Leading Toward Justice in Healthcare

by David S. Williams III, co-Founder and CEO of Care3 and 2013 Henry Crown Fellow of The Aspen Institute

I had the absolute pleasure of attending The Aspen Institute's annual Action Forum last week in Aspen, CO. As the 1st inaugural Resnick Aspen Action Forum (thank you Resnick Family of The Wonderful Company!), the theme was bold: Leading Toward Justice.

The past 18 months have seen multiple shocking results within the criminal justice system with the deaths of unarmed black men at the hands of police and the subsequent lack of prosecution for these deaths. While the blame for these deaths face fierce debate in the community and the courtroom, justice can only be served when all people receive equal treatment under the law.

In what I and many attendees describe as the most powerful speech about injustice ever given, Bryan Stevenson, Executive Director of The Equal Justice Initiative brought an assembly of 400 global leaders to tears when describing the injustice he faces daily in his work with death row inmates. This speech is a MUST-SEE for anyone looking for ways to make meaningful change as he provides a four-point framework to lead toward justice.

1. Get Proximate
2. Change The Narratives that Maintain Injustice
3. Stay Hopeful
4. Be Uncomfortable

The Aspen Institute also posted a summary of Bryan's talk which, of course, doesn't do him "justice" on its own. Please watch the speech, listen, and feel what all of us in the room felt.

But injustice doesn't only apply to law enforcement and the criminal justice system in America. Think about our educational system and, most relevant to my professional work, the healthcare system.

Healthcare in America - Is Justice Served?

By any measure, the healthcare capabilities of US-based hospitals and health centers are the best in the world. With leading institutions such as Mayo Clinic, Cleveland Clinic, and many other healthcare systems, the knowledge of evidence-based care generated at these institutions gives US residents the opportunity to receive top-notch care.

Or does it?

Introducing the 2014 AHRQ National Healthcare Quality and Disparities Report. This annual scorecard measures different ways healthcare doesn't reach the "underserved" defined as the poor, people of color, the disabled, rural, and seniors. Across all measures of access, quality, and outcomes, underserved populations trail that of the general population. Is that justice?

For example, in one graphic AHRQ ranks each US state in quartiles by the quality of healthcare delivered:

On a second graphic, AHRQ charts each US state by the level of disparity in healthcare delivered based solely on race:

(Note: A similar analysis was NOT completed in the 2015 AHRQ report)

An analysis of these charts (which AHRQ curiously didn't do themselves), one can see the states in which the highest level of care is delivered, while also having the highest level of disparity of care based on race. Six (6) states fall into that dubious group: Iowa, Wisconsin, Minnesota, Massachusetts, Rhode Island and Delaware (Michigan, Pennsylvania, NY and NJ are in the second highest quartile of quality, but also have the highest level of disparity).

Again, these six states have the capability to deliver the highest quality of care for their residents--but also sport the highest disparity levels of healthcare access, quality, and outcomes based solely on the race of patients.

Is this justice?

Further complicating this picture is a recent study by researchers at Johns Hopkins Medicine published in The BMJ (formerly British Medical Journal) stating that if medical errors were counted correctly, they would rank third on the list of causes of death in the US behind cardiovascular disease and cancer. The researchers penned an open letter to the CDC asking them to update their data collection methods to account for avoidable medical errors as a cause of death, not simply the underlying disease that led to the need for acute care. Their methodology in coming to that conclusion could also be applied to the environments in which healthcare disparities exist by race.

It doesn't take a scientist to recognize that a disproportionate level of medical errors likely occur to those in underserved populations. There is no accountability for avoidable medical errors in the same manner that (theoretically) the criminal justice system could apply accountability for broken laws because those medical errors are not counted.

If a disproportionate amount of the 250,000 suspected avoidable medical errors that lead to death in the US happen to patients in underserved populations because of poor quality being delivered, isn't that the same as unconscious bias (or perhaps conscious discrimination) leading to different treatment of people of color by law enforcement and the criminal justice system? Both groups have the capability of delivering better outcomes in the moment, but "somehow" the most optimal outcomes are not achieved.

Is that justice?

