Whether you’re aspiring to be a personal trainer or have already begun your career journey and are looking for ways to pick up some momentum, eventually, you’re going to wonder what steps you can take to get more clients. Luckily, with a bit of hard work and the right guidance, you’ll probably wind up with more work than you can possibly handle.
Finding new clients when you don’t have
extensive experience or brand presence to position yourself as an authority can
be quite difficult. If you’ve been unable to fill up your work schedule and are
looking for ways to maximise your income and client solicitation success rates
as a personal trainer, try starting with the following five steps:
1. Offer Free Consultations
Making yourself accessible and showing that
you’re willing to prove your expertise are two crucial efforts that you’ll need
to make in order to persuade prospective clients in your favour. The easiest
way to get your foot in the door in the personal training game is to offer up a
free fitness consultation.
During this initial meeting, you can assess
the client’s current condition, provide a few tailored recommendations, and
come up with a plan that you could help them execute for optimal results. If
you’re not sure how to perform a fitness
consultation, you may want to take a few personal trainer courses on
2. Post Videos on Social Media Routinely
Publishing instructional or conversational
videos on social media sites like Facebook and Instagram can help you make your
personality and knowledge visible on a public platform. Don’t expect amazing
results initially, as you’ll probably only get a few people viewing your videos
in the beginning. However, if you’re consistent about posting regularly and
making an effort to provide great advice, it’s a fairly reliable way to gain
You could also try doing live Q&A
sessions with people in your community through the live streaming features on
Facebook or YouTube. If you really want to push the issue and do some
aggressive marketing, you could invest wisely in a PPC ad
spend budget with Facebook Advertising or YouTube to display your
videos to a targeted audience based on all sorts of filters including
demographics and location.
3. Make Yourself Available on Numerous Platforms
In an ideal world, you won’t even have to
pitch your services to new clients because you’ll have a list of them wanting
to work with you on backorder. While it may take a while to develop such a
reputation and demand for your services, such a reality is much more likely to
pan out if you’re openly listing yourself on business directory sites
like LinkedIn and freelancing sites like Upwork.
On the same token, you should try to
diversify your advertising efforts across the top platforms, especially Google,
YouTube, Facebook, and Instagram. It’s a simple number’s game really – the more
advertising and directory platforms you’re listed on, the more prospective
clients will see (and potentially hire) you.
4. Browse Through Online Classified Ads and Project Listings
Sometimes you can find personal training
clients just by responding to classified ads that people post in search of a
local trainer. While this is a less common and often hit-or-miss approach, it
can and does work occasionally and is, therefore, a worthwhile step to include
in a well-rounded client solicitation regimen.
Along the same lines, sometimes you can
find people who are searching for remote training services via video chat by
looking through freelancing job ads under the personal training or fitness
5. Target Local Keywords Related to Specific Conditions
Finally, taking advantage of certain
keyword combinations in your SEO campaign is another great way to get the
attention of locals who may be in need of your personal training services. This
is a relatively underutilized technique that can be applied to any niche:
Take the name of your city, town, state, or
county and combine it with the name of your service. Then insert the word “for”
and add the name of a condition or problem that your service treats or solves.
For example, “London personal trainer for tennis elbow.” Now you have a keyword
that you can base some of your content around in order to attract targeted,
organic search traffic.
There Are More Than Enough Personal Training Clients to Go
When you consider how many people have the
short-term or long-term goal of getting in shape, and the fact that there’s
currently a shortage of personal trainers worldwide, there’s really no reason
for a skilled trainer to lack clients, especially if you take the five steps
Healthcare providers are among the long list of service providers that have embraced the mobile technology revolution. Some healthcare providers are supplying mobile healthcare devices to their staff, and others have introduced the Bring Your Own Device (BYOD) program that allows their staff to bring their devices and use them at work. Whichever the case, mobile technology enables staff to work remotely, which presents several benefits to healthcare providers.
with Use of Mobile Devices for PHI
While there’s no
denying that mobile technology has revolutionized how people work, healthcare
providers cannot turn a blind eye on the risks that come with the use of mobile
devices. Owing to their small size and portability, mobile devices are at a
greater risk of being stolen or lost compared to their immobile/fixed
In the unfortunate
event that a mobile device containing unsecured electronic protected health
information (ePHI) is lost or stolen, there’s an increased risk of a data
breach that can trigger HIPAA breach notification obligations for a
HIPPA-covered entity and/or their business associates.
HIPAA Standards for
Securing ePHI Data Secure on Mobile Devices
The HIPAA in 1996 mandated
the Secretary of the U.S. Department of Health and Human Services to come up
with regulations that would protect the security and privacy of certain health
information in the year 1996. In compliance with this requirement, HHS
published the HIPAA Security Rule and the HIPAA Privacy Rule.
