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The Rise in Health Literacy

Once upon a time the pronouncements of health professionals were treated as absolute. We attended their clinics and surgeries, described our symptoms and took whatever treatment was prescribed. Whilst in some ways unquestioning faith may have been easier for the health practitioners, it also meant that the level of health knowledge within the general population was fairly poor.

The result of this was that many diseases went undiagnosed until it was too late and ‘old wives tales’ were as likely as not to determine health levels in some districts. What was needed was a good dose of education; a way of helping the general population to be better informed about health issues.

Fast forward to the internet generation and we are all far more likely to be health aware. We can look up symptoms, check healthy diets and delve into treatment options for illnesses. In fact the only challenge facing us nowadays is to distinguish between the reputable sites and those which rely rather more on rumour and gossip than is good for us. Oh yes and having the strength of mind to work through the list of diseases associated with symptoms and be realistic rather than just plumping for the one at the top of the page or which looks most alarming. But in general being more aware of the course of illness and disease helps us to work with health professionals in designing a treatment plan which is appropriate for us.

And surfing our symptoms is not confined to the young. The rise of the silver surfer has resulted in the elderly also being more aware of what treatments are better for them. So much so that a recent BBC report revealed that regular internet use in older people was associated with good health literacy. In other words, the more familiar we are with surfing the more likely we are to research symptoms, ask for help in a timely manner, and engage with treatment.

But our increasing familiarity with the internet and associated technologies also has other benefits for health practitioners. Those who are used to surfing the web are more likely to accept time saving options such as online booking allied with pre-payment by card. This not only saves health practitioners time, it also is more likely to result in patients who show up for treatments. Additional reassurance can be gained by adding a SMS text reminder to the online booking system, prompting patients to attend appointments or to cancel in time for the slot to be refilled.

Linking in a pre-payment by card module to the booking system also enables practices to easily take a cancellation fee in the event of no-shows, bringing the added benefit of smoothing out cash flow. There are those who say that the ability to look up symptoms online can result in a generation of hypochondriacs but there have always been those who take their symptoms too seriously. What internet surfing does do is help practitioners and patients to work together to create the optimum solution and that can only be good for the health of the nation.

Staying active, boosting health

The adage that sitting at a desk for hours on end can be counter-productive has been given a further boost by a study carried out in America. It has long been claimed that being active, even simply by taking a break and walking around can help to reduce incidents of a range of health problems including diabetes and some forms of cancer.

This fresh study looked at the effects that sitting for long periods had on the femoral artery. The study observed that the way in which the femoral artery widened in response to blood flow deteriorated through long periods of sitting but that light walking breaks every hour significantly improved recovery of the artery.

This study, although limited in size, adds further weight to the argument for regular amounts of light exercise as opposed to sitting still all day and then hitting the gym. Whether the ‘standing desks’ which are growing in popularity are the answer is a debate for another time but from an employer, as well as a health practitioner point of view, the growing body of evidence would suggest that a sedentary work and home lifestyle is not a sensible course of action.

Of course, for the majority of health practitioners the opposite is true. The NHS Choices 10,000 steps a day challenge is scarcely a problem when someone is on their feet providing physiotherapy, osteopathy or other health treatments to patients. For them finding five minutes to sit down is the challenge and generally those five minutes are taken up in a rush to complete paperwork before the next patient knocks at the door.

If a sedentary lifestyle is not good for health, neither is one which is so packed with tasks that there is no time to rest. There is being active and being Active and if all of our activity is packed into continuous rushing around in response to must do tasks then being active can be counter productive. We all need time just to ‘stop and stare’, to rest our minds and bodies, to shake off what has gone before and prepare ourselves for the next activity. If we don’t give ourselves time then, rather like a student kitchen, the dirty cups of life pile up until it is difficult to see any clear way forward.

And when health practitioners naturally priorities patient treatment time, it is almost inevitable that administration creeps into leisure time. Taking simple steps to reduce the administrative burden can make a difference to stress levels. Tasks such as electronic filing of patient notes or sending out appointment reminders can easily be devolved to a virtual assistant service, as can dealing with routine phone calls and diary management.

Utilising the services of a virtual assistant not only removes the routine leaving the health practitioner free to concentrate on patient treatments, it also reduces the stress levels which can rise when a day is overfilled. Perhaps health practitioners need not worry about whether they are benefiting from regular exercise but in the interests of a balanced lifestyle, they also need some time to ‘sit and stare’.

Streamlining payments

The days of making manual payments are numbered if a report by Juniper Research is anything to go by. According to the report’s press release the number of household bill payments made via PC, mobile or tablet is expected to top 20 billion this year (2014) with the UK having 16% of the global market.

