The Commonwealth Fund, a private foundation supporting research and grants to on health care issues and policies, had an interesting review on the performance of the Affordable Care Act that was signed into law March 23, 2010 under heavy controversy.
Is it working??
In summary, their conclusion is that the US health care system better off in September 2014 than it was in 2010. As a visual thinker, I like infographics and here’s their assessment in pictures.
I love research that can drive practical health outcomes to the general public. One interesting initiative being sponsored by the California Healthcare Foundation is using online cognitive behavioral therapy for managing and overcoming pain due to health issue.
“Chronic pain affects about 100 million American adults — more than those affected by heart disease, cancer, and diabetes combined. Despite treatments that include surgery, medication, rehabilitative and physical therapy, and complementary and alternative approaches, many people with chronic pain will never recover to the point where they are pain free.” CHCF.org
Research is showing that teaching patients how to cope with their personal responses to pain can help minimize pain's impact on their activities of daily living. Cognitive behavioral therapy (CBT), a psychotherapeutic approach that teaches techniques for recognizing and restructuring negative thoughts and behaviors, has been successfully used to help chronic pain sufferers in group and individual settings. CBT shows patients how to handle the social and psychological aspects of chronic pain, including depression, anger, and anxiety, while developing self-management skills like activity scheduling and good sleep habits to manage symptoms. The challenge in delivering CBT for chronic pain by therapists has limited availability to patients due to cost, provider availability, and reimbursement issues. To increase access to the psycho-educational aspects of CBT for chronic pain sufferers, CHCF is looking to mobile health and health IT to make it more accessible and timely.
Read more: California Healthcare Foundation
It’s encouraging to see bipartisan legislation being pushed to support new models of healthcare reimbursement that will solve real cost and quality problems. The introduction of a new bill, "The ACO Improvement Act" (H.R. 5558)”, being proposed by Rep. Peter Welch (D-Vt.) and Rep. Diane Black (R-Tenn.) as bipartisan legislation to build upon the progress of Accountable Care Organizations (ACOs) in shifting the reimbursement of health care providers away from the traditional “fee for service” model to a focus on improving the health outcomes of patients.
As proposed, the legislation would encourage ACOs to use telehealth and mHealth by removing current barriers to remote patient monitoring tools and store-and-forward technology, with reimbursement "in a manner that is financially equivalent to the furnishing of a home health visit."
“If we are going to reduce health care costs and increase quality, the incentives built into the provider payment system need to be changed. In short, we need to reward value, not volume,” said Rep. Welch. “Paying health care providers based on improvements in patient health rather than the number of procedures they perform is the way of the future. Our legislation will advance these payment reforms and is based on the experience of ACOs in Vermont and around the country.”
CMS may also soon unveil a next generation model of Medicare ACOs that could expand telemedicine, and Rep. Gregg Harper's (R-Miss.) Telehealth Enhancement Act (H.R. 3306), which was introduced last October and has been referred to the House Subcommittee on Health, would authorize ACOs to include telehealth and remote patient monitoring services as supplemental healthcare benefits equal to that offered by Medicare Advantage plans.
All in all, I applaud these initiatives as it will make it easier to adopt the advancements in technology that are really making a difference in the cost and quality of care that is being delivered.
83% of IT executives report they are using cloud services today for healthcare IT according to the 2014 HIMSS Analytics Cloud Survey. Health IT is moving to cloud and it’s no longer a “nice to have.” – It has become a necessity.
As health organizations transform how they serve their patients, consumers, and partners, cloud computing provides a way to reduce costs, simplify management, and improve services in a safe and secure manner.
At Mozzaz, our solution is built on Microsoft’s Windows Azure Cloud platform which is secure, scalable, reliable and based on industry standard technology. This also allows us to easily deploy to private cloud environments running in secure data centers when an organization requires additional security and privacy measures. Check out Microsoft’s Azure Trust Center to review their security and privacy certifications.
By moving to the cloud, healthcare organizations can effectively deliver coordinated care which requires convenient access to data that can be shared securely within a hospital, health system, or across an entire community.
I’ve had the privilege of having Dr. Reg Reynolds on my son’s autism care team over the last several years. Although now officially retired, he still has passion in the autism treatment research and for the autism community. In fact he has wrote a great book “Teaching Children with Autism: An ABA Primer”. This book is a “must share” book with anyone connected to autism. It is written in plain English and systematically walks the reader through a number of concepts and applications that any parent could easily grasp. It’s packed with great sources of information on specific topics.