Healthcare providers do noble work. So do police officers. They are people we respect in our communities and need to perform at their highest levels to reach our best quality of life. Can we improve accountability and reporting to help increase quality and drive better outcomes for all? I believe we can.

Leading Toward Justice

Leading toward justice requires acknowledgement that injustice exists. Health disparities are a form of injustice and many organizations are standing up to research and fix the problem. These organizations have clearly identified the injustice in health disparities and are taking steps to eliminate them. Bravo.

Now it's time for action and results.

Care3 is built to battle inequities and disparities in healthcare using mobile and social technology. We welcome the opportunity to partner with healthcare entities such as hospital systems, health plans, community hospitals, and community-based care management firms in initiatives where measurable impact can be achieved with underserved populations.

About David S. Williams III

David S. Williams III is a leading innovator in consumer digital health. Care3 is inspired by David’s experience caring for his special needs son and the realization that the most vulnerable members of our society including seniors, people of color, and the disabled do not have equal access to healthcare and receive woefully inadequate quality of care in their homes and communities.  Care3 is built to fix these unacceptable and unnecessary inequities.

Care3™ launches Starter Care Plan feature to help caregivers get into their groove

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(Los Angeles, CA) - July 6, 2016 - Care3™, a leading  developer of mobile health technology, has launched a new feature called Starter Care Plan for all iPhone and iPad app users.  Successful caregiving depends on having the goals set and the tasks laid in a routine that families can follow every single day. Starter Care Plan offers a set of the most common care tasks that family caregivers face when caring for a loved one, thus helping to integrate the tasks into a new caregiving routine. “At Care3, we call this routine your ‘groove.’ Getting into your caregiving groove means you’ve integrated caregiving into your personal and professional life. When you’re in the groove, you’re efficient, effective, and your stress level is manageable.” explains David Williams, Care3 Co-Founder and CEO.

Starter Care Plan is designed to get family caregivers  into their caregiving groove as quickly as possible. Users first create their Care Team and then are prompted to create the Starter Care Plan. This creates daily and weekly Actions that families share so that no one has to complete all of the care tasks alone, avoiding high stress, missed days of work, and burnout.

Family caregivers can also send Care3 discharge instructions to make them mobile for a nominal fee. Caregivers simply email their paper discharge plans after downloading the FREE mobile app and signing up.

About Care3™

Founded by three former Aetna executives with successful entrepreneurial backgrounds in consumer and enterprise health technology, Care3 elegantly combines patient and family engagement with post-acute care coordination on the same platform to improve outcomes and reduce costly hospital readmissions for underserved populations including seniors, people of color, and the disabled. Download the FREE Care3 mobile app on the App Store now. Learn more at www.care3.co/blog.

Social Work and Technology. Time to Unite for Social Change

Social work and technology. Those two words don't typically flow together like peanut butter & jelly. Perhaps they should. Social workers perform the outreach to people in need and help them manage the complexities of life from healthcare, economics, job searches, financial management, and other areas that can cause people to have difficulty and friction in their lives, especially in underserved areas.

Care3 Co-Founder & CEO David Williams recently had the opportunity to present at the Network for Social Work Management (NSWM) annual management conference in Los Angeles. The session, entitled "Technology Innovation for Social Impact", was headlined by City Light Capital Founder and Managing Partner, Josh Cohen. Josh eloquently shared his framework for social impact investing across multiple sectors and featured Care3 among companies that are creating innovative technology for healthcare-based social impact. Josh serves on the Board of Directors for NSWM and sees the potential that adding technology for social workers can do to enhance theirs and their clients' lives.

"Care3 is a great example of a technology platform that helps social workers do what they do best. Take care of people who need a little help to manage the complexities of living." says Josh Cohen.

Technology can help community-based care managers in multiple ways as tech typically does. Organization, communication, data, and storage of information. Care3 delivers on those factors and more when it comes to care management firms and how they interact with colleagues and clients.

"We very much appreciate David's presenting the Care3 platform because we don't often get to see technology solutions designed specifically for us." adds Lakeya Cherry, Executive Director of NSWM.

