Das Keyboard, everyone’s favorite keyboard company that sounds like something Kraftwerk would carry with them on road gigs, has announced the 5Q, a smart keyboard with two-way communications to cloud servers.
What does that mean? It means you can program your keyboard to flash the letter E blue when you’re outbid on eBay or have the spacebar blink wildly when your website goes down. Read More
When I was a practicing neurosurgeon, I performed surgeries to treat severe deformities of the spine. It was time-consuming, painstaking work, with virtually no margin for error.
No one is born with the skills to do such surgeries. Starting in medical school and continuing at the hospital where I completed my neurosurgery residency, I learned alongside more experienced surgeons as we cared for patients in need of our help. The training was literally hands-on, and it sparked the curiosity that led me to investigate novel ways to diagnose and treat these disorders.
For me, the experience epitomizes the essential role of academic medical centers in training physicians. Looking to the future, having a well-trained physician workforce will only become more crucial as the health care industry focuses on ways of delivering and paying for care that reward quality and better outcomes for patients rather than volume of care. Yet because some repetition and redundancy is necessary for training, the rise of fee-for-value models casts uncertainty on the fate of academic medical centers — the very institutions primarily responsible for training those new doctors.
Readers may wonder why as an executive of a major health insurance company, I would take an interest in this topic. It’s not just that I once directed a residency program at an academic medical center and later served as chief medical officer at the same hospital, though those experiences inform my perspective. The fundamental truth is that all of us — insurers, health and hospital systems, the physician community and patients — stand to lose if we don’t work together on innovative ways to support medical education.
A MISSION IN THREE PARTS
The three-part mission of academic medical centers — clinical care, medical education and research — is what distinguishes them from community hospitals. They provide both routine clinical care and some of the most specialized care for rare and complex conditions. They also typically have a close connection to a medical school, and serve as training sites for medical students, residents and fellows. Lastly, they conduct cutting-edge clinical research that often serves as the basis for innovations in health care.
Due to their prestige and in deference to the multiple missions they serve, academic medical centers also have traditionally received favorable per-unit contracted reimbursement rates from private insurers and add-on payments from Medicare, both of which have served as indirect or direct funding sources for training and research.
But if recent years have demonstrated anything, it is that business-as-usual in the health care industry is unsustainable. Health spending in the United States continues to rise precipitously, and with it has come increased demand for high-quality care, improved outcomes and closer management of the costs of care.
Those costs, however, translate to revenue for academic medical centers. Spending on care by private insurers, state and federal government and patients themselves makes up about 85 percent of a typical academic medical center’s revenue, according to a report by PriceWaterhouseCoopers. Because those payments subsidize all other operations of the hospital, cuts to that revenue mean everything else, including training, will be affected.
As a former director of a neurosurgery residency program, I had first-hand knowledge how clinical care overlaps with education. Medical training requires discussion-based, didactic instruction and hands-on practice in a clinical environment. Inexperienced providers are appropriately slower and more cautious when they practice, and work must sometimes be stopped for instruction and redirection before repeating some steps.
Though repetitive and redundant medical services are considered crucial to education, they are also examples of the utilization-based inefficiency that value-based alternative payment models like ACOs and medical homes are designed to minimize.
Few would question that academic medical centers fulfill a vital role in our society, but it’s also clear that this role makes them among the costliest places to receive care. For the three-part mission to continue, we as health care leaders must find better ways to support and sustain it.
TRAINING THE NEXT GENERATION
An alternative funding plan might involve favorable tax considerations for stakeholders in the health care industry that make education grants to academic medical centers. This could help make up for the loss of fee-for-service revenue and could also drive competition for efficiency in training outcomes. Some might criticize this kind of tax break, but I would argue that money going towards training doctors to care for the American people is a worthy public investment.
This is just one potential solution. There are no easy answers, but a first step will be to understand the skills physicians will need in a value-based environment where those who pay for care — government, insurers, employers and patients themselves — will demand accountability for quality, outcomes and cost.
In such a world, doctors will need to assess the relative value and appropriateness of different treatment and test options, to communicate and collaborate as the member of a team, in order to improve care and reduce waste, and to also focus on patients’ experience and perception of value. Some academic medical organizations have explored potential solutions already, and their knowledge can be leveraged as we as a society rethink the entire model, including how inefficiencies can be minimized without compromising training.
