Tag Archives: Healthcare

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Study investigates effectiveness of hormone injections for weight loss in obese patients

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Obesity is defined as having an excessive amount of body fat — not as weighing too much. A patient can have a normal weight, but if their body fat percentage is high enough, he or she may be considered obese.

According to data from the National Health and Nutrition Examination Survey, between 2013 and 2014, more than 1 in 3 adults were considered overweight.

More than 2 in 3 adults were considered overweight or obese. About 1 in 13 adults were considered extremely obese, and about 1 in 6 children and adolescents aged 2 to 19 years were considered obese.

Between 2015 and 2016, the prevalence of obesity was 39.8%, affecting about 93.3 million of adults in the United States. Obesity affects some groups more than others.

For example, 47% of Hispanics and 46.8% of non-Hispanic blacks had the highest prevalence of obesity, followed by non-Hispanic whites (37.9%) and non-Hispanic Asians (12.7%). The prevalence of obesity was 35.7% among young adults aged 20 to 39 years, 42.8% among middle-aged adults aged 40 to 59 years, and 41% among older adults aged 60 and older.

During 2011-14, obesity prevalence was lower in the highest income group among women. Among non-Hispanic black men, however, the prevalence of obesity was higher in the highest income group than in the lowest income group. Both women and men who were college graduates had lower prevalence of obesity than did persons with less education.

Aside from any cosmetic concerns, obesity increases the risk of health issues such as heart disease, diabetes, high blood pressure, abnormal cholesterol and metabolic syndrome, all of which can be addressed with bariatric surgery options, including gastric band, gastric bypass and gastric sleeve. However, these procedures can cause complications (abdominal pain, chronic nausea, vomiting and debilitating low blood sugar levels).

The findings of a new small study found that a hormone injection helped reduce body weight and glucose levels in patients with diabetes and obesity in four weeks. Previous research by Imperial College London suggested that one of the reasons gastric bypass surgery works so well is because three specific hormones originating from the bowels are released in higher levels.

This hormone combination, GOP, reduces appetite, causes weight loss, and improves the body’s ability to use the sugar absorbed from eating. The researchers wanted to document whether infusing patients with the GOP hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin and peptide, to mimic the high levels seen after surgery, could aid weight loss and reduce high glucose levels.

In this study, 26 obese patients with prediabetes and those with diabetes were recruited; 15 patients were randomly selected to receive the hormone treatment, and 11 patients were given a saline infusion as a placebo over four weeks. The researchers also recruited 21 patients who had undergone bariatric surgery and 22 patients who followed a very low-calorie diet to compare the results of GOP. All patients were given a glucose monitoring device to track their glucose levels following treatment.

Patients on the GOP treatment lost an average of 4.4 kilograms, compared with 2.5kg for those receiving a saline placebo. However, patients who received bariatric surgery or who followed a very low-calorie diet lost significantly more weight than GOP patients. The changes in weight were 10.3kg for bariatric patient and 8.3kg for patients who followed a low-calorie diet.

According to Professor Tricia Tan, Professor of Practice (Metabolic Medicine & Endocrinology) at Imperial College London and lead author of the study, although the weight loss was smaller, using the GOP infusion would be preferable because there are fewer side effects than bariatric surgery. This study suggests that it is possible to realize some of the benefits of a gastric bypass without undergoing surgery.

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Can stem cells help teeth heal? Scientists say yes

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It is generally accepted in the medical community that stem cells play an important role in wound healing. They can develop into specialized cell types throughout the body, aiding in all kinds of tissue regeneration.

A new study led by Dr. Bing Hu from the University of Plymouth’s Peninsula Dental School, with collaboration from researchers worldwide, asserts that certain stem cell tissue regeneration extends to teeth. This finding offers up a new and novel potential solution to tooth repair and may inform the way dentists treat teeth in the future.

Published in early August, in Nature Communications, the study showed that a gene called Dlk1 enhances stem cell activation and tissue regeneration in tooth healing.

