same thing from other providers across the country.

We’ve had to refocus everything from our patient service center, which is our intake area, all the way through to claims submission. All aspects of our operations have changed. This has meant redefining policies, procedures and workflows. It has meant educating personnel at all levels of our organization.

What have been some of the biggest challenges? We hear about PPE a lot. We hear about declined visits and a lack of testing a lot.

Initially, PPE was a major issue. In addition to my role at Androscoggin, I also sit in the elected hospice seat for the National Association for Home Care & Hospice (NAHC). I realized in talking with my counterparts that we were not alone when it comes to PPE challenges.

It’s been tough. I’ll give you an example of why: When FEMA provides guidance to states around PPE, they have different categories, or tiers — normally ranging 1 through 4, though some states have adopted a 1-through-3 system. Different states do different things based on what their needs are. But unfortunately, home health care and hospice was never articulated categorically within those tiers at the national level, which leads to confusion.

In Maine, we have county emergency management agencies that report up to the State Emergency Management Agency, which collaborates with the Maine Center for Disease Control and Prevention. Nowhere was it articulated that home health care and hospice should be receiving PPE.

PPE was one big area that we had to address early on. I was really concerned for my staff and our ability to take patients. I was not going to assume responsibility for the care of patients if I could not put my staff out there in a safe way.

You mentioned, too, declined visits. I hear from other organizations across the country that have seen upwards of 20% to 30% of their business declined. We have not experienced those same dips. As a matter of fact, our home health census has stayed pretty flat. We have definitely seen a decline in hospice.

But the biggest challenge is related to delivering care within facilities, where many of our patients reside. For example, 50% of our hospice patients reside in either assisted living or long-term care facilities.

Right, wrong or indifferent, the facilities essentially locked their door and prevented access to care. That meant we had to have constant communication with facility administrators.

We worked very hard to have them understand the value that we could bring, the steps that we were taking to implement infection control standards. We screen our employees so we can have access to patients who are in the facilities and are on the federal hospice benefit.

I made it very clear that we were not going to discharge patients from our services — and that our documentation would reflect that we were denied access. That’s not a good or a fun conversation to have with facilities we have to work with on an ongoing basis.

What have been some silver linings that you’ve seen amid all of this disruption? What success stories can you share?

Nationally, the collaboration we’re seeing is great. Even locally, the amount of communication that is occurring between our organization and the hospitals that we serve has been great. We’ve sat at their emergency response tables. They sit at ours. It’s been just a lot of effort to ensure the health care needs of our citizens are being met.

You recently were on a webinar and talked about investing in your front-line workforce. What steps has Androscoggin taken to support staff and employees during this time?

We don’t have time to go into all of them, so I’ll highlight just a few. The resilience of our workforce is paramount, and resilience is derived from knowing that you’re cared for, knowing that you have a purpose and a mission.

No. 1, we have to keep staff safe and protected. That’s really been a focus. We know our staff members care about their own health and safety, but also their families’ health and safety. And I’ve heard over and over from staff saying they do not want to be responsible for transmitting COVID-19 to one of their patients or family members.

In addition to keeping staff safe, there are all the financial elements in a public health emergency that we had to address.

And then I really believe that an effective response to an emergency situation starts first and foremost with communication.

So those are the three areas we focused on: effective communication, physical and emotional well-being of our personnel, and then the financial well-being of our staff.

When we talk about those communication components, what are some examples of that?

Communication in an emergency situation really does require that people not over-communicate.

In talking with peers, I heard some people were putting out emails several times a day. That’s just over the top. That information becomes noise at some point. 

We decided to do a daily, branded update that’s color-coded. For example, we have a green banner for some of our employees. We have a maroon banner for others. External stakeholder communications we did with a gold banner.

In terms of that financial investment, is that providing something like hazard pay? Can you provide a little bit of detail around that point?