Once we understand what is required of the education mission, we can assess the alternatives for how these vital functions can be funded in a more straightforward, understandable and purposeful way. We cannot afford to allow high-quality medical training in the United States to erode due to a lack of foresight. As a country we not only owe it to the next generation of physicians but also to our children and ourselves.
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Integrated. Holistic. Connected. These words all carry a similar theme. If you use email marketing, they should have a special meaning. That’s because, in today’s world, it’s hard to run a successful business with just one form of digital marketing. Competition from other companies using apps, social media, blogs, email marketing and SEO make it difficult to excel.
Integrated marketing is a way to unify all aspects of your marketing strategy to provide consumers with one cohesive experience, while reinforcing each aspect of your campaign. This type of integrated thinking is proven to work when planning and executing your marketing maneuvers.
But too often there is an article, a panel, or a podcast discussion that wants us to identify how one channel is more effective than another. And, while these articles are trying to prove and explain how certain channels drive a greater return or result, they fail to mention that these channels are all exponentially more powerful together.
A look at social media and email
According to the Radicati Group, there are three times more email accounts than Facebook and Twitter accounts combined. Yes, combined. Add that to the fact that the average open rate on an email is 20%-30%, and the organic reach of your Facebook brand page is now down to less than 5%.
But if you are reading these stats and thinking the solution is to hyperfocus on email and shy away from social, you may be taking the wrong approach. In reality, when embracing an ‘and’ mentality, there are so many more ways to drive success. For example, you can leverage those strong email open rates to promote your brand’s social presence.
As you build your social base, you can still maximize the advantage of paid social ads to reach and engage more of your growing audience. Leverage these ads to promote an awesome, educational piece of content that you know your audience is craving. And then, capture names and email addresses to build your email audience and expand your reach even further.
Email is your hub and spoke
Email has been called the ‘workhorse’ marketing channel. Capable of being the catalyst that drives a marketing campaign, and serving as a way to further the customer relationship building process, email is your hub and it is a spoke. It’s a system of distribution that works cohesively with other platforms for efficiency.
For instance, Facebook and Google have both embraced the value of the “and” mentality by incorporating Custom Audiences and Customer Match, respectively. These programs let you maximize your marketing budget by leveraging your list of email subscribers/customers (your hub) to build lookalike audiences within the respective platforms. This increases your targeted reach and serves to target advertising content to your existing customers across Facebook and the general web. Essentially, it provides a ‘surround sound’ messaging experience that increases your chance of gaining the attention of your specific target audience.
When it comes to email as a spoke, successful marketing campaigns are focused on driving value for the customer. With customers at the center (your hub), email can play a key role by leveraging select keywords from SEO and PPC data to ensure your messages, offers and updates demonstrate consistency and will resonate with your customer base. Email can also leverage both in-person engagement (events, in-store) and digital data (clicks, opens, purchases) to deliver the most relevant messages.
Now what?
If you’re sticking with the “or” mentality strictly due to time, money, or experience limitations, you may just need to spend a little time researching your options. With the technological advances of the internet over the past few years, there is a way to integrate virtually everything. And ironically, once you do take steps to connect your marketing channels, you’ll end up saving time, energy and money.
Feeling inspired? Review your next two to three months of scheduled emails and figure out how you can embrace the power of ‘and’ in your marketing campaign. It could be time to test out custom audiences or customer match features. You could try incorporating your most popular keywords into your subject lines and/or the body of outgoing emails. You could also drive traffic from Facebook and Twitter to a signup form to grow your audience or send an email to your audience about a private Facebook community that you’re launching.
Now, here’s one final thought. Don’t think of the above options as, well, options. Use your newfound ‘and’ mentality. Try them all and see how integrating as many channels as possible can benefit you in the long run as you now have a great starting point for prioritizing your short list of integrated marketing tactics.
Have another ‘and’ marketing solution that worked for you? Comment below and share your learnings with other business owners like you.
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We all need help maintaining our personal spiritual practice. We hope that these Daily Meditations, prayers and mindful awareness exercises can be part of bringing spirituality alive in your life.