The HIPAA Privacy
Rule establishes national standards for the protection of individually
identifiable health information that can be linked to a particular person. The
HIPAA Security Rule, on the other hand, establishes national standards for
protecting ePHI, particularly how it’s transmitted, maintained, or stored.
For your healthcare
facility to be HIPAA-compliant, you must fulfill specific requirements. For the most part, you must ensure that
physical, administration, and technical safeguards are put in place and adhered
to, as follows:
Require User Authentication
is the process of verifying the identity of a user before accessing a mobile
device and the information stored in it. One of the ways to secure ePHI is to
ensure that mobile devices are configured to require user passwords, passcodes,
or personal identification number (PIN) to gain access. Doing so can help to
prevent unauthorized users from gaining access to devices, which can help to
restrict access to ePHI.
It’s vital that you
buy and install an encryption tool for mobile devices that are used to access
ePHI. In the event that any of the devices is stolen or lost, encryption makes
it impossible to read the information stored on the device. With some devices,
it is recommended to enable encryption on device backups as well.
Update Your Security
take advantage of vulnerabilities in common applications such as browsers and
operating systems. To keep your network safe, it’s vital that you keep your
security software and operating systems up to date. By doing so, you’ll also
prevent unauthorized access to ePHI on or through your mobile devices.
You must implement facility access controls to limit access to facilities where ePHI is stored.
You must implement policies that restrict the use of workstations.
You must implement policies and procedures o manage how ePHI is removed from mobile devices after a user leaves the organization.
You must maintain an inventory of all hardware before its relocated, and a retrievable precise copy of ePHI must be made before the move.
You must conduct risk assessments to establish ways in which breaches of ePHI can occur.
You must introduce a risk management policy to ensure employees comply with HIPAA regulations.
You must train employees to raise awareness of the policies and procedures governing ePHI.
You must develop a contingency plan that can be rolled out in case of an emergency.
You must restrict 3rd-party access to ePHI.
You must report any security incidents once they occur.
Besides adhering to
the above HIPAA requirements for compliance, there are various other best
practices for keeping ePHI data secure on mobile devices. They include:
Install and activate remote disabling and/or remote wiping to ensure that all ePHI is removed from the device in case it is stolen or lost.
Avoid using file-sharing applications and make use of MDM software that helps to containerize ePHI and prevents data copy.
Research mobile applications thoroughly before downloading.
Avoid using public Wi-Fi network when sending and receiving ePHI and only use a Virtual Private Network instead.
of mobile devices will undoubtedly add a lot of value to your organization on
the condition that the proper balance between usability and security is
achieved. Taking the right measures to keep ePHI data secure shouldn’t be a
matter of meeting compliance only. It should also be a matter of safeguarding
the integrity of your patients and your organization at large.
The role of mobile wayfinding solutions for hospital systems has quickly evolved from a novel service offered to an essential component of a patient-centric approach. The catalyst has been the growing importance of patient experience to meet both care and competitive standards. A wayfinding platform not only improves patient’s easy access to care, but also provides the experience that patients have come to expect from their healthcare system.
A modern wayfinding platform does more than fulfill its fundamental mission of helping patients find their way around facilities. It is a valuable channel for health systems to engage their patients before, during and after each encounter. All the services a provider offers can be embedded in their wayfinding platform providing opportunities to engage patients and build new avenues for business development.
Health systems have recognized this, and are making extensible mobile wayfinding platforms an important element of their efforts to improve patient experience. An extensible wayfinding platform aligns health care providers with the best aspects of consumerism, serving patients when and how they want to be served, using their smartphones.
Wayfinding Contributes to Positive Patient Experience
Digital, experiential wayfinding not only puts patients and visitors on the best path to their destination, but also gives the healthcare organization an important pathway to keep patients in their system for follow up care.
Patients typically need help finding the right area within a hospital and prefer a self-service navigation using their own smartphone instead of having to ask for directions. A wayfinding platform provides a hand holding experience for patients initial visit and extends to any subsequent visits.
Wayfinding Improves Continuity of Care
Apps that go beyond basic navigation and support physician lookup, messaging and other functions help develop ongoing, rather than episodic, interaction between the patient and provider and improve continuity of care.
Patients can receive an appointment reminder message, guidance to the closest parking followed by step-by-step directions in real time to their destination indoors. When they are seeking follow up care, they can make an appointment, view wait-times access their medical records, pay their bill and much more.