Dr. Hu, who is also part of the University’s Institute of Translational and Stratified Medicine (ITSMed), said, “Stem cells are so important, as, in the future, they could be used by laboratories to regenerate tissues that have been damaged or lost due to disease, so it’s vital to understand how they work.”

Here’s the scoop:

Dr. Hu and his team discovered a new population of mesenchymal stem cells in a continuously growing mouse incisor model. If you tripped on the term mesenchymal, no worries. So did we. It just means the stem cells that make up skeletal tissue such as muscle and bone. They showed that these fancy-word stem cells contribute to the formation of tooth dentin, the hard tissue that covers the main body of a tooth.

Importantly, the work showed that when these stem cells are activated, they then send signals back to the mother cells of the tissue to control the number of cells produced, through a molecular gene called Dlk1. This study and resulting report are the first to show that Dlk1 is vital for this process to work.

In the same report, the researchers also proved that Dlk1 can enhance stem cell activation and tissue regeneration in a tooth wound healing model. Why is this so important? This mechanism could provide a novel solution for tooth reparation, dealing with problems such as tooth decay, dental caries and trauma treatment.

Here’s why it matters

Professor Christopher Tredwin, Head of Peninsula Dental School and co-author of the paper, said the following: “We are highly excited by the recent progress in Dr. Bing Hu’s group. This new work, together with a recent high-impact paper, which is about another type of stem cells in the tooth: epithelial stem cells, puts Plymouth at the front of the world’s dental and craniofacial stem cell research and regenerative medicine. We expect those researchers will soon provide dental patients better time and cost-effective solutions to serious tooth problems.”

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Obtaining prior authorization from non-Medicare carriers for hyperbaric oxygen therapy

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Denied claims due to unauthorized patient procedures or services can be responsible for a major loss in revenue. Although most medical offices and provider-based departments are moving closer to 100% verification for patient services, there is still no guarantee that every account will be paid.

Claims that are denied due to no prior authorization happen primarily in a hospital setting. To ensure your claims will be paid, plan ahead, meticulously document, and follow the regulations as noted below.

Process

The coding of HBOT is represented by 2 separate CPT codes: 99183 and G0277. HCPCS defines CPT code 99183 as Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session. 99183 represents the professional component of the hyperbaric treatment and can only be billed as 1 unit.

The word supervision must be emphasized here. According to Federal Register 42 CFR, Direct supervision means that the physician or non-physician practitioner must be immediately available to furnish assistance and direction throughout the performance of the procedure.

The physician is not required to be present in the room where the procedure is performed or within any other physical boundary as long as he or she is immediately available.

HCPCS defines CPT code G0277 as hyperbaric oxygen therapy, full body chamber, per 30 minutes. G0277 represents the facility component of the hyperbaric treatment. It is important to understand the 30-minute increment language and how it relates to prior authorization of HBOT.

The following example will illustrate this: the hyperbaric provider has consulted on the patient and determined that a course of 30 treatments will be needed for Soft Tissue Radionecrosis. The nurse or technologist clarifies the ICD-10 diagnoses with the HBO physician and gathers the clinical data to present to the carrier for prior authorization of services.

The following steps are important and necessary to ensure that both the physician and facility are paid for services.

