Category: Business Continuity, Security & Risk Management


Telehealth Solutions in the Face of Our Current Crisis

Filed under: Business Continuity, Security & Risk Management, Healthcare IT, Project Management — Leave a comment
April 15, 2020

As we continue to face the realities of social distancing, isolation, and quarantining in the wake of the COVID-19 pandemic, health care organizations are seeking effective and timely solutions for addressing epidemic situations. Ideally, these solutions would greatly reduce the risk of exposure to infection for vulnerable populations and health care workers while still allowing for the provision of adequate care to patients. Telehealth is an ideal solution for the management of communicable diseases –aiding in remote assessment and provision of care for the infected as well convenient access to routine care for patients who are not infected (Smith, Thomas, Snoswell, Haydon, Mehrotra, Clemensen, & Caffery).  Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, and Smith also cite the psychological side effects of COVID-19 that potentially could affect patients as well as clinical and nonclinical staff – stress, anxiety, burnout, depressive symptoms, and the need for sick or stress leave. These all underscore the need for the provision of mental health support to aid well-being and cope with acute and postacute health requirements more favorably – aspects that telehealth has been shown to treat (Zhou, Snoswell, Harding, Bambling, Edirippulige, Bai, & Smith). Additional motivating factors include the decision of The Centers for Medicare & Medicaid Services (CMS) to issue an 1135 Waiver and expanded telehealth coverage for all Medicare patients during the COVID-19 pandemic, clearing the way for evaluation and management of most patients (Lee, Kovarik, Tejasvi, Pizarro, & Lipoff).

While all of these factors further the argument for adoption of telehealth treatment, some significant barriers to implementation may exist in your organization that may need to be addressed. These include the existence of suitable technology within the organization, provider willingness to accept this technology as a solution, provider credentialing, billing and reimbursement considerations, as well as lack of a supporting infrastructure within the hospital.  I list these considerations in order to promote the analysis of the readiness of your organization to implement telehealth as not only a short-term solution for the current COVID-19 crisis, but as an ongoing strategy to meet crises in the future.

 

Lee, I., Kovarik, C., Tejasvi, T., Pizarro, M., & Lipoff, J. B. (2020). Telehealth: Helping Your Patients and Practice Survive and Thrive During the COVID-19 Crisis with Rapid Quality Implementation. Journal of the American Academy of Dermatology.

Smith, A. C., Thomas, E., Snoswell, C. L., Haydon, H., Mehrotra, A., Clemensen, J., & Caffery, L. J. (2020). Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). Journal of Telemedicine and Telecare, 1357633X20916567.

Zhou, X., Snoswell, C. L., Harding, L. E., Bambling, M., Edirippulige, S., Bai, X., & Smith, A. C. (2020). The role of telehealth in reducing the mental health burden from COVID-19. Telemedicine and e-Health.

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From Voices on Project Management: Beware the Dangers of Technical Debt

Filed under: Business Continuity, Security & Risk Management, Project Management, Risk Management — Leave a comment
July 19, 2019

There are many implications involved with ignoring the data or choosing to overlook the outcome knowledge at one’s disposal. However, we often punish bad outcomes without truly understanding the bad decisions that led to them. See the story of Husband E. Kimmel, Commander in Chief of the United States Fleet during the Pearl Harbor attack in 1941, who was summarily relieved of his command ten days later. Fischoff wrote of experiments conducted in which subjects were asked to judge historical events that, “a past which is inordinately barren of surprises provides an inordinately weak test of the hypotheses applied to it (Popper, 1965). The judge who perceives a relatively surprise-free past may feel little compulsion to change the hypotheses which guided him in viewing that past. Thus, the very outcome knowledge which gives him the feeling that he understands what the past was all about may prevent him from learning anything from it.” (Fischhoff, 1974). Something to consider as we read Lynda Bourne’s Beware the Dangers of Technical Debt.

Fischhoff, B. (1974). Hindsight-foresight: The effect of outcome knowledge on judgment under uncertainty. PsycEXTRA Dataset, 1-29. doi:10.1037/e459202004-001

From Voices on Project Management:
By Lynda Bourne

Have you ever experienced technical debt on a project? As the debt builds up, everything looks good from the outside. However, when the crunch comes and that debt has to be repaid, a major reversal in fortune can occur.