If you’ll recall, when the Emergency Paid Sick Leave Act and Emergency Family and Medical Leave Expansion Act came out, there were questions for providers about whether or not they would opt into those programs. From my perspective, there was concern around the federal unemployment benefit as well. Some of our clinicians can make more on federal unemployment than they can working for us part-time or otherwise. We had to be really thoughtful about what benefits we wanted to put out there for our employees. We decided that we’re just going to make it all available.

We also applied for and received monies from the Paycheck Protection Program (PPP) right away — like the day that it became effective. We had our application submitted and received that immediately. We also have a program where, once a year, you can cash in earned time or paid time off. Then also, from the CARES Act, we were able to provide bonus pay for our staff. All of our staff received bonus pay, but our clinicians received an enhanced bonus pay based on the risk that they were incurring in working in the COVID environment. Again, those are just some of the steps we’ve taken.

There’s a lot that’s happened on the federal level to support home health providers. What actions have you found especially helpful? And is there anything else that you think still needs to be done to further support home health agencies?

What I found particularly helpful was in the hospice arena — being able to use telehealth for face-to-face. That was really helpful.

Lifting the 2% sequestration helped a lot of providers with enhanced cash flow, so that was really important, too.

But even more needs to be done in that regard. Revenues are down nationally for some providers, on average, by 20% to 25%. On the advocacy front, we’ve asked for a 15% increase in Medicare rates during the public health emergency.

What is Androscoggin planning in the year ahead?

We’re in the process of implementing a new EHR. We’re launching on June 1. I see a great opportunity for expanding the use of digital technologies. I don’t think that the telehealth toothpaste is going back into the tube. CMS has really been encouraging telehealth use by home health and hospice providers. They haven’t necessarily followed through to have that count for visits — and they’re not necessarily reimbursing appropriately for it. But that’s another story.

I also see an expansion of palliative care really playing out here as you look at serious illness and advancing illness in this country. I’ve definitely seen an expansion of that over the past two or three months.

The post Androscoggin CEO Ken Albert: COVID-19 Has Caused a Complete Shift in Our Operational Paradigm appeared first on Home Health Care News.

[Podcast] How to Adjust Your Creative Strategies In Response to the COVID-19 Pandemic?

Dana Callow, Creative Director

Dana Callow, Executive Creative Director, Healthcare Success

COVID-19 has been a life-changing event for us all. It’s the kind of event that has lasting effects on people that we can’t even truly see just yet. We’ve thrust an entire population into a cycle of grief that is ubiquitous but unique to every person. How will the healthcare consumer, patient, and caregivers‘ needs, wants, and actions change now and in the future?

Meanwhile, has your creative strategy, creative communications, and creative messaging kept up? Which changes should you make now?

In preparing for a recent webinar, I asked our Executive Creative Director, Dana Callow, to share some of her ideas about COVID-era creative messaging. Dana has created award-winning healthcare marketing campaigns for over 20 years and brings valuable personal and professional insights to today’s marketing challenges. I liked Dana’s ideas so much I interviewed her for this follow-up Podcast.

In case you don’t have time to listen to the recording, here is a synopsis of the most critical points we discussed. There is also a complete transcript of our discussion just below this synopsis:

Coronavirus and the stages of grief

The Elisabeth Kübler-Ross grief model helps explain how people deal with death and grief. It provides a useful context to understand the many ways people cope with extraordinarily difficult circumstances, such as their own impending death, the demise of a loved one, a financial crisis, or, as Dana suggests, the COVID-19 pandemic.

