ClickCare Café

Why The Pay Gap for Women Doctors Hurts More Than Women

Posted by Lawrence Kerr on Wed, Mar 21, 2018 @ 06:00 AM

rawpixel-com-267082-unsplash.jpgWhen our founder, Cheryl, went to medical school, there were only 5 women in her medical school class. (Actually our medical school class since both of us were in the same medical school class and shared a cadaver.)

Things have certainly changed since then, in some ways for better and in some ways, for worse.

Although Cheryl’s medical school class only had 5 women in it, in 2017’s incoming medical school classes, women made up just over 50% of students. As this is Women’s History Month, that seems a milestone worth noting. 

Surely, allowing the makeup of our doctors’ demographics to reflect the demographics of the talented people in our country is good for everyone. So the equity in representation of the genders in medical school classes is likely a step forward.

That said, I was, quite honestly, saddened and surprised to hear that female doctors earn 27.7% less than their male counterparts (an average of $105,000 less.) This number actually has increased since 2016.

The pay gap, of course, is a serious issue across all industries and physician pay aligns with the pay gap that is seen in other professions. And truthfully, the pay gap for lower-waged workers is probably more significant of a problem for those experiencing it.

But my concern about this pay gap in medicine goes beyond gender equity or salaries. My concern is greater because I believe this persistent — and growing — pay gap is representative of our tendency in medicine to devalue the contributions of some medical providers relative to others.

This instance is especially stark because the job being performed is exactly the same. So we're very obviously undervaluing the contributions of female doctors relative to male doctors.

But we do this across the medical team. We each have such unique contributions to a patient's case. When we refuse to use existing tools to do medical collaboration, we are effectively saying, "my opinion on this case is the only one that is relevant."  When we refuse to ask colleagues to collaborate, when we disregard the perspectives and input of others on the team, or when we neglect to consult on a case, we're devaluing those perspectives and the patient suffers. 

Stark data is always a chance to see where we find the same dynamics in our life or practice. So as Women's History Month comes to a close, I hope we can use it as a moment to reflect on how we might value, reward, and listen to all of the voices on the medical team, regardless of gender or title. 

 

ClickCare Quick Guide to Medical Collaboration

Tags: store and forward medical collaboration, hippa secure healthcare collaboration

Looking to the Future of Medicine: Machine Learning, Telemedicine, and iClickCare

Posted by Lawrence Kerr on Wed, Mar 07, 2018 @ 06:01 AM

markus-spiske-187777-unsplash.jpgWe’ve heard key investors say that the biggest startups over the next 10 years will be those that follow the model, “machine learning + _____________.” In other words, the future’s biggest companies will be innovating at the intersection of computer’s intelligence and human reality and wisdom.

Similarly, many people who look to the future of medicine see healthcare being increasingly supported — perhaps in profound or even dominant ways by computer diagnosis.

iClickCare, of course, is medicine supported by technology, also. And a big part of our work is finding the right balance and interaction between people and the technology. Our interface is meant to minimize the feel of using technology while maximizing the “behind the scenes” work that the technology is doing to support the collaboration and coordination. It’s sophisticated, patent pending technology that feels deeply simple to the healthcare providers that use it to collaborate.

This week, we were both saddened and inspired to hear about the recent passing of Catherine Wolf, a scientist who focused her work on the interactions between computers and humans. She was a forerunner in her field, working at IBM’s Thomas J. Watson Research Center and helping develop voice-recognition systems as well as early “picture phones” and cellphones.

She also was diagnosed with ALS 22 years ago, giving her firsthand experience of using computers to communicate when her mobility was limited to an eyebrow raise. She continued to work, innovate, and to write, learning to use technology as adaptations to allow her to continue to thrive.

Her story reminds us of the profound potential of the “collaboration” between humans and computers. We’re reminded of how much we’ve progressed in the last few decades and we imagine how much more potential there is.

We’re inspired by the potential for deeper humanity, creativity, and contribution, as exemplified both by Wolf’s work as well as her life.

 

For an in-depth look at why we choose the technology we did for iClickCare, and how it "gets out of the way" of the people using it, download our free Quick Guide: 

 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: telemedicine technology, store and forward medical collaboration

Interruption is Not Collaboration (But Healthcare Thinks It Is)

Posted by Lawrence Kerr on Wed, Feb 14, 2018 @ 06:01 AM

freestocks-org-229658.jpgI love listening to a podcast called Rework. They talk about work and business in interesting ways -- and although they're certainly not in the medical field, many of the insights apply. 

