Healthcare Economics: Value vs. Volume

The case for value-based care (VBC) has been evident for decades, but why has it taken so long for healthcare providers to embrace it? “It’s a mindset. ‘This is what we’ve always done,’ is the excuse,” says Bill Wynn, Vice President of Strategic Partnerships, VirtuSense Technologies. “COVID-19 has been the catalyst to start shifting providers toward a mode of value-based thinking and has highlighted the need to diversify revenue streams by augmenting fee-for-service (FFS) income with VBC.” 

Various legislation and programs have been approved over the past decade, but a universal implementation of value-based healthcare still alludes most care providers. The biggest barriers for initiating VBC, according to the 2019 survey by Definitive Healthcare, are lack of resources like staff shortages and integrated health IT systems; access to healthcare data; and unpredictable revenue streams—i.e. determining the financial risk involved in population health management. 

“The way we’re delivering care is becoming financially prohibitive,” Wynn notes. “When looking at the months where the COVID-19 impact was biggest, providers that operated on the VBC model were still making money, but other providers that make most of their money from elective procedures and are FFS-based didn’t, because they didn’t have patients coming in.” 

In September 2020, CMS issued guidance to healthcare providers to accelerate the adoption of VBC. “Many states have made progress in moving toward value-based payments in healthcare, yet there are still growth opportunities for more states to improve health outcomes and efficiency across payers including Medicare, Medicaid, and private insurance, by ensuring healthcare systems are financially incentivized to deliver the best quality, best value care. Aligning value-based care programs across payers could reduce the burden on providers who participate with multiple payers and improve the healthcare experience for patients.”  

Resetting the Healthcare Trajectory 

“The reason the healthcare industry is so slow in adopting a VBC model, is because providers are trained to fix things. The mindset of VBC is to never get to a point where you have to fix anything because you’re keeping your population healthy,” explains Dr. Tom Hale, Chief Medical Officer, VirtuSense Technologies. “Our current healthcare system is not preventative or patient-centric. It’s very much reactive.”

Here’s a typical scenario Hale gives to illustrate the inefficiencies of FFS. “Howard is having mild chest pain, so he calls his doctor, but the doctor either doesn’t get back to him right away or he can’t get in, so he calls his neighbor who advises him to to go to the emergency room. Howard goes to the emergency room—mind you, the ER is disconnected from the primary care physician. The ER doctor says, ‘Since you have chest pain, I’m going to admit you.’ They run a series tests, do a CT scan of the heart, and seek the advice of several specialists. At the end of the day the doctor determines Howard has chest wall pain, and that it’s not a problem. Now there’s a $30,000 medical bill, all because Howard couldn’t get timely access to his physician.” 

Lack of access and increased variation contribute to an environment that encourages higher and unnecessary utilization. “We have created the perfect model and infrastructure to get the results that we are getting—i.e. a model of care delivery that is inaccessible to patients, inefficient for providers, and wasteful and expensive,” Hale notes. 

“The United States spends more on healthcare than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health care spending may be considered waste. Despite efforts to reduce over-treatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains.”   – Waste in the US HealthCare System


If You Build it They Will Come 

Healthcare has built an infrastructure that creates $3 trillion in spending per year.  It is an infrastructure centered around hospitals and specialists that requires a high degree of utilization in order to financially survive. “It is what I like to call ‘Feeding the Beast’ — the healthcare beast. VBC changes the dynamic. The economic driver is based on keeping people well and out of hospitals and, by necessity, can only work if there is increased access to caregivers and providers and a decrease in the variation of care delivery and a navigated pathway for the patient’s healthcare journey,” Hale explains.

“Virtual care is the engine that will drive the success of a value-based healthcare model utilizing the technologic tools, data analytics, and AI and maintenance of the relationship between the caregivers and providers. The first two are occurring rapidly in all other industries, and the third is the ‘art of medicine’ applied through a different medium.” 

According to Hale, VBC needs to be a healthcare community endeavor. “Build the infrastructure around the doctors so they are able to do the right thing. The FFS economic model causes physicians to be bricklayers rather than being able to use their talents to be a general contractor. The physician/bricklayer, sees a patient and treats them, then moves on to the next one. The physician as a contractor, manages a population, which requires a more proactive approach to care.” 

Hale points out that VBC thrives on access, decreased variation in care (through centralization of the data) with intelligent distribution of the knowledge and support generated by that data—a 360-degree view of a patient’s health history, versus snapshots. Access is created through a multimodal approach which includes synchronous and asynchronous communication, telehealth communication tools, and a team care approach based in patient-centricity.

Bridging the Technology Gap 

“The difficulty in creating models which utilize virtual tools and data acquisition technologies is not the availability of the tools, but rather the transition in the infrastructure models. The economics have to work in the transition phase—the best of the past needs to be carried forward to the future and the pace of transformation needs to be certain that patients, providers and caregivers are not left behind,” he says. “This is evolution not revolution.” 

Remote patient monitoring (RPM) technologies and telehealth options are a big part of the solution for VBC because it decreases in-person visits and hospitalizations and keeps people healthier, especially during a pandemic. It also increases access to healthcare providers so you avoid costly scenarios like the one above with Howard. 

In the 2021 Physician Fee Schedule CMS is expanding its reimbursements for RPM and telemedicine and has commissioned a study of its telehealth flexibilities provided during the COVID-19 public health emergency. “The study will explore new opportunities for services where telehealth and virtual care supervision, and remote monitoring can be used to more efficiently bring care to patients and to enhance program integrity, whether they are being treated in the hospital or at home.”

“The inherent core to value based care is to keep people healthy. The tools, like remote patient monitoring, asynchronous communication, and Artificial Intelligence/Machine Learning create the ability to be the patient’s ‘general contractor’ as well as their personal physician and friend,” Hale explains. “Healthcare costs go down, profits go up, and patients have better outcomes from the proactive care that is created.  

“Everybody wins.”

This article originally published here.

Finding Your Way: Designing Functional & Beautiful Maps

Graphic design is all about solving problems and making things functional and easy to understand, and wayfinding materials such as signs and maps aren’t the exception. In fact, they’re the rule. If the information is wrong or misunderstood, there can be deadly consequences. But not all maps are life and death. Some can be really fun while providing factual information, such as maps for parks, playgrounds, museums, and more.

One company that knows how to put the fun in mapmaking is Visual Maps based in Copenhagen, Denmark. They’ve designed colorful, richly detailed maps for parks all over the globe for the past 20 years. “It started with an illustration for a DUPLO universe on a LEGO package I did, which was spotted in Legoland, which then commissioned me to do their park map,” explains founder and creative director Mads Berg. Since then, they’ve designed all the Legoland parks worldwide, and have specialized in park maps since.

Here are five tips for creating successful map designs.

  1. Combine fact with fiction for emphasis

Designing wayfinding maps for parks isn’t so much scientific as it is illustrative. Sure, you need to help visitors find their way around the park, but it’s much more loose and playful than a city map. “There’s a mixture of reality and fantasy in each design,” he notes. “Google does the reality thing beyond compare. We love to do the fantasy part.” Of course, they do this without overriding the wayfinding purpose.

  1. Visit the park to get perspective

Although Google Maps is a great resource, Berg always starts projects by visiting the actual park, “not only to see the facilities, but also to experience the park as a visitor and know the points of navigation and get a first-person point of view.” Make note of the biggest attractions and their popularity. Often, these are points of interest that draw visitors to the park in the first place, so capitalize on them in your design by making them prominent.

  1. Sketch it out

When he’s back in the studio he does a pencil sketch to get the point of view right and define the composition. “Then we do a digital disposition map, where we take all facilities/rides/buildings individual height/volume in to account, and lay it all out,” Berg says, adding, “It remains a nice challenge to detangle the pathways, and to distribute everything, keeping the pathways correct, but at the same time focusing on and exaggerating individual features.” The biggest challenge is capturing all the landmarks and details in miniature, while still making them easily identifiable, as well as capturing the topography. In a zoo, for instance, different animals require different habitats, like water or vegetation, so be sure to visually represent them where applicable.