Driven by Generation Y users, the growing acceptance of mobile payments is only expected to expand further as fears over security are lessened and additional mobile devices come onto the marketplace. Interestingly, when it comes to larger payments, users still seem to prefer the security of a larger screen with PCs and tablets leading the way.

Whilst this report concentrated on household bills, the acceptance of online payments generally is also on the increase. Shopping or booking events or holidays via the internet is also on the up and this means that consumers are far more accepting of the idea of providing credit card details whilst online. And the more accepting we become, the more that online payments becomes part of the mainstream.

That creates tremendous opportunities for health professionals who are looking to streamline administration and payments.  With a ready acceptance in providing card details; when someone makes an appointment to see a physiotherapist or other health professional the next logical step is for them to confirm the appointment by providing payment card details.

Having an appointment confirmed in this way has two benefits for the health professional.  Firstly, the act of providing card details tends to fix the appointment in the patient’s eyes, making it far more likely that they will turn up for their treatment. This not only helps to ensure a full treatment schedule it also makes it more likely that the patient will receive a full course of treatment at the time when it is most needed. Secondly, with card details to hand, it is simple for the health practice to process payments, either in full once the patient has attended or to take a payment on the card in line with the practice’s stated cancellation policy.

Payment card details can be taken at the time of booking an appointment either online or via the telephone. At that stage the payment amount is simply pre-authorised which means that the payment amount is ‘reserved’ against the card. Once the appointment has taken place, should the patient choose to pay by other means the reservation can simply be cancelled.Otherwise the payment is taken at the time of the appointment; speeding up receipt of funds and saving the invoice/cheque/bank clearance cycle.

With time at a premium, anything which helps to reduce administration and speed up payments is a winner in today’s health practice. Pre-authorisation of cards means no delay in payment collection and no need to spend precious time in sending out and chasing bills on a regular basis. And with pre-authorising reducing no-shows and therefore increasing the likelihood of patients receiving the treatment they need when they need it, pre-authorising is a win-win solution for patient and health practitioner alike.

Medal-Winning Physiotherapy

The 2014 Glasgow Commonwealth Games got off to a flying start with a flurry of medals on day one for the host nation.  But whilst all eyes are on the athletes themselves as they strive for victory, it can be easy to forget those who work hard behind the scenes to make the Games a success.

From cleaners to ticket collectors and from chefs to medical staff, those who volunteer or work at the games are on the front line when it comes to building Glasgow’s reputation.  For these games the medical team is headed by physiotherapist Liz Mendl.  Liz is in charge of some 1,400 volunteers including 400 physiotherapists.

Building on her experience of previous Commonwealth and Olympic events, Liz has introduced two innovations for these games.  The first is to head up each medical room with a ‘lead physiotherapist’ who is responsible for running the room and ensuring that those in need of help swiftly receive the appropriate treatment from the right member of the multidisciplinary team.  The second innovation is to instil ‘first contact’ physios at training venues to provide instant help for those who don’t have access to a team physio.

On their website the Chartered Society of Physiotherapy (CSP) highlights some of the many physiotherapists who have volunteered to help at the games.  Browsing through the summaries provided by the volunteers it is hard not to get an overwhelming feeling of the dedication and commitment which physiotherapists give on a daily basis.  Volunteer Emma Knott comments that “there is much more to physiotherapy than the magic sponge!” perhaps summing up best the challenge faced by the profession in helping people to truly understand the role which physiotherapists can play in keeping people fit and healthy. Yes, some may be called upon to deliver remedial treatment following one-off injuries; but physiotherapists also work with people in order to mitigate life-limiting conditions or even to help individuals to stay supple, preventing injuries from occurring in the first instance.

Measures, such as those introduced by Liz at the games, can only help to improve the public perception of the role of physiotherapy within the health profession. But this in turn may bring fresh challenges to the profession. Once physiotherapists are seen as front-line first-contact health professionals rather than ‘when everything else has been tried’ last resorts the profession is going to become even busier.  When time is at a premium the last thing that should be affected is patient treatment.  After all, when you have spend years training to bring your skills to benefit others, the last thing you want to do is to see valuable time spent on routine administration. Time saving measures such as online booking, diary management, electronic patient records and appointment reminders can all help to reduce time spent on administration, thereby maximising patient treatment times.

If the remainder of the games match up to the excitement on Day 1, then we are in for a feast of sport.  Let’s hope that the medical team aren’t kept too busy and can enjoy some of the events which they have given up their time to support.