  • Shock and Denial: We still have many people in this grief-phase, and some may never leave it. In the early days, the spring breakers were a perfect example of this behavior. Now that the country is reopening, others are resuming their lives with little to no thought about protecting themselves or others from the coronavirus.
  • Anger: Yes, some people have moved on, but others are still right there. Many people vehemently protest masks, guidelines, and restrictions. Worse, misinformation and conspiracy theories are now polarizing the nation, thereby threatening public safety as well.
  • Depression and Detachment: Many are still here, and won’t be able to move on until some sense of normalcy is restored. These are the folks who’ve gotten more quiet and introspective over time. You’ve seen this in your family, your coworkers, even that used to be a super happy cashier at the grocery store.
  • Dialogue & Bargaining: The vast majority of people are here and will stay here for quite some time. The good thing is they’re talking, reaching out, learning, responding. We need to support them and help them make their way to acceptance.
  • Acceptance: People are tip-toeing into this phase. These will be the resilient leaders who pave the way for others. Eventually, they will move on to “return to a meaningful life.”

Rethink your archetypes

Rethinking your healthcare archetypes is critical right now. Before you do anything, think about how your patient population might have evolved for better or for worse in their thinking, or even jumped from one archetype to another. While everyone around you will feel the need to move fast, it’s worth your time to reevaluate your audience before you push out messaging that might not resonate anymore.

Enter the new “COVID Resolutionists

Many people are looking to respond to COVID-19 by taking this opportunity to make positive changes in their lives. Dana predicts that healthcare will be the highest priority on most people’s lists.

What will the “COVID Resolutionists” need from the healthcare system and their healthcare providers that is new and different as the battle marches on? How do we promote, embrace, and facilitate all of those who are now more motivated to act on their health and wellness positively? How do we think about and protect those that might be internalizing toxic levels of stress?

  1. The people who were already obsessed with health and wellness are going to be even more obsessed. Wanting to “get ahead of the health game, they will move forward with or without our help.
  2. There is also going to be a large group of people who took their health for granted (did some things right, some things not so right) who will be seriously stepping up their game. They’ll want to make sure they know whether or not they have any underlying conditions. Expect to see a rise in everything from colonoscopies to mammograms, skin cancer checks, etc. Expect lots of new questions from avid Googlers about diets, exercise plans, vitamins and supplements, proactive screenings, etc.
  3. The deniers with comorbidities will also have changed, at least a portion of them. Whether motivated by fear or the urging of their families, they’re going to try and step up to the plate. They’re going to be terrible at it, as they weren’t successful before. They’ll need encouragement as they begin to reach out. They’ll also need real strategies and tactics to help them get going, and even more strategies and tactics to promote adherence. The rest of this group will likely take the “head in the sand” approach and keep on as they have. However, many of them may be internalizing real fears that will only exacerbate their existing conditions.
  4. The worriers – have never been more worried. Not only will they obsess about every symptom, but they will see the world more differently than others. It will be far more contextual for them. They’ll need your reassurance. They, too, will be prone to toxic levels of stress that could negatively impact their mental and physical health. You’ll need to listen to these folks very carefully and be ready to help them address mental health issues/needs.

Begin your new creative approach now

What does all of this mean? It means you can’t just look at anyone on the surface and take their actions or behavior at face value. There is a huge danger right now that we misjudge consumer behavior as having moved beyond grief, when in fact, they haven’t even started.

And what happens with any resurgence? It’s a measure twice, cut once across your segments. Constant monitoring to facilitate evolutions in your reopening messaging is going to be critical.

Finally, if you’d like to explore how Dana, I, and the rest of our team could help you with your COVID-19 related marketing challenges, please let us know.


Note: The following transcript is computer generated and may not be 100% accurate.

Stewart Gandolf:
Hi again everybody. This is Stewart Gandolf. Welcome to another podcast. Today I have the pleasure of interviewing our Executive Creative Director, Dana Callow. Dana has extensive experience, many years of experience writing and creating campaigns for healthcare. As we’ve been working together with some of our client projects, a lot of concepts come out, a lot of cool creative ideas come out constantly. Both of us are pretty philosophical about the current COVID pandemic. Dana has lots of great insights about how the creative strategy should change given that we’re in this pandemic. First of all, welcome, Dana.

Dana Callow:
Thank you. Happy to be here.

