EPtalk by Dr. Jayne 9/5/24

I enjoyed reading the results of Mr. H’s poll on company culture, where a full one-third of respondents said their company’s culture was worse today compared to a year ago. There’s always a disconnect between what employers think of their culture and what employees experience.

A recent story of culture gone wrong details a company retreat involving some hiking in Colorado. One member of the group became separated and was ultimately stranded overnight on the mountain in dangerous conditions that included freezing rain and high winds. Contributing factors included co-workers who retrieved pieces of gear that had been used to mark the way through a scree field, as well as delayed notification to search and rescue personnel.

Search efforts were pended overnight due to conditions, but the hiker was eventually found after a coordinated search effort that included nine agencies. The man sustained multiple injuries in falls as he tried to descend, and had to be carried to a point where an all-terrain vehicle could assist. I’ve done a fair amount of hiking in my time and would highly recommend always carrying the 10 essentials even if you’re in a large group.

HIMSS is starting to hype its 2025 conference, sending emails to alert members that registration opens next week. The conference is once again in Las Vegas, which I’m not thrilled about since HLTH is there also. I’d really like a break from conferences in Las Vegas and Orlando, but the lack of growth in conference facilities elsewhere makes those venues seem like a lock. Conference passes start at $995 this year with an Executive Summit pass starting at $1,445 that promises access to additional events including a reception and an evening special event.

When I first started working in healthcare IT, there was no such thing as social media, let alone the idea of digital influencers. Things have certainly changed and our industry is bursting with influencers, leading to changes in how business in certain segments is conducted. The University of Texas at San Antonio has added a major in Digital Media Influence to its lineup of degrees. Under the leadership of the Communications program, students will take production classes as well as courses that are focused on digital communication and digital audiences. They will learn technical skills as well as strategies to build and retain followers.

It will be interesting to see how many graduates complete the program and where their career paths lead. I hope they include such topics as “buy a real microphone, no one wants to watch you talking into a wadded up set of wired earbuds” and “how to film without giving your audience vertigo.”

There’s no denying that social media has changed healthcare, however. East Idaho News reports that a local hospital will convene focus groups following a complaint about delays in its emergency department that was posted on Facebook. The post received 190 replies, eventually leading the hospital to contact the author and invite her to participate in a focus group. The organization plans multiple sessions over the net few weeks and hopefully they’ll not only receive constructive feedback but will take action on it.

From The Name Game: “Re: here we go again. Did you see the reports of Jefferson Health buying its way onto the Philadelphia Eagles practice jerseys? They’ll also have their logo featured on the backdrop at press conferences.” Terms of the deal were not made public, but I suspect that they paid a pretty penny for the privilege. The article mentions that the practice jersey logo replaces that of an orthopedic group, but I wonder how many fans will actually notice, let alone care.

Bring on the creepy images and supernumerary digits: The Verge reports that Google Gemini will once again allow users to create AI-generated people, following a hiatus after the tool produced “historically inaccurate images, like racially diverse Nazis.” The tool should be available to Gemini Advanced, Business and Enterprise users quickly and is powered by Imagen 3. Guardrails will be in place to prevent users from creating realistic images of public figures, content involving minors, or sexual scenes. I recently tried Meta’s “imagine yourself” and was impressed by its ability to interpret requests for 18th century fashion, although it did give me mismatched earrings in three of three generated images.

No wonder primary care physicians are tired. A recent research letter in JAMA Health Forum looks at the impact of value-based contracting on primary care. Researchers identified 57 distinct quality measures that one health system’s physicians were expected to track based on value-based contracts with multiple payers. Medicare contracts averaged 13 measures for contract, followed by 10 for commercial payer contracts and five for Medicaid agreements. The authors’ discussion highlighted the disparities in different quality metrics, noting that not only were they addressing different conditions, but that some differed in the outcomes that physicians were expected to meet.

In other study-based news, it’s no surprise that patients report higher satisfaction levels when clinicians are seated when meeting with them. The authors specifically looked at “the effect of chair placement on length of time physicians sit during a bedside consultation and patients’ satisfaction.” Over 100 physician encounters with hospitalized patients were observed, and chairs were placed either within three feet of the patient’s bedside or at a “usual” chair location.

Outcomes included whether the physician sat or not at any time during the visit, along with patient satisfaction. The difference in physician behavior was notable, with 38 of 60 physicians in the “chair placement group” sitting during the visit but only five of 65 physicians in the “usual” chair location group sitting. During college, a friend of mine who was studying architecture used to regale me with the things that he was learning while I was suffering my way through organic chemistry. The idea that “people will sit where they are places for people to sit” appears to be as true in the healthcare setting as it is in theory.

Are your clinicians encouraged to sit at the bedside, or are they just standing at the wheeled workstation or a wall unit? Do they ask for something different? Leave a comment or email me.

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