Last week's episode really stuck with me as important and made me realize just how far behind the healthcare field is. The episode, Interruption is Not Collaboration, looked at the cost of interruptions in the workplace.

If you're like most healthcare providers, the thought of even talking about "interruptions" seems ridiculous. In a medical setting, the day is one long interruption. There's so many things scheduled and happening simultaneously, that we become used to the situation, not noticing the cost. 

In fact, as is cited in Rework's episode, when we are interrupted, it takes about 23 minutes to recover from that interruption, in terms of productivity and the quality of your focus. In other industries, business leaders have started putting in place systems and tools that limit interruptions. Not for emotional reasons, but because the interruptions are "expensive" in their impact on work, in productivity, quality of insight, and errors made. But in the world of healthcare, we accept interruptions as normal and do little to try to minimize them.

I believe that many of my colleagues have little interest in medical collaboration because when they hear "collaboration" they think of interruptions in the form of: 

  • Text messages
  • Phone calls (or calls they have to return) 
  • Videoconferencing appointments
  • More meetings to attend. 

Of course this is what providers envision when they think of collaboration -- because these are the common forms that collaboration ends up taking. But these forms of collaboration come at such a high cost in terms of the provider having to interrupt or step away from the rest of their work -- that the collaboration becomes very much not worth the trouble. The other challenge with collaboration taking this form is that because the medium is so ephemeral, the conversation is not archived or accessible over time. Once the question is answered (like so much in our virtual world), it ceases to exist.

This is why we believe so firmly that healthcare collaboration needs to take the shape of Hybrid Store-and-Forward® telemedicine. It's absolutely crucial that care coordination and healthcare collaboration be sustainable, and supportive of the rest of the provider's workflow. Providers need to be able to ask and answer questions on their schedule, in their own time. With this form of collaboration, questions and answers don't interrupt the rest of your work, you can answer in a way that works with the rest of your schedule, and the case is archived for future review. That means that all of your patients get the most focus you can provide, and that you get the satisfaction of finishing one thing before starting another.

Your work matters too much to allow interruption to be the way things happen. Demand more for yourself -- and demand more for your patients.

 

To learn more about Hybrid Store-and-Forward telemedicine, download our free quick guide: 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: healthcare collaboration, store and forward medical collaboration, hybrid store and forward medical collaboration

Are You Too Introverted for Healthcare Collaboration? Us Too.

Posted by Lawrence Kerr on Tue, Jun 14, 2016 @ 07:30 AM

openoffice.jpeg


Most healthcare providers don't have a lot of mental or physical space during their work day. Whether it's to make a phone call, have a bite of lunch, or a private conversation with a colleague.

I always used to find respite in the surgeon's lounge, both the respite of a quiet moment, and the respite of an inspiring or helpful conversation with a colleague.

Today's medical context is simultaneously more isolating and more exposed that it ever was before.

We're almost never left to quiet and solitude to reflect on a patient -- but we're also very much disconnected from our colleagues when it comes to collaborating on a case.

So I was curious to hear a radio story that looked to the origins of the "open offices" so popular now in corporate America. It's now quite mainstream to have an open, playful, flexible office, but when the advertising agency Chiat-Day created one, it was incredibly unique.

As Planet Money describes the office: "There was also a ping-pong table, a giant staircase to nowhere and the piece de resistance, the floor - poured plastic resin… The desks in this office were all on wheels, and the chairs were plastic with coiled springs for legs." It was gorgeous, it was bold, it was brash -- and everyone had to be moving and talking to each other all of the time. There was no room for anyone to have a private conversation, to store their things, or take some isolated time to think.

In fact, the architect that created it, Gaetano Pesce, still believes the design he came up with (pictures here) is transformative and is a boon for creativity.

Was the design a success or a failure? Well, it certainly depends who you ask. But many people who worked at Chiat-Day when they had the open office say that it was very cool but that it simply didn't work for everyone. For the more reflective, or the more introverted, or for those who simply needed to work in a different way, the office dictated a certain way of working -- rather than supported the unique way that each person wanted to work.

So on the one hand, I find the study fascinating because I think that in medicine, there is a very specific need to find a balance between connection and solitude. So much of what we talk about with iClickCare is that it connects you. We use telemedicine to facilitate healthcare collaboration -- connection among you and other providers. 