Stewart Gandolf:
Yes. Glad to have you. Dana, before we get started, I could brag about you all day, but I’d like to have you brag about yourself a little, just if you could give us, our listeners a sense of your background and how that relates to today’s topic at least. Not the whole thing, obviously, but just where these insights are coming from.

Dana Callow:
Sure. As you well know, I’m an agency veteran. I’ve been in the agency world marketing across a plethora of categories for 20 years. We’ll just leave it at 20, but I have spent a healthy portion of that time in the healthcare space in some way, shape, or form. Whether it was working for health plans like Humana, Blue Cross Blue Shield/BCBS, or working for major hospital systems and little hospital systems. Everywhere from rural Missouri to cities like Chicago and Detroit. Then a considerable amount of time working on pharmaceutical products. For the most part, products — drugs that are treating very rare diseases. Folks that are suffering from things that are lifelong afflictions, debilitating, definitely the kind that you’re talking about mortality sooner versus later.

Stewart Gandolf:
Very good. We were talking offline a little bit and I remembered as Kübler-Ross, you’ve heard of it more as the cycle of grief, but the concept is, and this was innovated by Kübler-Ross. There are various interpretations of that and controversy or whatever, but I still remember maybe it was in health class, but somewhere along the way in high school, this whole idea of people going through a cycle of grief that’s pretty predictable. Clearly, it’s a model, right? Not everybody goes through every stage. Some people go straight from the beginning to the end. It’s just a useful context as a place to start. As we’ve talked about the COVID pandemic, there certainly is a lot of grief and grief shows up in various fashion. Dana, since you’re such an expert and have used this model for your rare disease drugs so often, how about if you just give us a quick overview? Then we can drill down into each of these cycles and what you see is happening today.

Dana Callow:
Sure. I started using this model years ago. I think the other benefit I have that, I see it as a benefit, a lot of times people go, oh gosh, I’m so sorry. I also happen to be the caregiver of a child with special needs who is now 22. In that journey, I learned very clearly what the difference is between the common cycle of grief that we might go through for a broken dish or a fender bender versus a major health issue that impacts either you or a loved one or your entire family. I’ve always applied the model to these very serious circumstances and it is phased. It’s shock and denial followed by anger, depression and detachment, dialogue and bargaining, acceptance, and then returning to a meaningful life. When we talk about that in the rare disease space, the point that I’m typically making is the nuances as it applies to a very serious health condition.

Dana Callow:
Then the fact that it’s typically cyclical. When you’re dealing with something longterm, there are new developments in that disease, there are new developments that affect you physically, mentally, financially. There’s the impact on perhaps a family unit, et cetera. You’re constantly restarting the process or maybe overlapping processes on top of each other. I’ve talked in the past about for me and for lots of parents who are dealing with children that might have a serious condition, you go through it every so often. Usually attached to developmental milestones that you realize they may never make, or they might struggle quite a bit to make. What’s interesting about that as it relates to what we’re doing now, I thought about this the minute it started is that we literally thrust everyone on the planet into a massive cycle of grief, an intense one that wasn’t going to be easy for anyone to navigate. That was the first thought.

Dana Callow:
Then secondly, now we’re all navigating it differently based on who we are as people, our own internal resiliency, our ability to cope, our thoughts and beliefs, all of those things are coming into play. What we might see is behavior on the outside from people really might not reflect where they’re in that cycle. It’s just a really complex but fascinating and important issue as we move forward.

Stewart Gandolf:
Totally makes sense. Now, in our recent webinar, I’ve talked about the research. I do that a lot in our webinars. If you’re one of our longtime blog readers you’ll know from the recent webinars we’ve talked about it, and the research is very interesting. When you see photos of people in the Ozarks shoulder to shoulder, having a great big old party, there’s a tendency to assume everybody is like that, right? It’s just the research shows that’s clearly not the case. Some people for sure believe that there’s, “What pandemic? There is no such thing. It’s all a mass media ploy.” To other people who are in very severe consequences, I’ve just read an article from a lady talking about how much it pains her when they talk about, “Oh, don’t worry. It’s just the people that have immunocompromised or old.” She said, “You know, I’m in that target audience. I’m a little offended and I’m very, very scared.”

