Outcome Improvement
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February 2024
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How Would You Get Your Life Back?
Filed under: General, Healthcare, Electronic Records, Personal Information, Mobile Solutions & Smartphones, Contingency Planning & Disaster Recovery
Posted by: Tom @ 2:09 pm

Are you prepared to cope with the next disaster that comes along?  Even when there is no loss of life, it can be very difficult for anyone to fully recover mentally and physically.  Having electronic records and well thought out contingency plans could make a big difference in recovery.  They help even in the best of times. 

Imagine coming home from work one day and seeing what was left of your home surrounded by fire trucks and rescue workers.  Or you smell gas and start through the front door just as the entire place explodes.  Or there is a damaging storm, flood, forest fire, or earthquake.  Every one of these things is not likely to happen to any single individual.  However, over a person’s lifetime, probabilities add up, something serious could happen and we could lose everything.  Some people are luckier than others.  In addition, many people experience nuisances such as lost or stolen wallets, passports, credit cards or car keys at one time or another.  These loses can happen away from home and in a foreign country.  Although minor by comparison, until we get caught up in any situation, it can be difficult to understand their impact and realize the trouble and inconvenience they cause.  It wastes a lot of time. 

A woman in Missouri lamented as she stood in the ruins of her home.  It had been rebuilt after being destroyed in an earlier storm only to happen again.  She had just moved back in the week before.  Someone else had a laptop stolen at a business conference and did not have their files backed up. Between Acts of God, carelessness and deliberate acts, many disruptive things happen.  Imagine the bureaucratic nightmares that occur along with the pain and suffering.  Being better prepared gets lives back together faster and easier.

Facing reality, if it were necessary to evacuate a home and never return to it again, it is highly unlikely that anyone could take along everything that would be needed.   Without records it would be virtually impossible to substantiate insurance claims or establish a person’s identity.  What if someone needed to be taken to a hospital and get help from a doctor who was not familiar with their case.  How long would it be before they could be assessed and treated if they did not have a health record?  Delay costs lives.  Wouldn’t it be better if records were electronic and fit in someone’s pocket rather than in boxes of paper that had to be left behind?

People often lose everything they own when homes, neighborhoods and even whole towns are destroyed in fires, storms, earthquakes and floods.  The recovery process is often long and painful.  The last thing someone needs is bureaucratic red tape when they have already suffered enough.  Nevertheless, minor discrepancies in paperwork invite bureaucratic nightmares.  Whether information is missing, incomplete, inaccurate or simply does not match, even a typo that was made many years ago can be hard to change.  The rules of the game have changed, and we need to be able to substantiate who we are and everything about us.    Digital records that we carry with us or are backed up in “the cloud” make data available when and where it is needed. 

Even if paper records are not destroyed, they deteriorate over time.  Sorting through a shoe box for something and finding that it has become faded and is no longer readable can be pretty frustrating.  Conversion to electronic records is a big improvement. Although it takes time, gradual steps make a difference right away and not everything will need to be converted.

We recommend the following.

1.   Start by preparing basic contingency plans.  When calamities strike, being ready to address them is essential.   Plans can always be improved.

2.    Collect and save electronic files instead of paper ones, whenever possible.  Digital records provide convenience and portability.  Electronic records are easy to create when work is done a little at a time.  They are easy to search.  For example, include a list of phone numbers to call for help, a copy of a driver license or passport, a list of account numbers and instructions to access them on-line, copies of family photos, receipts, certificates, wills, powers of attorney, insurance policies, deeds, and tax returns.

a.   File records chronically by subject.  They can always be reorganized.

b.   Use file types such as PDF that can be read by anyone’s computer, tablet or smartphone.

3.    Create and include a consolidated, organized, digital summary of your health history.  It will help you to get in the habit of keeping electronic records, provide peace of mind, and enable professional caregivers to get up to speed quickly so they can help you when it is needed.  Use Lifelong Personal Health Record software (http://www.lifelongphr.com/) to store your data and create the summary.

4.    Backup Important Files.  In addition to having master copies on a personal computer where you can control and protect your data, backup electronic files using an encrypted Internet service and put copies on small portable devices such as smartphones, flash drives, tablets, bracelets and medallions for easy access.  Security is important to avoid worry about what someone else is doing with your data.

Not a Do-It-Yourselfer?  Contact us for assistance.


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Fat, Dumb and Happy No More
Filed under: Healthcare, Problems and Inequities
Posted by: Tom @ 7:54 am

When The Pentagon was found to have charged taxpayers $434 for a hammer and $600 for a toilet seat cover, people were outraged. What they failed to realize was that the same thing is happening to us all the time. Unless we see something blatant that affects us directly, we do not even think to question what is going on. A case in point is a healthcare system with similar excesses. 

The other day, I stopped at my local drugstore to pick up a new prescription that I had left to be filled.  The drug had not been in stock.  In retrospect, that should have been a red flag.  Others were probably too smart and were not buying it.  Anyway, when I went to pay the bill, I learned that it would cost $121.37.  This, by the way, was for a prescription strength version of a medicine that is available over-the-counter for a fraction of this amount.  My first reaction was that my insurance had not paid its share.  But no, they had disallowed the claim and I must pay the entire amount as if I had no insurance at all.  Needless-to-say, the drug got put back on the shelf.

