Fulfilling Health Calls Mission One Relationship At A Time

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Health Calls received an unsolicited testimonial from a family this past week. It makes us so proud and speaks to Health Calls Mission.

‘Health Calls is a wonderful service! All of the nurses are of the highest quality and you really establish a relationship with them.

 

Health Calls is always available and ready to help no matter the time! I’d never use another agency with my mom’s care!

 

Congrats (to) everyone… associated with this fine organization!’

As invited guests in people’s homes, we must negotiate care. We cannot simply “do”. This is a shift in the perspective  that often accompanies health care provided in a hospital or other clinical settings. In those settings, the structure and processes require patients to adapt to the organization.

In home health, we are the guests.  The ‘house rules’ could get in the way. Instead, Health Calls staff is focused on teamwork, alongside other community professionals to treat patients where they live. This requires actively listening to the patient and family: finding out what is important, what can be negotiated, and then aid and inspire patients to become informed about their conditions and take an active role in their treatment.

The balance of power shifts away from the healthcare team to the individual and their family in a healthy partnership. We support the patient and family while they build skills, and foster their confidence to continue to lead active and fulfilling lives, long after our work
is done.

We are thankful to be invited!

Medicare Releases Star Ratings For Patient Experience: Health Calls Receives Top Rating


Medicare released the first “Patient Survey Star Ratings” for Medicare-certified home health agencies last week.

Health Calls Home Health Agency received a 5 star rating in Medicare’s Patient Survey Star Rating.

Health Calls response rate to surveys is 33%, which is “a very strong showing”, according to Mike Little, Health Calls CEO and owner. “The findings show that Health Calls is the best and most well-rounded choice for home health services in Berks County.”

Maria Radwanski, COO and co-owner indicates that patients have the ability to remain anonymous or reveal who they are when completing the survey. “Even so, many patients do reveal who they are and take the time to write a note about the health care providers they saw in their homes.”

One recently surveyed patient wrote ‘this was the best care I have had from any agency. I’ve had several falls and this one was there to push me to understand what I could do and what I shouldn’t’.

This patient received critical safety information, in a manner that reflects that she was given important feedback during treatment to improve. The staff was able to do so in a way that involved the patient in the change process and maintained the patient’s respect and dignity while making the necessary changes.

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Difficulty Understanding Basic Health Information May Lead to Poor Health


Health Literacy is defined by the Centers for Disease Control (CDC) as “the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions”. Health literacy is a person’s ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and the ability to negotiate complex health care systems. Health literacy is not the ability to read. It requires a complex group of skills including reading, writing, and reasoning to understand concepts to make health behavior decisions.

Medication bottles collected in medicine cabinets across the country simply read: “Take as directed”. For those adults who have limited health literacy, or are limited in their ability to make sound health care decisions, this has little meaning. Take Charlie, for example,who has bronchitis and has been taking a swig from that cough syrup containing codeine the doctor prescribed. His caregiver discovered he was drinking straight from the bottle when she found him on the floor in his kitchen. He had been drinking the medicine staight from the bottle every couple of hours. If a little is good for you, more is better, right?

When compared to those with adequate health literacy skills, people with limited health literacy skills enter the healthcare system when they are sicker. Low health literacy skills are associated with an increase in preventable hospital visits and admissions. More than 75 million English-speaking Americans have limitations in their ability to make appropriate health care decisions. Health literacy can be improved. Patient teaching handouts, medical forms, and health web sites make it easier to understand and improve patient-provider communication.

The most important strategy for all people and especially those with limited health literacy is to have an advocate come along to doctor appointments, during short procedures and especially while in the hospital.
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Health care providers must find strategies that are helpful to the people they serve. According to health.gov website on health literacy important, basic strategies include

Identify the intended users
Use pre- and post-tests including use of the <a href=”http://
“>the “teach-back method”
Limit the number of messages
Use plain language
Practice respect
Focus on behavior
Check for understanding
Supplement with pictures
Use a medically trained interpreter or translator

What is your biggest concern for someone you love who requires health care?

Do you have any additional advice?

Futuristic Scanner Pre-orders Available


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Imagine having access to your body’s vital information and being able to get it in the comfort of your own home. Imagine that the information you receive will help determine if you are ill and in need of more professional care. The concept in reality could literally change the when what and where we seek emergency room care. No guessing involved.