  1. Use Color as a differentiator

Color is a major factor in map design, not only to represent actual points of interest, but to use as identifiers. For instance, use a color key to identify things such as restaurants, gift shops, restrooms, exits, etc., for quick reference. Berg says of his maps, “Each park has its own colorways and atmosphere.” Be sure to capitalize on this as part of the overall brand strategy.

  1. Keep it real and keep it fun

He admits that he likes balancing the realistic demands of accuracy and wayfinding with the aesthetics, by exaggerating details and colors to create intrigue and beauty. “I especially like Tivoli Gardens and Liseberg because of this equal balance between aesthetics and navigation service. They both have poster qualities as well as being a good guide.” Use icons and buttons to help identify and locate points of interest. It can be frustrating for a visitor, if the map shows one thing and in reality, it’s completely different.

The tips above can be adapted for any kind of map project, just be sure to capture the fantastic qualities that draw visitors and help them get around the park, museum, school, or city safely.

Enticing Menu Designs

Beyond offering a selection of food and beverage items, a good menu design is an extension of the restaurant’s identity, it’s well organized and easy to read, and hopefully it’s appetizing. Here, we offer up several menu designs with decidedly different ethnic and cultural offerings.

Köksbordet is a family-style restaurant serving locally produced foods in a friendly, relaxed atmosphere. Designer Björn Berglund, who’s known for his hand-lettering, was tasked with creating the identity. Köksbordet literally means “kitchen table,” so he intentionally made the o’s look like a round table, and the wavy baseline for the word indicates the restaurant’s close proximity to the sea.

Once the logo was determined, Berglund focused on a color palette derived from the natural ingredients served at the restaurant, and he worked with illustrator Fanny Schultz, who drew the imagery. “I love to collaborate on larger projects, if you find the right partner. The overall quality is so much better,” he says. The illustrations are used on the menus, business cards, and on the website.

“The menu basically follows the rest of the identity – but it´s important for me that it´s easy to navigate and that it makes you hungry and ready to order,” Berglund explains. He designed a simple template so the owners could easily update the menu offerings each day, and could be printed on a basic printer.

Common Bowlery, San Pedro, Mexico

Design: La Tortilleria

Common Bowlery invites patrons to select ingredients and create their own bowl of goodness. The menu features an array of fruits, vegetables and legumes to let customers mix and match according to their tastes. La Tortilleria created a complete identity system for the restaurant, starting with a name that fit the offerings, and then devised a unique logo that incorporates a custom hand-written style for the word Common, and a robust sans serif typeface for Bowlery.

Zita Arcq, cofounder of La Tortilleria, says, “When we created the brand colors, we knew from the start that we didn’t want to use the typical broccoli-green hues so overused in health-centered restaurants. Instead, we developed a color scheme inspired by lemons and mint. This harmonious blend proved to be a winning combination and was used on every communication application, and on the interior decoration, including the menu.”

Counter Reformation, Palm Springs, California

Design: Roberto de Vicq de Cumptich

This wine bar/restaurant is located within the swanky Parker Hotel, which also houses two other two other restaurants. “When the owner was throwing out ideas for the name, he came up with Counter Reformation, and we started working with the idea of tongue and cheek religious themes,” explains designer Roberto de Vicq de Cumptich, who is well known for his restaurant identities around the world. “Palm Springs is a unique place with a very liberal demographic that appreciates the antics of the branding.”

And the branding plays heavy on humor. For instance, the coaster imitates a holy wafer, the check is presented in an old hollowed out hymnal, and there are murals by the entrance depicting praying hands holding a liquor bottle. De Cumptich went so far as to recreate actual characters from old medieval manuscripts for the menus to create a masterful arrangement, sure to elicit a chuckle or two from customers.

El Vez, Ft. Lauderdale, Florida

Roberto de Vicq de Cumptich

El Vez is a Mexican restaurant with locations in New York City and Philadelphia. With the opening of its third establishment in Ft. Lauderdale, Fla., the owners worked with de Cumptich to establish the identity. “The owners like to mix the spirit of the city with Mexican culture and folklore, which is why each restaurant has a different theme. Ft Lauderdale is a tourist beach destination, with a big spring break contingency, so we wanted to convey the hedonism of sun-filled beaches that is part of the locale,” he explains.

“When you design a series of menus, they have to be identifiable at a glance and have a general common theme to unify them. ‘Day of the Dead’ themes are a bit cliché, and often expected in a Mexican restaurant, but on closer inspection you see what the skeletons are doing with each other, and it makes you smile and laugh,” de Cumptich notes. “We want customers to be part of the joke and laugh with us.”

Each menu features a different position—and he admits he had to tone down some of the depictions. The illustrations are paired with a geometric mosaic and printed in a warm or cool gradient to resemble popular printing techniques found in Mexico.


Where are they now?

This article was originally published on the HOW magazine website in January 2018. HOW has since ceased publication.

In the early ’90s, the graphic design landscape was undergoing a dramatic shift. Desktop publishing was in its infancy and everyone was making it up as they went along—some better than others—while trying to keep up with the new technology and software. Then in 2000, the dotcom bubble burst, and in 2008 the worst recession since the Great Depression hit. Many studios weathered the storm, while others simply closed shop.

Here, we talk with the survivors of the past few decades, many of whom have reimagined their careers, and in some cases, started new vocations altogether. (Poster design by Modern Dog.)

Cahan & Associates, 1984 – 2009

Bill Cahan, San Francisco

Remember when “annual reports” was an actual category in design competitions? No? Well, I do, and Cahan & Associates always earned top honors and swept the category. Bill Cahan and his designers changed the game when it came to designing the dreadful annual report. But, in 2009, Cahan closed shop after a near-death illness. As he says, “After 25 years of working like a maniac, I saw the illness and the economy crashing as a sign from the universe to change my life. I let go of everyone in my company and gave all the work we had to two associates, who started their own firm, with the caveat that they rehire everyone.”

He took a year off to reassess his life and get healthy, and in the process ended up meeting his future wife, and eventually having a son with her in 2011. Cahan also co-founded a nonprofit called NARPP, to help advocate for individual savers by creating a universal savings plan to help people get access to a 401k plan.

“The changes over the last 20 years have inspired me to shift my priorities. It started with a thought of how can we harness the power of design to solve big social challenges that can impact people’s lives in meaningful ways? And that lead to me working with an interdisciplinary team of experts in communication theory, behavioral finance, and choice architecture who collectively have a deep understanding of the behavioral and cognitive barriers to people making decisions in their best interests,” he explains. “I have seen the impact of this kind of work, and believe this shift could be a requirement for more effective design in the 21st century.”

And Cahan adds, “On a personal note, when I am not working, I am with my family. Being a stay at home dad and husband has been humbling and challenging in the best of ways—I am learning to listen more and talk less.”

AdamsMorioka, 1994 to 2014

Sean Adams, Noreen Morioka, Los Angeles

“In 1994, when we started AdamsMorioka, our goal was to clean up the world, make design accessible, and focus on optimism,” notes Adams. And they did. Their work for Sundance, Nickelodeon, and Disney, to name a few, was bold and bright in a time when much of the design was going dark and goth. The duo was covered extensively in trade publications, they were traveling and speaking about their work, and winning design awards.

They were not only busy running their own successful agency, but selflessly supporting and serving their professions, with Adams serving more than two terms as the National AIGA president, and Morioka as AIGA Los Angeles president. Adams had also started teaching design at ArtCenter, and he fell in love with it. It was too much of a good thing and something had to give. Late in 2014, Adams and Morioka went their separate ways.

Adams is now Executive Director of the Graphic Design Graduate Program at ArtCenter, and he teaches online courses for Design education is his passion, and he sees so much potential in design thinking and how it can change the world. “I want designers to be the people in the room who see the big picture and challenge the status quo, not merely the person who can make a pretty logo. A software program or new technology can’t replace smart thinking and real innovation,” Adams notes. He also runs his studio, Burning Settlers Cabin and has written several books.