Today’s meditation features a song by American folk singer Joanna Newsom. “On A Good Day” is a ballad of love and loss, emanating a fierce resilience that lovers and poets know only too well.
Hey hey hey the end is near
On a good day you can see the end from here
But I won’t turn back now though the way is clear
I will stay for the remainder
I saw a life and I called it mine
I saw it drawn so sweet and fine
And I had begun to fill in all the lines
Right down to what we’d name her
Our nature does not change by will
In the Winter ’round the ruined mill
The creek is lying flat and still
It is water though it’s frozen
So, across the years and miles and through
On a good day you can feel my love for you
Will you leave me be so that we can stay true
To the path that you have chosen?
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The battle between victims of the cholera epidemic in Haiti and the United Nations may resemble a classic David and Goliath story, except in this case Goliath hasn’t even shown up to fight.
The reason is that the United Nations is granted “immunity from every form of legal process” — even though public health experts believe UN peacekeeping troops are responsible for the cholera outbreak in Haiti, which has infected more than 750,000 people and killed more than 9,000 since October 2010. (Though a recent paper from Médecins Sans Frontières researchers suggests that there may be “a substantially higher cholera mortality rate than previously reported.”)
Nevertheless, on Jan. 9, 2015, US District Court Judge J. Paul Oetken dismissed a class action lawsuit brought by the Institute for Justice and Democracy in Haiti. But in March the Second Circuit Court of Appeals agreed to review the District Court’s ruling. The decision of the three judges is pending.
The United Nations should not be able to invoke immunity in order to foreclose on justice. The 1946 convention that granted them immunity also charged them with a responsibility. They aren’t to be accountable to no one. Rather, according to the convention, the UN “shall make provisions for appropriate modes of settlement.” But the UN has refused to do so in this case.
The United Nations should account for their role in one of the deadliest outbreaks of cholera in recent history. Some argue that time is better spent on halting the epidemic and not trying to point fingers at who started it. But while that trade may satisfy members of elite organizations, it is unlikely to satisfy people like Lisette Paul, one of the plaintiffs in the lawsuit. Her brother, Fritznel, became sick while working in the fields. He vomited and had diarrhea for seven days straight until he died. His medical and funeral expenses plunged his family into debt. Soon, they could no longer afford to send his daughter to school. The suffering of Fritznel, Lisette, and those like them shouldn’t be pitted against the prevention of future pain. They should have a forum to air their claims and the UN should provide it.
No one doubts that the ongoing cholera epidemic in Haiti is a man-made disaster. The debate is who, or what, was responsible. Cholera is a bacterial infection that causes diarrhea and vomiting and, unstopped, eventually dehydration and sometimes death. People can catch it from contaminated water. But it hadn’t been in Haiti for 100 years at least. So how did it wind up there in October 2010?
The short answer is human activity from South Asia. One team of public health experts matched the strain of cholera to a South Asian type. Another made a circumstantial case that the disease came from a camp of UN peacekeeping troops from Nepal. Before the troops were deployed to Haiti, there had been a cholera outbreak in Kathmandu, Nepal. Less than two weeks after the first cases, the Associated Press reported an overflowing septic tank, the “stench of excrement,” and “a reeking black flow” from the camp’s pipes to the Artibonite River, which 1.5 million Haitians use.
The UN doesn’t deny all of these claims. In fact, they rounded up an independent panel that reached many of the same conclusions. They also found that the cholera strain matches the South Asian type and the outbreak happened “as a result of human activity.”
But the UN panel report arrives at a different conclusion. Though they agree someone must have brought cholera to Haiti, they say no one should be blamed. This is because, they argue, there was a “confluence of circumstances.” These circumstances include the environmental conditions, the role that Haitians played in spreading the disease, an especially deadly strain of cholera, and the country’s poor sanitation and water conditions. Indeed, by the time the cholera outbreak hit, a mere 17% of Haitians had access to facilities that separate human waste from human contact.
The “confluence of factors” argument amounts to little more than victim blaming. If only Haiti had better water and sanitation, the argument goes, then cholera would not have spread.