Wayfinding to Navigate the Health Journey
Today, navigation provides the opening to a platform the provider can use to offer different services to the user and to interact at different points in the care journey. Gartner notes this evolution in its recent report that, “Wayfinding has evolved to encompass an ecosystem of technologies that combine in a way that assists a patient to conveniently locate and navigate the health care provider facility and space. Experiential wayfinding helps patients navigate an episode of care or navigate their health journey. Wayfinding of all forms is becoming a requirement as the complexity of care delivery continues in increase.”
It is hard to achieve a top-level patient experience when an encounter begins with the patient becoming lost, delayed and anxious. Those problems are preventable by offering mobile wayfinding, the value of which will continue to rise in tandem with the growing importance of patient experience.
Modern wayfinding produces a positive experience that serves as a platform for continued communication, giving providers the flexibility to create strategies, and easy access to care that supports their patient engagement goals. Wayfinding solutions therefore need to support those capabilities to help providers support their patients with excellent experiences throughout the continuum of care.
By Jeff Springer, senior vice president of healthcare solutions, CitiusTech; and Fernando Schwartz, vice president of data science and consulting, CitiusTech.
As consumers, we experience artificial intelligence
(AI) every day. In fact, we’ve come to expect the consumer experience it
enables, such as Amazon’s highly personalized suggestions for additional items
we might like. Now is the time to gain AI’s rewards in healthcare as well. Dr.
Eric Topol, founder and director of Scripps Research Translational Institute,
put it this way: “If properly and humanely deployed, AI has the potential to
restore efficiency to a wide array of burdensome healthcare processes, freeing
up physicians to treat their patients in the way they deserve. The path won’t
be easy, and the end is a long way off. But with the right guard rails,
medicine can get there.” 
While there are significant challenges with
interoperability, data sharing, and data access, organizations are taking
several approaches to overcome them. With an incremental approach to data
management and analytics, healthcare organizations can reap the benefits of AI
– specifically machine learning (ML) and natural language processing (NLP) faster,
enabling them to overcome challenges and achieve success in value-based care.
and Its Subsets
it’s important to have a shared understanding of AI concepts. AI is a term used
to describe the ability of machine intelligence to imitate human intelligence
through cognitive functions and behavior. Both ML and NLP are subsets of that broader concept. ML applies
algorithms and statistical models that effectively perform a specific task or
make predictions using patterns and inference. NLP enables computers to
understand, interpret and manipulate human language using computational
linguistics. At the highest level, these tools can be applied in healthcare to
help find the answers to questions and identify root causes—leading to workflow
improvements at a massive scale.
Advances Speed AI Adoption
Advances in data and analytics technology are making
it possible to significantly reduce implementation time for AI projects. From a
data management perspective, five years ago, it would have taken two years to
implement a strategy and infrastructure for data management needed for AI.
Hence, many organizations applied a project-by-project approach and didn’t take
advantage of the opportunity to reuse data for multiple projects. The results
were data silos and missed opportunities to leverage data across the
Today, new technology and new data approaches
expedite projects from the data, analytics and learning perspectives.
Specifically, today’s late-binding architecture enables organizations to take
only the data needed for a question, metric or pattern, and then curate
additional data as needed. This opens the door for going beyond the standard
healthcare sources, such as claims, HL7, and CCDA, to also include historically
cost-prohibitive data, such as social media, benefit information and
unstructured data. These data sets can be leveraged to determine the most
effective engagement models, risk patterns and communications. Today, if organizations
start by asking the right questions before implementing a new data set, they
could have answers in as little as three months, rather than years. By
leveraging existing infrastructure and data in conjunction with new technology,
organizations can begin to see success more quickly, while building out an
incremental, long-term strategy.
AI to Work Answering Healthcare Questions
organizations take advantage of the new technologies that enable sophisticated
data analytics, they can more easily apply ML and NLP to specific data sets.
Start with a question and determine what data can best provide answers. The
examples to follow illustrate questions organizations might ask to improve
clinical outcomes, revenue assurance, or operational efficiency.
Clinical Best Practices: Using
ML, healthcare organizations can more effectively analyze treatment patterns by
asking questions, such as: What interventions during a clinical encounter help
avoid sepsis? Or how can an ED visit be prevented? Once there is an
understanding of what contributed to positive outcomes, organizations can embed
care protocol improvements within clinical workflows.
Population Health: Again,
using ML, organizations can thoroughly analyze populations, treatment patterns
and results by asking questions, such as: Which segments are having trouble and
how can they be addressed? Are issues arising that are related to geography,
benefit structure, or disease pattern? ML can be applied to sift through many
dimensions and identify root causes. For example, a member of a diabetes
population segment lives within a certain zip code, sees a certain provider,
and is more likely to be readmitted. By asking the right question, variations
in care can be identified, and protocols and workflows can be adjusted to
Management: Healthcare organizations, especially
ACOs, strive to improve quality while tightly controlling costs. Using ML,
organizations can look for variations in practice patterns across providers,
patients and conditions. From there, organizations can implement protocols that
operationalize utilization management. For example, duplicate exams, such as
expensive MRIs, can be avoided by making recent results available to providers
at the point of care. And providers can be guided to the most cost-effective
location for a given procedure or exam.