ABA, short for Applied Behavior Analysis, has the most research support in the treatment for autism. As Dr. Reynolds says, “It’s not perfect and there are many myths and misconceptions but it is a proven technique when implemented properly.”
ABA is not a technique that should only be used in a school or therapy setting. Dr. Reynolds strongly urges parents to learn the teaching strategies and apply them in all their interactions with their child for a few reasons:
“First, experience has shown that a child’s progress in ABA is directly related to the extent to which his or her parents are involved in his or her teaching/training. Second, there are many opportunities for teaching/learning outside of any formal instruction program which may be set up for the child, and most of that teaching has to be done by the parents. Third, because ABA for children with autism is most often provided within the context of intensive behavioral intervention (IBI), and because this is expensive and outside funding is usually limited, parents should learn how to provide the instruction that their child is likely to need on an ongoing basis for many years to come.”
I look forward to my continued conversations with Dr. Reynolds and I’ll be sure to share additional insights on this blogposts.
Teaching Children with Autism, An ABA Primer (2013) by Dr. Reg Reynolds is published by Lulu Enterprises (ISBN 978-1-300-74618-8) and is available on their website, www.lulu.com
As part of a back-to-school series, the Microsoft in Education team highlighted several Windows education apps for students, parents and teachers. Mozzaz TalkingTiles was highlighted as popular app to support students with special needs.
Mozzaz in action at the Mississippi Adolescent Center
Watch the video here.
The versatility in the content that can be created with Mozzaz and now with the data collection and observation tracking features available in the solution further extends the power both teachers and parents can utilize to support our kids.
My first real exposure to developer hackathons was during my years at Microsoft. Even tech giants turn to the grass roots developer community that would include students, hobbyists, geeks and professional coders to hangout on a weekend, form teams and belt out some innovative code for a specific problem – and help find the “next big thing”.
As defined in Wikipedia:
Hackathons typically start with one or more presentations about the event, as well as about the specific subject, if any. Then participants suggest ideas and form teams, based on individual interests and skills. Then the main work of the hackathon begins, which can last anywhere from several hours to several days. For hackathons that last 24 hours or longer, especially competitive ones, eating is often informal, with participants often subsisting on food like pizza and energy drinks. Sometimes sleeping is informal as well, with participants sleeping on-site with sleeping bags.
Now the MIT Hacking Medicine hackathon always draws super smart people and talent looking to build the next disruptive healthcare technology that will better society with massive impact.
Impressive growth of health hackathons around the world as tracked by the MIT Hacking Medicine’s living database:
Read a great blogpost by Aman Bhandari and Sachin Jain on 3 Reasons Why Healthcare Needs Hackathons.
Great job guys!
There are many potential use cases for big data analytics (‘BDA’) in health care. BDA can be used to: help researchers find causes of, and treatments for diseases; actively monitor patients so clinicians are alerted to the potential for an adverse event before it occurs; and personalize care so precious resources associated with a treatment are not administered to a patient who cannot benefit from the intervention.
Now that we have our data analytics engine built in Mozzaz, we’re starting to gain new insights derived from big data analytics that will serve to advance personalized care plans, improve patient outcomes and avoid unnecessary costs. Here are some innovative ideas and solutions we envision in harnessing BDA:
- Clinical decision support – BDA technologies that sift through large amounts of data, understand, categorize and learn from it, and then predict outcomes or recommend alternative treatments to clinicians and patients at the point of care.
- Personalized care – Predictive data mining or analytic solutions that can leverage personalized care in real time to highlight best practice treatments to patients. These solutions may offer early detection and diagnosis before a patient develops disease or behavioral or mental health issue.
- Public and population health – BDA solutions that can mine web-based and social media data to identify triggers and help predict behaviors or outbreaks based on consumers’ search, social content and query activity.
- Clinical operations – BDA can support initiatives such as wait-time management, where it can mine large amounts of historical and unstructured data, look for patterns and model various scenarios to predict events that may affect wait times before they actually happen.
- Policy, financial and administrative – BDA can support decision makers by integrating and analyzing data related to key performance indicators.
Another great piece of visual artwork that conveys the message.
Glenda Anderson has a great blog resource on everything “assistive technology” with great tips, ideas and resources to help people with disabilities lead more independent lives. I came across this post on writing goals for AAC users that can be included in an IEP as we are currently working with a number of school boards.
Here are a few points from her blog (of which there is more) so I would encourage you to check it out:
Remembering that goals must be specific, measurable, attainable, realistic and timely, when it comes to AAC, we must also consider that who, what, when, where and how.
- Who does our student need to communicate with?
- What do they need to be able to communicate for?
- When do they communicate?