  1. Verify coverage and benefits with the insurance carrier. Ask: “Does the patient have active coverage, is this insurance the primary and when does the plan expire?”
  2. Verify that the patient’s plan provides coverage for HBOT. It is important to provide them with the CPT codes, 99183 and G0277.
  3. Ask if codes 99183 and G0277 require prior authorization. If authorization is required, provide the number of units you will need for each CPT code
    • If you are requesting 30 HBO treatments, the authorization request for 99183 would be 30 units.
    • If you are requesting 30 HBO treatments, the authorization request for G0277 would be for the number of 30-minute increments multiplied by the number of requested treatments which in this case would be 120 units. 1 hyperbaric treatment is typically billed as four 30-minute increments.
    • See table below for G0277 billing increments.
  4. Ask the representative to refer to their coverage determination on HBOT and ask if they cover the indication which in this case is STRN.
  5. Obtain a copy of the carrier’s coverage determination for HBOT prior to beginning therapy and highlight the indication and ICD-10 codes relevant to this authorization.
  6. Request a date span which will allow time for 30 HBO treatments to be administered. In this case, 60 days would be sufficient.
  7. Once authorization is given, document all of the above information clearly and thoroughly. This will include:
    • The authorization number
    • Number of treatments authorized
    • Authorization start and end date
    • Time, date and name of the person you spoke with
    • A reference number that has been assigned to this phone call or case
    • Request a faxed copy of the authorization
  8. Remind the patient that it is also their responsibility to make contact with their insurance company to ensure coverage, i.e., deductible, copay, coinsurance and maximum out-of-pocket expense.
  9. Communicate the HBO Authorization number and details to the billing department.

Closing

Recently, a hyperbaric facility received a denial notice on the explanation of benefits for hyperbaric treatments 11-40 specifically, the G0277 code. When the staff inquired as to why with UnitedHealthcare, they were informed that during the prior authorization process, they had requested authorization for 40 hyperbaric treatments. As of 10th hyperbaric treatments, UHC had already paid for 40 units of G0277 leaving the facility with a deficit of 120 units or 30 total treatments still to be paid. This would account for about $24,000 of lost revenue for one patient.

Resources

A HBOT prior authorization form template is provided here for reference (open access, after creating free account).

The WoundReference Hyberbaric Oxygen Therapy Knowledge Base features guidelines to promote high standards of patient care and operational safety within the hyperbaric program and other important tools. The WoundReference Curbside Consult gives you actionable, specific answers from our expert panel in a timely manner.

For customized safety programs and other wound care and hyperbaric medicine consultation services, visit MidWest Hyperbaric.

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Top senator: Rural health systems must be allowed to evolve, survive through telehealth

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Telehealth is getting some additional mainstream backing again in a significant way as one of Washington, D.C.’s leading healthcare voices continues to place his support behind it — Sen. Chuck Grassley, R-Iowa.

The reason for his doing so is because of the weakening of the rural healthcare community. These rural health systems face continual financial pressure, and many of them are facing closure. Thus, telehealth can help solve some of the many challenges confronting rural communities in maintaining access to care, Grassley says.

Sen. Grassley, chairman of the Senate Finance Committee, recently spoke out at a Bipartisan Policy Center event in Des Moines, Iowa, about rural health. “Rural communities are struggling to keep healthcare services available for their residents,” said Grassley.

The senator said during his talk that almost 20% of the state’s rural hospitals are at risk. “Some rural communities are facing the stark possibility of having no healthcare services available in their county whatsoever,” he added.

There have been 98 closures of rural hospitals since 2010, but hundreds more are likely to follow, the National Rural Health Association (NRHA) claims. As of February 2019, 46% of rural hospitals operate at a loss, up from 44% in 2018 and 40% in 2017. Financial strains mean that about 700 rural hospitals are financially vulnerable and at high risk of closure.

The American Hospital Association reports that there were 1,875 rural community hospitals as of 2019.

These hardships to rural areas because of a hospital closure can have a staggering effect on the communities where they are located. These health centers are the nucleus of their rural economies, creating jobs for residents, and serve as incentives people to move to a county and open businesses, the NRHA says. “Without a rural hospital, a community will crumble. The most recent hospital closures will leave communities across the country without local care and will devastate rural economies nationwide.”

Grassley believes that new models of care on the horizon, including the delivery of care through mediums like telehealth. Policies must keep pace with that technology, Grassley said at the forum. “Cutting red tape and prioritizing telehealth services will grow patient volume, expand access, improve care and increase flexibility,” he said.