Data Aggregation: Even with
standard EMR implementations, there can be tremendous variation in how certain
types of data are captured. For example, data points needed for population
health management may be captured in data fields and as unstructured text.
Using NLP, healthcare organizations can now parse many different types of data
from many sources. This enables access to data for risk-based contracts, such
as social determinants of health like transportation, weight loss, food
insecurity, and electricity.
AI to Gain Quick Wins in Quality Improvement
With today’s technology, healthcare organizations
can move more quickly to take advantage of AI, especially ML and NLP— seeing
results in months rather than years. With modern data and analytics approaches,
organizations can proceed incrementally to identify questions, metrics or
patterns that deliver quick wins in clinical, financial and administrative
outcomes. At the same time, these achievements contribute to a successful
long-term strategy to continuously improve quality and outcomes while assuring appropriate
payment in today’s value-based care environment.
Few healthcare leaders doubt that insights made available
through precision medicine and genomics have the potential to vastly improve
care and outcomes.
But the industry struggles to overcome numerous barriers
that, at first glance, seem to obstruct providers’ ability to fully leverage precision
medicine. There is no question that obstacles exist, but a well-considered
strategy can help providers move quickly down a forward path.
Let us consider the six primary obstacles to leveraging precision
medicine to its fullest:
Provider education and expertise. Precision medicine, as an
influencer at the point of care, is a nascent discipline. Few physicians
practicing today were thoroughly educated in genomics (the depth of training is
increasing, however, according to a 2017 article in the Association
of American Medical Colleges News).
Physicians find themselves in a position of educating themselves quickly,
especially as the FDA approves more targeted immunotherapies and treatments. In
addition, because of the rise of direct-to-consumer tests, patients themselves
are demanding doctors factor this information into their clinical decision
Slow-to-change standards of care. Without a doubt, delivery of
healthcare must be evidence-based. Genomic science has introduced so many
advances in such a short period of time, however, that many physicians remain
bound by approaches rapidly becoming outdated. The industry must find ways to
deliver new findings into the clinical workflow reliably and quickly, so
providers can utilize the best approach in each patient encounter.
Limited time to process new data. Physicians are already
presented with more data than they can effectively manage. Genomics represents
an entirely new and voluminous data set. To deliver any value, this information
must be rendered useful and readily available within the EHR. Access must be
smooth and seamless so physicians are not forced to leave their workflow to hunt
for relevant insights.
Foreign nomenclature. Currently, genomic results are returned
in PDFs (not as discrete data), rendered in vocabulary common to genomic
researchers and scientists. It must be “translated” into meaningful clinical
nomenclature and then integrated into the current workflow to be fully useable.
Regulatory and liability concerns. Genomic results do not
represent a snapshot in time the way phenotypical information might. A
patient’s genetic variant could impact care decisions well into the future as
the individual’s condition changes and genomic science advances. How does a
provider store and manage genomic data, making sure that its very existence
does not create liability issues in the years ahead?
Lack of or sluggish reimbursement. Payer policies and
guidelines lag behind discoveries related to precision medicine. What
reimbursement exists varies greatly from payer to payer and is founded on
disparate understandings of medical necessity. While payment is becoming more
common, physicians nevertheless must consider the financial impact of ordering
a genomic test – and what they will do if the results indicate that an
expensive or uncommon treatment is the best choice for a particular patient.
Innovation and Strategy
Key to Success
While these issues are complex, they are not insurmountable.
Savvy healthcare leaders are establishing precision medicine strategies today
in recognition that the landscape will become only more complicated.
Visionaries and early adopters are implementing scalable
informatics infrastructure as the backbone of their precision medicine
initiatives. Many of the obstacles above can be addressed by an
enterprise-spanning platform that:
Synthesizes genomic data with clinical
information into an ontology that creates a comprehensive view of the patient.
This compendium can then be delivered through the EHR, presented in a
meaningful vocabulary, where it can be actively used in real-time clinical
decision making. In addition, providers are able to reference evidence for
their decisions, which could help support medical necessity appeals and
short-circuit prior authorization processes.
Delivers fingertip access to multiple curated
knowledge bases. Physicians can re-interrogate a patient’s genomic data against
the latest scientific findings to ensure current standards are followed – now
and far into the future. This also gives physicians access to resources so they
can keep abreast of this rapidly changing field and helps shield them from
Enables broad usage of precision medicine tools.