Morioka became a partner and creative strategist with her wife, Nicole Jacek at NJ(L.A.). But she has a very different perspective than when she was at AdamsMorioka. “There is a very obvious sexist perception about a women-owned company from clients and peers,” Morioka notes. “Nicole and I were surprised that most potential clients would expect a male team member to handle the financial and contract needs. Even more alarming was the perception that women creatives could only handle ‘boutique’ projects.” As a veteran designer, she had hoped that the industry had moved past this. “Not only do we need to be aware that our profession does this, but we need to stop pretending that it will eventually go away. Better yet, we need to give more opportunities to women so their successes can evolve and eliminate this sexist perception,” she says.

They recently left Los Angeles, and moved to Portland, Ore., to lead the design studio at Wieden+Kennedy. “Nicole and I never thought in a million years that we would leave the warm weather of L.A., but W+K team have their own unique way of turning up the heat with their talent and thinking.”

David Carson

Art Director, Ray Gun magazine 1992 – 1995

Manhattan Beach, Calif.

Carson became the poster boy for breaking the rules in graphic design for his misappropriation of type and images as art director of Ray Gun magazine in the early 90s. People either loved or hated it, which was just fine with Carson. He did what he wanted to do and picked up many design awards along the way. In 2014, he was awarded the AIGA Medal for his unique design signature and his influence on the next generation of designers. Carson is still doing design his way and staying close to the beach so he can surf when the tide is right.

Much of his work of late reflects his passion and respect for the ocean and its wildlife. He recently created posters for Kill the Fin Trade, whose mission is to ban the shark fin trade in Australia, and he’s designing a line of surfboards for Starboard. The trademark Carson influence is evident in his designs. You can see the thought process and deliberation in his work, and it’s something he doesn’t take for granted, although he thinks a lot of designers aren’t using their heads enough. “There’s a gentrification of design,” he says. “Software and computers continue to make designers lazy, letting the computer make decisions for them. This will only get worse as large scale projects are in beta testing right now, and that will eliminate a lot of current design jobs.”

Jennifer Sterling

Jennifer Sterling has worked on both coasts, designing for clients in a variety of industries including fashion, editorial, luxury goods, and high tech. She is known for weaving textural images and typography in interesting ways to create depth and discourse. Unfortunately, many thought she took it too far in the 2001 AIGA 365 Annual, and she experienced a profound backlash from her peers for the way she portrayed the images. “I cropped the images to show why a piece was lovely. All annuals had been, to this point, a cover and a spread which really showed you nothing,” she explains. “I wanted the end reader to see the remarkable use of tactile devices, if that was what was prevalent, or the lovely calligraphy, or the juxtaposition of photography. It was all to honor these designers, many of whom were my heroes.” Needless to say, she wasn’t prepared for the reaction she received. Today, this design would be praised for its ingenuity.

Since then, she has worked on many life-changing campaigns including branding for “Vital Voices,” a non-governmental organization to promote female ambassadorships founded by Hillary Clinton and Madeline Albright, and an online interactive piece for Yahoo to deliver the AIDs vaccine to third-world countries. Currently, Sterling is based in New York City, still experimenting with typography and seeing how far she can push it using technology. “While my firm has spanned two decades I have witnessed a great deal. The Internet eliminated a major constraint to accessing and sharing knowledge. Because it is in the hands of 3 billion people worldwide in the form of portable devices, it has also eliminated the need for a central or permanent location for creating and organizing information. This and the staggering advances in media compression has made innovation in all fields (not just design) quicker and easier to build on,” she says. “As far as challenges for the future the design arena has ultimately been responsible for one of two things: The product or the message. As AI (artificial intelligence) and VR (virtual reality) become more commonplace in society the questions and responsibilities of how and why will become more necessary, both as a consumer and as an innovator or citizen.”

Sayles Graphic Design 1985- 2008

John Sayles and Sheree Clark, Des Moines, Iowa

Sayles Design, 2009 – present

This Midwest firm grew fast and steady in the ’80s and ’90s. John Sayles had the creative chops, and Sheree Clark ran the business side, wrangling new clients and nurturing those relationships. As a team, they were unstoppable … until the economy crashed in 2008. “We found our clients downsizing. The contacts we had established over the years were being let go. It became apparent we had to re-establish our approach and our connections,” Sayles explains. “Sheree and I had to face that the business could no longer support the overhead of the business, which included seven employees.” They closed SGD. Clark shifted gears to pursue her new passion which revolved around nutrition and healthy eating. Sayles took time to “breathe and reset” before starting over as a one-man shop, J. Sayles Design.

In addition to his agency, in 2015 he started a vodka company called Swell. It’s now the second fastest growing Iowa Spirits company, due in large part to Sayle’s branding expertise. “This is what I have been doing for more than 25 years. I know how to market and promote a product without spending millions of dollars.”

Clark’s journey is quite different. She’s gone from running a design business, to helping people design better lives for themselves. “Fork in the Road [her business] is truly a crescendo of all my life experiences. I work with clients to problem-solve, and ultimately to transform their health, reclaim vitality and mental focus, and help ensure they gain clarity on their vision and purpose. These are all things I have done for myself over the course of the last six-plus decades of life.”

Oh Boy, 1994 – 2002

David Salanitro, San Francisco

Oh Boy Artifacts, 2001 – present

Oh Boy, founded by David Salanitro, was one of the hottest agencies in the late 90s producing elegant corporate communications and branding materials for companies like Mohawk Paper, Schwab, and West Coast Industries. In 2001, he launched Oh Boy Artifacts, a beautiful collection of high-end notebooks, journals, gift wrap and other fine paper products. These coveted items were an instant hit and designers couldn’t wait to get their hands on them. But, just as quickly as the Artifacts collection came on the scene, the agency was struggling. “Nearing the end of 2001, the recession came upon us, and the studio quite suddenly shed its clients,” Salanitro says. Artifacts carried the studio for a little while, but it wasn’t enough, so he closed shop and moved to the East Coast to continue the Artifacts collection.

He took some time off to reflect, read, and write. In the ensuing years, he returned to the West Coast and lectured at the Academy of Art University, then he moved to Chicago to work for Avenue as the executive creative director, and then ended up in his hometown, Fresno, Calif., where he currently resides. Lucky for us, he’s launching a new Artifacts collection in 2018 through Kickstarter.

“This time I see it differently, I see that it can be important,” he says, adding, “There is a certain beauty evident in a thing by the measure of care people invest in it. It’s a simple if/then equation: if we care enough about what we make, if we go all in and put the whole of our capacity into it and consider it in a larger context—the way something catches the light, the grain of its surface—then others too will pause and take notice. The consideration I give to a simple thing like a notebook, or our part in grander gestures that inspire people to forgo the paper sack and return to wrapping gifts, is evidence of that care that we pass along. I don’t want to sell paper, I want to bring back the sense of event to gift giving and encourage people to pause and grin and share a few extra moments of appreciation—of one another. … The ground is shifting. More people are trying to take better care. We are trying to craft our lives in ways that allow us to recognize beauty and smile. I’m in this for the grins.”

Modern Dog 1987 – present

Robynne Raye & Michael Strassburger, Seattle

Every designer in the ’90s envied Modern Dog, led by Robynne Raye and Michael Strassburger. They designed posters for local theater companies and musicians such as Liz Phair, The Pretenders, Better than Ezra, and The Roots, among others. They made it look so cool and easy. “I think at one time—in the ’90s— we were working for five different theaters in Seattle,” Raye recalls. “There’s a very small percentage of people that go to live theater, and it was weird for us, because we were trying to get the same people to the different theaters. We were essentially competing against ourselves in this genre, and we wondered why they didn’t just hire other designers. That was very strange.”