Stewart Gandolf:
People are all over the place in terms of how they’re responding to the various stages. I’d like you Dana to take a few minutes and maybe a couple of minutes per each to drill down on shock or denial, what that means and how you see that playing out. Anger and the various phases, just to put meat on the bones, because I think really what the key here is, is as you’re writing and creating and you can obviously expand on this more, you’re the creative director, but what do these things mean maybe? Then we’ll come back and talk about, okay, how do you adapt your creative strategy to that?

Dana Callow:
Sure. When you look at shock and denial, it’s so funny, I was right there when they were showing the spring breakers and everyone was so offended and just so upset with them. They were in shock and denial. We might see it as that’s bad behavior and that’s a lack of empathy or care or concern or maturity. But really for many of them, and I’m not saying all of them because there are always the I before E, except after C, but many of the people, even the folks out there protesting I will not wear a mask and attaching it to whatever reason that they are, many of those folks are still in shock and denial. Well, shock and denial and anger. They haven’t even truly begun to process what might be our new normal, the impact it might have on them.

Dana Callow:
They’d rather just be mad and live in that place of this isn’t happening. I think that that’s important as you start to talk to people or as a physician or any kind of provider is really looking beyond what might be that outward reaction to understand where they are because that’s going to affect the type of education and support that you provide to them. That might even affect how you’re looking at them from a treatment perspective. Thinking about what’s underneath that shock and denial and anger is going to be important. After that, we move into depression and attachment. Looking around the world, looking around my sphere of people, looking at the folks in my family, the people I spend most of my time with. I think a lot of us are still here and could be here for a considerable amount of time based on the fact that we really have no answers to where this is going.

Dana Callow:
Many of us are there and we won’t be able to move on until we figure out what normal is, whatever it might look like. You’ve probably seen it. You’ve seen people get quiet. You’ve noticed people, maybe they’re not talking about it as much or asking as many questions because they’re processing. They’re processing and they’re trying to figure out new routines. They’re trying to figure out how to adapt to this changing world. One thing you can bet is there is a level of stress there that whether you can see it or not is something I think we’ll have to consider as people start to go back to their regular healthcare routines and to their providers and start to address issues that they might be having.

Dana Callow:
You might even have noticed it in that super happy cashier at the grocery store is not the same person that they used to be. That someone who’s probably living in the depression and detachment piece of this. Then dialogue and bargaining. I mean, a lot of us are moving into this space. We’ve got one foot in depression and detachment and one foot in dialogue and bargaining because our will to live, our will to move on, our will to find a new normal will drive us there even though we’re still a little scared, a little stressed out, a little concerned. We don’t know what we don’t know yet. A lot of us are starting to move into that place where, okay, I want to talk about it. I’m going to start reaching back out to my healthcare providers, to my mentors, to my confidant, to people that maybe I’ve talked to a little bit but I have been detached from and I want to start to bounce ideas and things off of them.

Dana Callow:
I think to be ready for those folks who are going to come in. They’re going to have a lot of questions. As a healthcare provider, no one healthcare provider is going to be able to answer all of those questions. When we look at how most physicians out there, they have a set of resources that they offer to people beyond what they do in the day-to-day. Checking back into what those resources are, thinking about the places and spaces you can guide people, I think that’s going to be really important. Feeding their desire to move into that next phase, that’s going to be critical. The flip side of that, that’s going to reduce their stress and then reduce potential complications for any conditions that they have now or may develop in the future.

