Saturday, December 19, 2015

Loneliness Is Real Killer

Take a step back and set aside for the moment all the typical chatter and story lines about how technology is empowering changes in healthcare. You know, like HIPPA security, health records exchange, patient-centric care, OASIS ICD coding, hospital re-admissions stats, laptops in the exam room – it goes on and on. Not that these are not appropriate matters and issues mind you, but I see a much more ‘human’ story emerging.

I have been a technology professional for more than 40 years and over that time I have continued to marvel at the revelations that are generated as new frontiers are pursued and outcomes evolve. My work in technology enabled health care has not failed to live up to that history and provide such revelations.

What I am increasingly observing first-hand is the human dimension, the magnificence of human response to encounters with technology when it delivers on ‘quality of life’. This of course can be easily seen with the impact of life saving advances in technology provided by the likes of drug treatment break-throughs, genetic therapies, imaging systems. These are critical and vital to quality of life and care to be sure. Yet while we all seem very familiar and comfortable with understanding and accepting the impact of conditions on health such as obesity, alcohol abuse and air pollution the fact is that loneliness has a greater life shortening probability impact than any of those conditions.

In my work with ChartaCares I see time and time again how technology ‘lights up’ people and patients not because the technology delivers ‘gee-wiz’ digital transactions making it easier for care recipients to do things like reorder a prescription and care givers to do billing more efficiently but because technology opens up and creates a new and enhanced connection to life as it is actually being lived. When one’s quality of life is so significantly and positively impacted the outcome of technology operates at what I referred to earlier - at the higher human level.

I see the defeat of loneliness and despair as a killer being achieved every day when I see via the technologies that we provide a senior who wants with great anticipation and excitement to join an active senior group experiencing together an on-line social gathering of friends with a common interest or an autistic or handicapped child break through the isolation in their lives and reduce their fear and stress via interactions with a humanoid robot or family members who are geographically separated increase their daily interactions and increase the knowledge of the condition and care of their aging parents via a unified communications platform. Everyone lights up! Why? As so very well defined by Eric Kim, Victor Stretcher and Carol Ryff in their research on preventative health care, a ‘purpose in life’ has been gained. The correct embrace of technology enables the elderly and those individuals with life conditions to recapture meaningfulness in their lives. This is why we at ChartaCares believe there is no better way to make a difference.

Wednesday, November 18, 2015

The Future of Health Care Is All In the Stars (and the Numbers)

Quantification of circumstance can deliver a rude awakening. The challenge faced in the U.S. as an aging population gains steam will demand aggressive solutions. But first, let’s visit the numbers:
Boomers are retiring at the rate of 10,000 per day – yes that’s each and every day.
Those over 65 are headed for a total population of 71.5 million
Add to that number those over the age of 50 and we are headed to an elderly population base of 112 million.
This is a population grouping that will post staggering numbers in: Alzheimer’s, Dementia, Diabetes, Chronic Heart Disease, COPD and hip and knee replacements.
By my actual personal count the number of different prescription drugs being advertised on TV and aimed at this group numbered 36 each with three repeats within two hours on average.  50% of adults take at least two drugs a day, 20% take five. Medication management and adherence is critical.
Clearly this is a generation in transition and, yes, it is in need of assisted car
Health care policy makers are working feverishly to address the quality of care and not just its cost. Health care models that pay more for better population health are underway. A rating system for home care services called the HOME HEALTH STAR RATING operated by the Centers for Medicaid and Medicare is now actively reporting results and awarding the ‘stars’ (the stars referred to in this article’s title) to home care providers. Here numbers come once again into play. In 2014 more than 2600 hospitals faced penalties costing over $450 million dollars resulting from less than acceptable hospital re-admission rates. Get tagged with a three star rating or less as a home care provider and you are probably going to be forced out of the business.
The National Association of Health Care has reported that 75% of health care operators will be or will be approaching unprofitability by 2017. One leading researcher reports that the number of health care service firms in home care will be reduced by over 80,000 and industry employment will decline by over 400,00 by 2019.
So, not only do we have a generation in transition but we have a care service provider industry struggling to meet generational demands, lower payments, increased regulatory scrutiny, a higher wages model and a lack of qualified caregivers. It is an industry reeling and in a dramatic transition itself.
Driven by these facts and conditions I make a continuous effort to search out and vet innovative health care technologies that will enable the ‘boomer’ generation to age more securely at home, improve the quality of their lives and simultaneously empower home care service providers to become more efficient while adding a demonstrable competitive differentiator to how they compete for new business. One recent discovery is MyHomeReach. The impact that MyHomeReach can have on hospitals seeking to reduce re-admissions is significant. Towns and community governments can now get a handle on their aging population’s health status thereby reducing the burden on first responders to what will be an alarming increase in medical conditions that need attention. With a product like MyHomeReach corporations also can now have a path to assisting the growing numbers of ‘sandwich’ generation workers who are frequently late to work or become absent due to the demands of caring for aging parents. Home Care services can offer a technology that embraces their customer base.
As has been the case so often in the past, innovative technologies arrive in with save-the-day solutions. Ahaa moments! MyHomeReach is a classical case in point. It’s the right technology and it’s available at the right time. If you want to get ahead of the numbers and reach for the STARS, get more information about MyHomeReach at or call me at 603-580-5497. I’d be happy to share what I have learned.