Things sailed smoothly through the early 2000s, as well. In fact, in 2007, the Louvre requested five Modern Dog posters for its permanent art collection. Raye and Strassburger couldn’t believe it! Then in 2011, everything changed. One of their designs was ripped off and repurposed on Disney merchandise sold at Target. The two decided to sue the big corporations for copyright infringement—perhaps against their better judgment. To pay their attorneys, they sold the Modern Dog building, let go of the few employees they had, and moved the business into Raye’s basement. Although they eventually won their case, it took three years and nearly bankrupted them. Modern Dog is now a part-time venture, with its principals taking on new roles.

“I do about 8 -12 projects a year,” Raye says. “Currently I’m rebranding a small hair salon, designing a poster, and conducting a workshop at Amazon. I divide my time between teaching at two Seattle Colleges—Cornish College of the Arts (Jan. 2000 to present) and Seattle Central College (April 2015 – Present)—and doing design work through Modern Dog.”

Since 2012, Strassburger has worked full time at the Seattle Aquarium. He is still technically Vice President of Modern Dog, though he is not involved in the day-to-day activities. He also has a new company called Living Fancy. “I’m not the young buck I used to be, and after decades as co-founder of Modern Dog helping design products for clients like Blue Q, I needed to settle things down a bit,” he explains. “The most natural evolution for me was to start my own line of products as Living Fancy. Now I am my own product developer, art director, and designer! I can’t help it. I just love doing this stuff.”

Cocktail Cards That Pack a Punch

Designer Maria Montes is a life-long learner when it comes to lettering and typography. Splitting her time between Barcelona and Melbourne, she works on custom lettering projects, illustrations, and type design, and once a year she travels to the remote village of Cabanabona (about 75 miles from Barcelona) to study lettering and calligraphy under the tutelage of Keith and Amanda Adams. There she immerses herself in historic manuscripts, studying lettering techniques from the masters to improve upon her skills.

She says, “I have a strong graphic design background and I am very passionate about all kinds of letterforms: from calligraphy to lettering to typography. I am daily training my eye to become a better designer.” And Montes isn’t selfish with her knowledge. She teaches calligraphy workshops in Melbourne, and speaks at design conferences sharing her work and fondness for details.

“I have a strong background in calligraphy and typeface design, and both disciplines are extremely technical where attention to detail is key. When I draw organic forms, I loosen up and look for energy instead of technicality. I never looked actively for this style of illustration but I am personally drawn to details,” she notes. One of her favorite quotes is by Giorgio Armani: “To create something exceptional, your mindset must be relentlessly focused on the smallest details.”

A couple years ago, Montes was invited to participate in the Ladies of Letters series, Flourish Together by designer Carla Hackett and letterpress printer Amy Constable (Saint Gertrude Fine Printing) to design a series of four letterpress cards. “At the time, I was already in the middle of putting together my first solo exhibition in Melbourne, called Breaking The Ice. It consisted of a series of eight full-color illustrated cocktail artworks and pattern prints, so I offered to convert four of my full-color pieces into two-color letterpress cards, and they agreed instantly.”

What you see below is the result of the collaboration and the details

Mojito cards

There was a long research process for each illustration. First, I look for the message, something naughty and fun at the same time. Based on the origin of the cocktail, I try to add some cultural references to the piece. Then, I sketch the lettering and I go through many iterations. The base for each lettering style is my own calligraphy. After the calligraphic sketch is balanced enough, I use tracing paper and I redraw all letterforms adding or removing weight, contrast and adjusting letter spacing.

For the Mojito card, the original full-color piece features the actual colors used in a Mojito, but being restricted to two colors for this series, made me reconsider the colors so they would work well with the other cards.

Absinthe images

I was a little worried that the hairlines in Absinthe wouldn’t reproduce well in letterpress. Each piece was born as a large format, full-color artwork, so I went through a reduction process where I removed elements and the color palette, but kept the soul of each piece intact. Each card has been digitally redrawn using vectors. I asked Amy for the minimum line stroke to make sure that the letterpress would translate all details, and the result was great. The color palette is clearly inspired by the popular Green Fairy name associated with Absinthe. I wanted to create a glowing visual experience.

Green Fairy alphabet

“Absinthe” was originally a custom-lettering design. This design got stuck on my mind and a year later, I went back to it and drew all 26 letters of the uppercase alphabet using Illustrator. The result is Green Fairy, which started as one weight, but quickly turned into a layered/chromatic font.

Currently Green Fairy is a font family of 6 weights (chromatic layers). The font is close to be finalized and commercially available. You can subscribe to my mailing list to be up to date with the release date.


The inspiration behind my Negroni artwork is a blog post from called How to Drink like an Italian. On this post, Andrew Knowlton states: “Italians drink differently than we do. They sip, stir, linger over low-octane cocktails.”

The cocktail venue where my solo exhibition was hosted, offers a variation on this cocktail called Chilli-Choc Negroni. I love chillies so I decided to go ahead with this version of the classic Italian drink.

I wanted to use the colors of the Italian flag without being too obvious. Chillies gave me the red color palette I needed, so I began to illustrate them as my starting point. The other ingredient from this cocktail’s recipe is Vietnamese mint, which became the second main element. Initially, the ingredients were drawn by hand and colored on the computer. For the letterpress printed version of the artwork, I redrew all the ingredients in vector format again.

Following the Italian theme, I wanted to introduce an Italian word that could be easily understood in English, so I chose salute. This lettering has been designed using my own Copperplate calligraphy as a reference. On the other hand, negroni is a lettering design based on my own Fraktur calligraphy.

Old Fashioned

My desk is divided between analog and digital tools. On the left side, I have my pens, brushes, inks, paper and an A2 lightbox that I love. On the right side, I have my computer, Wacom tablet, camera, and iPhone. I think in your work you can either specialize or you can be versatile, and do different things in different ways. I get bored easily, so I like jumping from one discipline to the other or ideally, combine them when possible.

Next year, Montes is having a solo exhibition at the Contemporary Art Center La Panera in Catalonia. She says, “The space is amazing and the crew I am working with is incredibly supportive. I am really excited to share new work with friends and family.”

Lettering Tips for Beginners

Joanna Muñoz, founded Wink & Wonder in Los Angeles, Calif., in 2013, as a freelance creative outlet outside of her full-time job as a graphic designer. “I got engaged not long after starting out and my work suddenly shifted toward calligraphy/lettering, as I documented the process of creating stationery and signage for our wedding. Everything else just kind of fell into place from there,” Muñoz says. “I stumbled across the Goodtype Instagram feed and was hooked. I felt like I struck gold finding a really great community to be a part of.” She’s been busy working on hand-lettering projects ever since.

Here, she shares advice and techniques to help aspiring lettering artists get started and follow their passion.

 1. What tools are best for people just getting started in lettering?

I’m a big fan of using what you have at your disposal before going on a shopping spree. The reality is that tools can only take you so far. It’s consistent, mindful practice and learning the fundamentals that will help propel your work forward.

Pencils— I’ve experimented with tons of brands, but always fall back on a few favorite tools: My go-to pencil is the .5mm Alvin Draft-Matic Pencil – the lead is thin enough for precise lines but wears down with use and creates that same texture you get from traditional graphite pencils. Using mechanical pencils alleviates the need for sharpening. For erasing, I use a kneaded eraser as it’s mess-free and does a great job of getting rid of lines.

Pens— I mainly use the Tombow Fudenosuke Hard and Soft brush pens when I initially create a piece. The soft brush pen has plenty of flexibility for me to create thick and thin lines by applying or releasing pressure, while the hard brush pen offers a little more structure and rigidity. I also use Micron pens (mostly .005, .01 and Graphic) for refining lines, and a Sharpie Brush Tip marker for filling in big areas with black ink.

Paper— I love Moleskine grid notebooks for sketching ideas, Pocket Scout Books for lettering on the go and Canson Marker Paper when I need to create a final piece because it’s super smooth, bleed-proof when inking, and transparent enough to use with a guide underneath the page.