Dana Callow:
Then acceptance, I think maybe there’s a few, just highly evolved humans out there who are stepping into this. I think it’s fewer than we might expect. Even if you hear people who sound like they’ve accepted it, who are voicing a lot of like, this is what I’m going to do and this is how I’m going to handle it. This is where it’s going. I think there’s not a lot of those folks yet, but I am very encouraged to see them stepping into that phase because I think that’s where the leaders are going to come from. They’re going to pave the way for others. As much as this has all been this very overwhelming place that we’re living in, I think out of it is going to come so much innovation and so much progress because there’s nothing like putting a wall in front of a motivated person. They will figure out how to get around it, over it, or through it.

Dana Callow:
I think those folks are few and far between. I do think no matter who you are, if you come in contact with someone like that, we need to embrace that. They’re probably not going to be a huge problem for healthcare providers other than they will have read so many things and come to you with so many questions that are deep and have a lot of dimension to them. Being ready to have those conversations is what’s just going to keep them in that healthy place of moving forward. Then returning to a meaningful life. I mean, I couch this as stay tuned for the next available operator. I don’t know that I believe anyone is there yet, but I’d like to meet them. I think that’s what we’re all going to be trying to do for each other and all of the folks who play in any one person’s health and wellness ecosystem is going to be a very important part of that.

Stewart Gandolf:
Very good. It’s interesting because the idea of dialogue and bargaining because I always heard the model as bargaining but dialogue and bargaining is intriguing because… I think this model is useful because we go through different phases. The same person can go through different phases, right? They may generally be in dialogue and bargaining, but once in awhile get into depression, anger, and back and forth. I think the idea of being able to talk it out with friends. We recently met a friend in Palm Springs. We have a vacation rental there. We did our first social distancing friend visit. It was amazing to have that chance to just talk things through. We haven’t done that really, and it’s not the same when you’re doing it on through Zoom.

Stewart Gandolf:
I think that it’s really intriguing to know that these are out there. People are in general categories probably. At any given moment, they may be staying in one and probably we’ll go through this predictable sequence rather. Let me ask you. The key question here is here from a marketing standpoint because neither of us of course therapists, but how does this impact our creative strategy? That’s the meat of this. What can we do as marketing people and recognizing that we have a broad audience of people in our podcasts including super sophisticated marketers primarily at pharma or hospitals or wherever. We also have private practice doctors and everywhere all over the place. Just in general, if you were to give some advice on what your creative strategy should look like today. Well, today and then even as things start to continue to evolve, what would those kinds of things be?

Dana Callow:
The way that it’s strategy first, right? We have had for many, many years some pretty accepted patient archetypes. People behave in a particular way when it comes to their healthcare. While those may have become more robust over time, I think now is the time for everyone to stop. Whether it’s with your internal marketing team, in conjunction with your agency, just you yourself and your thoughts. It’s time to sit down and think about seriously, think about your patient population. The segments in it and how they might have changed because that’s what’s going to impact how you might change your overarching strategy or simply your messaging. Because we have people who have taken quarantine so seriously and then you have the people who I lovingly say hashtag what virus. Everything in between as far as how they’re thinking about it, but then you also have how they behave as patients.

Dana Callow:
That’s where I coined the little term COVID resolutionist because it’s like when you make a New Year’s resolution. So many of us do that, whether we’re super demonstrative about it or not is debatable. Some of us just have a list in our heads. Some of us just have one. Some of us have a dozen. There seems to be this thing every year where we see the New Year as a time to change or to attempt change. I think that COVID is going to do that for a lot of people when it comes to their healthcare. That’s where I think the idea of the cycle of grief next to how it will have actually changed people is how strategy must change. When you look at those, and I’ll keep it really simple, when you look at those patient populations, you’ve got your people who are on top of their health and wellness, your type-A personalities. Diet, exercise, staying on top of as they age, doing all the right things to make sure they know what their underlying conditions might be.