The value of genomic insights is curtailed when data is siloed in a specialty-
or department-specific system. Making functionality available across clinical
areas gives all providers access to data that might impact care and outcomes.
The future of healthcare has been made more exciting because
of precision medicine and genomics. With a well-considered strategy, healthcare
leaders can begin to leverage value today and prepare themselves to be
successful for years to come.
Different factors may necessitate a cosmetic dental procedure. That given, various methods, too, are used to achieve the desired dental appearance. The processes may be undertaken voluntarily or may be as a result of reasons beyond one’s control. Whatever the reason may be, Golsen Cosmetic Dental has all the know-how and solutions. Their highly trained dentists ensure their clients attain a beautiful and perfect general appearance of the mouth, teeth, and smile. One need not be embarrassed anymore about the deformity of the mouth, teeth, or smile that may be because of:
could range from serious road carnages to bar brawls and fights. Such accidents
leave the dental structure disfigured to a varying degree, depending on the
impact of the force applied to the mouth. It could lead to a dislocated jaw
bone or just a missing tooth or two.
the case, this would mean your teeth and facial appearance aren’t as they were
before. This could also mean difficulty in taking food or a broken, ugly smile.
However, through dental implants procedure, one can get tooth lost through such accidents replaced.
Foods, Drinks and Habits
food and drinks to sustain our body functions and to unwind. However, the
downside of some foods such as blackberries and cherries is that over time,
they cause tooth discoloration. Drinks, too, such as wine and coffee, cause
stained teeth, and so are habits such as smoking.
can’t abstain from such foods, drinks, and habits, through teeth whitening
procedure, their side effects on the color of the teeth are minimized.
The teeth can, as a result, regain their white color or the shade of white one desires regardless of the food or drink or habit one takes on. One is at least still assured of the benefits of a pearly white smile when one decides to flash one, thanks to teeth whitening.
together with environmental factors, can result in congenital disabilities such
as cleft lips or cleft palates. Such congenital disabilities not only cause
difficulty in feeding and speech, but also cause dental problems when the cleft
extends to the upper gum, which results in inhibition of tooth development in
However, cleft lips and cleft palates, through a combination of cosmetic dentistry procedures, are easily rectifiable. Through the processes, the general facial appearances and dental functions of the child are significantly improved. Children born with such congenital disability can thus lead a happy, healthy life just like the rest of the children.
though they say old is gold, with old age comes numerous dental challenges that
if not properly taken care of, can remove the gold in old age and replace it
with pain and suffering.
dental challenges include weakening of gums leading to falling off of teeth,
damaged enamel, crooked teeth, and other dental cosmetic problems easily solved
through dental veneers.
If you’re in the body-hacking sphere, you’ll surely have
heard people talking about noopept at this point. But then, what exactly is
noopept, and why do people seem to like it so much?
Noopept has a history dating back to 1996, and it has actually been used for some time in Russia as a treatment for age-related cognitive decline. One particular reason why so many people are looking to noopept for its many benefits is that it’s thought to be around 1,000 times more potent than piracetam by weight. Out of all of the current nootropics currently in circulation, it’s one of the more popular nootropics, next to the racetam family.
What does noopept do, precisely?
How noopept works
When an individual takes noopept, reactions occur within the
brain that improves alpha brain wave function. Not sure what that means? Well,
when alpha brain wave function is heightened, people are much more likely to be
able to commit information to memory, recall earlier information they’ve
learned, as well as understand more complex problems and better seek out a
Also, when someone takes noopept, there’s an increase of
tonic inhibition within the hippocampus, which contributes to increased
feelings of well-being, a reduction in stress, as well as reduced anxiety.
Surprisingly enough for a chemical that has such significant
cognitive effects, the side effects reported from those who take noopept are
minor, if they appear at all. Some people do, however, report side effects like
irritability, nausea, or insomnia, if taken too close to bedtime.
These side effects are commonly reported by frequent users
of the substance on various public forums, but any study that has taken people
who haven’t used noopept before hasn’t stated any side effects whatsoever,
making it extremely likely that if noopept is used sparingly, there would be an
extremely low chance of encountering any side effects.
It would appear that noopept is extremely tolerated by the
vast majority of people who consume it.
The sciences associated with brain-hacking and the optimization of human functioning are all still in their infancy. Despite the relatively low amount of concrete knowledge, noopept has shown time and time again to be an extremely well-tolerated nootropic with very quantifiable and measurable benefits. Noopept is safe, inexpensive, and most importantly, quite effective.
For many people, noopept is the starting point on their nootropics journey as it’s one of the fastest acting nootropics currently available. Who knows, in the next coming years, noopept might be commonly taken by people at large to keep them at peak mental fitness. Either way, noopept has firmly created a spot for itself in the world of brain-enhancing chemicals.