Walter DeBrouwer’s hand held body scanner, once science fiction in StarTrek, is a very real concept. The Scanadu will be released early next year. The Scanadu is a handheld device, pinched between two of your fingers and held against your temple to obtain a reading. The numbers: heart rhythm, heart rate, blood pressure, temperature, and oxygen levels in your blood. Imagine the power this information bears in helping a person to understand the effects of their diet, exercise, rest patterns, and overall lifestyle on overall health.

Know Your Health Care Rights


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Today our United States Representative in Congress Jim Gerlach visited our agency office. It was an honor to speak to him about the impact of the Affordable Care Act on his constituents as we see it. Since we visit people in their homes every day, we hear many different stories about the impact of health care reform. We spent the better part of an hour discussing the impact of health care reform on all the people we interact with, the challenges and benefits of home health services, and to see how we can be of service to the congressman.

It was a timely visit, on the eve of our country’s birth as a free and independent nation. We are blessed with so many privileges because of our Constitution and Bill of Rights that make us free. Let me share with you some of our conversation.

We spoke freely with pride about our fine, talented, professional staff that are in people’s homes working to help community neighbors, our patients. We want to maintain our ability to employ these fine people on our staff by providing them with an income and affordable health care insurance.

In speaking of our patients, the people needing our health care services, we spoke of the interest that people have to continue to be able to choose where they want to receive services and who provides them. Receiving these services at home is the most cost-effective option within the health care system. We also work very hard to help people avoid going back to the hospital by teaching them how to be in charge of their care, be independent, and remain at home.

We also spoke of free enterprise and the pride we have of being a small, locally owned business, run by people who know and live in this community. We asked to provide some input about issues and decisions that effect small business both locally, regionally, and nationally. Affordable health care is high on the agenda of every small business owner, and certainly at the top for us.

How lucky we are to have the right to speak freely and be received without fear of reprisal. I am very grateful. We are blessed.

That is how our nations Bill of Rights works every day.

But did you know there is a Patient Bill of Rights? The Patient Bill of Rights that was adopted by the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998. Virtually any organization that provide services and bill Medicare and Medical Assistance are required to inform patients of these rights when they start providing services to the individual. Health Calls provides every patient with a copy that is maintained in a folder with other materials in the home of every patient we serve. These Rights apply to care in all settings: doctor’s office, outpatient clinic, hospital, nursing home, and in home care.

So what does the Patient Bill of Rights say?

Information Disclosure: You have the right to accurate and easily-understood information about your health plan, health care professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help should be provided so you can make informed health care decisions.

Choice of Providers and Plans: You have the right to a choice of health care providers who can give you high-quality health care when you need it.

Access to Emergency Services: If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. These services should be provided whenever and wherever you need them, without the need to wait for authorization and without any financial penalty.

Participation in Treatment Decisions: You have the right to know your treatment options and to take part in decisions about your care. Parents, guardians, family members, or others that you select can represent you if you cannot make your own decisions.

Respect and Non-discrimination: You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.

Confidentiality of Health Information: You have the right to talk privately with health care providers and to have your health care information protected. You also have the right to read and copy your own medical record. You have the right to ask that your doctor change your record if it is not accurate, relevant, or complete.

Complaints and Appeals: You have the right to a fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals or other health care personnel. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy of health care facilities.

Some practical advice to assure that you are adequately informed:

Speak up if you have questions or concerns, or if you don’t understand information provided to you. It’s your or your loved one we are talking about and you have a right to know.

Pay attention to the care you or your loved one is receiving. Make sure you/they are getting the right treatments and medications. Don’t assume anything.

Make sure staff providing care are introducing themselves and you know what their credentials are.

Notice whether or not the staff is washing their hands. Hand washing is the most important way to prevent the spread of infections. Don’t be afraid to gently remind the caregiver.

Make sure the health care professional confirms your/ your loved one’s identity before giving medications or treatments.

Educate yourself about the diagnosis, services provided and the care plan. Gather information. Write down important information the doctor tells you and ask if the doctor has any written information you can take with you to look at later.

Thoroughly read all forms and make sure you understand them before you sign anything. If you don’t understand something, ask for a better explanation.

Make sure you understand how to use any equipment that is being used.

Know the medications and why they are prescribed. Ask about the purpose and ask for written information (can be provided by the pharmacy). However, you will want to ask questions before agreeing to have the prescription filled, so ask your health care provider. What are the benefits of taking this medication? Will it interfere with anything else I am taking or eating? Is there a generic form of this medication? Know both the brand and generic names of the medications. Know the possible side effects to watch out for.