Holiday Blues

Once upon a time we just went on holiday and everything we did when we were away was part of the holiday experience. Nowadays it seems as though spontaneity is out the window as we have to have a clear idea before we go and our every intention is scrutinised in detail by those responsible for booking and insuring the trip.

Completing a holiday insurance form recently, a colleague was struck by the number of exclusions and ‘do you intend to..’ questions. They felt that having to think up and list activities in advance killed the joy and anticipation of being able to relax and just ‘go with the flow.’

Admittedly activities such as base jumping and volcano boarding are not in the usual run of chill-out holiday activities. But an activity such as ‘walking on a mountainside for more than an hour’ is hardly a dangerous pursuit, particularly if you are visiting areas of Switzerland or Austria where it is hard to avoid strolling on gentle slopes.

Of course, the insurance strictures do have a basis in fact as some activities are more likely to result in injury than others, particularly when combined with a relaxing glass of your favourite holiday tipple. In fact, statistics from the FCO last year revealed that of the 19,000 people who asked for help whilst abroad, just over 3,500 had been hospitalised. But whether or not hospital treatment is required there are still a fair number of people who do need further help when they return to this country. From broken limbs to strains and misaligned joints; the chances are that those working as chiropractors, physiotherapists and osteopaths are likely to be called upon this summer to treat those holiday injuries.

When the call comes, it is good to be able to respond at once; but this is not always possible, particularly if answering the call means pausing an existing treatment session. That’s where a virtual assistant service comes in handy. Calls can be switched seamlessly to the service with callers being greeted as if from the health practice itself.

Not only does this mean that your potential clients receive a swift and positive response right from the start, it also helps to ensure that your appointment book is kept as fully up-to-date as possible. And of course, if you don’t have to interrupt a treatment session in order to answer the phone, using a virtual assistant service also enables you to provide a first class service to those who attend treatment sessions.

Additional benefits of using a virtual assistant service include the ability to take card details at the time of booking, thus helping to smooth out cash flow and reducing on administration time. Pre-authorised card payment also enable health practices to take a no-show fee in accordance with their published criteria, should a patient fail to attend an appointment. Add in an appointment reminder service, and the chances of missed appointments are considerably reduced.

With appointment booking and card deposits taken care of the health practice can concentrate on what it does best, treating those in need.  If your clients are going away this summer, encourage them to think carefully about how they answer the holiday insurance questionnaire. But if the worst comes to pass at least, thanks to some virtual assistance, you may well have time to treat them on their return.

The cost of health

The Royal College of Nursing (RCN) has overwhelmingly rejected a proposal to charge patients for NHS appointments.  Had the proposal been successful it would have led to the RCN backing the idea of a £10 charge for health appointments, but in the end 91% of delegates at the RCN conference voted against.

Those in favour of the proposal said that making a charge would not only raise much needed revenue for the NHS it would also emphasis the value of NHS appointments.  In other words, charging for appointments would help people to appreciate the value and cost of NHS appointments and in the process make people think a little more about the way in which they use NHS resources This would in turn, the proponents argued, result in the twin benefits of reducing unnecessary appointments and reducing no-shows; both of which waste considerable NHS resources as well as potentially delaying urgent treatments. After all, it helps no-one if health practitioners are sitting idly by waiting in vain for someone to turn up. That time would far better be used in helping another patient.

Commenting on the vote a spokesperson for the Department of Health said “We are absolutely clear that the NHS should be free at the point of use, and we will not charge for GP appointments.”  But with no-shows a constant drain on both NHS and private health care services, practices are increasingly turning towards the use of appointment reminders as a means of encouraging people to attend booked appointments or to cancel them in good time.

Sent by phone, SMS text or e-mail, appointment reminders not only jog patients’ memories, they also act as a spur for patients to get in touch and cancel appointments if they are unable to attend.  This in turn enables health practices to re-book appointment slots.

For health practices such as osteopaths or physiotherapists which do charge for appointments, not only do no-shows waste valuable treatment time, they also act as a cost drain on the practice.  Whilst the option of sending out appointment reminders is one option, another great way to cut down on no-shows is to take a secure card pre-authorisation at the time the appointment is booked.  Having a card pre-authorised tends to sharpen the mind when it comes to remembering to attend appointments. Pre-authorising a card doesn’t prevent the patient from paying by other means when they attend the appointment but should the patient not attend the health practice can charge a pre-agreed sum to the card.  Pre-authorised card booking can be taken either over the phone or when an appointment is booked online.

With a report from the BBC revealing that the NHS may be facing a funding gap of some £2billion in the next year, we suspect that the debate about the way in which health care is funded and managed will rumble on for some time.  Adopting systems such as appointment reminders which help to ensure patient care is delivered when it is required whilst at the same time maximising resources can only be a positive move.