Grassley has reintroduced a bipartisan bill that would allow rural diabetic patients to receive regular vision screening using telemedicine. His bill, the Rural Emergency Acute Care Hospital (REACH) Act, is designed to create a new rural emergency hospital classification under Medicare. Many of these hospitals are currently designated as critical access hospitals under Medicare. Thus, these care systems must maintain a required number of in-patient beds and provide emergency care services, which can be draining on their finances.

The space previously used for the in-patient beds could be used for providing other patient services, including telemedicine. The REACH Act also details the costs associated with having a backup physician available via a telecommunications system.

“We hope to get that moving forward, but we had a tremendous problem the way that it was introduced last year,” Grassley said.

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4 critical success factors for transitioning to independent living

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For most young adults, leaving home and setting out on their own is inevitable, but success in this endeavor is not.

Students with a learning difference and their parents can increase the likelihood of a successful transition to adulthood by focusing on four critical areas to prepare for the obstacles ahead.

Common Themes

Reducing dependency: Right now, your student is dependent on you for a variety of things from waking them up and keeping track of their schedule to making food for them. The goal, before they leave home to set out on their own, should be personal independence. This means slowly but methodically moving through the prompting hierarchy.

Teaching basic skills: Sometimes parents assume their young adult understands expectations and how to accomplish the tasks they are given. Often what the student needs is more specific instructions on how to complete tasks, including a break own of some tasks into steps so they are less overwhelming.

This may mean using modeling when teaching new tasks and using task lists, so the student has something to refer to when parents aren’t around. Click here to see an example weekly checklist.

Set expectations: It is important to set expectations with your young adults so that they understand what you expect of them before they are ready for independence. This can be an uncomfortable conversation, but it is necessary to make sure everyone is on the same page.

Set several goals leading to the main goal of independence to keep your student focused and reduce the chances of them becoming overwhelmed.

Critical Success Factor No. 1: Cleaning and Organizing

Teach basic cleaning skills: Walk them through each task and model each task so that they understand your expectations.

Break tasks down into less overwhelming steps: This will give them a more attainable goal and increase the chance they will complete the task.

Set realistic expectations: Set expectations now to help your young adult develop a routine to use once they are on their own.

Use task lists to reduce your student’s dependency on you: You can create these with your student or find them on the internet.

Create a schedule: Organizing cleaning tasks on a schedule creates routines that they can continue to follow when they are on their own.

Critical Success Factor No. 2: Planning, Scheduling, and Routines

Begin using a schedule ASAP: Have your student start using a planner to keep appointments, upcoming events and their cleaning schedules. Right now, you are serving as their planner &#8212 use this to reduce their dependency on you.

Plan free time: Your young adult needs to learn to plan out their down time before setting out on their own, especially if they are accustomed to you planning free time for them.

Use alarms for events including waking up in the morning: You won’t be there to wake them up or to make sure they get ready for an appointment. Now is the time to have them start setting alarms for themselves.

Set morning and evening routines: Morning and evening routines are extremely important to make sure they are prepared for their day. This should include wake up times, bedtimes, hygiene, and when they need to head out for their day.

Critical Success Factor No. 3: Safety

Teaching basic home safety: This includes how to use a fire extinguisher, smoke alarm maintenance, using home appliances, and the importance of home security.

Understanding resources in the community: It’s important for young adults to understand who to contact in their community. If you know where your student will live, help them create a contact list for emergencies, home repair, doctor, and dentist.

Teach basic home maintenance: Learning simple home maintenance now will help save money in the future. Teach them basic skills like unclogging a toilet, resetting circuit breakers, and using basic tools like a screwdriver and pliers.

Critical Success Factor No. 4: Cooking

Teach them to use kitchen appliances: Understanding how to safely use appliances like the oven, stove and other small appliances are key to avoid potential disaster in the kitchen.

Teach basic cooking skills: Review skills like boiling water, chopping, measuring ingredients, storing food and following simple recipes.

