Nuesoft Xpress™ client Brenda Dalton, MBA, MSN, RN-C, WHNP spoke on the importance of “Making a Business Case for your Health Center” at the Mid-Atlantic College Health Association conference Oct. 22-24 in Lancaster, Pa. Her presentation highlighted the importance of maintaining a high level of business know-how in your approach to student health care services so that you can maximize your health center’s performance, market your department, build and maintain relationships with the decision makers of your university and reach key goals.

“Colleges are faced with having to validate rising costs of tuition; as tuition costs increase, sometimes student health services get the lower end of the budget,” said Dalton. “That’s why it is so important for student health care providers to make an effort to gain the attention of those who influence or control the budget.”

According to Dalton, one of the ways you can maximize your health center’s performance is to automate many of the everyday functions required to run your office. For example:

* Use a computerized scheduling system

* Electronically integrate a student’s demographic information with her/his medical record

* Increase accuracy with an Electronic Medical Record (EMR)

* Track immunization compliance

Dalton said that once the steps to maximize your health center’s performance have been made, you should begin to market your department:

* Use student groups and organizations to tell your department’s story.

* Communicate department accomplishments to public relations for inclusion in campus newsletters, web pages or other campus communication tools.

* Be a featured health writer or interviewee in the student newspaper.

But marketing may not be enough, either. Dalton stresses that a big part of being successful stems from the ability to articulate results effectively to decision makers.

With so many health care centers closing down, Dalton notes, “When I can, and as often as I can, I want to sell the value of my department. It’s about survival.”

Jennifer McDuffee writes for Nuesoft Technologies, a provider of Medical Billing Software and Medical Practice Management Software. This article previously appeared in Nuesoft Xpress e-Nues.

Article Source: http://EzineArticles.com/?expert=Jennifer_McDuffee

Within colleges and universities, the burden of pandemic flu planning is likely to fall upon many student health directors, even at institutions with environmental health and safety departments. John Covely, a consultant on pandemic flu planning and the co-author of the University of North Carolina at Chapel Hill’s pandemic plan, explains why this is so.

“Traditionally, emergency planning originates from public safety, or environment health and safety, but a communicable disease poses the biggest threat to students in group quarters. Thus, student health directors are often leading the emergency planning effort for the whole university, because the entire plan – not just the student health component – could be the difference in life or death for their students.”

The importance of having a campus-wide plan that is ready – not just in the preliminary stages – when the pandemic strikes is all the more clear when you consider that, unlike seasonal flu, H5N1 has an increased risk for the typical student demographic of young, healthy adults. The startlingly high mortality rate of up to 60 percent is partly due to a protein, also found in the strain of virus responsible for the 1918 pandemic flu outbreak, which causes a response in a healthy immune system known as a “cytokine storm”, often leading to respiratory failure and death.

Planning for such a massive and yet unpredictable event may seem a formidable task, but Dr. Anita Barkin, chair of the American College Health Association’s pandemic planning committee, counsels that those universities and colleges that have yet to formulate a pandemic plan shouldn’t feel overwhelmed by the work that lies before them. “Pandemic planning is about good emergency preparedness. The things we do to prepare for any emergency are the things we would do to prepare for pandemic flu,” she explains.

Although the tragic Virginia Tech shootings this spring were a different kind of emergency, the issues are similar to the issues faced in the event of a pandemic flu outbreak. Coordinating resources, communicating with everyone on campus and deciding at what stage classes should be called off are questions that have to be answered in most emergency situations. Take your pandemic planning one step at a time, advises Barkin.

“The first step is to find out whether there is an existing emergency plan on campus,” she says. “If there is, who is in charge of it? Health providers on campus should then take charge and begin to formulate the plan.”

There are many unknown factors, but build the framework of the plan first with the elements you can be sure of. Form a committee with all key areas represented, including executive leadership. ACHA’s Guidelines for Pandemic Planning provides a list as an example that may help you collate this. Identify the functions that will be critical in the case of a pandemic and the personnel on campus responsible for each of these, making sure there are enough people representing each function that should some become sick, the plan is not compromised. Identify decision makers, a chain of command, and what channels of communication are to be used. Finally, decide on the role of student health services. Many campuses will have the student health director as the key decision maker in the event of a pandemic, but for some it will be more appropriate for the student health director to have an advisory role instead. In any case, college health professionals will be crucial to the success of every plan.

The biggest question that is central to every campus-wide pandemic plan: when is the right time to send students home? Covely warns that universities cannot necessarily wait for cues from state public health departments before they make their decisions. “The university has to have its own in-depth criteria in advance of a pandemic, and the student health director should be very involved in developing those criteria.”

Barkin suggests looking back to the 1918 influenza epidemic for context.

