Friday, 26 July 2013

Health Surveillance Screening or Health and Wellbeing Screening-Why Not Both?

Many companies already engage in statutory health surveillance screening which is based on the risks in the workplace. Is there an opportunity for companies to upgrade these programmes to become an organisational wide health and wellbeing programme?

Health Surveillance Screening
Occupational health is concerned with the relationship between health and work. Health problems often impact on work and conversely work can impact on health.
The law requires employers to provide a safe place of work for their employees. They must identify workplace hazards and manage health risks that arise. Companies are also required by law to provide 'reasonable accommodation' for employees with illnesses or disabilities.

Health surveillance also frequently includes health screening of employees on an annual basis to ensure that the working environment is not having a negative impact on employee health. Typical health surveillance screenings include audiometry (hearing check) and spirometry (lung function check) and often blood tests too.

Health and Wellbeing Screening
Health and Wellbeing screening aims to promote health awareness and proactive risk management by identifying employee health risks and tailoring lifestyle recommendations accordingly. These health screenings offer the opportunity to identify previously undiagnosed illnesses and to address them before they become serious.

Health and wellbeing screening is primarily used as an employee benefit either as a stand-alone measure or as part of a wellness programme. Wellness programmes are usually tailored to suit the requirements of each individual company and include measures such as fitness programmes, dietary advice and mental wellbeing awareness.
A health and wellbeing screening can contain a combination of tests. A typical basic test profile could consist of Height, Weight & BMI, Blood Pressure, Cholesterol, Fasting Glucose or extend to a more advanced profile including Kidney Function Test, Liver Function Test, Full Blood Count, Thyroid Function, Urinalysis, Resting ECG & Advice on Cancer Awareness.

Why Not Both?
Health surveillance screening and health and wellness screening require a similar amount of administrative resources and planning and consume the same amount of employee time. So is there an opportunity for HR to effectively upgrade existing screening programmes to offer a real employee benefit?

We think so and innovation in health screening software can now provide the self service tools and automation to minimise costly process issues. This means that the substantial effort and resources invested in health surveillance in the workplace can be communicated to each employee in an engaging way so that is also seen as a company benefit. Ultimately, this can empower your employees to better health and productivity.

Paul Mc Carthy is the CEO and Founder of Full Health Medical.

Thursday, 18 July 2013

Little (miss) sunshine and the heart

These days, I always seem to be thinking about balance in medicine; a balance between risk and benefit, a balanced diet and so on. So as Ireland swelters in unusually hot weather conditions, I’ve found myself wondering about the balance between too little or too much sunlight and the health implications. I’m not alone in this. Over-exposure to sunlight and we need to think about skin cancers, for example. But what about too little? Well, one issue associated with too little sunshine is low vitamin D levels and it is suggested that a large number of the population of Ireland and the UK are currently deficient in said “sunshine” vitamin.

Research about vitamin D seems to be very popular at present and there seems to be an ever increasing body of evidence that vitamin D deficiency is associated with a multitude of illnesses. These range from the role of vitamin D in bone health, cancers, cardiovascular diseases and auto-immune diseases. There is even a vitamin D hypotheses in terms of explaining  the increased prevalence in northern latitude of multiple sclerosis. See Holick MF et al in the Am J Clin Nutr 2004 or Ascherio A. Ann Neurol 2007 for more.

Low vitamin D levels have been linked to increased coronary heart disease risk. However, frequently the findings were in small studies. In the last fortnight research was publish in JAMA regarding the MESA cohort. This was a large study of ethnically diverse patients who were free of clinical heart disease at time of enrollment. Amongst the findings it was noted that low serum levels of 25-hydroxy vitamin D independently predicted raised long-term risk of coronary heart disease events among white participants (as opposed to African American for example). This study was described by a JAMA editorial as being “robust” and it is interesting that outcomes were adjusted for a multitude of CHD risk factors: age, sex, BMI, smoking status, excercise, diabetes status, cholesterol for example, so it appears as if the evidence is getting stronger. See here for more.

Although it would seem that there is an increasing body of evidence linking low vitamin D to increased coronary heart disease, a word of warning. Perhaps it might be best to consider getting your levels checked rather than spending longer in the sun. Skin cancer has been increasing over the past decades. According to the World Health Organisation one in three cancers diagnosed is a skin cancer. Reducing exposure to sunlight’s UV rays really is our own resposibility. See here.