Saturday, October 31, 2015

Humanoid Robots That Are Reducing Children's Care Related Pain and Stress by 50%?

There can be no doubt that robots have entered the medical care and services space. Different classes of robots are at work doing surgery, delivering medical supplies around hospitals, dispensing medications, cleansing hospital rooms and picking up laundry. Some are on the verge of lifting patients from bed to wheel chair. Soon they will be welcoming you at your medical check-in and escorting you to your appointed location. The next evolution has now begun. This next evolution is “humanoid” robots that work as medical assistants.

“Humanoid” robots are a next higher class of robot. They are equipped with human like interaction intelligence such as cognitive-behavior recognition, facial recognition and emotional response assessment. As such, they make ideal medical assistants. Know that humanoid robots are already working in pediatric care and have been clinically proven to reduce a child’s stress and pain by 50% when facing medical procedures. In dental practices humanoid robots are calming children as they have their first experiences with dental procedures.

In skilled nursing facilities they are doing everything from informing residents what’s for lunch to playing Bingo to leading exercise classes. In more specialized environments they are terrific in helping treat Autism. They increase vaccination rates. I have even seen where they can aid in dementia therapy. The point is they are here, they are real and they are ready to be on the job.

Their flexibility in adapting to customized medical protocols makes them extremely versatile.

I have been engaged for more than 45 years in the advances in technology. My work around humanoid robots has been the most exciting. Humanoid robots establish an entirely new interface to the world around us – innovation and imagination reign supreme. Not a day goes by when yet another breakthrough concept or idea fails to surface.

Besides, can there be anything better that seeing a fearful child transform into a smiling, excited and happier child? The medical profession will once again demonstrate their leadership in doing what they are foundationally committed to doing – increasing the quality of care. A positive experience by a child with medical care and or dental care can impact a lifetime of their perspective on health care and health self-management.

Strictly from a business perspective I have seen how humanoid robots increase business development and enhance patient loyalty. Not insignificant benefits of using this technology.

If you would like to know or learn or about my experience with humanoid robots in medical care call me at 603-580-5497 or e-mail me at I’d be glad to share what I have learned.