Technical debt refers to the costs of having to go bac…

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Voices on Project Management https://ift.tt/32zYfyZ

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Implications of Hurricanes Katrina and Rita on Organizational Emergency Management Planning

Filed under: Business Continuity, Security & Risk Management — Leave a comment
August 23, 2013

An early assignment in my Public Emergency Management class asks us to consider the differences in response outcomes in the cases of Hurricanes Katrina and Rita. My research indicates that the differences with regard to emergency management in the two incidents are stark. But, as Waugh indicates, “both disasters have raised serious questions about the capabilities of the national emergency management system to handle catastrophic disasters” (Waugh, 2006 p.10). There is evidence that the disparity in the way Katrina and Rita were prepared for and responded to was by no means fortuitous. Chua points out that “the data show that the nonchalance towards the disaster’s imminence, grossly inadequate preparations, and the chaotic responses seen in Katrina stood in stark contrast to the colossal scale of precautionary measures and response operations primed for Rita” (Chua, 2007, p. 1526). The author points to a number of lessons which clearly illustrate the divergence in the way both disasters were managed:

  • The prediction of Katrina was underestimated, while the Rita threat was taken seriously and government formalized a comprehensive national response immediately.
  • Resources necessary to handle Katrina were not effectively mobilized, leaving supplies and personnel inadequately pre-positioned. The Rita threat was met by large-scale federal resources.
  • Some 100,000 residents were not evacuated on time in Katrina, but a massive evacuation order was called 2 days before Rita hit.
  • Lines of authority were not clearly drawn in Katrina, resulting in infighting among agencies. Proper demarcation of authority was established from the onset during Rita (Chua, 2007).

Disaster management benefited from the confluence of events surrounding the two hurricanes in 2005, resulting in a superior effort with regard to Rita.  However, Haddow, Bullock and Coppola indicate that the Katrina and Rita disasters emphasize the need for evacuation planning and the shortfalls that often lie in existing plans, including the inability for authorities to conduct a full-scale test that provides them with an idea of how the plan works in a real-life situation. “In the Katrina evacuation,” the Authors relate, “failure to consider how the evacuation would affect people of lower economic standing resulted in thousands refusing to or being unable to leave. In Hurricane Rita, as determined by a University of Texas study, a strong majority of the deaths (90 of the 113) associated with that storm were a result of the poorly planned evacuation itself” (Haddow, Bullock & Coppola, 2008, p.192).

What are the implications for organizational emergency management?  In my case, I had never considered the real possibility of a hurricane hazard in my operational bailiwick, but Hurricane Irene in August, 2011 changed that assessment.  Hurricane Sandy in October, 2012 reinforced the idea that the East Coast of the United States and New England can be particularly vulnerable to this threat.  A major problem for businesses is that there sometimes is only a small probability of a hurricane strike when an evacuation decision must be made. According to Lindell, Prater, and Peacock, when a hurricane is 36 hours from landfall, the National Hurricane Center can issue only a maximum strike probability of 25%, or possibly even lower if the storm has an erratic path (Lindell, Prater, & Peacock, 2007). Because of these figures there is a reluctance among emergency managers to initiate evacuations when the strike probability is this low because they are certain to incur significant costs in an evacuation. It is in the face of this indecision that Lindell, Prater, and Peacock recommend that decision analysis is an appropriate technology for coping with this type of situation and that it should be integrated into any emergency planning.  Adoption of Protective Action Implementation also is an effective path to guard against loss of life and property.

 

Chua, A. Y. (2007). A tale of two hurricanes: Comparing Katrina and Rita through a knowledge management perspective. Journal of the American Society for Information Science and Technology, 58(10), 1518-1528.

Haddow, G. D., Bullock, J. A., & Coppola, D. P. (2008). Introduction to emergency management. Burlington, MA 2003: Elsevier/Butterworth-Heinemann

Lindell, M. K., Prater, C. S., & Peacock, W. G. (2007). Organizational communication and decision making for hurricane emergencies. Natural Hazards Review, 8(3), 50-60.

Waugh, W. L. (2006). The political costs of failure in the Katrina and Rita disasters. The Annals of the American Academy of Political and Social Science, 604(1), 10-25.

 

 

 

 

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