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Monthly Journal of Informa on Technology

Summer 2016 Update

 Spring 2017 Update

In this 

Issue: 

Pg. 2 New 

Members 

 

Pg.3 Annual 

Strategic 

Meeting 

 

 

Education/

Updates: 

Pg. 5 Becom‐

ing a Model 

System Up‐

date 

 

Articles: 

Pg.6 “How 

Urgent Care 

Centers are 

Impacting 

Hospital 

Operations.” 

 

Pg. 9 

“Building a 

Network 

That Enables 

21st Century 

Healthcare 

Experience” 

 

 

 

Sponsorships: 

Pg. 13  Sup‐

porting spon‐

sors 

 

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2016 —2017 Great Lakes Chapter Leadership

Mentoring

Chair:

Andrea Barnes

Members:

Carolyn Obrecht

Program

Co-Chairs:

Michelle Toups

Nicole Sulak

Members:

Gerald Artman

Amy Bilyea

Donald Dingman

Carolyn Obrecht

Sponsorship

Chair:

Patty Davis

Members:

Brent Smith

Networking

Chair:

Cinthia Brooks

Vice Chair:

Members:

Max Mendieta

Mike Cwik

Brent Smith

Tom Matonican

Audit & Finance

Carolyn Obrecht

Certification

Chair:

Mark Thompson

Vice Chair:

Elizabeth Hooper-Linn

Members:

Link Chapter

Representative:

Sam P Niemi

Membership

Chair:

Ben Smyth

Members:

Steve Panoff

Brent Smith

Tom Matonican

Membership Directory

Chair:

Elizabeth Hooper-Linn

Newsletter

Chair:

Wieslaw Herdzik

Vice Chair:

Cheryl Kotenko

Members:

Alicia Kozak

Web Site

Chair:

Brent Smith

Great Lakes Chapter

Officers

President

Brent Smith

President Elect

Tom Matonican

Secretary

Michael Cwik

Treasurer

Kellie VanDeusen

Past President

Josh Wiggins

Board Members

Mark Kato

Tanya Hahn

Chad Gutzman

Sam Niemi

Directors

Northern Michigan

Gerald Artman

Upper Peninsula

Regina Bergh

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First Name Last Name Company

Ashley Rychwa MidMichigan Health

Luke Crimmins Munson Healthcare

Andrea Jamrog Covenant HealthCare

New Members 

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Annual Strategic Planning Mee ng

Great Lakes HFMA Chapter leaders, volunteers and future volunteers, It is with great excitement that I invite all of you to par cipate in our annu-al strategic planning session. As we wrap up another successful year for HFMA (thanks Brent Smith!!!!!) with the upcoming early careerist event on April 28th it is me to start planning for the future of our organiza on. Please join me in our annual strategic planning session scheduled for May 18th. The event will start off with the May board mee ng and the strategic planning is scheduled to begin at 9 a.m. I decided to wait un l a er LTC to formalize our agenda for strategic planning. If you know of anyone that would like to serve on a commi ee or take part in the strategic planning and they are not on the list, please forward this email to them. Please RSVP your a endance and fill out and return the a ached SWOT analysis by May 5th. I hope everyone has a great Easter weekend! Remember to RSVP and to register for the Early Careerist event. h p://www.greatlakeshfma.org/ Tom Matonican tom@cbmservices.com This will take place in the following loca on: McLaren Bay’s Lincoln Center Lecture Hall 820 S Lincoln Street Bay City, MI

Picture Above:  Amanda Givens in  

Phoenix attending LTC 

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FAREWELL FROM DAWN BALDUF

I am all set for Phoenix and LTC, which will be my last official act as your Regional Execu ve. It is a bi er

sweet me for me, as I will no longer be very ac ve in HFMA given my new role as a chaplain. However, I

am very much connected to HFMA’s principles of remembering the pa ent experience in all that we do.

I work closely with pa ents and their families now, and I am thankful for my past experiences on the fi-

nance side of healthcare. I can point them in the right direc on if they have concerns about their finan-

cial obliga ons and ease their minds a bit. The overarching principle for chaplaincy is the ministry of pres-

ence. It is about simply being a en ve and caring, really listening and being there. I can’t fix things, but I

can sit and hold someone’s hand or read Scripture.