Friday, October 23, 2015

Digital Pens and ‘Smart Paper’ Transforming Health IT

Healthcare providers around the world agree that quality patient care is their top priority, and capturing patient data digitally is critical to improving patient care. Today, most healthcare processes are still paper-based. Many healthcare providers are concerned about the risk of inaccuracy, disruption of workflow, and harm to patient care quality involved in adopting new and complicated data-capture and password encumbered tools like in-room computers, laptops or tablet PCs.
Using a digital pen and smart paper forms makes every sense from the critical perspectives of patient interactions to reducing the expense of data capture and digital document management. Its day has in my opinion- arrived. Whether it be in hospitals, medical practices, SNFs, VNAs or Home Care it just makes sense – economically and operationally.
We all know the drill. Enter any doctor’s office or emergency room and the first thing you get handed is a clip board. Why are the paper forms on the clip board not SMART? Using a digital pen the data can be immediately captured and electronically, instantly stored. The smart paper documents and forms can even be signed with the signature electronically captured.
The patient’s room has become a data center with as much time given over to logging-in and data capture as to discussing symptoms and giving care advice.
The next advance in health care technology will be Digital Pens, SmartpaperForms and the smart clip board. Yes, you understand it correctly. Why? Because it is simple and efficient to adopt, deploy, and use.
The benefits are too clear for the hospital or medical practice to avoid the inevitable.
Patient interactions are enhanced – avoiding distracting laptops, tablets and computers during care or treatment.
Increased Accuracy and Completeness – All care giver handwritten notes are accurately captured by high precision digital capture technology built into the pen itself.
Handwritten entries and notes can be converted to digital data – automatically.
You use your existing paper forms – no expensive programming transitions to electronic forms.
Minimal Training and Workflow Interruptions – Because digital writing uses a the familiar practice of writing with pen and paper, its use requires little training and is easy to learn
Eliminate document scanning – documents are auto captured, filed and stored instantly and can be instantly shared into workflows or with other care givers.
Signatures can be captured, diagrams drawn, boxes checked, items initialed when and where necessary – simply by signing or using a digital pen
Digital writing is the perfect bridge between the paper and digital worlds.
SmartpaperForms can now be printed on typical office laser printers using common office grade paper. You retain the use of your ‘tried and true’ paper forms. SmartpaperForms eliminate the need for expensive pre-printed forms or multi-form carbon sets.
Why spend on buying laptops and tablets and managing all the surrounding security concerns when you can now just print your existing health care and business forms as smart paper forms and use a secure digital pen? Capture handwritten entries and notes, and capture the form and the data instantly using digital pen technology.
I forecast that digital pen and smart paper will become the new kid on the health care block – fast and soon.
If you would like to discuss my experiences with digital pen technology in health care simply call me at 603-580-5497 or e-mail me at I’d be happy to share what I have learned.

Friday, October 16, 2015

Six Forecasts on the Health Care Landscape That Lies Ahead

As the ‘Boomer cataclysm’ hits - and I do mean cataclysm- there will six major changes:

1.       The very number of Boomers that hit the retirement path will bring new and increased attention to the state of and the processes of our health care system. Until now the issues have been in a bit of a back seat as Boomers continued in the workforce. That will change exponentially going forward. And, just like every other social issue that the Boomer generation addressed along their way, they will re-write it. They will change the paradigm. They will force a new dialogue and wrest control from the hands of Congress, Government Administrators, Insurance companies and Drug companies. They will force a re-write of the ACA and the health care business model to make sense to them and their new found circumstance. Their numbers will overwhelm current ‘policy’ – at the rate of 10,000 joining their ranks every day, and they will do it quicker than we think.

2.       States and local towns and communities will be overwhelmed with the demands on first responders, EMTs, Fire departments and emergency rooms. Establishing strategic programs to aggressively manage preventable admissions and reduce re-admissions will be a necessity. This will require a cost effective method –a system- to maintain electronic oversight on the elderly who are aging at home. Enhanced communications that monitors well-being will be mandated.

3.       Telecom companies will be required to up their game in offering rural communications. No longer will they be able to or permitted to ‘cherry pick’ service only the lucrative population centers they wish to serve. What good are technologies like telehealth and telepresence if you don’t have a connection?

4.       The attitude towards the use of technology in health care – especially home care services- will change from one of ‘well, not really’ to that of a ‘must have’. If labor costs and models are going to become more productive than technology will be the productivity lever as it has in every industry.

5.       Corporations will need to develop an enlightened and engaged dialogue with employees that are ‘sandwiched’ between their jobs and caring for aging parents. The answer will be found in providing technology driven connectivity - provided as a benefit - that reduces absenteeism and unexpected work interruptions as employees struggle with the demands of their jobs and the demands of their aging parents.

6.       The full and free exchange of health records will be torn out of the commercial arena and taken over totally by the government. Count on it! Commercial gamesmanship with health care records will be eliminated.






Tuesday, October 6, 2015

A Tablet That Saves Lives and Reduces Hospital Re-admission Cost and Penalties.

A computer tablet “GIVEN” at the time of discharge to primary care patients would reduce re-admissions costs and penalties and save a life or two.  Why are we not doing this? The cost of tablets has fallen to such a low cost range – sub $100. - and the software is here and ready to facilitate doing it, such that a ‘discharge tablet’ will and needs to become a standard component to the primary care practice of discharge and transition care management.

Today, the hospital discharge experience remains a ‘blurred flurry’ of an experience for most patients. Once wheeled out the door, trying to recall and reflect as to what was said, what you are supposed to do or not do and the how and when and with what medications can be highly stressful for the patient and post discharge caregivers, family members or guardians. Discharge time is not the ideal time for a speedy lecture that contains and is jammed full of life critical information and terms and data that are terribly unfamiliar.