Care3 elegantly combines patient and family engagement with post-acute care coordination on the same platform to improve outcomes and reduce costly hospital readmissions for underserved populations including seniors, people of color, and the disabled. Social workers are the engine of this practice so we were honored to share Care3 at the NSWM conference.

Care3 is introducing its Beta Partner Program which offers the Care3 platform to independent care management firms for free for 60 days. The goal is to assess the value of Care3 for their work and measure impacts. Eighteen companies have signed up for the Beta Partner Program already. To learn how you and your firm can participate, email us at beta@care3.co/blog.

#Care3How2 - Call Everyone in to Action

Welcome back to our series #Care3How2! We’re examining how you can use Action Messages in seven different real-world situations to ask for help, get support or share information. Today we’re delving into the the situation when you need someone to do an odd task. Just log in to Care3, and create your Action Message. Fill in all the important details and select who you want to receive the message (everyone or just certain individuals).

Recommended Actions • Give a Ride • Visit Your Loved One • Add Appointment • Pick Up Medicine • Get Answers • Buy Something • Do Something

Here are more examples of tasks and projects you could use Action Messages for:

• Help me clean and organize Pops’ garage • Need research on wills and estate planning • Granny’s yard needs to be mowed • Plan this year’s family reunion • Bingo with Aunt Shirley on Monday • Set Robbie’s audiologist appointment • Install safety bars in my bathrooms

There are many other unique forms of assistance needed in every different family, though. The important thing is to make sure you ask for help, whatever it is. As a primary caregiver, you can't hesitate or feel like you are putting people out. They want to help! They’ve said so many times. Allow them to pitch in and share the effort by simply telling them what’s needed in clear, specific terms. That way, these actions are easily completed, and everyone feels a sense of accomplishment in working together to support and care for your loved one.

Eliminate the stress, isolation and guilt of caregiving by communicating with everyone in your loved one’s life with Care3.

#Care3How2 - Remote Family Caregivers Power "C-Commerce"

Yes, #Care3How2 has done it. We've coined a new term for remote caregivers purchasing items for loved ones. We call it "Care Commerce" or "C-Commerce" for short. One of the challenges of caregiving is providing assistance from afar. In today’s migratory society, many adult children live in different cities and states than their elderly parents. This can lead to feelings of guilt and helplessness when it comes to the care their parents may require as they age. Being on a Care3 Care Team is a great way to keep family members and close friends who may live in other places involved in the ongoing care being provided for your loved one.

Recommended Actions • Give a Ride • Visit Your Loved One • Add Appointment • Pick Up Medicine • Get Answers • Buy Something • Do Something

What kind of help can be provided by out-of-town team members? In addition to offering answers, support and thanks to those who are the primary caregivers, these members can often take care of the purchase of caregiving supplies and other needed items thanks to the convenience of Internet shopping. You got it: C-Commerce. For example, let’s say your 81-year-old mother lives with your brother in another state and no longer drives. While you are unable to help with day-to-day errands and tasks, you still want to contribute.

Here’s one way. Now that your Care3 Care Team is set up and running, you receive an Action Message from your brother. It appears your mother wants to resume her beloved knitting hobby now that her tremors are under control due to medication. The problem is that her knitting supplies were somehow lost when she moved in with your brother. Eager to help out, you accept your brother’s Action Message by tapping “Accept” From there, you go online to purchase some yarn in your mother’s favorite colors as well as the knitting kit she used to have, which comes with all the needed accessories and tools. You enter your brother’s address for the shipping location, and voila! The Action has been satisfied! Not only have you saved your brother time and money, but your C-Commerce will make your mother feel cared for and loved.

That’s what caregiving’s all about, isn’t it? Caring from afar? Engage in C-Commerce.

#Care3How2 - Answers to Questions in Seconds is Infectious

In this #Care3How2 installment, find out how one Action can lead to another and another. You could say it's the "infectious" nature of caring. Beyond making it easy to get help with specific tasks and errands, Care3 can also help you gather information and advice from your care team, such as when illness strikes or there’s something you need to figure out quickly. Both caregivers and the loved ones they’re caring for can use Care3 messages to ask questions and receive answers in real time. People respond almost immediately to text messages so sending a request this way is likely to get people to act more quickly.