“In 1918, the virus spread across the country in three to four weeks. If you think about the fact that the virus traveled from coast to coast in that short a time when the primary means of long-distance transport was the train, and then you think about how much more quickly we can travel today by plane, that timeline is going to be compressed significantly.”

In other words, don’t wait too long to send your students home. Nor should your trigger for this decision rely on the geographical proximity of the virus to your campus alone. Covely explains:

“Geographical proximity is not definitive enough in this age when in a single day, there are 50,000 passenger flights throughout the world,” he says. “Because New York City and Hong Kong have major international airports, epidemiologically, New York City is actually closer to Hong Kong than it is to Buffalo, so waiting to suspend classes until a confirmed case gets to your region, or within 500 miles, may be too late.”

The factors that will determine how early you make the call to send students home will center on the composition of your student population. If your students are mostly from in-state, they will probably be traveling home by car and so you can wait slightly longer before canceling classes and closing the campus down. If many students live a long way away and are going to need to use mass transportation, you may have to act more quickly or risk being swamped with very ill students at a time when the local hospitals will not have the resources to help.

There are three main elements that will shape the logistics and the scale of your plan, and help you figure out the best trigger to send students home. Remember that, as Barkin comments, “The longer you wait, the higher the rate of infection, the less chance of being able to get students home and the less likely you can manage the burden of disease.”

These factors are as follows:

Student demographics, particularly the number of students who live on campus and the number of non-local students who are likely to be dependent on care.

The size of your staff (taking into account that up to 50 percent may be sick at one time).
Your ability to stockpile enough basic supplies, including medications, as well as personal protective equipment such as respirators.

This is where things start to get more complicated, however. Most student health services can’t afford to stockpile many medical supplies. “ACHA is running a survey on pandemic planning,” reveals Barkin. “Of the schools that have responded, most have not stockpiled, or if they have, it’s not a lot.” This could clearly prove disastrous, and for many colleges is a manifestation of what Covely cites as one of the biggest challenges of pandemic planning for some universities: “getting buy-in from the executive leadership.” Pandemic planning is by no means a cost-free exercise.

One tip if you are facing resistance from campus decision-makers over spending money on pandemic planning is to emphasize the fact that once you’ve formulated a response to a possible pandemic, you will have a robust emergency response strategy that can be adapted to fit virtually any emergency, whether it’s evacuation in the event of wildfires, such as Pepperdine University faced recently, a terrorist threat, or an “active shooter”. Investment in, say, developing a Web site with emergency information and updates can be a public relations bonus and a reliable resource. Villanova University’s plan includes broadcasting SMS text messages and e-mails and using an emergency Web page for mass communication.

When you do know the scope of your resources, both human and financial, you can continue to flesh out your plan. Excellent resources can be found on ACHA’s Web site: http://www.acha.org and http://www.pandemicflu.gov. A tip from the experts: be wary of developing your plan in a vacuum. “I know of a school that didn’t know their gymnasium was being considered as a point of vaccination until they happened to find out in the course of an outreach program,” Barkin relates. “The local health department hadn’t informed them.” This is very obviously a benefit of starting a dialogue with your local health services: you find out what they have planned and you can also coordinate your plans to add value and decrease the number of unknown factors.

Dr. Mary McGonigle, director of the student health center at Villanova University, says that their dialogue with their local health department led to Villanova being assessed and labeled a “push” site, a location that is self-sufficient in this type of emergency. She explains:

“In the event of a pandemic, we’d go and pick up supplies from the county and then administer medicine to our Villanova community. That includes students, faculty and their families.”

Help from the county is a financial boon but being self-sufficient and staying local also lowers the risk of spreading the virus so rapidly. The dialogue helps your local health services too. If your local hospitals are likely to have a shortage of beds, they may want to use college dorms for surge capacity at the peak of a pandemic. In return, they may be able to offer you some resources, although research suggests that most hospitals have not had the budget to be able to stockpile effectively either.

Once you have your plan together, it’s important not just to file it away and forget about it. “Planning for a pandemic is very much a work in progress, but it is often hard to keep up the interest in reviewing and updating plans, especially when H5N1 activity drops out of the news,” explains Covely. Tabletop exercises are one way to test the effectiveness of a plan and a good way to maintain interest. Covely specializes in facilitating these tabletops and finds that they can significantly increase staff’s buy-in as well as providing useful discussion points.

“Used before the planning begins, tabletops provide a way of educating employees and getting them interested in developing continuity of operations plans,” he says. “They are excellent for post planning too, in order to test the plans. I am always amazed at the creative analysis and insight that comes from a tabletop.”