Are there certain warm-up exercises you do? 

If I’ve taken a longer break than usual, I typically jump-start my muscle memory by writing out the alphabet (in cursive) until the rhythm of the pen or pencil starts to feel natural again. Most days, I simpy start out with really loose sketches of a concept to warm up.

What basic techniques would you recommend for a beginner?

Learn the letterforms – Understanding the different elements of each letter – serifs/san-serifs, x-heights, ascenders/descenders, flourishes, etc. – and how they work together will really up your hand lettering game. If you’re drawn to script styles, learning basic calligraphy will do wonders for you as well.

Relax – Having a death grip on your pen/pencil and applying too much pressure will cause your hand to tire out faster and create forced lines and letterforms. Ease your grip and (literally) go with the flow.

Go big – Sketch your concepts out as a whole word or phrase, and don’t draw letter by letter in full detail. Sketching loosely and focusing on the bigger picture will help you determine the overall composition of your piece. It’s best to create several quick layouts and include all of your design elements to see what works best (or doesn’t), especially if you’re using a photo and incorporating lettering. Once you’re happy with the structure of a piece, you can move on to refining the details.

Contrast is key – When using brush pens, you’ll generally want to apply pressure on a downstroke to create thicker lines, and release pressure on an upstroke to create thin lines. The change in pen pressure will create varying line width and give your work some added dimension.

Where (or who) do you look for inspiration? 

Instagram is my social platform of choice for inspiration. I’m a huge fan of @Goodtype’s wonderfully curated and very diverse feed, where you can see artwork from concept to completion and in every medium imaginable. Founder, Brooke Robinson, also does a phenomenal job of showcasing new artists alongside well-known ones.

In terms of inspiration, Gemma O’Brien, Jennet Liaw, Becca Clason, Lauren Hom, Nick Misani, Noel Shiveley, Adé Hogue, Christopher Craig, and Danger Dust never cease to amaze me. Not only are they talented, but they all create pieces with an incredible attention to detail and have mastered a variety of lettering styles.

Do you have a practice project you would recommend for beginners?  

Lettering a quote is what most, if not all, letterers have done at one point or another… and I still do it when I can’t think of anything else to write. Inspirational quotes are overdone, so challenge yourself by doing something different. Why not try a phrase from your favorite television show, an uninspirational quote, or a pun for a fun twist?

The last few quotes I’ve lettered were based on the latest season of Game of Thrones. Not only was it super fun for me to draw, but it’s a topic that almost everyone can relate to and hopefully appreciates. Think about how many words and design elements you’ll need to draw and how you want it to fit on the page. Start with loose sketches and begin to refine once you’ve locked in a composition that works for your piece. Most of all, remember that exploring different ideas, tools, styles, and techniques is all part of the process. Have fun with it!

One Community’s Response to COVID-19, One Year Later

Several members of the leadership team at Montgomery Place in Chicago took the unprecedented step of moving into their community in March 2020 when COVID-19 lockdowns went into effect in senior living communities across the nation. Here, CEO Deborah Hart, COO Paul Zappoli, and CRO (Chief Relationship Officer) Stefanie Dziedzic talk about the decision to move in and what they took away from the experience, in their own words.

Making the Decision to Move In

Deborah Hart: When COVID attacked us in 2020—and I use that term very judiciously—nobody knew how to deal with it. We were all learning as we went, basing it on experiences of infection control procedures. But COVID gave the entire senior living industry a new component to deal with. Because we immediately sensed fear, several members of the executive leadership team, myself included, chose to literally move into the building. We had some vacant apartments that we could utilize. Some people were on beds, others were on air mattresses or sleeping bags, but we chose to be here 24 hours a day so that when our staff and residents needed us, we were here.

The residents were fearful of COVID when it first happened, because nobody understood any of this. When we announced that we were going to literally move in, it was accepted very openly.

Deborah Hart

Stefanie Dziedzic: This was not an initiative that was done for show. It was really done from the heart, and I think that’s what made it successful. Residents couldn’t see their families. They couldn’t see their friends. They couldn’t do the things that made their life normal. We were what made their life normal. And so it really was an easy transition to make. Now, a full year later, it’s almost hard to remember how scary it was and how quickly things were changing.

Paul Zappoli: We moved into Montgomery Place because it was the right thing to do. We can’t help a resident or a staff member, if we’re not there. As we all know, emergencies don’t only happen when you’re there. They happen at the most inopportune times. So having someone in the building that is three minutes away from the problem is really important.

Hart: It wasn’t uncommon to get a call at 2:00 am. We were with our staff members, supporting them all through the night. We would do rounds at all hours just to make sure everybody was comfortable. It gave a calm to the overall organization and a comfort to residents and families that I don’t think we could have accomplished in any other fashion.   I was doing daily newsletters to residents and families. We also did a CCTV announcement three times a day, and staff were knocking on doors as many as seven times throughout the day, checking in on individuals, delivering meals, delivering library books, as well as doing wellbeing checks.Deborah Hart 

Communication was Key

Dziedzic: When I look back at the CCTV videos now, I’m like, What were we thinking? The graphics are terrible and the jokes are worse. But the residents appreciated it and they understood the intent and the spirit behind what we were trying to do.

Hart: Just like residents, staff were very scared. They didn’t understand this any more than anyone else. And the media and news reports became very confusing. So we did an Herculean effort in order to help educate, give comfort, and show and demonstrate everything from mask wearing to being able to put on all of the appropriate PPE—and making certain the PPE was present. They gained confidence. They also didn’t have a choice. [They] could not work from home.

Zappoli: It was very hard to actually get the staff’s comfort to a certain level where they’re able to execute their jobs. They came to work with a positive attitude, but the uncertainties created fear. And I saw that across all staff members. I saw this video by Dr. Matthew Bai, an emergency room physician at Mount Sinai Hospital in New York. He explained what he was dealing with on a day-to-day basis, and I sent it to the entire staff because I felt like it would be inspiring for them to watch it on their own.

I learned a lot from that video, and I talked to staff and I said maybe you shouldn’t be fearful of being around [COVID-19]. You maybe shouldn’t even be fearful of contracting it. What you should be more fearful of is spreading it.So knowing what you can do to stop the spread—wash your hands, don’t touch your face. You know, the simple things.

Hart: The most important lesson that I have pulled out of COVID, and the response here in senior living, is to understand and be empathic to staff, to residents, to understand their fears and develop a plan of action as a business that can respond, and not create more fear. Without communication fear sets in very fast. And communication is not just a one-time event. It is constantly repeating the same message. It’s consistency, and it’s demonstrating calmness as you go through the process, as well as letting people see your emotions. There were a lot of events that occurred and we had to let people see that we were human too. And that helped.

Creating Community

Dziedzic: The days were so long. I don’t recall ever feeling as mentally and physically tired as I did in those days—and yet invigorated at the same time. Some of my favorite memories from that time were dinner with my colleagues and getting to know each other. It really became a family environment. We were literally spending 18 hours a day together. And then as the days went on and we didn’t have any positive cases, we would get these alerts on our phones when somebody had a sore throat and we would panic. And then we would all be like, Okay, sore throats are still going to happen in the middle of a pandemic. Let’s not freak out. And we would talk each other off of our ledges. And I think the bond that came out of that experience is one of my absolute favorite things.

Barbara Dwyer, is a resident who tested positive for COVID-19 and ended up in the hospital for dehydration. After being released from the hospital, she says this of the care she received by staff at Montgomery Place:

“This was a good place to be because someone would bring me food, check my oxygen levels, take my temperature … whereas where I was living before, I don’t think I would have survived. Just having someone around me and watching over me was a good thing.”

Resident, Barbara Dwyer

Leading by Example

Hart: Leadership has to be very person oriented and you have to be able to pivot quickly—and in COVID we had to pivot very fast. You have to make rapid decisions. You have to have confidence in your decisions, even though underneath you’re wondering, Is this the right choice? We gained the confidence of our staff and our residents. We were doing the steps that we expected our staff to do (like delivering meals) so that they understood, we were part of this team that had to work together.