Recommended Actions • Give a Ride • Visit Your Loved One • Add Appointment • Pick Up Medicine • Get Answers • Buy Something • Do Something

Here’s an example to help illustrate. Imagine you’ve set up an Care Team for your beloved Aunt Leigh, an active senior who lives alone in the suburbs of your city. Aunt Leigh has recently come down with some sort of flu, and she’s unsure what daytime flu medications would be best for her symptoms. Since you’re swamped at work, you want to message your care team for their recommendations.

To do that, you simply create an Action Message in your Care Team conversation. From there you'll be prompted to enter your Action title (“Give me daytime flu med recommendations”) and you can add any additional notes on her symptoms or active ingredients that she has to avoid due to potential interactions with her other meds. You can then select whom the message goes to, everyone on the team or just select individuals.

Within minutes (or seconds!), various family members have chimed in with their battle-tested advice and suggested flu remedies. Cousin Simon has even offered to pick up the medicine he swears by at the pharmacy (there's that C-Commerce again) and bring it to Aunt Leigh at lunch. One Action generated another. Actions are infectious, right? Thus, neither you nor Aunt Leigh has to figure this out alone or worry about getting to the store. Your care team has her back, and now that they know she’s sick, they can check in on her as she recovers from this nasty bug and resumes her busy, independent lifestyle.

#Care3How2 - Can't Make the Pharmacy Run? What Now?

We’re spotlighting the different ways you can use Care3 to request help from your care team – from rides to social visits. Today we’re focusing on one of the most common errands for caregivers. How many times have you had to run to the pharmacy to pick up a prescription drug or an over-the-counter cold remedy for your loved one? And how many times has it been an inconvenience, given your busy schedule and the closing time of the pharmacy?

Recommended Actions • Give a Ride • Visit Your Loved One • Add Appointment • Pick Up Medicine • Get Answers • Buy Something • Do Something

Next time, instead of stressing about making it the drugstore between soccer practice and PTA, why not send out a request for help using Care3? Chances are, someone on your care team may be able to swing by and pick up Grandpa’s blood pressure medication. In addition, they’d likely be thrilled to lend a hand. Family and friends are always asking what they can do to help with Grandpa, right? This is one of the ways of answering that question and allowing others to pitch in with a clear, specific task.

Start by logging onto Care3 and clicking the Action Message icon in the Care Team conversation. Then enter the name of the medicine, the pharmacy, the pharmacy’s location and the time the prescription will be ready. In the “Notes” section, you may want to note the pharmacy’s closing time as well as anything else relevant, such as the expected price of the drug and the fact that the pharmacy already has all of Grandpa’s insurance information on file. Send off your request and receive a notification on your iPhone during soccer practice that your neighbor Ellen has volunteered. Click “Thanks” to show your gratitude and exhale knowing that it’s one less thing on your plate for today.

See how Action Messages get others to help? There’s still more you can do with them, though.

Take Action - 3 Amazingly Simple Ways to Get the Most Out of Every Doctor Appointment

Primary caregivers are typically the calendar keeper.  That means keeping track of all manner of medical appointments, such as checkups, dental visits, annual mole checks, physical therapy sessions and more.  Get organized – and keep your Care Team looped in – by using Care3 to schedule, coordinate and remember appointments for your loved one.  Unlike a wall calendar, it can be consulted on the go by you and your care team, plus it comes with built-in reminders and a recording feature. An example helps to illustrate things.

Let’s suppose you’re the primary caregiver for your 24-year-old son Dylan, who has a congenital disorder that is causing his kidneys to fail.  He is currently in need of a transplant and living back at home.  Many family members and close friends want to know how Dylan is doing and what his doctors are saying.  By inviting those who care about Dylan to be part of your Care3 Care Team, you can keep everyone up-to-date using one centralized platform versus trying to communicate with everyone individually, which can be time-consuming and draining.

For example, Dylan has a transplant evaluation at a regional hospital next week.