Plan a weekly menu and go grocery shopping: Keep it simple. Find 3 to 5 basic recipes to work on with your student now so they can practice.

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The economic impact of our aging population

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Most of our current crises — global warming, for example — are critical today because they’ve long been underestimated or ignored. The worldwide crisis posed by a rapidly aging first-world population, on the other hand, wasn’t even recognized until recently.

Today, the crisis is already fully present and, unless addressed, will worsen rapidly.

A Little Known and Frightening Statistic

A 2016 article in The Lancet on the implications of rapidly aging world populations cites some disturbing statistics. Important among them is this: Although over the past six decades the world population aged 60 or older has increased only slightly — by around 9% — in the next 40 years this group will more than double, from around 800 million to 2 billion.

The U.S. is one of the countries that will be most affected by this dramatic increase, resulting in lower birthrates, lower labor participation rates and dramatic increases in Social Security payouts and healthcare expenditures.

No current government policy fully addresses any of these changes. A few government agencies, especially the Congressional Budget Office, have issued warnings backed by data, but to date, the realistic and detailed congressional proposals needed to remedy these economic stressors haven’t been made. The longer we wait, the more drastic and politically unpopular these remedies are likely to be.

The Effect of Labor Participation Rates on Social Security Funding

The labor participation rate measures the ratio of employed workers to the total working age population. There are a couple of eye-popping elements in this simple statistic that will have significant economic consequences over the same 40-year period when the population aged 60 and older will more than double.

Even if workers of every age were treated equally, this increase in an aging population would still represent a real problem for Social Security, which depends upon the contributions of current workers to fund benefits for those who have retired.

Workers over 60 soon become workers of retirement age, with the result that this group, which includes the populous baby boomer generation, will require increasing contributory amounts from current workers to keep Social Security funded. The problem is that too few workers will be making contributions and too many retirees will be drawing benefits. That’s even in the best case, when all workers are treated equally.

But all workers are not treated equally. As I’ve written in more detail in an earlier article in this series on aging, workers begin to suffer from involuntary layoffs at age 40.

By age 50, more than half will find themselves involuntarily removed from their jobs. This describes a labor participation rate artificially reduced by what amounts to a prejudice against older workers.

This shrunken workforce can’t possibly make sufficient Social Security contributions to provide the needed retirement benefits for a rapidly growing aging population with increasing longevity. But that’s only one element of this age-related economic crisis.

A Society Moving in the Wrong Direction

Congress has long been aware that without some change in the contributory structure, Social Security will eventually run out of money, most likely before 2035. For an equally long time, Congress has been unable to do anything about it. The increasingly bitter partisan divide over entitlements, especially Social Security, Medicare, and Medicaid, has made finding a solution acceptable to both Democrats and Republicans elusive at best.

The Democratic position, represented by groups like The Center for American Progress, is that existing tax breaks for the ultrawealthy have contributed to an unsustainable degree of economic inequality.

Increasing those taxes effectively solves two problems: the social dysfunction of extreme inequality and the shortfalls in existing entitlement programs. Making up the shortfall with tax increases won’t be easy. In 2019, Social Security and Medicare cost about 9% of GDP. In 40 years, they’ll cost nearly 12%.

Republicans in Congress strongly oppose funding entitlements “on the backs of the rich.” One popular Republican solution to the Social Security shortfall problem is simply to do away with it in its current form.

Instead, Republicans have proposed an entirely different way of killing two birds with one stone: instead of increasing taxes on the rich to both reduce inequality and fund Social Security, conservative publications like The Federalist have proposed privatizing Social Security to increase benefits while reducing government involvement.

How would this work? Well, for one thing, each participant would obtain their benefits directly from their own contributions. Most likely these would be invested in the stock market, much along the lines of existing 401(k) plans. Democrats find this kind of solution deeply abhorrent — an abnegation of government responsibility unlikely to work.