Zappoli: My motto is we need to be better everyday. Better tomorrow than you were today. Work hard and do the best you can.

Hart: I think the most surprising thing that came out of COVID for me is how quickly we were able to adapt. Any time you’re faced with a calamity, you’re always wondering, How am I ever going to make it through? As an organization that serves seniors, we have to go through emergency preparedness. All sorts of emergencies. It’s totally different when you’re living it, but we were able to do it and we were able to create a playbook. So should anything similar happen in the future, we can go back to it and say, this is how it works.

The Effects of Isolation

Zappoli: Every time we were able to see residents, we did our best to have a conversation and make them smile. And that helps all the way around. It was immensely beneficial to staff members because they became very close to all of the residents. So we relied on them to give us feedback so we could stay attuned to our residents.

Hart: When COVID struck, everything shut down, including, outpatient therapy for a period of time. We saw how devastating isolation can be. Our residents declined mentally and physically when we were asking them to isolate in their apartments. When we saw how many people had declined, we were very concerned about it.   Our need as human beings is to be with people. And we saw the decline that can be created by isolation, and I never want to see that again.Deborah Hart    

Dziedzic: Natalie Hackett, our director of rehab services was extremely concerned about physical decline in the residents and she was smart enough to think, You know, if they’re not going to come to me, I’m going to go to them. She took VSTBalance [which uses artificial intelligence to identify mobility deficits in older people] door-to-door so that people could get their assessment in their apartment, and she did inpatient therapy on an outpatient basis, and people started to improve. It really helped illustrate for the residents and their families, what an impact immobility had on people’s gait and balance and stability, and was really able to tell the future story of, Hey, if we don’t get ahead of this, this could really be a big problemWe could have falls, we can have injuries and we don’t want any of that. So by utilizing that technology and really showing people a mirror for where they were, it helped them overcome their fear and come out of their apartments and really start to re-emerge and re-engage and get stronger and healthier.

Coming out of this better than before

It has been the toughest year I’ve ever had to deal with in my career, but it also strengthened our mission and values as an organization. Our staff knows that we will support them at any moment and that will make us stronger.

Paul Zappoli

  Dziedzic I think where you work matters, and nobody wants to get up and go to work and spend a third of their life or more with people they wouldn’t want to normally hang out with. We are fortunate that we are a small enough team and a small enough organization that we can still maintain those personal connections. There’s no real barrier to anybody on our team coming up with a good idea and walking into our CEO’s office and saying,  Hey, I really think we need to think about this, or we need to consider this. And it will always be considered. And I think having that shared experience of living through what we’ve lived through, has taken us to a different level as a team, as an organization, and as a community.

This article was originally published here.

AI Can Boost Your Hospital Patient Score

Customer surveys are the best way to gain meaningful insights into your company’s products and services. People who take the time to fill out surveys usually have very strong opinions one way or the other, so making a good impression is paramount. Healthcare is no different. New technologies using artificial intelligence create better care for patients and in turn, improve your hospital patient score. 

When hospitals receive good HCAHPS survey results, it’s the equivalent of earning a golden ticket. The results of the HCAHPS survey—the Hospital Consumer Assessment of Healthcare Providers and Systems—are publicly reported and provide the patient perspective on the care they received at your hospital. These quality scores are linked to the Hospital Value-Based Purchasing (VBP) program, which directly correlates to hospital incentive payments. In other words, bad patient scores impact the bottom line.  

The HCAHPS survey contains 21 patient perspectives on care and patient rating items that include the following key topics: 

  • Communication with doctors & nurses 
  • Responsiveness of hospital staff 
  • Pain management 
  • Communication about medicines 
  • Discharge information 
  • Cleanliness and quietness of the hospital environment 
  • Transitions of care 

The survey is administered after discharge to a random sampling of adult patients. More than 4,000 hospitals participate in the HCAHPS with more than three million patients completing the survey each year.  

Value-Based Purchasing Program

The Hospital VBP Program is designed to improve the quality of care and patient experience in the hospital. It encourages hospitals to improve the quality, efficiency, patient experience and safety of care that Medicare beneficiaries receive during acute care inpatient stays by: 

  • Eliminating or reducing adverse events (healthcare errors resulting in patient harm). 
  • Adopting evidence-based care standards and protocols in order to obtain the best outcomes for Medicare patients. 
  • Incentivizing hospitals to improve patient experience. 
  • Increasing the transparency of care quality for consumers, clinicians, and others. 
  • Recognizing hospitals that provide high-quality care at a lower cost to Medicare. 

Hospitals are rewarded based on the quality of care provided to Medicare patients, not just the quantity of services provided. These ratings are then measured against other hospitals and improvements from previous baseline periods.  

Achieving a good VBP rating is especially challenging due to current and future healthcare staffing shortages, most notably, nurses.  

Providing a Better Patient Experience with AI

VSTOne from VirtuSense connects patients, staff, physicians, and family without requiring clunky monitoring platforms, additional personnel, or complex workflows. The platform integrates with wearable vitals monitors, smartphones, and a central console to provide continuous monitoring and rapid alerting no matter the circumstances.

VSTOne can improve the patient experience and provide support for your staff.  

Communicate with Doctors & Nurses: Connect patients with staff, physicians, remote specialists, and family members with VSTOne’s two-way video and audio communication capabilities. 

Prevent Patient Falls: VSTOne’s AI and LIDAR sensors work together to not just detect, but predict patient bed and chair exits 30-65 seconds before they get up. VSTOne has reduced patient falls by up to 60% compared to E-sitters at 20% for substantially less.  

Pressure Ulcer Alerting (coming soon): VSTOne will recognize when a patient hasn’t moved in their bed and is at risk of developing pressure ulcers, detecting both upper and lower extremities. 

Rapid Response Time: Untethered, real-time monitoring sends alerts to the right people at the right time to prevent adverse health events. Speed and security are priorities. Because VSTOne processes AI on the edge device, no sensitive data is transmitted across your network, just the alert itself. This means that the network requirements are extremely low—up to 125 units can run on a single dial-up modem. 

Fewer Disruptions: VSTOne automates routine vitals checks and non-emergency in-room visits. The wearable vitals patch captures heart rate, respiratory rate, temperature and SpO2 in real-time, so night-time disruptions from rounding can be eliminated. 

VSTOne is a game-changer when it comes to improved efficiencies in care for hospital patients.

If you’d like to learn more about VSTOne, click here.

A New Healthcare Delivery Model With AI & RPM

The COVID-19 pandemic has exposed significant weaknesses in our healthcare system today. Increased patient volumes stressing staffing capacity, increased caregiver exposure, and dwindling supplies of PPE continue to strain our hospital and senior care systems. The people that this affected the most are the patients and frontline healthcare workers who are working with antiquated resources and without adequate support to deal with these challenges. These problems are not new, but the pandemic has highlighted how ill-equipped our existing system is to deal with them. We have seen that a new delivery model is necessary in order to move forward, which is why many healthcare providers are considering AI and RPM platforms. 

COVID-19 Changed Everything

Dr. Tom Hale, Chief Medical Officer at VirtuSense Technologies says, “We’ve been aware of the possibility of a pandemic, but since the last true global pandemic was over 100 years ago—the Spanish Flu in 1918— healthcare delivery has not changed significantly in preparation of pandemic extremes. COVID-19 has unmasked the inadequacies in our healthcare delivery model. Healthcare will be forever changed and it is evident that to not change the model is a recipe for disaster.” 

For decades healthcare has operated based on a reactive model of care delivery, with patients acting as the sentinel alerting event. You feel sick, you call a doctor, they give you medicine or send you to a specialist, you get better. Rinse and repeat. “Most care models in the healthcare industry have spent billions on infrastructure to support this model. By definition this causes providers to enter the disease cycle in the middle to the end—never the beginning,” Hale explains.