1. Easily Notify your entire Care Team of the Appointment

You’d like to notify the care team that this long-awaited appointment has finally been scheduled, and you’d also like to let them know what you learn during the appointment. With Care3, both tasks are a cinch. Start by logging into Care3 and tapping the Action Message icon in your Care Team Conversation. You will then be prompted to enter all the pertinent details – such as the date, time and location.

2. Share the Goal of the Appointment with your Care Team

In the “Notes” section, you can note the fact that this visit is the critical first step in Dylan qualifying for a kidney transplant.  Then, you can choose to make the appointment visible to everyone on the team or just the team members you select.  (You can also make appointments visible only to you if desired.)

3. Record the Doctor's Instructions and Share with your Care Team

Flash forward to the day of Dylan’s transplant evaluation.  If you have downloaded Care3 onto your iPhone, you can use it to record the doctor’s comments and instructions during the appointment.  Start by asking the physician if it’s okay to record him or her.  After you’ve gotten permission and logged onto Care3, click the paper clip icon at the bottom left in your Care Team conversation.  Then tap the microphone icon to bring up the recorder. Then just tap the red square to start recording.  Now you can relax and listen to the doctor carefully without having to worry about jotting down notes.  Everything will be captured.  As an added benefit, you automatically share the recording with your care team so that they can hear what the doctor said for themselves almost in real-time.

With Care3 Nothing is lost in translation, and everyone’s up to speed. Download now!

#Care3How2 - Party Time! Get Friends to Visit Your Loved One in an Instant

Care3 helps you organize your caregiving activities and share them with family and friends who want to help. In recent posts, we’ve discussed how you can use Care3 to coordinate a ride in just one tap using our exclusive Action Messages. Today we’re going to look at how Care3 can help you easily and quickly set up social visits, which can combat loneliness, isolation and depression as well as provide some downtime for you as a caregiver.

Recommended Actions • Give a Ride • Visit Your Loved One • Add Appointment • Pick Up Medicine • Get Answers • Buy Something • Do Something

Imagine that your elderly mother, who’s known as Nana, lives with you and your family. You’ve noticed that she’s been a bit down lately. She’s mentioned several times that she has not heard from her siblings or old friends in some time. Even though Nana tires easily, you’ve seen how a short social visit can really lift her spirits. So you decide to arrange a get together for Nana next weekend. As an added benefit, you’ll be able to slip out during the visit to run some errands and enjoy a little personal time. Sounds like a win-win, no? Plus, with Care3, you know you can set up a visit in seconds.

Start by logging on to Care3 and tapping the Action Message icon in your Care Team conversation. You will then be prompted to enter all the details that folks need to know – such as the date, time and location. Add any other important information in the “Notes” section, such as the fact that the visit will be capped at two hours to keep Nana from getting overtired. Then, instead of sending this Action Message to everyone on the team, you may choose in this instance to select just Nana’s area siblings, old friends and former neighbors so that it’s a more intimate gathering of the people she’s been missing. Keep tabs on your iPhone as one or more people accept the Action and your idea quickly turns into a reality.

See how Action Messages can streamline your efforts? Next up on the blog, we’ll examine how you can use Care3 to track appointments.

#Care3How2 - Requesting a Ride is Easy

Welcome to our series called #Care3How2! In this series we show you how to do some of the most common care activities on Care3 and why our care-sharing app is far more efficient than email or other mobile apps.

Are you a caregiver who’s trying to do it all? Or a remote family member who’d like to do more – from either near or far? At Care3, we’ve learned that many caregivers would love to have some assistance, but they’re simply too busy and overwhelmed to call around and see who might be able to pitch in. On the flip side, we’ve found that family or friends are often ready and willing to help out, but in many cases, they just don’t know how.

This is where Care3 comes in. By assembling a Care Team that’s connected via our messaging app, Care3 users are able to create Action Messages for help that reaches all team members. Compared to multiple phone calls and emails, a Care3 Action Message is a highly efficient way to put the word out and find out quickly who can lend a hand. Team members can also text thank yous just like a normal text message. Everyone’s involved and supporting each other, whether or not they can help with that particular task.