The ongoing and fluid nature of pandemic planning is very much evident in some of the complex and thorny issues that have no definitive answer. These may need to be revisited and rethought as scientific discoveries are made, as you approach a pandemic, and if your college’s resources change. One such issue is the availability of expensive antivirals. The federal government has announced that it is stockpiling them and coming up with a strategy for distribution, which might seem to take some of the financial pressure off student health services. Barkin however has a caveat. “I’m concerned that stockpiles would not be distributed in enough of a timely fashion to make an impact on the community. Katrina is a situation that has to come to mind.”

Even if you did manage to persuade campus decision-makers to invest budget in stockpiling antivirals, a potentially challenging feat, there’s a chance that they would be ineffective by the time a pandemic occurs, as overuse can cause the emergence of a resistant strain. Barkin explains that infectious disease experts are talking about using a treatment cocktail – Tamiflu plus one or two other agents – to protect against the emergence of resistant strains, but this would be prohibitively expensive for the average college health center.

Another ethical dilemma surrounding pandemic planning concerns who should get prepandemic vaccines. Scientists are developing vaccines based on the strain of avian flu that has been circulating in Asia, hoping that the vaccine would be enough of a match to combat the illness until a proper vaccine could be developed six months after the pandemic’s emergence. But supplies of this prepandemic vaccine will be limited.

“Some of the conversations around who should get these prepandemic vaccines are very complex,” says Barkin. “Should it be health care workers that get it, or public safety workers such as firemen? Should it be government officials, or the very young and elderly?” Recently, the federal government has announced a three-tiered approach to vaccination that it has developed in consultation with public focus groups and ethicists that places health care workers in the second tier. Whether your health center staff will receive the vaccine, whether it will be in a timely fashion, and how effective it will actually be, are all factors that will affect your pandemic plan greatly – and demonstrate how much of your planning has to leave room for the unknown.

One thing that is beyond question is the importance of student health services acting now. Formulating a pandemic plan may be a slow and ponderous task, but there’s one vital aspect that will slow the spread of a pandemic and can be tackled by your department immediately without getting tangled in red tape and endless meetings. Barkin elaborates:

“Every single student health service needs to be involved in educational outreach efforts to distribute information on the role of flu vaccinations, cough etiquette, when to come to work and when to stay at home if you are ill and the importance of creating a personal preparedness plan in the event of a pandemic.”

This public health education can be a collaborative effort with human resources and residence life staff. Covely agrees and even suggests extending the scope beyond campus boundaries. “It’s part of being a good and responsible neighbor to the community, and it has tremendous public relations benefits to the university,” he says.

The collaboration required in pandemic planning can build bridges, but be prepared for it also to be particularly challenging. McGonigle relates:

“At Villanova, we’re still in the stages of planning. We’ve done a lot. But I would say the most difficult part is trying to connect and communicate with all the different departments on campus and plan for all the different scenarios.”

Indeed, planning for all contingencies – not just the obvious problems of effectively treating the sick and minimizing the mortality rate, but also coping with disruptions to services and shortages of supplies caused by huge absenteeism and the ensuing breakdown in the transportation system, and questions such as whether to pay staff if the campus is shut down – has caused planning at many colleges and universities to take much longer than anticipated.

Pandemic planning is also dogged by a sense of unreality: could something this vast really happen? (The answer, as every health professional knows, is “yes”, and is a question of when and not if.) Media coverage of pandemic flu is patchy and focuses on sensational stories rather than the need for personal emergency preparedness. Because it’s not an issue in the forefront of the public’s mind, it’s sometimes hard to conjure up the necessary sense of urgency, particularly because there is always some issue on campus demanding more immediate attention. Barkin sympathizes, but has some sobering last words on the subject.

“Recently, the issue of pandemic flu has fallen off the radar,” she says. “We’ve been talking about it for two years and now there are other pressing issues that have pushed it to the back burner. But the issue of pandemics is not going to go away. We’ve had them throughout history and if you look at the patterns, we’re due for a pandemic soon. It may or may not be H5N1, and it may or may not be on the 1918 scale. What we cannot ignore, however, is the planning that’s needed, because in a pandemic, health centers and heath care providers will be looked to and expected to know how to respond.”

Cassie Harman writes for Nuesoft Technologies, a provider of Medical Billing Software and Medical Practice Management Software. This article previously appeared in Nuesoft Xpress e-Nues.

Article Source: http://EzineArticles.com/?expert=Cassie_Harman

Make your health center part of the solution to a student affairs problem. When planning your budget, consider how your requests will also help the student affairs department to meet its objectives, and then be sure to articulate that. For instance, when requesting additional staff, think about making a case for how having more qualified professionals on hand in your health center will better enable you to keep students healthy and enrolled at your university.