If the U.S were truly, as we would like to believe, a fully participatory democracy, the Social Security shortfall problem would already have been solved. According to a research study funded by The National Academy of Social Insurance, 83% of Americans want Social Security fully funded “even if it means increasing the Social Security taxes paid by wealthy Americans.” This view, according the study, holds true across party lines and income levels.

But the U.S is not a fully participatory democracy. It is more like a vulnerable and damaged democracy trying to balance citizens’ wants with imperatives demanded by powerful, influential, and not necessarily democratic actors.

The Social Security shortfall, like many other growing crises in the country, will likely by solved, at least to a degree, but only at great cost years after a better lower-cost solution could have been achieved.

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Employees want to be recognized, but not how you think

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Your employees want you to recognize their hard work and efforts, but a survey of 16,000 professionals in 4,000 companies representing various industries and roles reveals that they may not want to be recognized for only major accomplishments, don’t necessarily want a cash reward, and some would prefer that the recognition didn’t occur in front of everyone in the organization.

According to a recent Deloitte Greenhouse survey, most employees (54%) would prefer a verbal “thank you” for day-to-day accomplishments, while 31% would prefer to have that thanks in writing.

When the accomplishment is significant, almost half of employees (47%) would prefer a new growth opportunity, compared to 23% who would rather have a salary increase.

When asked what they would prefer to be recognized for, 40% wanted to be recognized for their success. However, 24% thought they should be recognized for their knowledge or expertise, and 20% thought their effort or hard work should be acknowledged — even if the project wasn’t a big success. In addition, 16% would prefer to be recognized for living the company’s core values.

Regarding public versus private recognition, almost half (49%) of respondents chose public but narrow recognition (shared with a few), followed by 34% who only wanted the recognition to be between the employee and boss. Only 18% preferred the recognition to be public and broad (shared with many people).

Why money is not the top way that employees want to be recognized

“People likely realize that staying relevant in the future of work will require continuous learning,” says social-personality psychologist Dr. Suzanne Vickberg, the applied insights lead for Deloitte’s Greenhouse Experience Team, and author of “Business Chemistry: Practical Magic for Crafting Powerful Work Relationships.”

While most people would welcome a bonus or raise, she says it may be seen as having short-term value. “A growth opportunity, on the other hand, is a longer-term investment in one’s career.”

Shunning widely shared recognition

There are at least two reasons why many employees don’t want their recognition shared with a lot of people. “Some people likely just feel uncomfortable in the spotlight,” Vickberg says. Also, some people think it feels more sincere when delivered privately on in a smaller group. “For some, public appreciation can feel like a spectacle that isn’t really about them or what they’ve contributed.”

Gender and generational differences in how people want to be acknowledged

“We didn’t find a lot of statistically significant gender differences,” Vickberg says. However, women were more likely than men to prefer a written thank you. So, what accounts for this? “Perhaps this is because women are more likely to be thank-you-note-writers in their personal lives,” she muses.

The largest generational differences are present in who employees prefer to be recognized by. “Millennials are most likely to value recognition from leadership, while baby boomers more highly value recognition from their colleagues,” Vickberg explains. “With such a large proportion of the workforce now represented by millennials, programs designed to encourage peer recognition should be viewed as a supplement to, not a replacement of, recognition from managers and leaders.”

Business Chemistry differences

The biggest differences were based on the four Business Chemistry types:

Pioneers value possibilities and spark energy and imagination. They’re outgoing, spontaneous, and adaptable. “Say ‘thank you’ and provide them a chance to try something new,” Vickberg advises. “Ask their colleagues or the boss’ boss to deliver the thanks.”

Drivers value challenge and they generate momentum. They’re technical, quantitative, and logical. “Give them a challenging opportunity and thank them when they’re successful — and also thank them when their expertise has been crucial.” These individuals would really appreciate the higher-ups acknowledging their performance.