- Where do they go in their lives?
- How are they going to communicate?
There are 4 primary functions of AAC. This should be the heart of your IEP goals:
1. Expression of wants and needs
2. Exchange of information
3. Social closeness
4. Social etiquette
Take into consideration where your client is in the communication process. What is important to him/her. Know the purpose (see Janice Light's questionnaire about picking the right vocabulary. This will help you to choose your goals. The purpose of the communication.)
Resources for writing AAC goals:
- Gail M. Van Tatenhove, MS, CCC-SLP has provided a powerpoint entitled, “AAC in the IEP”.
- The AAC Institute has provided: Writing IEP Goals? Start by Asking Questions by Robin Wisner, not specifically for AAC but more about asking ourselves questions that will help us to avoid those repetitive, testing type activities being used in conjunction with our kids’ IEP goals.
- Documenting Assistive Technology in the IEP Developed by the Georgia Project for Assistive Technology walks you through each step of the IEP process, including writing goals.
- Dynamic AAC Goals Grid provides a wonderful planning guide/checklist to help you walk through the process of seeing where the gaps are.
- DynaVox "Writing Goals" Tips providing the SMART approach: Specific Measurable Achievable Relevant Time Limited
- PrAACtical Suggestions: Writing Goals for People Learning AAC discusses AAC as a means to an end. A focus on language and communication means that we have to consider all of the various ways that the person communicates. PrAACtical AAC Goals Sample goals can serve as inspiration to develop specific, measurable, individualized AAC goals. They also have a nice, short article entitled: “I Made a Communication Board. Now What?” that can be very helpful in guiding your teaching approach.
- How I Do It: Writing IEP Goals for Students Who Use AAC with Lauren Enders providing a very valuable perspective on writing IEP goals for students who use or need AAC and some wonderful resources.
- Linda Burkhart has a guide, entitled: Writing IEP Goals and Objectives for Authentic Communication for Children with Complex Communication Needs
- SpeakingofSpeech offers an actual goal bank for supporting AAC use.
- USHAonline provides Sample AAC Goals:The goal is the measurable educational literacy goal. How to set goals for assistive technology in an IEP.
Great work Glenda and thank you for your contribution!
In one of our recent training sessions with the Speech & Language team at Waterloo Regional District School Board we had a great conversation on the importance of data collecting in not just speech therapy but in special education in general.
I just wanted to share some of the conversations we were having the SLP (Speech & Language Pathologist) team:
Q: Why is data collection important?
SLP: How do you know if your student is making adequate progress in therapy? Regular education teachers are able to collect data on their student’s performance through classwork, homework assignments, and test scores. This data is important because a teacher can quickly see, based on the child’s performance on these tasks, if the child is making adequate progress or if the child may need some kind of individualized instruction. Data will tell you if your interventions are working or not. If you do not take data, you have no objective measure that your intervention is benefiting the students.
Q: What makes it challenging?
SLP: Taking data is very important and yet given all the responsibilities those SLPs working on the schools have, it can be a daunting task. Between all the IEP meetings, IEP paperwork, SST meetings, collaborating with other professionals, consultation, answering emails, planning therapy, implementing therapy, doing assessments, returning phone calls, staff meetings, bus duty…there is seriously barely time to use the bathroom and many of us eat lunch at our desk as we read our email (I know I have!!). Add the fact that within our therapy groups, we often have 3-5 children and it is common that they are all working on different goals. Taking data, analyze the data, and use the data to plan and implement therapy becomes very, very challenging.
Q: How do you take data today?
SLP: I take data nearly EVERY session on every child. The exception to this, is if I am using the session just for teaching the concepts. For example, I do not take measurable data on days that I am teaching placement on the /r/ (which sometimes can take several weeks) or days that I am teaching the meaning of several basic concepts, etc. On these teaching days, I will write notes on my Monthly Progress Notes Sheet regarding what we were teaching, what methods were working (if working on articulation placement), etc.
Q: How will Mozzaz Care help you in programming and data collection?
SLP: We see Mozzaz Care helping us in many ways – everything from content and lesson plan creation, to creating interactive activities and of course – AUTOMATIC DATA COLLECTION and OBSERVATIONAL notes and tracking. Our special-ed kids respond very well to tablets and computers, so using tablets for therapy and learning and be able to collect data from the app as they’re using will be a huge time saver and even more accurate. We also love the fact that you can incorporate videos and audio files into the tiles and pages – video modeling is very effective! As we progress with this team, I’ll continue to post updates on how Mozzaz Care is helping this team and the students achieve the speech and language goals.