Dana Callow:
They are ahead of the cancer game. They are ahead of their eye health. They are on top of those things. They’re just going to get more on top of those things and that’s okay. That’s okay. Then there’s this giant group of people. I definitely fall into probably one end of this one, but there’s this giant group of people. We do a lot of things, right? We don’t do all the things right. We try things with our diet and our exercise. We fall off the wagon. We know we need to get that colonoscopy but we put it off until like, okay. My mother gave me a hard time about it. My spouse is staring at me like it’s time. You have a family history, whatever, go get it done. I think you’re going to see a lot of those people who are pretty good about their health, really stepping up to the plate and wanting to check the boxes and do all the things. Making that easy for them, making that comfortable for them, encouraging them to pursue those things.

Dana Callow:
I think that it’s a great time to message around that for that group. Like, let’s embrace the idea that I’m going to make a resolution to not let something like this scare me as much as it has ever again. Get ready for that flood of folks who want to, they want to figure it out. They want to dot their i’s and cross their t’s. Then you’re still going to have that giant group of folks, they are the deniers and we all suffer from it. That’s why I say I’m on the edge of the previous group because I’m the worst when it comes to… I take care of everybody else before I take care of myself, but that’s a different kind of denial. Then when you look at people who know, they know that they have diagnosed conditions, they know there are life changes they should make, they should have made a long time ago. They have been recently connected to their mortality on a whole new level.

Dana Callow:
The interesting thing about this group I think is that we’re going to have to approach them as if they fall into two categories. You’re going to have the deniers who, yes, I have severe diabetes but I have not addressed my diet and exercise and I never planned to. But this connection I now have to my mortality, the connection that my family has been literally in my face about every day before COVID and now even more since COVID happened, all right, I’m going to give it a go. I’m going to give it a shot. That’s good news, but they’re going to be terrible at it because they always have been. They’re going to need a lot of support. A, messaging that assumes that there are some people in that camp. Targeting those folks with, if you weren’t ready before, we hope you’re ready now. Let’s talk about whatever it is that we need to. Let’s do it. Getting them to go ahead and act on that notion, and then they’re going to need a ton of support.

Dana Callow:
They’re going to need a ton of atta-boys and atta-girls and all kinds of strategies and tactics to help them stay on the bus. Then you’re still going to have a group of those deniers who head in the sand. I won’t go. I’m not, I’m just going to know that it’s not going to come for me. That group is going to be really tough to reach as they always have been, but this might be the time for a proactive conversation. Healthcare providers could be a tipping point. They are feeling it, their family. You could be that exclamation point on the sentence to help them go ahead and give it a shot. Then the group, I think, well, and one more thing on those folks. If they do just put their head in the sand, that doesn’t mean that they’re not experiencing a lot of stress around it. That stress can be toxic and actually exacerbate their situation, whatever it might be. That might be something to message around as well.

Dana Callow:
Then the worriers, they’ve never been more worried than they are now, and that will continue. Again, I think very solid pragmatic information and facts that help them address their fears and concerns that make them feel comfortable and confident about seeing their healthcare provider, about pursuing whatever health issues they might have. They’re going to need confidence instilled in them. I think that’s an important messaging strategy with those folks. Again, these are also folks who are going to possibly suffer from just a great amount of stress. Recognizing that and being able to have the conversation around that to make sure that that doesn’t either aggravate an underlying condition they might not even know they have or exacerbate one that they do, that’s going to be important. I think the gist is sometimes we try to be very focused in our messaging, one size fits all. I don’t think that that’s where we’re going. I think targeted messaging that gets to these audiences where they are in this journey is going to be paramount.

Stewart Gandolf:
Then the last question I have is pretty universal today. In fact, you and I have a conference call in what, 23 minutes, about this with a client. The point is that a lot of providers on the provider side are reopening in stages. Some are wide open for business, others are not. Then there’s a whole fear of what happens as the other shoe drops, are we in the beginning? Are we just in the continuation of the first phase, which a lot of people argue? Is there a second wave? All those kinds of things. That makes it very flux right now. The idea of reopening, in this very uncertain environment where just like I described everything is changing, looking at a different model with Maslow’s hierarchy of needs, safety is way down there at the bottom. Basically, self-survival and safety are at the core of this. Nobody’s going anywhere if they don’t feel safe. What are some of the communication strategies that providers might be thinking about now with all this that we just discussed in mind? But really, about safety and reopening, and do you have any tips on that for our audience?