Whenever a new medication is prescribed, tell your health care provider about any allergies and other medications prescribed to be sure that it is safe to also take the new medication.

Ask for a list of providers for services recommended. The hospital or nursing facility should not automatically assign providers for on-going care. You get to choose who you want for continuing care needs.

Happy Independence Day!

Forgot to take your medicine? There’s an App for that.


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A survey of over 1,020 people recently by the National Community Pharmacists Association found that nearly 6 out of 10 people admit to not taking medicine as prescribed by their doctor. Reasons given were forgetting whether or not they had already taken the medicine or not refilling a prescription before running out of it. Twenty-two percent reported taking a lower dose than the doctor recommended and 14% stopped the medicine without checking with their doctor first. Nearly a third reported costs were an important decision maker in deciding if they were going to fill or refill a prescription.

Thirty percent reported forgetting whether they had taken their medication, and 28% said they failed to refill a prescription medication in time. About 2 in 10 said they have taken a lower dose than instructed (22%) or did not fill a new prescription (20%). Fourteen percent admitted to going off their medication without consulting their physician.

Forgetting to take medication is the problem for many people. Pre filling medication planners for a week or two at a time and using wrist watch alarm clocks or a phone app reminder system will greatly improve a persons ability to adhere to a schedule. There are also paper forms that can help a person remember what needs to be taken.

For most people, before deciding to stop taking medication on their own, consider asking your doctor the following:
What benefits do this medicine provide?
What will happen if I don’t take this medicine?
What are the alternatives to taking this medicine?
Is there anything I am currently taking that I can stop?
Are there any potential side effects if I take this medicine with other medications that I am prescribed?

If the person has difficulty obtaining or refilling prescriptions, a new system to obtain medications can occur with a pharmacy that delivers. Many pharmacies now offer refill reminders or automatic refill service which greatly improves adherence as the pharmacy will also contact you with an automatic telephone reminder when the prescription has been refilled. Many also find that scheduling family or friends to pick up medications on a routine basis will help those who do not have access to delivery service and find it more difficult to leave their home.

If funds to purchase medication are a problem, request your pharmacist to refer you to participate in drug company grant programs. Consider consulting with the pharmacist regarding use of generic drugs and also don’t be shy about asking your doctor who prescribed the medicine about the availability of drug samples to help off-set the costs. Many states have an additional assistance program for low income families who require prescriptions.

Medication schedule confusion can be managed by developing a customized pill card complete with schedule, pictures of the pill and the number of pills to be taken each time with easy to follow graphics. This tool is also extremely useful for someone with limited reading skills.

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Laptops in the Room


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I visited my rheumatologist in January for a routine yearly exam. The doctor used a laptop and a microphone. He dictated what I told him right after I said it. Last year he did not have a laptop. I saw my primary care doctor in March for my yearly physical. She used her laptop keyboard to record my answers to her interview questions. Last year she did not have a laptop. All of the staff who work for my home care agency use iPads when they do their visits with our patients. We have been using an electronic medical record since 2007, and specifically with the iPad since November of 2011. All patients in our local hospitals have experienced staff working with computers as part of their hour to hour routine.

Technology for health care documentation is quickly evolving and is here to stay. This is an important provision of the Accountable Care Act. In fact, health care organizations of all types who are not using an electronic record are penalized with less reimbursement if they have not adopted an electronic medical record. The intention of the electronic health record is to provide real-time access to health information at the point of care. This allows for complete information to assist clinicians help patients make important medical decisions.

Discussions with real-time data is meaningful. Patients are supported with the accurate, available information for better decision making. Studies have shown that health information technology can improve patient’s ability to follow recommendations and reduce medication errors and cost.

So what’s at issue? Healthcare professional staff are often ill-prepared for use of this technology. The system used may not be the most used friendly. Most of the negative experiences patients have related to computer use is due to the negativity portrayed by the health care professional using the device.

And that’s the point. It is important to recognize that the computer is a tool to help with information management. Doctors using the computer effectively are pulling up lab work completed and going over the results with the patient and their family. The patient is positively reinforced when their hard work sticking to a low salt diet has an effect on their lab values. The patient who endured ill side effects of chemotherapy is rewarded by a clear PET scan picture viewed at the followup visit with their doctor.

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Other benefits to the health care consumer is access to healthcare records any time they want to view them. Many hospitals’ health record systems are changing and the healthcare consumer will have access to it by using a login and password to confidentially view personal health records, both current and from the past using electronic access. If you haven’t received information about how to access your personal health record coming to you in the mail.