By Hants Williams, director of clinical operations, VirtualHealth.
The buzz around social determinants of health (SDoH) is making waves across the healthcare industry. Linked to roughly 80 percent of overall health, stakeholders are increasingly embracing the opportunity of addressing SDoH in care management workflows.
SDoH are defined by Healthy People 2020 as the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.” Essentially, these elements encompass the non-clinical factors that can promote or hinder a patient’s ability to fully comply with care plans.
Transportation sits at the heart of current SDoH initiatives as a fundamental prerequisite to optimal care. Simply put, if patients cannot pick up their medications or get to appointments, a provider’s ability to impact their patient’s health is minimized. Consider, for example, a recent Connance survey that links 50 percent of re-admissions to factors such as transportation and home instability risk.
In the era of value-based care, the simple act of helping patients access
transportation can notably improve the outlook on clinical outcomes and costs. For
instance, medication adherence is a focal point of industry efforts to improve
clinical outcomes, but if a patient cannot access transportation to pick up
needed drugs, the potential for improvement is minimized.
Access to transportation is low-hanging fruit in terms of performance improvement, and providers must get ahead of the transportation challenge to implement successful, sustainable population health strategies. It’s also why forward-looking organizations are addressing this critical element of SDoH by equipping care managers with tools that speed identification of transportation needs and available services.
Understanding the Challenge;
Recognizing the Opportunity
Industry statistics reveal that the transportation challenge is significant and is expected to compound in the coming years. Estimates point to 3.6 million Americans missing or delaying medical care because of an inability to get to their appointments.
Understandably, the transportation issue is
exacerbated in low-income and elderly populations as well as rural regions
where public transportation is scarce. Many patients simply lack the disposable
income needed to maintain a reliable source of transportation. In terms of
elderly populations or those with disabilities, physical or mental conditions
that eliminate or significantly restrict driving as an option create additional
The current and coming transportation challenge is sizeable and will require significant resources. Fortunately, the business case for improving the outlook is an easy one to make: A recent study examining non-emergency transportation costs in Florida found that if a mere 1 percent of medical trips resulted in the avoidance of an emergency room visit, the state could save up to $11 for each dollar spent.
Providers and payers alike are increasingly turning to tools that help identify SDoH needs like transportation in near real-time, allowing care managers to proactively seek out community resources that can help. For example, one state-run managed Medicaid program deployed a care management platform that allows clinical teams to access pre-approved community services and schedule transportation appointments immediately once needs are identified.
With the help of customized algorithms and advanced artificial
intelligence tools, drivers can be deployed to patients’ homes in anticipation
of needs rather than finding out after the fact that appointments were missed,
or medications were not picked up. The efficiency of the analytics platform is critical
to changing the dynamic as clinical teams would otherwise be tasked with combing
through millions of line items in patient records to identify potential needs.
Advanced solutions allow users to easily monitor transportation
requests across all patients or drill down into a single case to manage unique
details of each trip, such as advanced authorizations or ensuring the
appropriate vehicle has been scheduled to accommodate assistive devices, child
seats and companions. Care managers improve efficiency by scheduling recurring
trips and tracking specific patient requests or preferences, which can be
shared with the transportation vendor and other care coordinators.
Leveraging the transportation functionality, the state-run Medicaid
program completed nearly 24,000 transportation entries in 2018. Through
advanced analysis, it was able to forecast usage trends across months, time of
day and geography to help its clients optimize operations and predict
transportation expenditures. For example, the organization can determine which
patients are frequent transportation users, which can alert care managers to
book multiple provider appointments at once to reduce costs versus on separate
Personalized care management and coordination is part of the healthcare industry’s overarching goal of cultivating healthier communities. SDoH indicators such as transportation are critical to these efforts. Forward-thinking organizations are taking hold of the opportunity to improve care management by investing in infrastructures that support greater access to transportation.
At this point, most of us in health care have read similar statistics about why we need to do more to address social determinants of health (SDoH) — the conditions in which people are born, grow, live, work and age, and how those factors impact individuals’ health — to improve patient outcomes. These conditions and their resulting social needs include, but are not limited to, a person’s equitable access to nutrition, housing, transportation, education, and employment opportunities.
Time is of the essence to tackle some of these social determinants, especially when coupled with the rapidly shifting patient demographic, sometimes called the “silver tsunami.”