But iClickCare also has another important role -- it protects you. Rather than the video-conferencing scheduling nightmare, or the million-and-one consult phone calls, or the barrage of emails that most of us face, iClickCare is specifically designed to work on your schedule, in your way. Hybrid store-and-forward telemedicine is asynchronous -- which means that you don't need to be answering consults, or requesting consults on any particular schedule -- you can do it in the way and at the time that works for you. 

So we are always on the lookout for tools, spaces, designs, and cultures that are designed with people in mind -- all people. 

Collaboration is good, but has to be on individuals' terms.

 

This is our guide to all the details, pros, and cons of hybrid store-and-forward telemedicine. You can download it here, for free:

 

ClickCare Quick Guide to Hybrid Store-and-Forward

 

 

Tags: telemedicine, medical collaboration, hybrid store and forward medical collaboration, healthcare collaboration, store and forward medical collaboration

Huge Legislative Changes for Store-and-Forward Telemedicine

Posted by Lawrence Kerr on Tue, Jun 07, 2016 @ 07:00 AM

store-and-forward-legislative-changes.jpeg

 

The American Telemedicine Association reports an amazing change in regulations: 49 of 50 states now have Medicaid programs that cover telemedicine for low income beneficiaries. (The single outlier? Hint: the smallest state in the nation.)

This report also notes that Missouri is a new member of an exclusive but growing group of states on the cusp of expanding coverage to store and forward Technologies. Store and Forward means non-videoconferencing, but instead communication with pictures and words in an email-timeframe. At this time, Missouri joins New York by specifically including -- and covering -- providers of all types and across the continuum of care.  

These legislative trends are at the convergence of several trends that are obliterating the barriers to telemedicine. Modern technology that assists in the everyday care of patients -- telemedicine and telehealth -- is no longer an experimental, conceptual idea. It is no longer about pilots, trials, and demonstration projects. In fact, telemedicine isn't even that cool or new anymore -- it is a mainstream, valuable, everyday tool.

With this change in telemedicine's place in society comes a change in providers, and a change in supporters. No longer is the only telemedicine model that of a central expert "helping" dispersed or lesser-resourced/educated/connected outposts. Now, and especially with store and forward telemedicine, these tools can help all providers support, challenge, educate, and collaborate with each other. And it's a good thing, too. Sometimes the most influential provider in the room is the one with the least number of degrees, but the closest contact with the patient. Sometimes, it is the patients themselves.

Missouri and New York, while pioneers, are enabling what we at ClickCare have been espousing and creating since our early grant days in the 1990s. They are enabling patients' access to care. They are ensuring that everyone, including the patient, should be involved in care at the right time and the right place. And most importantly, they are allowing collaboration to happen -- which means better care for each patient. 

So we call for more pioneers to join Missouri and New York in cultivating and enabling access, collaboration, and (don’t forget) education.

 

Still learning the basics of Hybrid Store-and-Forward® telemedicine? This guide can help:


ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: store and forward, store and forward medical collaboration, hybrid store and forward medical collaboration, telemedicine, regulatory issues, telehealth, healthcare collaboration

Why Physicians Assistants Are Key to Medical Collaboration

Posted by Lawrence Kerr on Tue, Oct 14, 2014 @ 08:17 AM

PA Week photo resized 600

One of the fundamental values of ClickCare is that all parts of the medical team -- the patient, the family, and medical providers across the spectrum of care -- are crucial to healing and good care.

So as Physician Assistants Week wraps up, we wanted to take a moment to congratulate all physician assistants for the job that they do, day in and day out.

Physicians Assistants understand the need to collaborate as well as anyone. As they grow and expand from office to community and integrate and coordinate care, they are increasingly burdened with time wastage and hassle when medical providers don't communicate.

So thank a Physicians Assistant today. In doing so, remember that the medical team is a team made up of many kinds of providers. And we all need to work together for any of us to succeed.

 

Wondering whether you can use your smartphone in the medical setting? Get our free guide to secure "Bring Your Own Device (BYOD)" policies here:

iClickCare IS BYOD Secure

 

 

Image courtesy of marine_corps on Flickr, used under Creative Commons rights.

Tags: collaboration, telemedicine, care coordination, healthcare collaboration, store and forward medical collaboration, healthcare provider burnout, Physician Assistant

When Telemedicine Includes a Chicken

Posted by Lawrence Kerr on Thu, Oct 02, 2014 @ 08:39 AM

chicken resized 600

A recent story in the NY times told the story of a doctor in Israel who offhandedly told a patient's son that, of course, a Rabbi could visit the patient in the hospital. The doctor only had second thoughts when he found the Rabbi in the hospital room, waving a live chicken around the patient's head to a unison of prayer.