For an accountant like me, it is easy to see what is happening.  Costs are what they are, but who pays and how much they are charged is another matter.  One way or another, costs are going to be marked up and allocated to someone for payment.  Nature abhors a vacuum so if there is pushback in one place, something else must give way.  When an insurance company avoids paying at all, so much the better for their bottom line.  If they negotiate too many discounts or too many people who lack insurance and cannot pay are subsidized, everyone else foots the bill.  The consumer has little say in the matter.  Costs simply get spread through the prices of products that we buy, the taxes we pay, insurance premiums, co-pays and deductibles, contributions that we make and so on.  It is anyone’s guess what the true cost or price should be for anything.

There are different prices.  Some people pay nothing out-of-pocket at all.  Until the alarm goes off, we simply take whatever comes along without question.  In my case, I had one other piece of information about medicines that most people do not know.  I had learned from Bloomberg Businessweek that roughly half of the costs of prescription medicines are wasted because they do not work as the prescribing doctor had intended. In 2008, this amounted to $145 Billion wasted by all of us in that year alone. A year ago, I spent $100 on a co-pay for eye drops that did not work. Quite frankly, I was not ready to risk adding to this waste especially when there were other options. 

Looking at the world around us, I believe that it is important to find out the facts, tell it like it is, and fix what is wrong. If you agree, please join in by sharing your comments and experiences with us.            


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Learning’s Defining Moments Leave Lasting Impacts
Filed under: General, Healthcare
Posted by: Tom @ 4:29 pm

I often wonder what led me to do certain things that have proven to be invaluable.  One of them was to take typing in high school; the other was to take my first computer class in college.  At the time, boys seldom took typing, and I was in the last class of Mechanical Engineers to graduate without having to take a computer class.  I can remember hearing the dean emphasize this point in a meeting to discuss schedules for our senior year.  I am not sure whether he was telling us that we were lucky or that we should take one anyway.  All I know is that a good friend from the business school took a computer class and had a terrible time with it.

As a practical, hands-on person, I am a little surprised that I would have done anything that was not required.  I looked upon many required courses in Mechanical Engineering as being too theoretical with too many theorums to prove and not enough practical applications.  With the exception of a machine design class where we designed, built and tested our design, I preferred my business classes and was driven to be an engineer primarily because it seemed the best route to a good job.

After that first class, I found more and more reasons to get involved with computers.  I also found that knowing how to type gave me a distinct advantage.  Since then I have found that many of my peers have been forced into retirement because they lack skills that have become second nature to me.  It is sad to see how a person with an obsolete education is much like a machine that was built with old technology.  Although attempts are made to adapt or refurbish machines to perform like new ones, once they need to be replaced, they are simply thrown on the scrap heap.

Unfortunately, obsolete people with declining health require costly treatment and little to show for it.  Sadly, while machines get melted down and recycled, people at first get paid to do nothing.  Later as they add a growing number of affirmaties, they consume vast amounts of money for medicines, surgeries and constant care.  Hopefully, advancements in medicine will bring increased quality of life and reduce these costs.  However, people need new challenges that keep them mentally alert.  Perhaps, new occupations will be found that require minimal retraining and put them back into leading more normal, interesting, healthy and productive lives. 

I am happy that a series of decisions to stay informed about new innovations has helped to keep me in the game.  Hopefully, this is a lesson to all to keep learning.  

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What are we being exposed to?
Filed under: Healthcare, Occupational Health and Safety, The Environment
Posted by: Tom @ 2:18 pm

When I wake up in the morning feeling congested, I turn on the Weather Channel.  As the Air Quality Report shows Unhealthy for Certain Groups, I think about growing up in a polluted Pittsburgh where the sun shone as an orange disk through the smog.  Later I saw a power plant in Ohio with a stack so tall that the company bragged that pollutants would never reach the ground.  Years later, I heard a that dust-borne bacteria from the Sahara Desert was killing coral in the Caribbean, and an aunt of mine complained that each time she took a cruise to Alaska there was less and less beautiful ice.  Forty years ago, I even heard about receding ice when I visited a glacier in the Canadian Rockies.  I also remember once when the smell of forest fires in Colorado was noticeable in the Northeast.  A lot has been learned about pollution since then.  Considerable progress has been made.  It is especially noticeable in Pittsburgh, but there is still much to be done in many other parts of the world.

I started my career at a steel mill with smoke and gases spewing everywhere and later spent time in factories all over the country that used dangerous chemicals.  I think about workers who have died from exposure to asbestos and coal dust including those involved in the cleanup of the World Trade Center site in New York after the 9-11-2001 terror attacks.  I remember the controversy about acid rain traveling to New Jersey from Ohio and dust coming to the Caribbean from the Sahara.  Now the talk is about mercury from China raining down on the waters off the coast of the Western United States and tainting wild fish caught in the sea.  Reports show more widespread damage as researchers keep looking for it farther and farther from the sources.  Measures like tall stacks may help to prevent high localized concentrations of pollutants, but cannot keep up with the broad, longterm impacts.

No doubt these poisons are building up in our bodies.  Certainly does not sound pleasant or reassuring, does it?  Especially when no one really knows precisely what concentrations are hazardous to our health!

The question is, “What can we do about it?”  Or, would it be better not to know so much?  One thing is certain.  This is an important subject for Outcome Improvement.  Please watch for more commentary on it.

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