SDoH studies in no short supply
seems everyone is in a race to figure out what SDoH approach will move the
needle toward lower risk for their patient populations. But payers, in
particular, have taken on a hefty amount of the leg work needed with social
determinant “barriers to care” studies, because they are generally the most
financially accountable, from a population health analytics perspective, to
Recent news about of these payer SDoH pilot programs and research studies have
been both interesting and useful across the care continuum, a summary of which
WellCare, which provides managed care plans for more than 4.4 million Americans, ran a pilot program on more than 33,000 patients, referring them to more than 100,000 community-based social services programs, and was able to reduce inpatient spending by 53 percent, outpatient spending by 23 percent, and emergency spending by 26 percent.
In its Bold Goal 2019 Progress Report, Humana focused on patients in specific lines of business, including their Medicare Advantage program, where 91 percent of seniors who have at least one chronic condition. They enacted the Centers for Disease Control and Prevention’s “Healthy Days” self-reporting method of measuring healthy vs. unhealthy days and have also screened half a million people for SDoH since 2018, with the goal to screen one million by 2019. Humana notes that these social barriers are “deeply personal,” which requires closer partnership to track and measure population health.
Blue Cross is already instituting food, nutrition, and housing services as part of some of its plans. But it also recently announced an investment of $40 million with Solera Health, to address both mental health and SDoH matters, including “food insecurity, medically tailored meals, transportation, falls prevention and social isolation” with lifestyle modification programs such as diabetes or management, and tobacco cessation programs.
A study by the Anthem Public Policy Institute says individuals and the public (researchers and journalists) perceive SDoH differently. Individuals tend to lead with concerns about the health care “system,” whether they can find the right provider, followed by whether they have adequate “social support.” The public tends to “frame health outcomes through the lens of structural factors like education and income level perhaps, in part, because these factors are easier to measure.”
UnitedHealthcare and the American Medical Association partnered to expand the existing ICD-10 diagnostic codes being used to identify social and economic barriers to care. This adds 23 more codes to that list, some of which would “indicate a patient’s inability to pay for prescriptions, inadequate social interaction, or fears about losing housing.”
workflows provide best locale for SDoH communication
Despite all of the
various innovative steps being taken to bring SDoH to the forefront, we know
that most patients still aren’t
talking about SDoH concerns with their physicians. There are many reasons why, but one
logical solution to bolster SDoH communication between physicians and patients
is to incorporate, at minimum, the ability to identify social needs where they
are already doing business — in these EHR, CRM, and other third-party
As is evidenced by the siloed health IT data systems that have for too long
crippled the health care industry’s transparency and ROI, we know that simply
identifying social barriers to care is not enough. Within the designated
“source of truth” that is most responsible for driving patient engagement,
whether that is an EHR, CRM, or other platform, we need to build — or integrate
— expanded capabilities for SDoH identification, referrals, and tracking each
throughout the continuum of care to close the gaps that currently exist.
That is not to say that physicians must now wear yet another hat — that of a
social worker or a social services case manager. But being asked to solve SDoH
from the current physician’s workflow perspective, without integrating SDoH
into the patient record, is basically saying to physicians:
“Improve clinical outcomes. But first, you must identify non-clinical data, be
responsible for referrals to improve these individual circumstances, and track
each of those referrals’ progress, all in different platforms, and none of
which talk to one another.”
This is not setting our patients or their physicians up for success.
The idea of a standardized SDoH screening mechanism within the EHR has been
endorsed by the National Academy of Medicine, the Medicare Access and
Children’s Health Information Program Reauthorization Act of 2015, the 2016
Centers for Medicare and Medicaid Services’ Quality Strategy, and several other
organizations, as released in an Annals of Family Medicine study. But unfortunately, in this
first U.S. study of its kind to address feasibility, “little is (currently)
known about how to capture and present (SDoH) information in community health
centers’ EHRs.” Nor did the study conclude how to integrate EHR-based
documentation needs into community health centers’ existing workflows.
The main barriers cited in the Annals’ study were that EHR-based SDoH tools:
(1) Create a too-fragmented view of the patient, with relevant data in too many
(2) Might add a layer of difficulty to obtain and act on SDoH data
(3) If SDoH patient information has been acquired on paper, that requires yet
another dual, manual data entry problem when “referral workflows were (already)
seen as too time-consuming, especially when no follow-up was planned,”
resulting in “an unmanageable follow-up workload.”
To date, the EHR has done a good job of serving most of the goals to take our
country’s health records digital. But it is also safe to say that the EHR, in
and of itself, cannot be all things to all persons working in health care. In
addition to the major enterprise EHR systems, there is a proliferation of
specialty, industry-specific EHRs, which may or may not have separate CRM
platforms, not to mention all of the other third-party, various other platforms
you can see within any one given practice, such as separate billing and
referral management types of platforms. There is a reason that
“interoperability” among all of these disparate health care data systems has
become another hot topic for the industry.