Dana Callow:
I think clearly communicating all that you are doing to provide a safe environment is important, but I think combining that message with general health messages, you’re right. We don’t know if we’re still in phase one. We don’t know when phase two might happen. We don’t know any of those things. To some degree, all of this is quite a grand experiment and a tough one. I think just the utility of communicating, this is what we’re doing to keep you safe and healthy. I’ve seen a lot of good work done out there down to the…this is the brand of disinfectant that we’re using. This is what we’re doing. Coupling that with health and wellness messages that cater to your audience, whether you’re a specialist or a GP or a big hospital system with lots of offerings, or a pharmaceutical product, whoever you are. Combining that functional message with that comment, come and see us. We’re here for you, here to help you. Don’t wait to tackle whatever might be happening in your life with regard to your health and don’t let your primary care go. I think it’s a marriage of messages with where one doesn’t necessarily take precedence.

Stewart Gandolf:
That is a really important thought because we’ve talked about this on a number of webinars recently with research and so forth, but this is an opportunity for thought leadership in your community. Some people are doing this better than others, and obviously some health systems are well-funded than other private practice. They may not be, or some pharmas have that as part of their mission. Again, we have a very broad audience listening to our podcast, but thought leadership is such an important part of this. Everywhere I look, I read today in Fierce Healthcare an article about how for a while there or actually it was a different publication where for a while their hospitals are just thought of as these entities, faceless entities. The public was losing touch with them and they didn’t really understand any kind of, despite the hospital’s point of view, that community commitment.

Stewart Gandolf:
Nowadays, there’s a resurgence where certainly depending on where they’re located, hospital systems and healthcare providers are seeing a resurgence. I think this is a time to continue to consider thought leadership and figure out how you can be not the educator, both sides of the brain, right? Dana, the right and left brain side.

Dana Callow:

Stewart Gandolf:
Certainly, the educator, the thought leader, but also the compassionate people, the people that are really invested in the community. As we wrap up here, I don’t know if you have any additional thoughts on any of this stuff, Dana, because I think all these communication strategies are important. Our audience may be looking for new insights on where do we even begin.

Dana Callow:
Yeah. I think you’re exactly right. I think one of my favorite phrases is, measure twice cut once. I think circling the wagons internally no matter who you are and having a very thoughtful and thorough conversation about your patient population, your geography, the mindsets of people and how your patient archetypes might have changed. Then a balanced message that plays off of both right and left brain is spot on, not easy but spot on.

Stewart Gandolf:
Well, I think it’s a terrific opportunity, a COVID resolution. It’s a terrific opportunity. Then you alluded to this a little bit ago, rethinking your personas but also rethinking your marketing and creative strategy and your messaging. We’ve been, from the very beginning it is something I’ve been writing about is to look at your marketing from a new. I think that okay, for a lot of people on the hospital side at least, they’re just dealing with patients and reacting to a crisis. It’s hard to think very strategically, but this is a good time now where, okay, we’re past, in most cases obviously. It varies by where you are in the country, but most of us are past the sort of crisis phase. We have Telehealth and Telemedicine in place…we have providers in place largely.

Stewart Gandolf:
Who are we? What do we stand for? I challenge our listeners to think about that because it’s a terrific opportunity. Some people in some organizations fall to the wayside. Others can really demonstrate and take a leadership position, not just from a business standpoint, but from doing good standpoint. Thank you, Dana. It’s been great having you for this healthcare podcast discussion. As I predicted, this would be a great podcast and you did great and thank you.

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