Whitney Palmer

Healthcare. Politics. Family.

The Decision to Nighthawk Isn’t Always Crystal Clear

Published in the July 2011 American Hospital Association Hospitals & Health Networks

By Whitney L.J. Howell

Teleradiology is growing, but experts caution about potential pitfalls

Hospitals never close, but that doesn’t mean someone from every specialty is always on call. A growing number of facilities aren’t scheduling radiologists for overnight and weekend shifts, and others no longer have them on staff. Instead, they rely on teleradiology companies to fulfill their imaging needs.

Also known as nighthawking, teleradiology steadily has grown in popularity in recent years. A 2009 study by VHA Inc., a nationwide network of community-owned health systems, reported 56 percent of U.S. hospitals use it. Many hail the service for its convenience and instant subspecialty coverage.

“Teleradiology is essential for small, rural practices that want to deliver high-end care, but don’t have enough volume to offer fellowships for subspecialty providers or that can’t afford to hire more staff to cover nights,” says William Bradley Jr., M.D., University of California–San Diego’s radiology chair. “Diagnosis quality also goes up because radiologists’ reading scans are already awake and alert. Someone who’s been awakened in the middle of the night is likely to miss finer details.”

Contracting with a teleradiology company also can help hospitals attract and retain talented radiologists, says Michael Modic, M.D., chairman of the Cleveland Clinic’s Neurological Institute. “Some radiologists are willing to forgo the additional reimbursement—sometimes as much as 10 to 15 percent of business—if they can avoid the night shift,” Modic says. “They want more work-life balance, and hospitals use teleradiology to retain them.”

But not everyone agrees teleradiology is financially sound or safe. Relinquishing additional reimbursement could have long-lasting effects, says David Levin, M.D., chairman emeritus of the department of radiology at Jefferson Medical College of Thomas Jefferson University. Having outside companies read scans could cause a permanent dip.

“It’s possible that reimbursement could start to drop because teleradiology companies bill less for reading scans,” he says. “If they’re billing $40 for reading an MRI, but hospitals bill $80, insurance companies will start wondering why they’re reimbursing at higher levels.”

Hospitals without in-house radiologists also lose an advantage when shopping for new imaging equipment, Levin says. Knowledgeable in-house radiologists can be intermediaries who negotiate with vendors for significant cost concessions on updated imaging equipment.

Levin disagrees that teleradiology improves diagnosis quality. Teleradiologists not only lack access to all patient records with potentially pertinent information that could alter a diagnosis, but neither can they consult with other providers if they have questions.

To read the article on the original Website: http://hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/07JUL2011/0711HHN_Inbox_telehealth&domain=HHNMAG

July 13, 2011 Posted by | Healthcare | , , , , , , , , , , , , , , , | Leave a comment

Conference Spurs Participants To Consider Higher Education Diversity Challenges

Published in April 28, 2011, DiverseEducation.com

By Whitney L.J. Howell

DURHAM, N.C. – Inclusivity was the buzzword on Wednesday at the annual Diversity in Higher Education Conference at Duke University in Durham, N.C. It permeated conversations of modifying higher education to more readily accept non-mainstream cultures, changing what people consider to be the color of the race problem, and making online education and technology more effective for diverse students. The challenge: making it all happen.

“Everyone seems to be onboard with diversity and inclusion, but the struggle is how to operationalize it,” said Dr. Benjamin D. Reese Jr., vice president of the Office for Institutional Equity at both Duke University and the Duke University Health System.

Duke University and the Duke University Health System collaborated with the New York-based Conference Board organization in staging the two-day conference, which concludes today.

According to Dr. Louis Mendoza, associate vice provost for equity and diversity at the University of Minnesota, higher education needs to give minority groups a venue to reclaim their cultural and ethnic identity and respect those characteristics. It isn’t enough to open the door to minority groups, expecting them to conform completely to the entrenched institutional philosophy.

“Diversity must move to the center of educational excellence,” Mendoza said. “It can’t be a case of telling a minority student or faculty ‘you can come in and play, but then what are we going to do with you?’ These individuals deserve a seat at the table as a social, intellectual and economic asset.”

Honoring diversity in community research and including populations in those endeavors are also important, he said. Many

Dr. Robert Jensen, journalism professor, University of Texas at Austin.

groups resent being studied if they are denied the opportunity to offer their own insights and perspectives.

But reaching the point where minority individuals or groups feel true equity can be difficult, Mendoza said. Some schools view themselves as post-diverse—institutions with enough minority and international students—and others don’t want to upset the comfortable status quo.

The ideas sparked by the discussions about creating and improving inclusion are why many participants attended the conference. Terri Lockwood, director of programs for Appalachian University’s academic affairs department, said she came, hoping to take inspiration or nuggets of information back to her institution. She was pleased, she said, to hear a different perspective on how to handle discussions of equity between members of dominant and minority races.

“Appalachian has a commitment to diversity that we’ve woven into our strategic plan, and I came here looking for new methods of improving inclusivity at the school,” said Terri Lockwood, director of programs for Appalachian’s academic affairs department. “It’s clear that, as we work within our own parameters in society, it’s important that we try to work together to find a balance for the needs of all groups. No one needs to get offended or defensive in the process—it’s just a fact of life.”

According to Dr. Robert Jensen, journalism professor at the University of Texas at Austin, race continues to be a problematic topic in the United States because the country is, as he dubs it, a “White supremacy society.” Not a society in which Whites actively work to subjugate African Americans or other minority groups, but one in which Whites receive the most privileges and have little desire to change that situation.

For this reality to modify, the response must be radical, he said. Schools and employers can no longer pay lip service to diversity. The sentiment that multi-cultural inclusivity is essential must be authentic—institutions must not only think it and say it, they must do it, he added.

“It’s great to have an advocate that is neither of color nor specifically in the diversity and inclusion field,” said Patrice Hall, vice president of global equality, diversity and inclusion for Mercer, a global human resources company. “So much of diversity and inclusion work is dominated by people of color, so Jensen’s points about society being dominated by Whites explain why the work we do is often viewed as ‘less than’ and parochial by the mainstream.”

Some academic leaders recommend tailoring online education programs and other technologies to enhance the chances of success for minority students. Although historically Black colleges and universities have been slow to embrace online education, the field is growing, and minority students are flocking to this method of earning an advanced degree, said John Ebersole, president of Excelsior College. Excelsior is currently working with many HBCUs to help them establish online programs in a relatively low-risk way.

Virtual curricula will only truly flourish in the HBCU environment, however, if the programs speak the students’ learning styles, said Dr. James Anderson, president of Fayetteville State University in North Carolina. High enrollment isn’t enough to make an online program worth keeping.

“Enrollment numbers mean nothing. I’m interested in seeing that we get these students through graduation,” Anderson said. “We need to train our faculty to properly teach courses online—you don’t get to do it just because you want to. It’s important that we present information online in ways that fit our students’ learning styles. We need to teach them to be analytical learners because that style is associated with success in college.”

To read the article online: http://diverseeducation.com/article/15410/

April 28, 2011 Posted by | Education | , , , , , , , , , , , , , , , , , , , , , , | Leave a comment


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