The power of sport

It may be the top sportsmen and women who hit the headlines but the power of sport to engage and enthuse at all levels never ceases to amaze.  From rumbustious back street kick-abouts to photos in the Guardian recently of Brazilian children practicing overhead kicks on a flooded pitch; sport can be a unifying and defining activity.

One thing is certain, with Wimbledon and the World Cup around the corner, our streets and parks will soon be filled with enthusiastic sports players all dreaming that one day they will be able to emulate Murray or Messi, Nadal or Neymar.  But, played at any level, sport can come at a price.

That price is the chance of injury.  You may be a top flight sportsperson, used to training every day and carefully balancing nutrients to optimise body health and fitness.  You may be a weekend player, turning out for the local team before heading off for a drink; or you may be an occasional player, turning out with short bursts of enthusiasm before retreating to more sedentary forms of support.  Whatever level you play at, the odds are that injury will hit at some stage.  And when injury hits, the quicker it is treated the better.

For health professionals such as physiotherapists, chiropractors, sports injury practitioners and osteopaths, the challenge is to be on hand to treat regular clients, whilst at the same time squeezing in more immediate cases.  No-one wants to leave diary slots vacant but equally no-one wants to turn down prospective patients.  The answer is to take every opportunity to ensure that prospective clients can make and attend appointments.

Online booking will capture some clients but others may prefer to speak to a person at the end of a phone.  Switching phones to a virtual assistant will help to ensure that when the phone rings, someone will answer without the need to interrupt ongoing treatments to answer the phone. In fact, using a virtual assistant service has multiple benefits including improving the image of the health practice, establishing a dialogue with clients and freeing up treatment time which would otherwise be spent in answering or returning telephone calls.

Once the appointment has been made it is important both for the patient and the health practice to ensure that treatment starts in the timescale agreed. No-shows not only delay the start of important treatments, they leave empty gaps in health practitioners’ diaries which could have been filled by other patients.

Encouraging clients to keep the appointments which they have made is a two-fold process.  Appointment reminders sent out via SMS text or e-mail have been shown both in the NHS and private practice to reduce the number of no-shows.  Similarly, confirming bookings with a pre-authorised debit or credit card sum also serves to improve attendance rates, generally because this means that the health practice can take a non-attendance fee in accordance with advertised practice.

World cups, tournaments, championships; the sporting calendar rolls ever onwards and with every passing phase brings a new crop of injuries.  Making sure that they are on hand to provide prompt treatment will earn health professionals their own niche in the sporting hall of fame.

Mustn’t Grumble

In a survey to mark Dementia Awareness Week (18-24 May) the Alzheimer’s Society revealed that 54% of people had waited for six months or more before seeking professional help  for signs of dementia.  The time delay appears to be fairly similar in respect of all health conditions with a separate YouGov poll reporting that 57% of adults who had had a health problem in the past year had put off asking for help.

Reasons given for the delay include a reluctance to make a fuss (47%), the fear of having a serious health problem (23%) and embarrassment (22%).  Delays in reporting in particular relate to dementia, heart and digestive problems.

Commenting on the survey, Alzheimer’s Society Chief Executive, Jeremy Hughes acknowledged the difficulty which people have when confronting diseases such as dementia but went on to say that “the sooner you know what you are dealing with, the sooner you can feel in control again and get on with your life.”  But the delay factor doesn’t just affect those with potentially serious illness.  For every patient who seems to live in the surgery, another will hold off reporting even persistent complaints.

This can lead to minor strains or injuries being exacerbated up to the point at which they become debilitating.  When patients do finally pick up the phone, if they don’t receive an instant answer, they may drop the idea of further help.  This means that prompt telephone answering is not just vital for health professionals such as doctors and dentists; other professionals such as chiropractors, podiatrists and physiotherapists all have a responsibility to ensure phones are answered as swiftly as possible.

For smaller practices this isn’t always as easy as it sounds.  Curtailing a treatment to answer the phone is not only unprofessional, it can in some cases result in further damage occurring.  And whilst some patients may be prepared to leave their details on an answerphone, many will be reluctant to do so. This is particularly the case when someone has delayed asking for help; the unanswered call acting as a trigger to retreat away from the decision to seek help and back towards trying to manage the condition without outside intervention.

The solution is to link up with a virtual receptionist service.  Virtual receptionists can answer the phone and make appointments on behalf of the health practice, leaving the practitioner free to concentrate on what they do best, helping people to recover from illness or injury. Not only does this help to ensure that treatment plans are carried out smoothly and without interruption, it can also free up vital time which can be used in treating additional patients.