Research by the American Journal of Medicine suggests early interventions are the key to better outcomes, COVID-19 being no exception.

“Many patients who arrive at the hospital by emergency medical services with COVID-19 do not initially require forms of advanced medical care. Once hospitalized, approximately 25% require mechanical ventilation, advanced circulatory support, or renal replacement therapy. Hence, it is conceivable that some, if not a majority, of hospitalizations could be avoided with a treat-at-home first approach with appropriate telemedicine monitoring and access to oxygen and therapeutics.”

Predictive Analysis

VirtuSense Technologies’ mission is to change this delivery model. Through years of work around AI and sensor technology the team at VirtuSense developed VSTOne. This breakthrough technology has enabled a proactive model for care delivery. VSTOne is a continuous remote monitoring and telehealth device using artificial intelligence (AI) and machine learning (ML) to aid providers in acute and post-acute settings to more effectively care for chronically ill and COVID-19 patients. The platform uses an array of machine vision and IoT sensors to monitor patient vitals (movement, heart rate, respiratory rate, blood pressure, O2, etc.); artificial intelligence to recognize anomalies; and mobile applications to alert healthcare workers before a patient’s condition declines. 

VSTOne receives a constant stream of health data from chronically and critically ill patients and leverages AI to interpret it, resulting in actionable alerts and decision support. Instead of waiting for a patient to report their symptoms, VSTOne recognizes early warning signs before the symptoms themselves manifest. Early warning enables early intervention, which means that patients will be able to avoid many serious health issues all together.

Telehealth is the Way Forward

Because of VSTOne’s telehealth capabilities and vital sign data acquisition, caregivers can manage more patients with fewer resources and lower exposure to infectious agents such as COVID-19. Traditionally, a nurse or tech will check patient vitals every few hours to monitor their condition. During the pandemic, every visit means new PPE. Remote monitoring reduces the need for them to enter the patient’s room. With VSTOne, a patient’s vitals are continuously monitored and are available as data points in time or as trends to the nurse’s phone as well as to a central monitoring station. Rather than 3-4 snapshots of the patient’s condition, VSTOne creates a movie of real time trending information. When relevant changes occur alerts are sent immediately so that interventions can begin as quickly as possible. Because of the use of the AI and ML the specificity is remarkable with little to no false alerts.

During pandemic surges, this is crucial for maintaining open rooms and resources for critically ill patients. “VSTOne gathers patient information in the hospital room in real-time. It has telemedicine capabilities with a camera and microphone, so when a nurse receives an alert she can see the patient and communicate with them from her smartphone,” Hale explains.

“There’s nothing more inefficient than going back and forth to patient rooms, taking vitals, etc. This technology will streamline workflows and potentially allow nurses to care for 30–40% more patients with greater accuracy and less work.”

AI is Everywhere

AI is proving to be a valuable tool during this pandemic to detect and prevent the spread of COVID-19. For example, AI technology has been deployed in public places like Beijing’s Qinghe railway station and at hospitals like Tampa General to detect people with COVID-19 symptoms and prevent them from spreading the virus. 2

We developed VSTOne to be the first step toward a better, more connected healthcare system. Many different organizations are addressing isolated parts of the issue, but these solutions are still triggered by patients’ self reporting symptoms consistent with the traditional reactive healthcare delivery model. What VirtuSense has done with VSTOne is create a comprehensive ecosystem that addresses multiple angles of the care delivery problem with greater sensitivity and specificity. 

Technology will change how healthcare is delivered both during the pandemic and after. Continuous monitoring combined with AI gives providers the full picture of a patient’s health without burying them in data. The insights and alerts will enable healthcare providers to care for their patients irrespective of time, place and situation making high-quality care accessible to everyone. VSTOne is the first step.

This article first published here.

How AI Can Augment an Already-Stressed Nursing Workforce

According to the American Nurses Association, there will be significantly more registered nursing positions available by 2022 than any other profession—more than 100,000 per year. This isn’t even factoring in the more than 500,000 RNs that are planning on retiring. The U.S. Bureau of Labor Statistics projects the need for 1.1 million new RNs in 2022 to avoid a nursing shortage. 

There are four driving factors impacting these numbers: 

1. Nurses are retiring earlier

The ANA estimates that 1 million nurses will retire between now and 2030. Not only is the profession expected to lose a large number of nurses, but when experienced nurses leave, healthcare organizations are left to mitigate the threat of lost knowledge. Nurses will leave with the critical nursing experience and knowledge they have accumulated

2. The Aging Population is increasing

The U.S. has the largest number of Americans over the age of 65.  As the population ages, the number of health conditions, chronic illnesses, and co-morbidities requiring healthcare services grow. These increasing healthcare needs require healthcare organizations to increase nursing staff to provide quality care safely.  

3. Shortage of nurse educators

According to AACN, U.S. nursing schools turned away more than 80,000 qualified nursing applicants in 2019 due to insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as budget constraints. 

4. Nurse burnout

Nurses are overworked and mentally and physically exhausted, especially after the COVID-19 pandemic. 

Although hospital administrators are facing a huge dilemma in the coming years, there are technologies available now that can augment their current and future nursing workforce to keep patients healthy and safe. 

Artificial Intelligence Assists Nurse

VSTOne has enabled a proactive model for care delivery in the hospital. VSTOne is a continuous remote monitoring and telehealth device using artificial intelligence (AI) and machine learning (ML) to aid providers in acute settings to more effectively care for more patients with fewer resources. The platform uses an array of machine vision and IoT sensors to monitor patient vitals (movement, heart rate, respiratory rate, blood pressure, O2, etc.); artificial intelligence to recognize anomalies; and mobile applications to alert healthcare workers before a patient’s condition declines. 

VSTOne receives a constant stream of health data from chronically and critically ill patients and leverages AI to interpret it, resulting in actionable alerts and decision support. Instead of waiting for a patient to report their symptoms, VSTOne recognizes early warning signs before the symptoms themselves manifest. Early warning enables early intervention, which means that patients will be able to avoid many serious health issues all together.

Less Rounding & Fewer False Alarms

Because of VSTOne’s telehealth capabilities and vital sign data acquisition, more patients can be managed with fewer resources, thus reducing the workload for nurses. Traditionally, a nurse or tech will check patient vitals every few hours to monitor their condition. With VSTOne, a patient’s vitals are continuously monitored and are available as data points in time or as trends to the nurse’s phone as well as to a central monitoring station. Rather than 3-4 snapshots of the patient’s condition, VSTOne creates a movie of real time trending information. When relevant changes occur alerts are sent immediately so that interventions can begin as quickly as possible. Because of the use of the AI and ML, the specificity is remarkable with little to no false alerts.

Floor Management

The VSTOne Console allows you to manage your entire floor from a single screen. You can assign rooms to nurses and staff, track shifts, onboard patients, and view the status of each room in real-time. VSTOne automates routine vitals checks, non-emergency in-room visits, and gives patients the means to talk with family, specialists, or their doctor remotely.

A New Way Forward

We developed VSTOne to be the first step toward a better, more connected healthcare system. Many different organizations are addressing isolated parts of the issue, but these solutions are still triggered by patients’ self reporting symptoms consistent with the traditional reactive healthcare delivery model. What VirtuSense has done with VSTOne is create a comprehensive ecosystem that addresses multiple angles of the care delivery problem with greater sensitivity and specificity. 

For more information on VSTOne, please click here

This article originally published here.

Fall Detection is NOT Fall Prevention

Many fall “prevention” companies aren’t actually preventing falls at all, but rather notifying caregivers after a resident is already on the floor. There’s a big difference between detecting falls and preventing falls, depending on the technology you use. 

Most “solutions” in the marketplace are reactive, and thus ineffective: 

  • In-room sitters are expensive and not scalable
  • Telesitters require additional IT infrastructure while still requiring costly sitters to monitor video feeds
  • Bed and floor pads often send false alerts causing alarm fatigue. When real alerts are sent, it’s usually too late–the resident is already on the floor. 