The story of the rabbi, the doctor, and the chicken probably sounds a little bizarre to some. Although I'd guess that if you've been practicing for a while, it may not surprise you much. The truth is that although this particular patient's custom was a little less familiar to us, patients always have their own customs and beliefs. And as the author points out, as medical providers, we sometimes ignore, edge out, or belittle these customs or beliefs at the expense of good medical outcomes.

Maybe the little boy you just stitched up needs his twin brother to visit him in the hospital or he won't sleep well at night. Maybe the woman scheduling her surgery needs to schedule after Christmas passes or she won't actually give her wound the time to heal it needs. Maybe it's worth standing in the hallway outside the OR for a few minutes while a patient's family prays, as it will help everyone feel more comfortable, and who knows, may even help the surgery go well.

What does all of this have to do with telemedicine and medical collaboration? Well, everything, actually.

We've found that when medical providers don't collaborate, the humanity of their patients can get lost between the cracks.

If the doctor in Israel had gone off duty right before the Rabbi arrived with the chicken, maybe the new doctor would have made a different decision, without the benefit of context. The new doctor might have banished the chicken, and with it, the trust and buy-in of the patient and his family of the medical interventions at work.

With iClickCare, we find that the little things that make medicine a thoughtful, human, respectful, open practice can actually survive. The "story" of who a person is can come across in a conversation between people, or if folks are too busy or schedules don't match up, in a synchronous exchange via Hybrid Store and Forward Telemedicine. It's the little comment about "I'd say to go ahead and take the stitches out, but make sure Dad is in the room for a minimum of tears" or "Let's schedule the surgery for this week, not next, since Ramadan is coming up" that make the difference between extraordinary care and, just, medical care.

So don't banish the chicken. And use whatever collaboration tools you need, to help.


Curious whether hybrid store and forward telemedicine could help you care for your patients?

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: collaboration leadership, medical collaboration, good medicine, healthcare collaboration, store and forward medical collaboration, communication with patients, concierge medicine

Why Afternoon Tea is Crucial to Medical Collaboration Teams

Posted by Lawrence Kerr on Mon, Sep 29, 2014 @ 08:32 AM

afternoon tea, medical collaboration is aided by social interaction

Last week we shared 5 things that make a medical collaboration team great. And today we look at the the 6th thing:

Afternoon tea.

As our last post discussed, social interaction is critical to collaboration. A study from MIT showed that when social interaction happens, productivity increases. A call center made the simple change of scheduling all their coffee breaks at the same time, and call response time - an easy to measure statistic - decreased markedly. Which leads us to Anna of Bedford, whose birthday just passed on September 3rd. As the industrialized society grew, and dinner was served late, people began to have a light snack at 4 or 5 pm. Anna took it one step farther: she served tea. These tea times were gathering places for gossip and moments to discuss the affairs of the day. Anna's friend, Queen Victoria, followed suit. The practice became fashionable, spreading, and becoming what we now know as the British Afternoon Tea.

We do not know if call response times decreased then, but we do know that it was the time of the peak of the British Empire.

In medicine, we used to do a lot of versions of afternoon tea, to keep relationships strong and the lines of communication open. In fact, modern residents won’t believe this, but we used to have “GI rounds” of beer, wine, and cheese in the pathology lab conference room. The surgeons actually talked to the pathologists too!

The truth is that these times for afternoon tea in the medical profession are dwindling. But the need for social interaction and conversation hasn't decreased. It's crucial when we do any collaborative venture whether it is in person, by phone, with paper, or ideally with Hybrid Store and Forward telemedicine.

So as you collaborate, remember that we are collaborating with another professional with skills and knowledge different from ours. That person can be anyone with any title, HIPAA compliant of course. And in that collaboration, I've found it useful to keep the following in mind:

  • Talk and listen. “Yes sir, no sir” doesn’t hack it any more than “My way or the highway”
  • Engage in energetic conversation. Healthcare can be depressing. We don’t have to add to the depression. Bad outcomes taken seriously, but bad administrative and regulatory environments, not.
  • Connect with all of us, not the boss. Hybrid Store and Forward allows connections and conversations to take place both anywhere and any time.
  • Carry on inside and outside of the meeting. Continue the conversation, as in “I just had another thought”.
  • Be individuals and explore, but return and share. It’s the patient who should win roundsmandship, not the last man standing.
  • Take time to make one more entry. “Thanks”; “We came to a good plan”; or “Keep in touch”.