One in three people over the age of 65 will develop dementia and it’s a fair bet that almost 100% of people within the same age bracket will develop strains, foot problems or other similar treatable problems at some time or other.  Taking steps now to help them to contact a health professional easily and swiftly may just help to prolong their overall health in times to come.

Keeping on track

Whether you are a physiotherapist or a hair specialist, an osteopath or a dentist; it’s a fair bet that you chose your profession because you wanted to help people. It is also a fair bet that the matter of paperwork and records wasn’t really a factor which came to the fore when you were deciding on your chosen profession.

But no-matter what the profession nowadays it seems as though movements are circumscribed by reams and reams of paperwork. And unless something is done to rein this in, the volume of paper can not only seriously interfere with patient treatment times, it can also detract from the provision of effective treatments.

In an era in which every patient and every treatment comes with a paperwork trail, it is little wonder that records can become lost or treatments delayed as records are transferred from one place to another.  Partly in an attempt to smooth out the pathway and partly to improve self-management of long term conditions the Richmond Community Neuro-Rehabilitation Team has trialled a patient-owned folder.  The folder not only contains important contact details, it also contains details of the patient’s condition and therapies which have been agreed upon.

Since the folder was trialled in 2012, the team has seen pick-up time for new patients improve by five days. In addition 92% of patients agreed that the folder helped their therapy as they were able to use it as a continuing reference point.  But even with initiatives such as the patient-owned folder there is still the hurdle of paperwork to overcome.

Moving away from a paper based system to electronic records can make a huge difference.  Paperwork safely stored in an electronic folder can be accessed at the touch of a button.  This not only saves the time taken in finding missing paperwork it also enables health professionals to quickly call up information when patients get in touch as well as facilitating the transfer of information between professionals. All of this not only helps to improve patient treatments, it also creates valuable additional time which can be spent on treating additional patients.

No more searching through filing cabinets, no more waiting for days for the post to arrive; electronic storage of patient records can make a huge difference to the daily practices of health professionals; bringing them back on track to the reason why they joined the profession in the first place – the treatment of patients.

Optimising Sporting Performances with help from your dentist

What does it take to help an elite athlete to stay at the top of their game?  Good nutrition, a balanced training regime, access to the best physiotherapists and osteopaths?  Well if a recent (April 2014) conference in London is anything to go by the need for good oral hygiene and a trip to the dentist should be added to the list.

In September 2013 a study published in the British Journal of Sports Medicine revealed low levels of oral health among London 2012 athletes, with 40% being bothered by oral health problems and 18% reporting that dental problems impacted on training and performance.  The study was carried out on a cross-section of athletes competing at the games.

Now the oral health and performance in sport conference in London has backed up those findings with a series of discussions and presentations on the impact of oral hygiene on sporting performances.  Whilst good dental hygiene won’t turn a novice into an elite athlete, for those at the pinnacle of sport where the slightest edge can make the difference between Olympic Gold and also-ran, it seems as though dental hygiene is a contributing factor.  And the effect is not just confined to those who seek to be ‘the fastest’.  The British boxing team have already noticed a difference since regular dental checks were introduced as part of the training regime.

But good dental hygiene is not just for athletes.  Type 2 diabetes and heart problems have also been linked to poor oral health, making a visit to the dentist a potentially life-saving activity.  Plaque can lead to gum inflammation and studies have shown that inflammation anywhere in the body, including in mouth and gums, can have a detrimental effect on arterial health.  So studies have concluded that regular brushing and attention to oral hygiene including trips to the dentist can help to protect heart health.

But as the British boxing team managers found, a visit to the dentist is not on many people’s priority list.  It is important therefore to ensure that making appointments and contact with the dental surgery is made as easy as possible.   Systems such as online booking and automated appointment reminders can make a huge difference to attendance rates.

Whilst a nagging toothache is a strong enough reminder that something needs to be done, without pain our impulses to make a check up appointment are fleeting at best.   Being able to log in via PC or smart phone and book on the spot enhances the chances of capturing that fleeting idea.  And for surgeries which operate a ‘book your next appointment now’ system for those who do visit, an automated appointment reminder will help to decrease no-shows from those who forget the appointment that they made six months ago.

Talking about the boxing experience, Dr Mike Loosemore said of the enforced dental checkups: “They may not appreciate it now, but hopefully they’ll appreciate when they’ve got a gold medal round their neck in Rio.” For non-athletes the reward may well be a lessening of the chances of heart or diabetes problems in later life.

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