But does that mean someone should be able to leak contaminated raw sewage with impunity? “From a legal perspective that stuff is all totally irrelevant,” counters Brian Concannon, the executive director of the Institute for Justice and Democracy in Haiti. “If the UN negligently introduced this disease into an environment they knew was weak, then legally it’s still responsible.”
Still, this isn’t an open-and-shut case. Daniele Lantagne and the rest of the UN panel give two reasons why not. First, there is no hard scientific link between the peacekeepers and the outbreak. Someone else from South Asia could have been in Haiti at the time and, however miniscule the possibility, they could have carried the strain. Second, the introduction of cholera undoubtedly was an accident and not a deliberate act.
But this only raises more questions that the UN should answer. No one argues that the peacekeepers contaminated the water supply on purpose. If they had the disease, they may have had no idea. In fact, it is possible to be totally asymptomatic. But this doesn’t answer why they weren’t screened for the disease. After all, a cholera outbreak was reported on September 23, 2010, in Kathmandu, which is where the peacekeepers trained for three months. They received a medical examination before traveling to Haiti. Why weren’t they tested for cholera? A recent article in PLOS Medicine reports that the rapid diagnostic test only costs $2.54 per person and a single-dose prophylaxis on the higher end runs $1.32 per person.
Even if they were definitively singled out as the cause, it would be unfair to punish the peacekeepers. They weren’t experts. Peacekeeping troops are hired out, largely from poor countries, to the UN for $1,028 per soldier per month of duty.
But that doesn’t mean no one could have foreseen harm. Just two days after the January 2010 earthquake, the US National Center for Medical Intelligence wrote that it “expects damage to urban water and sewage infrastructure will increase rates of diarrheal disease, possibly to include cholera.” Even if an accidental act and a confluence of factors spread cholera, the important ethical questions are when those factors were known, and by whom.
It isn’t only outsiders like Brian Concannon and the IJDH who are calling on the UN to hear claims from the victims of cholera. In his first report as the UN’s independent expert on the situation of human rights in Haiti, Gustavo Gallón called for a “reparation commission for cholera victims.” Given that the UN proclaimed that victims of human rights violations must be able to seek remedies and reparations, Mr. Gallón reminds us, anything less would be hypocritical.
In October 2015, four UN Special Rapporteurs joined Gallón to argue that “the victims of cholera have access to a transparent, independent and impartial mechanism that can review their claims and decide on the merits of those claims in order to ensure adequate reparation, including restitution, compensation, satisfaction and guarantees of non-repetition.”
More recently, Jan Eliasson, the Deputy Secretary General of the United Nations, wrote a letter that the “Secretary General and I are fully committed to ensuring that the Organization fulfills its human rights obligations.” Yet the letter doesn’t mention financial compensation nor does it mention any “transparent, independent and impartial mechanism” to review claims.
One out of every fourteen Haitians has been infected with cholera. They deserve an official forum to examine why this happened and who is responsible. People like Claudine, another client of IJDH, who spent her life savings to bury her father should be made financially whole. As of today, none of this will happen.
This blog originally appeared at PLOS Public Health Perspectives.
Photo Credit: V. cholerae on TCBS. Via Flickr VeeDunn CC BY 2.0.
— This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.
The newest
, big-screen Nest Learning Thermostat 3.0 is down to $199 today on Amazon, which is a match for the best discount we’ve ever seen. These don’t go on sale all that often, so if you have one on your wishlist, I wouldn’t hesitate.
If you like the sudden realization that Facebook knows more about you than some of your closest friends, you will love the new Slideshow feature.
Amid the killing of its own Olympic mascot
, the dysfunctional clean up
of its polluted of its waters, the shutdown of its doping lab, the declaration of a financial emergency
, the presence of the Zika virus
, and various other calamities
, Rio’s Olympic ambitions are a disaster. And the latest news out of the city is just as bad: On Wednesday, a collection of body parts was found washed up next to the Games’ beach volleyball venue.
Apple has been raking it in with this whole “iPhone” thing, so they’ve got some spare change to drop on a shiny new campus. The spaceship is finally looking like it’s almost ready to blast off.
This is site is run by Sascha Endlicher, M.A., during ungodly late night hours. Wanna know more about him? Connect via Social Media by jumping to about.me/sascha.endlicher.