While healthcare finance is, of course, a different perspec ve, there are s ll lessons to be learned. It is

important on a daily basis to be a en ve to what you do and how you do it. Are you really there, or are

you just going through the mo ons? Ac ve listening is key in both our professional and private lives. Liv-

ing in an authen c manner ma ers, regardless of the posi on you hold.

The changes to the industry have prompted HFMA to look at itself and make changes to stay relevant and

true to its mission. That means change, and there is plenty on that going on at both na onal and local

levels. The 2.0 ini a ve will be rolling on new ideas and programs. Na onal is looking at enterprise mem-

berships. One of the chapters in Region 6 has talked a great deal this year about new thoughts and

“rocking the boat” to make necessary changes for its membership. That takes courage and commitment.

And this region is full of amazing folks who possess these a ributes! I am proud of the accomplishments

made this year by our RE Council as well as the local chapters who have con nued to ba le membership

declines and volunteer atrophy.

I just completed a unit of clinical pastoral educa on. I thought it was going to be a program to teach me

how to be a chaplain, but it was really a process to look inward and figure myself out a bit be er. It was a

difficult, some mes painful process, yet I am a be er person for having gone through it. I am generally

more aware of the needs around me, as well as my own needs. Each one of you can make an impact, be

it nega ve or posi ve on HFMA and the organiza on for which you work. I would ask you to reflect on

your ministry of presence and what that looks like in your life.

I am blessed to have served in many capaci es during my tenure

with HFMA. Many of you have become friends, and I thank you for

the difference you have made in my life.

Be well, be present.

Dawn Balduf

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"Becoming a Model System: How Intermountain

Healthcare Leverages Transforma onal Strategies to

Achieve Greater Systemness"

Thursday, May 18, 2017 A keynote speaker from renowned Intermountain Healthcare will provide prac cal insights on achieving sys-temness. In addi on, dis nguished panelists from major health systems.

Schedule Registra on: 5:15 p.m. Dinner: 6:00 - 6:45 p.m.

Program 6:45 - 8:15 p.m.

Loca on: St. John's Golf and Conference Center

44045 Five Mile Road Plymouth, MI 48170

SPEAKER

Bert Zimmerli, CPA Chief Financial Officer & Execu ve Vice President

Intermountain Health

PANEL LISTS Anthony J. Tedeschi, M.D.

Chief Execu ve Officer Detroit Medical Center

Kevin Webb, Ph.D., FACHE

Chief Acute Care Officer Promedica

Carolyn Wilson, MBA, RN

Execu ve Vice President & Chief Opera ng Officer Beaumont Health

MODERATOR

Dan Riina, FACHE Partner

TRG Healthcare, LLC

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Booming Demand: How Urgent Care Centers are Impac ng Hospital Opera ons

Date 4/9/2017

The construc on and use of urgent care centers in the health care industry has steadily in-creased over recent years. The growing popularity of urgent care centers presents an oppor-tunity for hospitals to extend networks or expand partnerships in order to reach new clien-tele. Further, it offers an opportunity to enhance brand recogni on in new and exis ng mar-kets.

According to the Urgent Care Associa on of America (UCAOA), urgent care dates back to the late 1970s and was created with the inten on of mee ng a community’s immediate health care needs. It was a slow but steady start for urgent care in the beginning, but the concept of seeing a physician without an appointment eventually began to gain popularity among pa-

ents. Over the past 20 years, the urgent care industry has con nued to expand and earn the trust of those seeking a safe and affordable place to receive medical a en on.

Today, urgent care centers are physician-staffed and typically offer extended hours (evenings and weekends), providing quality care without the costs and wait mes associated with the average emergency room (ER) visit. Urgent care centers are best suited for situa ons that re-quire more immediate a en on; o en mes, this serves to be more prac cal than seeing a primary care provider, who can be challenged with offering consumers the hours or immedia-cy an illness or accident can demand.

Why the Increase in Popularity?