Of course there are many drivers to re-admissions. One set are those conditions that subsequently arise are medically driven chronic conditions. The other set are those that are manageable by patients and care givers. Some major examples are:

Failure to understand the post discharge care plan – originally delivered by someone who thinks you should understand or conveyed via a 19 page 8 pt. type set document that details all the horrific possibilities. What did he or she say I was supposed to do?

Failure to use prescribed medications correctly – if at all. Simply being confused on which pill to take first and when and or why.

Failure to monitor health vitals indicators – blood pressure, weight, oxygen levels etc.

Improper wound condition awareness and care – is this wound healing properly?

Failure to communicate condition changing issues in a timely manner such as medication effects, breathing, sleep, balance, hearing etc.

Providing a specialized discharge tablet with a guiding conditions checklist and a history of care activity events and trending conditions can significantly and positively impact these issues and more. A ‘one touch’ always ready connection to the exact information when a patient needs it and providing active monitoring to care givers via a specialized tablet will go a long way to reducing re-admissions. Less than $100. per patient even if given away and not charged for or returned seems like an ROI for everyone involved and worth securing….and saving a life or two along the way is not a bad outcome to strive for with today’s technology enabled health care.

If you would like to discuss deploying a discharge tablet contact me at or at I’d be happy to discuss the potential and the possibilities of a discharge tablet for your patients and care organization.





Monday, October 5, 2015

STAT! The Othe Side of the Hopital Needs Oxygen

With so much news, advertising, promotion and discussion revolving around HIPAA IT, “meaningful use”, EMR, security breaches and a seemingly un-ending list of other related Health IT security and compliance subjects, it is easy to lose sight of the fact there is still a business to run. All this noise can easily impact and distract IT decisions or derail IT initiatives that can improve how a hospital or home care business can and should be operated in this day and age. What I call the ‘other side of the hospital’ is a back office that needs to run and that has significantly real business process automation needs.

It seems that everyone has become so HIPAA IT and EMR centric that sustaining attention on the business side has been relegated to a remote and distant second tier. Almost with a, “Oh yeah, there is that to get to too” attitude. There are clearly needs outside of EMR centric systems. A/P, H/R, workflow processing, business document management, contract management, project management are still central requirements of any well run health care business. As I also work with non-hospital or home care businesses I see firsthand the strides that those businesses are making in advancing their business processes into the digital age with forms automation, mobility and workflow processing, A/P and H/R on-boarding and fluent system integrations for example.

Driving a health care business solely from an EMR centric focus creates severe debilitations on efficiency and profitability. While an EMR initiatives are indeed critical and necessary in health care services, those systems and that as a strategy simply does not address enterprise wide business operational needs. There is a lot more that needs to go on in a health care business than automating patient records. I see real dangers ahead if health care IT doesn’t begin a re-focus attention and investments on the ‘other side of the hospital’.

There are a significant number of forms that surround health care business management that EMR systems do not address. There are a significant numbers of A/P invoices that need approval and processing. There is the ever constant on-boarding of staff in H/R. There are numerous sometimes hundreds of contracts and business associate agreements that need management. EMR systems do not address those areas yet, somehow, we are being led to think they might, can or will. That’s not happening.

Today’s advances in business process management technologies out classes what I have seen in EMR. Hospital IT leaders and home care business operators would do well to take a pause and revisit the IT agenda on the other side of the hospital or their home care business. If you haven’t looked recently, today’s business process technologies have exponentially advanced the ‘state-of-the-art’. Bringing the other side of the hospital into the digital age can provide a dramatic boost to profitability. What is available in business process automation today is fast to achieve, unbelievably easy to do and extremely cost efficient. Amazing, really.

While the subject of business process automation in health care may not have the ‘hair-on-fire’ glamour of EMR, it is like oxygen- you won’t miss it until it starts to deplete. There is still a business to run on the other side of the hospital.
I look forward to a discussion with those hospital leaders working to run the 'other side' of the business at


Saturday, October 3, 2015

Predicting Re-admissions Moves from Fiction to Fact

Predicting Re-admission Moves from Fiction to Fact

Over the last 45 years I have watched ‘technology’ gain an increasingly stronger foothold on the data and information we contend with on a daily basis. Focusing technology on making ever better decisions is of course critical. Perhaps in no sector are the benefits of computer-aided decision making becoming more demonstrable than in healthcare. Lives depend on such tools.