Guardians value stability and they bring order and rigor. They’re practical, detail-oriented, and reserved. “Ask them whether they prefer a new opportunity or financial reward.” Vickberg says these employees should be thanked for making a strong and steady effort and when their expertise adds a certain value. “You can recognize them yourself or invite leadership to share but keep it a bit quiet.”

Integrators value connection and they draw teams together. They’re empathetic, diplomatic, and relationship-oriented. “Offer them a sincere thanks and ask if they would like a growth opportunity.”

You need to acknowledge their efforts and commitment to core values as much as their successes. “They would appreciate an acknowledgement from you, and you can include their colleagues, but limit it to a small group.”

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Podcast: Why your values matter as a healthcare professional

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This podcast originally appeared on NurseKeith.com.

Podcast: Click here to play.

In this episode, Keith Carlson welcomes Jacob Morris, an expert in values-based applied research. Understanding the values that make you who you are can help you to live those values in a way that empowers and enriches both your life and your career.

Morris founded the Discover Your Values program in a grassroots effort to bring the latest research on values-based development to the forefront of the coaching industry and the general public through the work of social psychologist Shalom H. Schwartz.

Morris received his coach training from Gallup, Wellcoaches, and Harvard University. He is a Gallup-certified Strengths Coach. Prior to becoming a coach, Morris spent 17 years in management at a Fortune 100. His corporate experience spans a number of functional areas, including marketing, sales, product development, loyalty, e-commerce, communications, and learning and development.

He has lived and worked on three continents and is a lifelong learner. Morris is also a professional student in the liberal arts program at Harvard University. His top three values are: creativity, freedom, curiosity.

Find Jacob and his work at:

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Which industries will benefit most from the industrial internet of things?

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A common statement among historians of the 1849 gold rush was that the people who were most likely to make the most money from their endeavors were the ones who made tools for the miners and not the actual miners themselves.

As industries like transportation, manufacturing, technology, energy and healthcare pursue success with the industrial internet of things (IIoT), this colloquial wisdom stands true. IIoT equips these sectors with the information to operate their businesses more effectively.

It’s no wonder why a majority of the companies who successfully use this technology have reported increases in revenue.

To understand why this is, we must look to the challenges industries are working to overcome and how IIoT helps them cross this digital chasm in business.

Imagine if you’re part of the power grid in the center of Phoenix, Arizona, with high temperatures averaging above 100 degrees for months at a time. For your region, controlling temperature to make it livable for every day is a critical foundation of the city.

In fact, the ability to route power to a specific area experiencing a meteorological event so efficiently is the source of millions upon millions of dollars in energy and utility spend across the country. By cooling off homes in a specific region before a heat wave hits, regions are saving millions of dollars on energy and receiving money back from the government for doing so.

This story goes on across many other industries, including transportation and healthcare. The industries who have data closest to the problem or provide people enough data to make decisions faster are key.

By 2025, 75% of data in these industries is expected to move out of company environments and in our environments — an area known as the edge. Overall, this massive shift in data is a pretty big jump from the 10% of industrial data at the edge today.

IIoT is growing at a rate far greater than most fields. So why is it that industries across tech, transportation, energy, manufacturing, and healthcare are receiving such a big value with the introduction of IIoT?

In order to see the value it brings to these industries, we have to dive into what’s happening in these industries today and the opportunities they might achieve tomorrow.

For many of these industries, their systems, production mechanisms and technology were created up to 30 years ago. From aging facilities and oil rigs in Southern California pumping energy out of the ground to the modern-day automobile engine, not much has changed in the mechanics that contribute to these highly reliable systems.

With IIoT, companies are able to attach sensors or make decisions at the edge, which reduces the time it would take to get information back to the office or a car shop.

Business processes like predictive maintenance in manufacturing and transportation will help replace industrial parts before they fail. This is the case even in the energy sector and healthcare, where having continuous operations and avoiding system downtime may mean the difference between life and death.

As business leaders, managers and experts across the industries look to where they should bring about their next innovation, IIoT becomes even more crucial. It will be critical for any industry that operates in the field, even defense and aerospace, to leverage this technology.