There are various drivers behind the recent growth of urgent care. The UCAOA es mates that growth has been steady the last several years, as between 300 to 600 urgent care centers are added per year, resul ng in the current popula on of around 7,400 centers. Challenges on the supply side, such as difficulty in finding a primary care provider and the increase in costs associated with ER visits, are a factor in the increase. A larger demand by consumers for con-venience, both in terms of proximity and hours, has also resulted in a need for more urgent care centers. More recently, lenders and investors have recognized the success of the urgent care model and have begun to look for opportuni es to par cipate in the ongoing growth.

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The business model is based on low-margin, high-volume care, as the average visit costs $150 with a total visit me of under 60 minutes in 84% of cases, compared to an ER visit that aver-ages $1,354 and consumes four hours of wait me. Costs are much lower in an urgent care se ng, as detailed with some of the more commonly treated ailments shown in the chart1 below:

An easy conclusion to reach would be that an urgent care center would draw lower-acuity pa ents away from emergency rooms, resul ng in less over-crowding of the ER and im-proved efficiency. However, a

study presented in April, 2016 by Grant Martsolf, et al, found that retail clinics opened near emergency departments are not associated with a material reduc on in low-acuity emergen-cy department visits. This data supports the no on that urgent care centers prompt pa ents to seek care for condi ons that might have been treated at home or at a primary care office. Thus, urgent care centers may not be an avenue for reducing ER overcrowding, but may pro-vide an opportunity for accre ve revenue through partnership or expansion. This widening of a hospital network may increase referrals and reten on of pa ents who will seek care through urgent care centers and might find themselves referred to physicians or tes ng facili-

es within the network. If a hospital invests in quality care and branding, the uniformity of care provided in an urgent care se ng will enhance a pa ent’s overall experience and may engender confidence in the en re health care system, promp ng pa ents to u lize other ser-vices of the hospital.

How Hospitals are Ge ng Involved

For hospitals interested in expanding their network to include urgent care centers there are several op ons. Some hospitals have pursued partnerships with an exis ng provider of urgent care services. This allows the hospital to step into a rela onship with an exis ng provider that has experience in managing the low-margin environment that demands a unique staffing ap-proach. This partnership has benefits for both the urgent care provider and the hospital be-cause the provider receives benefits from the local hospital’s brand recogni on and gains ac-cess to physicians employed by the hospital. In return, the hospital benefits from a reduc on in ini al investment requirements and receives another referral source.

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It is es mated that the majority of urgent care centers in the U.S. con nue to be operated as free-standing facili es, while 20% are owned solely by hospitals and another 15% are struc-tured as joint ventures. Hospitals that pursue the partnership model must be aware of the challenges that come with informa on sharing beyond their exis ng network.

Hospitals that opt to open urgent care centers have the ability to target neighborhoods and demographics that are either underserved or have a poten ally advantageous payor mix. The hospital’s brand recogni on can provide immediate legi macy to the start-up centers and these centers have the ability to share complete pa ent informa on, ensuring a seamless pa-

ent experience. Hospitals pursuing this path must ensure that staffing and the scope of care provided do not tarnish the hospital’s brand in the ini al stages of the learning process. Tradi-

onal sources of financing for nonprofit hospitals, such as tax-exempt bonds, the U.S. Depart-ment of Housing and Urban Development (HUD)/Federal Housing Administra on (FHA) Sec. 242 program, the U.S. Department of Agriculture (USDA) Business & Industry or Community Facili es program, or bank direct purchase financing, are typical op ons for financing these assets on a standalone basis, or as part of a larger strategic plan.

As demand for lower-cost alterna ves to care that do not sacrifice quality con nues to grow, opportuni es for hospitals to expand into the urgent care center environment will con nue to present themselves. Hospitals can act on these opportuni es to grow market share and ex-

pand brand recogni on, while simultaneously mee ng pa ents’ needs and providing quicker, low-er-cost care than that offered in a typical ER se ng.