To yield maximum value for our customers, integrating SDoH data is
best-approached from a workflows perspective — not just connecting disparate
data systems for the sake of “more data,” but to make caregivers’ lives easier,
and to create actionable data that enable better business decisions. And
we already know that one of the easiest ways to improve efficiency for health
care organizations is to remove dual, manual entry between EHR, CRM, and other
third-party platforms that hold patient data — these are the first and most
valid case studies of how to improve organizational efficiency while bolstering
There has been a flurry of innovative partnerships and technological
improvements to address SDoH, all of which should ultimately be supported by
policy changes — each of these as prevailing themes at trade shows and
conferences in recent years, such as the America’s Health Insurance
Plans’ (AHIP) annual conference, held recently in Nashville. Meanwhile, we look forward to
participating in more discussions about how those of us in health IT can do our
part — bridging SDoH informational and communication gaps between physicians
and patients. This could include integrating non-clinical SDoH concerns into
the patient’s clinical record, in and out of these platforms, establishing
standards for capturing SDoH to make data-sharing easier, and even incorporating social
services databases for more streamlined SDoH-specific “referral management.”
We talk a lot about how to achieve interoperability in health care, with all of
its disparate data systems, and SDoH is another compelling and recent reason
why we must accelerate these solutions, which would ultimately benefit health
care and all of its stakeholders — patients, physicians, payers, and everyone
By Chris Goettl, director of product management, security, Ivanti.
The first months of 2019 have
seen a record number of reported security vulnerabilities. But potentially the riskiest,
is BlueKeep. BlueKeep is a vulnerability (CVE-2019-0708) that affects Windows
7, Windows XP, Server 2003, 2008 and 2008 R2, which many feel will be exploited
The concern has been so great
that Microsoft has issued public updates, even for the no-longer-supported XP
and Server 2003 operating systems, and has been very active in issuing warnings
to apply the fixes right away. Some may even say that Microsoft has been
uncharacteristically begging everyone to apply the necessary fixes. The NSA too
has issued an advisory and
warning to fix this immediately.
Why is this so important for healthcare organizations? It’s been reported that “70 percent of devices in healthcare organizations will be running unsupported Windows operating systems by January 2020.” This is a greenfield opportunity for the perpetrators of BlueKeep to expose health records and personally identifiable information (PII), presenting monumental, potential risk.
How does it work? BlueKeep is
considered a ‘wormable’ vulnerability because it does not require
authentication or user interaction to exploit. As such, the worm can spread
from system to system taking advantage of the vulnerability.
Numerous possibilities exist
for a wormable exploit like BlueKeep. For example, if it uses something like
Emotet, a more sophisticated malware platform, a piece of malware could get
onto a system and have the potential of making intelligent decisions about what
it should do next. It could then automate those steps and adapt to its
Or, what if BlueKeep finds
its way on to somebody’s home computer? In that case it’s probably going to
just sit back and grab any email exchanges that are going on, scrape some email
addresses, and try to spam itself out to spread itself further.
if it got into a hospital’s network it could switch into ransomware mode –
creating perhaps an even more damaging version of WannaCry – holding critical
and even life-saving information hostage.
perspective, the WannaCry attack of 2017 was reported to cost as much
as $4 billion, making it one of the most costly ransomware attacks to ever hit
our global economy. The fact that six
security firms have independently reached successful exploit of BlueKeep makes it pretty likely that a weaponized version of BlueKeep
may be a lot more real than some of the other recent threats. Even though
nobody has detected an attack “in the wild” yet, it’s only a matter of time
before the first attacks occur. Bleeping Computer confirms private
MetaSploit modules have already been developed for demonstration.
So, what needs to be
done to keep BlueKeep away? Follow these three important steps:
comprehensive asset management solution to ensure that you have full visibility
into any and all legacy systems that may have one of the vulnerable operating
systems. It only takes one system that remains unpatched to expose your
network. Don’t let any system slip through the cracks.
the latest updates to all of your legacy systems before BlueKeep hits the
streets. You don’t want to get an ‘I told you so!’ from your incident response
and security team.
Minimize the impact on your
IT teams through automation. With the latest versions of MS SCCM not supporting
Windows XP and Server 2003, the job of applying patches can be a bit more difficult. But
it doesn’t necessarily mean that you must perform your patching manually. You
can patch up to 50 systems including
Windows XP and Server 2003 by accessing this free 60-day license to Ivanti
Security Controls here.
For those who have not
patched BlueKeep yet, it is only a matter of time before the first malicious
exploit is distributed. You can be sure that healthcare organizations will be at
the top of the target list. Be prepared and apply fixes today. Cyber adversaries are likely reverse
engineering the patch as you read this, getting ready to exploit organizations
and individuals alike. Let’s work together to avoid a potential repeat of