Good advice for the current strong sunlight is don’t forget the Australian mantra regarding adequate clothes, sun-cream and hats, “Slip-Slop-Slap” before heading out into the sun.

For Health Screening Software that gives personalised Vitamin D advice CLICK HERE

Friday, 12 July 2013

Does Health Screening have a role in General Practice today?

Most GPs have a strong belief in preventative health but the practice is often a time poor environment. From the doctor’s point of view, the root causes of many illnesses such as diet and exercise take too long to address.

Whilst providing written feedback on all results is desired, the work schedule simply doesn’t allow it. Time spent writing reports is an administrative and costly chore that nobody enjoys and this time is far better spent with patients. 

With the right tools, set-up and discipline, health screening can be an additional high value service to add to your practice without it eating your time. It can create a new revenue stream with good margins and attract new private clients. If something is picked up, these clients are likely to become patients with repeat visits to your practice.  A good set-up means having the process entirely nurse led and the patient doing more of the work in advance.

Here are 10 steps that outline the basics for running a health screening operation:
  1. Schedule specific monthly dates for your health screening service, it may only be one to two mornings per month.
  2. Contract one of your trusted nurses to lead the screening programme.
  3.  Decide what screening products you are offering. The combination of Height, Weight & BMI, Blood Pressure, Cholesterol, Fasting Glucose is a basic offering. Adding Resting Electrocardiogram, Lung Function Test, Kidney Function Test, Liver Function Test, and Full Blood Count is a more premium profile.
  4.   Create awareness. Decide the most appropriate way to promote your new health check service. It may include posters in your practice waiting room, a message on your prescription pads and awareness campaigns aimed at specific age groups.
  5. Take bookings and encourage your patients to book online, this reduces your admin time.
  6. Encourage patients to complete their questionnaire online, this reduces time required with the nurse, which is the major variable cost in running a health screening.
  7. Optimise your resources, perhaps there is a room that can be made available for the nurse on the set days e.g. when a doctor is out on call or off.
  8. As the GP you can set a specific time, for example 8 days post screening appointments to review and approve reports and to call any high priority cases.
  9. Enable your patients to download their own screening report securely, this reduces admin and printing costs. Hard copy reports cost money but can also be provided.
  10. Schedule times for follow-up consultations which should close out very quickly as the patient will have reviewed their report in advance.
Dr. Ann Shortt, Founder and Medical Director

Friday, 5 July 2013

What Qualities Really Influence Patient Satisfaction?

A survey by of 2917 patients has been analysed by a number of leading academics. 7 elements of the customer experience that patients use to rate their health service provision were identified.

1. Accessibility to Physician or healthcare services
2. Communication between the patient and the provider
3. The personality and demeanour of the provider
4. Quality of medical care processes such as diagnosis and treatment
5. Care continuity such as follow up conversations and referrals
6. Quality of healthcare facilities
7. Office staff – the link between the patient and the physician

Healthcare experiences that met each of these qualities were deemed to be ‘excellent.’ It is useful to take a moment to reflect on how your health screening service might be rated across each category.

At Full Health we have always maintained that better communication between the provider and the patient is the key to patient satisfaction, engagement and empowerment. Excellent communication at the point of consultation and of test results thereafter are crucial elements. 

In the words of Buddy Scalara “Engage your patients and move them along the journey.”

The study divides communication into 4 categories:

1. General communication,
2. Listening,
3. Treating the patient as a partner,
4. Giving information. 

Technical, medical information is often the focus of communication between the physician and the patient and the manner in which this is conveyed is crucial to ensure patient satisfaction. The method and delivery of this information must be accessible and presented in a people friendly manner.

Patients who rated physicians as excellent in this category made comments such as:

“Very easy to approach and communicate with”

“Excellent communicator”

“Plain spoken, straightforward in his approach.”

“Explains everything to me so that I can understand it.”

It is obvious that every physician should strive to provide this level of service. Yet increasing resource constraints caused by pressures such as aging population, narrowing budgets and margins and regulatory changes have led to multiple projections of demand outstripping supply. 

In this challenging environment how can an ‘excellent’ level of service provision and communication be ensured for every patient?