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Building a Network That enables 21st Century Healthcare Experience

The network has never been as cri -cal to the healthcare sector as it is today. Electronic health records (EHR), WiFi-connected medical devic-es, and clinician smart phones are

among a plethora of healthcare technologies that depend on the network. These technologies are leading to new possibili es in healthcare management, pa ent and family experience, and most importantly, pa ent outcomes. Emerging use cases for the Internet of Things (IoT) are also showing tremendous poten al in healthcare. The success of these technologies depends on a network architecture that can support the capacity, coverage, security, and segmenta on re-quirements unique to healthcare, while adhering to a litany of compliance standards. This IDC Analyst Connec on highlights the cri cal issues healthcare IT professionals must consider when building a network for today's needs.

The following ques ons were posed by Extreme Networks to Nolan Greene, senior research an-alyst with IDC’s Network Infrastructure group, on behalf of Extreme Networks’ customers.

What significant trends confront a network IT professional in healthcare?

At a high level, mee ng the coverage and capacity needs of the myriad network connected de-vices in today's healthcare environments, while ensuring security and compliance, remains a top concern of network managers in this sector. The classic challenge of BYOD is par cularly acute in healthcare, given the well-known propensity of many providers to use their personal smartphones and tablets on the job. BYOD combined with an explosion in the number of organ-iza onally owned mobile devices in healthcare - many of which are mission-cri cal - means that pervasive wireless coverage is non-nego able. It also means that coverage should be able to accommodate device density. In a hospital se ng, where smart healthcare devices combine with employee and guest personal devices, the network needs to be able to support appropri-ate data rates depending on the cri cality of the use case.

With such a wide range of user groups involved, security, access policies, and iden ty manage-ment are also necessary considera ons. Enabling dynamic network segmenta on through Net-work Access Control (NAC) keeps sensi ve pa ent data out of the wrong hands. It also helps en-sure connected medical device safety, allowing healthcare organiza ons to not run afoul of HIPAA and equivalent protocols outside of the US while mi ga ng the risk of a breach that can endanger pa ents and harm the ins tu on’s reputa on. Finally, as is the case across all ver -cals, cloud-based applica ons have taken hold in the healthcare sector, leading to heightened requirements for applica on performance assurance and more granular applica on access poli-cies.

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What major challenges does IT bring to healthcare networks?

IT could mul ply the number of network endpoints in a healthcare ins tu on by a factor of 10. IT amplifies many of the same challenges brought to the network by mobility i.e. cover-age, density, access policies, and security. These last two are where IT can become especial-ly challenging. The headless (opera ng without human interven on) nature of IT devices can create difficulty in ensuring proper access and security enforcement. This makes IT end-points, which are con nuously processing sensi ve HIPAA-protected data, a prime target for hackers.

The con nuous processing of data also has implica ons for network architecture. IoT net-works need to be architected for data processing at the network's edge, as tunneling the steady stream of data back to the datacenter will hinder network performance. Of course, this also has implica ons for compute and storage. There are also DNS and DHCP challenges with IoT as a barrage of new IP addresses come on to network, requiring ghtly integrated management to ensure con nuity of service. Proper network segmenta on is an important first step as it can lay a founda on for proper network access mechanisms along with effi-cient traffic filtering. The poten al use cases for IT righ ully generate a great deal of enthu-siasm. Among them are asset management, medical imaging, telemetry, wearables, and lo-ca on services beacons. Knowing both the risks and rewards, healthcare organiza ons need to determine acceptable risk levels for IT and build appropriate network and security archi-tectures.

What challenges are emerging from IEC 80001‐1 Risk Mi ga on and other impending gov‐ernment regula ons for healthcare, such as emergency compliance of devices?

IEC 80001-1 is an interna onal, voluntary standard detailing ac ons that healthcare ins tu-ons must take when connec ng medical devices to the network to ensure safety, effec ve-

ness and security. A major risk factor of IEC 80001 is its lack of standardiza on. As an unen-forced standard, ensuring compliance that looks the same from place to place, is impossible. IT vendors can provide compliance configura on instruc ons, but compliance is not neces-sarily "built in" and implementa on guidance can vary widely among vendors. Add to this that it coexists with non-voluntary FDA and JCAHO standards and their interna onal equiva-lents, and there is room for confusion that leads to addi onal risks. 80001-1 is a goal for risk mi ga on that healthcare organiza ons can leverage in support of these mandatory stand-ards.