Recommended Actions • Give a Ride • Visit Your Loved One • Add Appointment • Pick Up Medicine • Get Answers • Buy Something • Do Something

So let’s take a look at exactly how Care3 works – in this case, getting a ride for your loved one (or giving it!). Imagine you are a caregiver for your aging father, who lives with you in your home. Your father, who suffered a stroke and can no longer drive, needs a ride to an occupational therapy (OT) appointment on Thursday. The problem is, it’s at the same time as a conference with your daughter’s third grade teacher, and neither appointment can be easily rescheduled. While this would be a stressful problem if you have little to no assistance, it’s easily solved when you have a Care3 Care Team behind you.

Start by logging on to Care3 and tapping the Action Message icon in your Care Team conversation. You will then be prompted to enter all the details that your team members need to know to determine whether they can help – such as the date, time, location, and length of the OT appointment.

Here's where it's super simple. See that check box labeled "Ride Needed"? Just tap that box to add the check and everyone knows that your father needs a ride to the appointment. Add any other important information in the “Notes” section and select whether you want this message to go to everyone or not. (You can also send it to only selected individuals.) Fire off your clear, specific Action Message and receive a notification minutes later that your cousin Robbie can give your father a ride. Send a “Thanks!” message to show your gratitude and smile as you see that other team members are sending their thanks to Robbie as well. It feels good to work together!

Oh, and don't forget to record the OT instructions, either so everyone knows how to help your father, too!

Getting a better sense of how Care3 works? It's time to take action. Download Care3 now!

Caregiving - Love in Action

Caregiving is not a burden. We believe that caring for someone you love is a love in action. The stress most people associate with caring for a parent advancing in age or a special needs child comes from the uncertainty surrounding changing circumstances, not from the responsibilities of caregiving. In fact, we find that people want to be more involved but are limited often by distance, time, money, or other factors. This inability to contribute leaves many relatives and close friends feeling guilty and helpless. But what if pitching in to help the ones we love was easier? What if we could remove the obstacles time and distance place on our ability to lend a hand or show our support? What if you could make caregiving more social? That day has come.

It's time to change the perception of caregiving. It's time to take action! And Care3 will help you act.

Care3 uses Action Messages to share care tasks with supportive family and friends in your messaging conversation.

Here are some actions to get you started thinking. Each action can be completed by you, or you can get others to help. Trust that others around you want to take action also! Don't take it all on yourself. Share in action.

Example Actions:

• Get/Give a Ride • Visit Your Loved One • Set Appointment • Pick Up Medicine • Research Conditions • Buy Groceries • Help with Activities of Daily Living (ADLs)

It's time for some Action. It's time for Care3. Download now on the Apple App Store!

The New Normal: Caregivers as Leaders

When a loved one is suddenly struck ill or has a catastrophic event, it changes the world--and without our permission. We are stunned into paralysis—shocked into disbelief—and even shamed into silence. Becoming a caregiver thrusts you into a leadership position. People look to you for guidance, updates, and strength even though you feel the same feelings they do. Leaders are supposed to project an air of invincibility, right? Consider this excerpt from Nelson Mandela’s Leadership Lessons:

Show courage: Mandela was often afraid for his own safety and even his life. Yet, he never showed fear to either his compatriots or his adversaries, saying that a leader “must put up a bold front.”

One of the greatest leaders in world history recommends that we show no fear. A chink in the “bold front” armor may signal weakness, or worse yet, fear and doubt in whether the mission can succeed. So we keep quiet. Play it close to the vest. We never let our family or friends see us sweat.

The problem with that approach is that inevitably when others see that we are, in fact, human, it is such an anomaly that our family and friends think that the sky is falling. Showing vulnerability from time to time, sharing the experience with close family and friends, and rising above it can add to a perception of strength rather than take from it--and result in better health for your loved one.

When our loved ones get sick and need our help to recover or even live comfortably day-to-day, it’s important to talk about the challenges with people you trust—while also letting those around you know that everything isn’t perfect. This includes family members. You will need their help if you want to balance the responsibilities of caring for a loved one and maintaining the life you had already created for yourself.

Do what you do at work. Get your team (a care team) together, set a goal, make a plan, and lead. But talk openly about the challenges with trusted friends and family. Success in this mission means a healthy loved one and a strong, supportive family.

Don’t you want that anyway?