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the side by side   -   2 year solution



Onset of 2 Year Solution Model


A Pilot Hospital System would survey their Clinically Licensed Social Workers to help identify those items and services which most connect with the general population of homeless in their area. In the same effort, the hospital would also ask the CLSWs to quantify the specific characteristics of patients who experience success from incidental treatment all the way through ongoing maintenance of care.


This rubric would be used as a guidepost for two things:


Determining the best support provisions brought to community outreach locations.


Identifying a field of circumstances by which to measure “small victories” and “success stories”.


At the same time, the CLSW would be asked to suggest a small number of potential patients from the homeless population under their ongoing care who fit the criterion of a success story. These patients would be higher functioning and likely living with the support of a holistic care center at this point of their care continuum.


These patient cases would each be presented to the hospital with the intention of advocating for them to receive acceptance into a part-time Hospital Advocacy Program. A compensation package would be customized for each Advocate in direct measure with their own unique needs/desires, offering them intimate motivation to participate. Another benefit to the Advocate would be the work experience they would gain and the potential for this experience to follow them with a strong professional recommendation to obtain work elsewhere at some point in the future.


After the hospital decides which and how many Advocates to sponsor through this part-time work program, the CLSW would design a stress-free outreach curriculum which might vary slightly


The CLSW and the candidate would have the benefit of a trusting relationship between themselves already and the CLSW would work together with the candidate to design a specific compensation package that satisfied the candidate. Likewise, the candidate would receive specific expectations of time and a calendar of upcoming events. The candidate would also receive very specific expectations of their training and involvement in order to make a completely informed decision.


Once the candidate decided to agree to the position, they would sign a contract of part-time employment and schedule a short series of training alongside their CLSW sponsor. This training would be minimal and would include:


Education on intended stress-free approaches. Exposure to the range of services that can arise out of emergency room visits.

The rights and privacy ensured of every patient by law.

The legal provisions provided to patients and the newly adopted benefits of fingerprint scanning including the anonymity of being connected only to a Medical Record Number rather than a patient’s given name or address.


The advocate would receive transportation to and from every meeting/event and they would be made aware of the potential for earning the professional recommendation of the hospital concerning future employment opportunities they might independently pursue in the future.


Once the CLSW / Advocate team are ready to attend a community outreach event they would work together to present a stress-free approach of the organization in order to assimilate easily. The following intentions would include:


Clean, modest, unassuming clothing choices

Inconspicuous packaging of provisions being brought.

Professional identification should accompany the team and should be kept concealed – the CLSW ID providing full name and title while the Advocate ID is limited to the title of “Outreach Advocate”.

Playing card sized, laminated support material is brought along but not displayed.

No special table or setup would be brought along.


The general procedure would unfold as follows:


The CLSW and Outreach Advocate would arrive early with their inconspicuously packaged provisions (unmarked opaque bins) set nearby.

The team would sit together anywhere within the community space provided for the homeless participants and engage in unscripted conversation together. The Project Coordinators of the event would assimilate a stress-free, unscripted acknowledgement of the Team into their normal interactions with homeless participants. The Project Coordinators would also make participants aware of the helpful provisions the couple had brought with to share with them.


It would be the team’s approach to engage each individual in stress-free conversation as they provided them with the supportive provisions they brought along. Such initial topics would touch on acknowledgements of their need for support. The CLSW and Outreach Advocate would look for unique clues specific to each individual. These clues would be largely based upon their generalized knowledge of the most frequent medical and social needs of homeless. Topics might include asking them if they’ve had anything good to eat recently, asking if the food provided at the center ever hurts their teeth or noticing if they are limping and asking if they could use some fresh socks.


Conversations would be individual and would not suggest care, inquire people’s names or mention literature or services. Little by little, conversations would lead to the benefits of these provisions in their lives. Acknowledgements of health and pain-based need would emerge of these conversations most primarily. The team would then also educate the benefits of care available to them at the hospital and, most importantly, would educate them as to the hospital system’s approach of homeless individuals and the promise of charting their medical needs only based upon a number instead of their name or living location. If the team sensed interest and trust from the individual, they would offer them a laminated, playing card sized version of these facts to take along and think about in the event they feel unwell and could benefit from visiting the emergency room.


The team would answer any questions arising out of the natural interest of each individual and if no questions emerge, they would simply offer the promise of a next visit and would acknowledge specific needs they paid attention to and would ask for support from the hospital for to bring at a later date.