The historic technology landscape has seen us traverse the disciplines of knowledge management, in the creation of the experienced-based organization and the emergence of the knowledge-driven organization all inspired by computer assisted tools. Most recently we have been drenched in the world of ‘big data’. First came the attention to wealth management, now comes healthcare.

The rising importance of reducing hospital re-admissions has many ‘motivators’. Government penalties against hospitals for poor re-admission rates are paying a huge role. Reputational damage to hospitals for poor re-admission rates are debilitating. The difference that I now see, is that ‘knowing’ is one thing but the ability to now also do something about has become the real difference. Like the weather, which remains outside of our control, knowing about it is important but what can you do about it? Well, re-admissions probability management has reached a state where you can not only know about it you can do ‘something’ about it. Actually, you can now do many things about it.

What has happened is that specific use case computer models can exert a proactive discipline on care giver decisions and staffing time allocation. The conventional model is that a designated number of nurses arrive to address the residents on the assigned patient floor. This may not always be the best approach. What if floor five has more critical patients at risk for re-admission than floor two? What tools are available to instantly reallocate nursing resources to the most critical re-admission probabilities? With today’s predictive analytics such actions can be taken in real time. And the cost of adopting this technology has plummeted. No longer is ‘big data’ the exclusive domain of a few data scientists. Health care professionals, nursing floor staff can do ‘big data’.

The transformation has been in creating a usable tool that links the ‘data’ to the ‘intervention’ choices at the care giver level and in real time. This is a very dramatic transformation.

Extending this on-going ‘knowledge link’ to the hone care or skilled nursing service provider only increases the likelihood that a re-admission can be avoided. With probability based successful identification rates exceeding 85% health care can now know exactly where to look and take action. Commercial businesses have been applying this model for years, out of necessity, and with years of success. If I operate a fleet of trucks or airplanes I need to have a pretty good idea of where the potential problems are and which vehicles or planes are likely to surface with a problem next. Taking this exact model into the health care sector means I can now know which patients are most likely headed back to the hospital if I don’t not take action becomes a manageable agenda. Now, I don’t mean to equate matters that pertain to people with machines but the case is hard one to argue. Both need maintenance. and I can now know which ones are going to break down.

With the oncoming onslaught of ‘boomer’s’ needing care, unless these new systems are put into place, emergency rooms will be over-run with avoidable re-admissions. Predictive analytics in healthcare has now made what was previously deemed fiction, fact.

Contact me at  if you would like to learn more. I'd be happy to share what I have learned about this technology with you or your team.

Thursday, October 1, 2015

A Corporate Benefit for the New Era

A New Era Corporate Benefit Program That Will Save Employers Millions

There is no disputing the fact that the radically increasing numbers of ‘Boomers’ retiring is going to impact business and human resource management in ways yet unimagined. Today’s rate of ‘retiring Boomers’ is at 10,000 per day… and that daily number will continue to increase.

For employers this means that a steadily increasing number of workers will be ‘sandwiched’ between job demands and caring for aging parents. This trend will stress every organization. Already, absenteeism driven by ageing parental care is costing millions, as employees attend to the daily care demands of aging parents. Unexpected absences will not only stress employer productivity but the stress of giving this care will add additional health risks to an employee’s personal well-being, impacting the employee themselves, and thus adding to employer health costs as they attempt to balance and cope with the stress of aging parental care and their job demands.

Presenteesism” will escalate – employees seemingly present and on the job - but not really - due to attending to unanticipated care demands and unanticipated care driven distractions will also escalate.

Providing employees with a ‘care connectivity’ service would provide a win-win-win for everyone. A system that provides real time monitoring, oversight of care events and care activities and immediate connectivity to professional medical care such as doctors and home care providers and local services like taxi’s and groceries and plumbers would mean that (1) the aging parents would remain in constant touch, (2) employees would know exactly what’s going on and (3) employers would reduce absenteeism and presenteeism.

Provided as a service offered by employers this “benefit” would not only significantly enhance the employer/employee relationship but it would also provide a very valuable opportunity for building a corporate dialogue as part of an enlightened corporation’s culture, one that understands and has empathy about the ‘real world’ that employees are facing every day.

Human Resource professionals like it or not will be increasingly drawn into this fray. The numbers alone will demand a strategy. We at ChartaCares support human resources executives seeking to proactively respond with a care management system provided as a benefit…. one that delivers daily tangible benefit. With our system employees can more positively attend to the demands of both work and care in the new era of technology enabled healthcare.

See| Menu: Quality of Care | MyHomeReach to learn more or contact me directly at