And most of all remember to take time for tea.

 

Want more stories from the front lines of collaboration?

 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: coordinated care, care coordination, medical collaboration, store and forward medical collaboration

5 Surprising Things That Make a Great Medical Collaboration Team

Posted by Lawrence Kerr on Sat, Sep 20, 2014 @ 07:42 AM

great teams resized 600

Recently, a consultant from MIT visited a frustrated manager at a call center. The manager was experiencing something that many medical providers have experienced at different times. He was struggling to figure out "why some of his teams got excellent results, while other, seemingly similar, teams struggled?" It's that same frustration we wonder about as providers: we feel "flow" and pride in giving excellent care at one place where we work, while everything seems difficult at a different hospital or location.

After months of data analysis, the call center folks found that the teams that performed best were those that communicated best: "we’ve found patterns of communication to be the most important predictor of a team’s success. Not only that, but they are as significant as all the other factors—individual intelligence, personality, skill, and the substance of discussions—combined."

So how can you improve communications? Well, the hospital lounge is evidence that we've known the answer all along. The call center made one simple change to try to improve communication: they adjusted break schedules so everyone could take a break, make a coffee, and have a conversation at the same time. That change had huge consequences. Soon, they were seeing such increases in efficiency that they anticipate a savings of $15 million per year.

And while medical providers tend to measure success more in terms of patient outcomes than in terms of efficiency, we think there are some interesting patterns to inform our providers for medical collaboration. The coffee-break solution helped cultivate good teamwork, but what are the characteristics of what a good team actually looks like?

5 things that turn a good group of people into a great team for medical collaboration, via HBR:

  • Everyone on the team talks and listens in roughly equal measure with short communications. That's why the entire continuum of care -- nurses, aides, doctors, and everyone in between -- must be included in the care conversation.
  • With conference room encounters, members face each other and have energetic conversations and gestures. With communication technologies this means feedback, prompt responses, and a simple thanks. Video conferences take time and money. But store-and-forward telemedicine tools allow for this kind of energetic exchange of ideas.
  • Members connect with each other not just the group leader. The typical "hub and spoke" consultation doesn't allow all team members to collaborate or share information. Face to face conversations and some telemedicine can support these kinds of "horizontal" conversations.
  • Members can carry on back-channel and side conversation with the team. We feel everyone, no matter where in the hierarchy, should be talking to each other.
  • Members periodically break, explore outside the team and bring information back. While there's a place for efficiency and 100-hour weeks, we certainly think that medical providers benefit from not being excessively overworked and overtaxed. One benefit (among many) is that team members that have a little wiggle room in their schedule can bring back new ideas and information. 
And if teams are a part of your work, check out other stories of medical collaboration in this quick guide: 
ClickCare Quick Guide to Medical Collaboration

Tags: collaboration leadership, medical collaboration, store and forward medical collaboration, communication with patients, patient satisfaction, provider burnout

New York State Recognizes ClickCare -- and Telemedicine

Posted by Lawrence Kerr on Tue, Aug 05, 2014 @ 08:00 AM

New York Award to ClickCare

 
As a company passionate about making healthcare work better for patients and medical providers, we don't often talk about the "behind the scenes" of ClickCare itself.

This past week, however, we paused to reflect on how the success of our mission and the success of our company are deeply linked. We were fortunate enough to be chosen from hundreds of potential companies to be part of a business accelerator hosted at Binghamton University. Start-Up New York chooses businesses, particularly those developing key technologies that are ripe for expansion and that will develop jobs for New Yorkers. It's a coveted award, because it gives companies the depth of support and experience that they need. 

In being selected as one of these companies with the most potential to expand -- affecting our community and the lives of local folks in the process -- we realized that the award shows just as much about healthcare as it does about ClickCare. ClickCare is poised for expansion because of the medical need for accountable care, the huge demand for coordinated healthcare delivery, and the gap that exists in HIPAA secure communications. ClickCare's way of making telemedicine accessible is part of this bigger movement.

So as we move in to our new offices, we're conscious that this award puts a spotlight on not just us, but on everyone working to change healthcare. May we all take a little encouragement from the recognition that the state of New York gives to the importance of this work.

For more thoughts on telemedicine and how it can change healthcare, click here:

ClickCare Quick Guide to Telemedicine 

Tags: telemedicine, medical collaboration software, coordinated care, medical collaboration, Telemedicine and HIPAA, healthcare collaboration, store and forward medical collaboration

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