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In business, one of the biggest challenges to IT is internal groups bypassing IT for expediency. Does this occur in healthcare?

A. Yes, this is common in healthcare. I'll highlight two common ways non-IT employees bypass IT for expediency. Past IDC surveys of physicians have indicated that nearly half use their personal smartphones for pa ent care. This does not necessarily mean that all of these physicians are not ge ng their personal devices sanc oned for work use, but it does bring up concerns. Accessing pa ent data on personal devices can be risky, and illustrates the need for both strong iden ty management and containeriza on of enterprise applica ons on the device through MDM and other mechanisms. Healthcare IT must ensure that BYOD is me culously managed to ensure that no unnecessary risks emerge.

The other example is Shadow IT, or the procurement of IT solu ons without the knowledge or approval of the IT organiza on. This something that occurs regularly in the healthcare industry. As is the case with other ver cals, there is typically no malicious intent with shadow official IT knowledge, shadow IT applica ons may not be granted appropriate access levels and bandwidth priority from the networking team, thus hindering their performance in some cases or hindering cri cal applica on performance in other cases. Moreover, given the lack of oversight by a compli-ance-fluent IT team, the proper controls surrounding HIPAA, PCI, and other protocols may not be in place. Visibility into departmental behaviors from both a device and applica on standpoint are cri cal in balancing security and business requirements.

Q. Many healthcare facili es are located in compe ve markets where providers are looking for compe ve advantage. How does the network increase value of IT to the business?

A. Having a modern network infrastructure allows healthcare organiza ons to deploy state-of-the-art technologies for treatment and preven on, such as smart medical imaging devices, te-lemetry, remote health monitoring, and next-genera on asset management. Importantly, recent EMR/EHR requirements and ini a ves around the world require a state-of-the-art network infra-structure. Advances in EMR/EHR on the network are laying the founda on for a more stream-lined and less error-prone healthcare system, allowing providers the opportunity to enter data in real- me to EHR systems via mobile devices. There are other opera onal advantages, such as those achieved through cloud-based applica ons for resource planning and management, pro-ject management, as well as email and collabora on. An assortment of analy cs applica ons on the network can help healthcare systems collect valuable data through the network and take ac-

on in real me.

Advances in WLAN capabili es are enabling be er pa ent and guest experiences through WiFi services. High-speed guest access allows family members to communicate easily while a loved one is in the hospital. Loca on-based services have the ability to provide accurate wayfinding ca-pabili es for pa ents and guests naviga ng unfamiliar territory during poten ally trying mes, as well as the ability to provide context-based communica ons to mobile device users based on their needs. In terms of pa ent outcomes, network applica ons can streamline healthcare

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informa on management, leading to be er pa ent experience, adherence to treatment, and ul mately be er pa ent outcomes. In areas with mul ple healthcare systems, these types of compe ve differen ators can influence provider choice. However, these factors are also hav-ing an impact in na onal healthcare systems, as illustrated by successful implementa on of telehealth systems and generally steady progress toward a completely digi zed NHS in the UK.

ABOUT THIS ANALYST

Nolan Greene is a Sr. Research Analyst with IDC’s Network Infrastructure group covering Enter-prise Networks. In this role, he is responsible for market and technology trends, forecasts, and compe ve analysis in the Ethernet switching, rou ng, wireless LAN, and adjacent networking markets. He also assists in survey design, end-user interviews, and contributes to custom pro-jects for IDC’s Consul ng and Go-To-Market Services prac ces.

 

 

 

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We are always looking for ar cles, job openings or local Great Lakes content for the

newsle er. Please feel free to call or email your materials to myself , Cheryl or Alicia.

Wieslaw Herdzik Cheryl Kotenko Alicia Kozak

989‐839‐3304 989‐839‐3184 989‐839‐3732

Wieslaw.Herdzik@midmichigan.org Cheryl.Kotenko@midmichigan.org Alicia.Kozak@midmichigan.org