Think like an MBA. Not all of us in health care have a business background, but the people who we report to probably do. Learn what makes these analytical types tick. Use and understand their language when making budget requests. Terms to know and use include “return on investment” (ROI), “profit margin”, “quality assurance”, and “operating costs”.

Engage in “Show and Tell.” Even though we are health care practitioners, health and counseling center staff also need to think of ourselves as marketing professionals. Hopefully, over the past year you have done a little public relations work for your department. Newsletter articles highlighting your health center, health promotion literature or survey results all serve as reminders of the value that you offer to your campus. Prepare a packet that showcases your efforts. Make sure that you measure results from each initiative and include those in the packet.

Chart your success. Remember, you are not just asking for a budget. You are justifying that you deserve it. Recall all of the things that you have done over the past year to provide for a healthier student population. Then, be prepared to tell your story. Produce charts and graphs that illustrate how you’ve moved the needle in various areas, including decrease in incidence of disease, percentage increase in number of students who show proof of immunization, increase over last year in numbers of student visits to your health center, etc.

Cassie Harman writes for Nuesoft Technologies, a provider of Medical Billing Software and Medical Practice Management Software. This article previously appeared in Nuesoft Xpress e-Nues.

Article Source: http://EzineArticles.com/?expert=Cassie_Harman

“Health centers at many public institutions used to get 100 percent of their funding from the state, but times are changing,” said Jennifer Lepus, director of university health services for the University of Maryland – Baltimore County.

The UM-BC student health center is one of hundreds nationally that have struggled with state budget cutbacks. Health centers at impacted schools may still receive some funding by offering student health insurance plans, but reimbursements from those plans – which are provided by a handful of companies that contract with colleges to offer exclusive group rated coverage to students – are typically not enough to support a health center budget.

“Our difficulty in offering only a group rated insurance program was that voluntary enrollment was not enough to sustain it,” said Western Kentucky University’s Health Services Director Libby Greaney. “So, WKU’s solution has been to accept commercial insurance plans, and file those claims.

WKU began billing insurance companies in 2001, after student health fees were cut the previous year.

“If your doctors are board-certified and credentialed, they can establish themselves as primary care physicians. This enables you to see community patients who are in-network with the plans that your health center accepts. If balanced properly, you can increase your service net and your revenue streams.”

According to Greaney, more and more schools are realizing the benefits of opening their health centers up to commercial plans, and taking a similar approach to WKU’s.

“People are beginning to see the need. They are talking about it and addressing it,” she said. “Those in college health who are resistant to the idea may be viewed as ‘old school’ if they do not embrace the concept.”

“More and more senior vice presidents at colleges are hearing about this approach, and are giving the directive to their health centers. I would encourage health center staff to be more in the driver’s seat.”

But Greaney also recognizes a natural conundrum. While accepting commercial carriers can open up additional revenue streams for college health centers, it may also impact access to care. The reality is that not every student enrolls in school with insurance coverage. Students without coverage either go without care, or must pay out of pocket for medical costs that are growing more expensive each year.

With the American College Health Association and some states calling for colleges and universities to provide health care coverage to all students, some schools are offering a menu of options.

For example, Lepus and her staff at UM-BC have opted to accept both a student health plan and plans from commercial carriers.

“If the goal is for every student to have coverage, we can achieve that by offering both options,” Lepus said. “The school plans are less expensive for people, but we have found that many young people today are covered by their parents’ insurance plans until they turn 23 years old. That means that a large number of students have coverage through private carriers, and it seems logical that when they come in to be seen, we can bill those insurance companies.”

The University of Utah at Salt Lake City is another example of a health center that has found that billing to commercial insurance carriers as well as offering a traditional student insurance plan through the university is a win-win for both students and the health center.

“By offering both options, we have a medium-sized pool of students who are required to come to us with their insurance, but we are also affordable and convenient for students with out of state insurance who will be paying out-of-network percentages or deductibles,” said Tiffany Smith, office manager/patient advocate for the University of Utah at Salt Lake City’s health center, which attracts about 7,000 students each year. “When we bill commercial insurance carriers, we make the process easier for our student patients, and this keeps them coming back to us in the future.”

And when they come back, it means additional revenue for the health center.

Although accepting commercial insurance carriers might seem overwhelming, Greaney offers a bit of advice to other health center directors who are considering it:

“Start small, and utilize the resources that are available to you,” she said. “Namely, people who have gone through this either in college health or out in the community.”

Jennifer McDuffee writes for Nuesoft Technologies, a provider of Medical Billing Software and Medical Practice Management Software. This article previously appeared in Nuesoft Xpress e-Nues.

Article Source: http://EzineArticles.com/?expert=Jennifer_McDuffee