Solution Model Fully Functional



Onset of 2 Year Solution Model


A Pilot Hospital System would collect existing trends of data showing various financial hardships rising out of the treatment of homeless individuals. This data is readily available and would be organized into a report for submission to the Department of Health and Human Services (HHS) and also to a number of non-governmental organizations dedicated to advancing science around the world (NGOs). The purpose of this effort is to achieve grants for the funding of software solutions. Such grants are available when “Meaningful Use” can be demonstrated. The financial hardships which are known to demonstrate this need include the following:


Average time doctors spend on administrative issues.

Average time nurses spend on administrative issues.

Average time spent collecting and following through with administrative issues.

Annual numbers of homeless individuals who have no means of paying for care.

Numeric evidence of duplicated records.

Examples of incidents where patients receive wrong or excessive resources due to duplicated records.

Examples of incidents wherein records do not transfer with accuracy between hospital systems.

Examples of incidents where a patient suffered poor care or death due to duplicated records, loss of critical time or poor interoperability of data transfer between hospitals.


Once Meaningful Use is established with HHS and/or NGOs, through proving massive cost expenditures imposed upon taxpayers and the hospital system, a value will be placed on:


Improved patient care

Doctors/Nurses giving more time to clinical care

Improved accuracy of care

Less time/money spent per patient


Such is the process by which grants are obtained through the government and non-governmental organizations. In addition to the grants which are allocated, the government also provides large incentives for EMRs (electronic medical record collection which expedites and improves care).


The overall funding would then become available and be allocated within the hospital system and supporting pharmacies. (Pharmacies are linked to hospital systems and benefit from provisions associated with prescriptions for medicine and supplies.)


On or Before Year 2


Since the electronic medical record software is pre-existing, there is no need to re-create new software. A Startup company would be hired to link the existing record format to an HL7 Standard (this is the international standard for the exchange of patient information, i.e. “interoperability”). Linking to an HL7 acts in the way of an interpreter, making the software interoperable. A patent would be added to the hybrid software at this point.


The thumbprint scan technology (which is also pre-existing) would be linked to the initiation of a new record, making the record immediately “live” and interoperable with pharmacies and other hospitals. Each “live” record is then instantaneously sent to the Cloud.


A HITRUST Certified* and HIPAA Covered Entity** is also procured to accompany the hiring of the Startup. This Third-Party provider instantly extracts the data from the cloud, storing it in-house within the private protection of their own data servers. The Third Party provides several functions thereafter:


Manages compliance to extremely strict demands of the HITRUST certification – annual recertification is required.

Manages compliance with all HIPAA laws and regulations on a case by case basis.

Hires an auditing company to satisfy an annual audit of all compliances required of a Covered Entity – ensuring absolute privacy for every medical record.

Provides the hospital(s) with full details of every annual audit and full disclosure of any evidence of breach. A breach, by law, must be published on a public government website and if occurring is accompanied by multimillion-dollar fines, loss of license and possible jail time for those involved.


Once the HL7 standard is linked to the pre-existing software, information technology workers would install the new hybrid, sync it with the existing EMRs and provide/connect fingerprint scanners.


Immediately thereafter, clinicians and administrative workers would receive procedural training. This training is expected to be minimal since the system is based entirely upon the pre-existing software. Fingerprint scanning is an existing technology which is commonly used, and its procedure would be easily assimilated during this training period.


The hospital would also draw up easily understood language depicting the use, storage and guaranteed private security of each patient’s print and corresponding MRN. Administrative workers and clinicians would receive training as to the informed consent of each patient for the improved care protocol of the hospital. Laminated copies of this language would be available for patients who desire full disclosure to it.


Concurrently, surrounding pharmacies would receive the same installation of software and provision of fingerprint scanners. Proper procedural training would be provided regarding scanning for the medical identification of a patient. Alternatively, authorized case workers or care givers could provide matching electronic bar-code MRN (medical record number) to obtain prescriptions on behalf of the absent patient. This would override the need for a scan in special circumstances wherein the patient has agreed to such assistance.


Solution Model Fully Functional

* HITRUST is an organization helping the Healthcare Industry comply with HIPAA regulations. It is the Healthcare Industry's annual certification assessment enforced upon all business associates and subcontractors doing business with them. This is the gold-standard certification ensuring no breach or significant changes have occurred relating to the scoped control environment accross a wide array of domains.

**HIPAA Covered Entities are defined in the HIPAA rules as (1) health plans (2) healthcare clearinghouses, and (3) healthcare providers who electronically transmit any health information in connection with transactions for which Health and Human Services has adopted standards.