If you’re a manager in transportation, high tech, manufacturing, factory automation, energy or healthcare, look no further for the technology disrupting industry today.

My hope is that, much like the forty-niners, these industries get the tools they deserve to bring us into a new age we’ve never seen before.

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Are you playing in the right healthcare sandbox?

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Within the healthcare industry, there are endless choices when it comes to carving out the career path that’s right for you. Whether in medicine, nursing, leadership, or elsewhere, the world can indeed be your oyster if you play your cards right, network assiduously, make good choices, follow your values, and honor your intuition.

We can, of course, encounter option paralysis when faced with too many alternatives; however, with a burgeoning healthcare industry facing an increasingly aging and diversifying population, the avenues for career success and satisfaction are legion. So, are you playing in the right career sandbox?

What You Want Matters

If you decide to become a nurse, there will be plenty of people with strong opinions about where you should work after graduation, what kinds of nursing are best to pursue, and how you should structure and plan your new career. If you go into medicine, the same plethora of choices and opinions apply, and there are plenty of sandboxes to choose from.

From physical therapists and speech language pathologists to those seeking success through informatics or public health, what you want matters more than any “shoulds” that your friends, colleagues, professors, family, and even total strangers impose on you. Those “shoulds” should likely go in one ear and out the other.

So, how does a newly minted healthcare professional make the right choices? Consider these notions for this process:

  • Why did you enter the healthcare arena in the first place? What drew you to this industry?
  • While you were in school, what were the experiences that held the most meaning for you?
  • Do you enjoy task-based work or are you more of a thinker, planner, leader, scientist, or theoretician?
  • Is patient care the thing that lights your fire? If not, it certainly isn’t the only game in town.
  • What are your career goals for 5 years, 10 years, and perhaps even 20 years hence? Do you have a plan or are you trusting your intuition and serendipity (a strategy that can actually be quite successful if you’re good at trusting your gut and being in the right place at the right time)?
  • If you’ve frequently been told what you “should” pursue, do any of those choices feel right?
  • Where do your greatest talents and strengths lie vis-à-vis the skills and knowledge inherent in your new career?
  • If you have a sense of what you want in the mid- or long-term, what path(s) do you feel are most likely to get you where you want to go?
  • Are there others who’ve carved a professional niche that you would like to emulate?
  • Do you have debts and financial concerns that your new career must adequately address?
  • Will the career path you’re planning allow you to create the lifestyle you desire and deserve?

These and other questions can help you focus on what’s most important, leading you in a direction that’s aligned with your desires, goals, strengths, and personal/professional interests.

There’s No Shortage of Sandboxes

Let’s say you graduate from nursing school and take a med-surg position because everyone said you should. After a year or so, you realize that acute care nursing is far from what you really want to do.

With your clinical skills, knowledge, and experience, you can plot any career course that can move you in the direction of the professional satisfaction and lifestyle you desire. However, in order to accomplish this, you need to know yourself well so that your choices are aligned with your true nature.

If you’ve finished medical residency and landed a position that doesn’t suit you, you may feel locked into your chosen specialty even though you’re beginning to chafe at the restrictions of your current path. Remember that when you see only limited choices, it’s probably because your thinking is limited; can you open the window and let in the fresh air of your many potential options?

And if you’ve chosen a clinical career route (RN, MD, PT, etc.) but then realize you have more gifts in areas like leadership, informatics, or other nonclinical milieus, you must realize that an informatics nurse is as valuable as an oncology nurse, and a medical consultant is as valid a choice as that of trauma surgeon. In our society, certain roles seem to hold more prestige than others, but you truly need to ignore those unfounded opinions and chart your own course.

There are, of course, many healthcare career sandboxes in which you can play. Make prudent choices, listen to the voice inside of you more than the ones imposing their will from the outside, and trust the power of your intuition and self-knowledge. The world is truly at your feet; can you see the possibilities?

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