These tactics serve as Band-Aids that cause more disruptions for residents without making a real impact on falls. 

Not All AI is the Same

Artificial Intelligence (AI) is a game changer in fall prevention in long-term care for older adults, but not all systems utilizing AI are the same. In fact, there are major discrepancies between fall reduction providers when it comes to their AI capabilities. 

Real-Time AI Detects Falls

Some products on the market use AI-enabled video surveillance that notify staff after a resident is already on the floor. These systems tout their ability to get to a resident within 10 to 20 minutes after a fall, but is that really effective, especially if the resident is injured? A fall is a fall.  

Predictive AI Prevents Falls

At VirtuSense, we believe the best approach to stopping a fall is to prevent it altogether. Using AI and a remote monitoring platform, VSTAlert can identify and alert staff of bed and chair exits 30 to 65 seconds before a resident gets up. One community saw an 82% decrease in falls after implementing VSTAlert. 

It’s 98% accurate which means fewer false alarms and fewer falls so your staff can care for those who need it most when they need it. 

Detecting falls after the fact, doesn’t inspire confidence. Predicting and preventing falls offers the best protection for residents and peace of mind for their families. 

This article originally published here.

AI Can Lessen the Burden for LTC Admins & Nurses

McKnight’s recently released its 2021 Mood of the Market survey results, which polled 627 long-term care administrators and nurse managers on the state of their profession. Not surprisingly, the survey results were pretty dismal compared to the same responses in 2020.  

When asked, “Has the pandemic made you more likely to leave the profession?” 29.4% said “yes, definitely,” compared to 17% in 2020, while the diehards who responded, “No way,” dropped nine points from 33% to 24%.  

Pandemic Burnout

Given the extreme circumstances they’ve been under the past 20 months with no clear light out of the tunnel now that the Delta variant has reared its ugly head, administrators and DONs are exhausted. Many are working extended hours and picking up floor shifts, because they’re understaffed.  

Staffing shortages are the biggest challenge in healthcare and even more so in long-term care, but there are ways to remedy this. AI technologies can assist your staff and help them care for more residents with fewer resources and better outcomes, especially for residents who are considered a high fall risk.  

AI to the Rescue

High-risk residents usually require extra staff, which isn’t feasible in current times. VSTAlert uses AI technology to monitor residents in real time and notify staff 30-65 seconds before they get up. Alerts are immediately sent to staff so they can get to them before they are out of bed. VSTAlert is 98% effective and it only sends. 5 false alarms per day, so staff aren’t wasting their time running room-to-room.  

The one bright spot in the McKnight’s survey is that 98% of respondents find their work meaningful, which isn’t something that can be said if you work as a fry cook at a fast food restaurant. Investing in an AI-enabled technology like VSTAlert, empowers your staff to focus on the meaningful work—i.e. resident care—and not the busy work created by false alarms and the lengthy documentation required after a fall.

This article originally published here.

Multiple Medications Can Increase Fall Risk for Older Adults

Most adults 65 and older take at least one prescription drug, as well as over-the-counter medications. It’s no surprise, given that 85% of older adults have chronic conditions. 

According to a recent study by PDS, an estimated 94 percent of older adults received a prescription for a drug in 2017 that increased their risk of falling, a startling increase from 57 percent in 1999. The study also found that the rate of death caused by falls in older adults more than doubled during the same time period.

In fact, between 1999 and 2017, more than 7.8 billion fall-risk-increasing drug orders were filled by older adults in the United States, the majority for antihypertensives, which treat high blood pressure. The use of antidepressants also rose sharply, from 12 million prescriptions in 1999 to more than 52 million in 2017, according to the study.

Medication Side Effects

Experts acknowledge that while these medications are necessary, they can be problematic because the side effects are often drowsiness and dizziness, which contributes to falls. The Washington Post reports, “Some drugs also can impair cognition and judgment, affect mood, and produce lightheadedness, loss of balance, blurry vision, slower reaction time, and wooziness. To try to address this, the CDC has launched a campaign to improve collaboration between health providers and pharmacists to assess patients’ medications and screen them for their risk of falls.”

Every year, millions of Americans 65 and older — 1 out of 4 — suffer falls, which are the leading cause of fatal and nonfatal injuries in this age group, according to the CDC. Even a nonfatal fall can be serious, especially if it results in a fracture or head injury. Three million older Americans are treated in emergency rooms annually after falling, and 800,000 are hospitalized.

Fall-Risk Assessments

Experts aren’t advising that doctors stop prescribing or recommending drugs to older patients, but they are suggesting that patients be more vigilant in questioning the side effects and making sure their doctors know all the drugs they are currently taking. Having regular fall risk assessments are also recommended. 

VSTBalance uses artificial intelligence and machine vision to identify mobility deficits in older adults and compare against normative data to determine their risk of falling. The system automatically generates reports after each assessment, helping therapists and physicians create more effective care plans and route patients to personalized home exercises, wellness, and/or therapy. These assessments may also quantify if their medications are impacting their mobility. 

This article originally published here.

Where Were the Adults?

originally published January 20, 2019

Like most people, I saw the image of the smirking high school boy in the MAGA hat staring at a chanting Native American man and my reaction was swift — I immediately jumped on the kid and his schoolmates for their white privilege. But, after watching the actual video, I’m not sure the kid was wrong to just stand there. He didn’t do anything. He didn’t touch the man or say anything to him. In all likelihood, he didn’t know what to do. There’s a strange man, standing very close to him, banging a drum and singing loudly into his face. As a parent, that upsets me. I know the man didn’t mean harm, but if someone got in my daughter’s personal space like that, I would’ve stepped in. Which leads me to this question: Where was this young man’s parents?

I encourage my kids to speak up if they believe in something. I’ve taken them to an anti-gun rally and a local women’s march. My older daughter led a “sit in” at her school on the one month anniversary of the Parkland school shooting to honor the victims. I’m proud of my kids and their interest in social activism, but I’m also part of it. I go with them to keep them safe — from themselves and others. They’re children. I would never put them on a school bus and send them to a rally out of state wearing political paraphernalia and hope for the best. The parents of these boys from Covington Catholic School should be punished; not the boys.

Honestly, what did they think would happen when they sent those boys in MAGA shirts and hats to Washington, DC? Are they unaware of the political climate in this country and the hate emanating from both sides? Frankly, it was completely irresponsible and dangerous to send those boys into that situation. I don’t even want to go into why I think it’s wrong on so many levels to send a group of adolescent boys to protest a woman’s right to choose — that’s a whole other argument. Those boys parents should have been with them to protect them from themselves, the protestors on the other side, and the media.

While I don’t agree with the sentiments of the boys, I can’t blame them. They’re still children who are likely repeating the things they hear at home. Their parents — and the school administrators — should have known better than to send them into a political shit storm and expect them to come out of it clean.

Remote Worker Experience …

I was interviewed by  the Greater Peoria Economic Development Council in July and they published this nice article.

To be successful in the writing industry means one has to possess a broad range of versatile skills. Emily Potts has been a prominent writer, consultant, and editor based in the Peoria community with a scope of clients and employers nationwide.

Emily Potts - writer, editor, consultant - works remotely from Peoria.
Emily Potts – writer, editor, consultant – works remotely from Peoria.

More than 25 years ago, she moved to Peoria from Milwaukee in her role as assistant editor for Step-By-Step Graphics, a national graphic design magazine published by Dynamic Graphics (SBSG), which was based in Peoria. She was also attending Bradley University, and upon graduation, worked at other local companies including Central Illinois Business Publishers and Caterpillar. She eventually returned to SBSG as its managing editor, eventually becoming editorial director and rebranding the publication and gaining national recognition. After that, she worked as a remote acquisitions editor for a major publishing company based near Boston for nearly 8 years, and then as a solo writer and editor for several years, before becoming managing director at Pavy Studio, based in Lafayette, Louisiana. Read the rest of the article here.