Category: Uncategorized

There are many pieces to the massive Federal exchange that enrolls people for insurance under the Affordable Care Act (ACA, “Obamacare.”) One of them allows insurance brokers and agents to enroll potential beneficiaries directly. (This is different from the consumer-facing part of the exchange, where consumers can enroll themselves.) On October 13, 2018, the Centers for Medicare and Medicaid Services (CMS) detected “anomalous activity” and by October 16, confirmed that a breach had cooccurred. About 75,000 individuals’ records were stolen. CMS shut down the system on October 20 to install new security measures and planned to have it back online by October 27.

CMS was unusually close-mouthed about the breach, noting only that it was contacting those affected and would offer them identity theft protection. This being the case, we can only speculate about what exactly happened. It could have been as something as simple as an agent leaving their password on a Post-It Note under their keyboard, or as sophisticated as exploiting an unknown fundamental vulnerability in the myriad of software packages that make up the entire exchange system. It must also be remembered that the Exchange software talks to several other systems, including the IRS, and the breach may have come from anywhere in the chain. A 2015 report by the HHS Inspector General found the that the whole healthcare.gov system suffered from some vulnerabilities which had not been rectified as of the date of the report. It is now, of course, three years later.

What Lessons Can We Learn From This?

Because CMS has explained virtually nothing about how the breach happened, it is hard to tell what lessons we can draw from it – other than to note that so far, any system that humans can attempt to secure, humans can find a way to penetrate. No system is entirely safe.

Because CMS did not respond to questions, we do not know, for example, whether end-to-end encryption was used for data transmission, and we do not know if the particular data files accessed were encrypted. Encrypting data in both storage and transmission provides an additional layer of protection – in the ideal case, even if the hackers get the data, they can’t use it.

Was It An Inside Job?

Security officials in both the public and the private sectors are well aware that even with all recommended safeguards in place, they are still vulnerable to hacks by employees or other trusted agents. After all, someone has to be able to access that data to use it. Even if the USB ports on the laptops and desktops are filled with glue, even if biometric identifiers are used, an insider can dump data, zip it into a file, and send it to cloud storage, where it can be accessed by anyone with access to that portion of the cloud. And that will include a population beyond one’s own employees. A really sophisticated hacker can keep events from being logged or modify the logs so that there is no trace that the transmission ever happened. Based on the information CMS was willing to release, we cannot conclude that this was not an inside job. The only fact that militates against it is that the amount of data stolen was so small. If someone were really trying to make a killing on the dark web, they would steal far more. Perhaps this breach was just a “proof of concept.” Or it may merely be a case of unauthorized access. We just don’t know.

Trust? Verify? But?

The experiences of the military and the National Security Agency (NSA) with insider theft of data in recent years suggests that even the steps the military and the intelligence services have taken cannot completely protect them from inside jobs. Edward Snowden, Chelsea Manning, and Reality Winner all were thoroughly vetted and had authentic credentials. Still, the data got out. (Perhaps it is true, as was said in the early data of the web, that “…data wants to be free.”)

No One Is Safe

Security experts repeatedly tell us that our existing systems cannot be made impenetrably secure. It is the very nature of the technology we use now – for health insurance, for banking, for voting – to send large amounts of critical data across unsecured networks for at least part of their journey. All we can do is encrypt, vet out employees, and – hope.

World War I officially ended on June 28, 1919, when the Treaty of Versailles was signed. However, fighting ended seven months earlier due to an armistice on the 11th hour of the 11th day of the 11th month. For that reason, November 11, 1918, is generally regarded as the end of “the war to end all wars.” In November 1919, President Woodrow Wilson proclaimed November 11th as Armistice Day with these words: “To us in America, the reflections of Armistice Day will be filled with solemn pride in the heroism of those who died in the country’s service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations…”

Although the name “Veteran’s Day” was not used until 1954, this day was designated a legal holiday to celebrate and honor the ending of World War I. In 1938, Armistice Day was “dedicated to the cause of world peace” and to honor the veterans of World War I on November 11th each year, becoming a federal holiday. In 1954, after World War II and the Korean War, President Dwight D. Eisenhower changed the name of the holiday to Veteran’s Day to honor American veterans of all wars. In 2018, Veteran’s Day falls on a Sunday which means there will be a Federal holiday for workers on the following Monday. State and local workers’ schedules are determined locally, therefore you should check with your locality to determine whether offices will be open or closed on Monday, November 12, 2018.

What is the Difference between Veteran’s Day and Memorial Day?

The original concept for the celebration of Veteran’s Day was for a day observed with parades and public celebrations and a brief stoppage of business beginning at 11:00 a.m. The observance of Veterans Day ton November 11th preserves the historical significance of the date and helps focus attention on the important purpose of Veterans Day, a celebration to honor America’s veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good.

Memorial Day, also a federal holiday is held on the last Monday in May. It is dedicated to remembering soldiers who lost their lives in battle or from injuries received in battle. Veteran’s Day is a day to honor all veterans, living or dead, who serve or have served in the military honorably during wartime and peacetime. Veterans come from families in all parts of the United States; men and women who serve are embedded deeply in the community. Here are some facts about American veterans:

• 16.1 million living American veterans served during at least one war.
• 5.2 million American veterans served during peacetime.
• 2 million American veterans are women.
• 7 million American veterans served during the Vietnam War.
• 5.5 million American veterans served during the Persian Gulf War.
• 2 million American veterans served during the Korean War.
• As of 2014, 2.9 million American veterans received compensation for service-related disabilities.
• As of 2014, three states have more than 1 million American veterans among their population: California, Florida, and Texas.

How to Celebrate Veteran’s Day

Veteran’s Day is a good day to find a way to thank veterans for serving the United States. There are many veterans living in communities around the U.S., some of whom don’t have relatives to care for them. You can visit patients in Veteran’s Hospitals, nursing homes or neighbors that you know are veterans. Honoring veterans with celebrations and parades is a great idea, but helping them after their service to the U.S. with daily life has great meaning to them as well. Many restaurants offer free meals to veterans on Veteran’s Day, and other businesses give discounts or assistance in any way they can.

Most lawyers realize that their firms would benefit by implementing legal practice management software. Case, contact, and document management tools; accounting, billing, and time tracking features; calendar, schedule, and docket control are all made easier. This allows attorneys to spend their valuable time on clients and cases, rather than on daily paperwork.

There are many benefits to adopting software programs for a law office. They coordinate communication between attorneys and support staff. This helps to properly assign duties and manage deadlines. Additionally, the document management tools allow for a fast, paperless search of files on the go. Generally, practice management software keeps cases organized.

By checking out some of the features that the top law practice management software tools offer, firms can choose the right option for their needs.

How Could Choosing ActionStep Improve the Daily Flow of a Law Office?

This highly flexible, cloud-based practice management solution offers an integrated approach that addresses the basic needs of small to medium-sized firms. ActionStep allows users to design their own workflows to suit their areas of specialty.

Other noteworthy features that ActionStep provides include the following:

• Calendar management
• Client billing
• Client conflict and copyright check
• Client Portal
• Data Security
• Email management
• MS Office Integration

Additionally, with this software, attorneys can access, search and retrieve billing, documents, emails, and file notes, etc. with merely the click of the button.

Why Should Attorneys Choose Bill4Time?

Bill4Time is exactly what it claims to be; it is a time and billing software for companies that bill based on hourly rates. In addition to its standard office software, it has a legal edition. The industry-specific version has America Bar Association (ABA) Task Codes. It also offers checks for conflict of interest, as well as trust accounting and reporting.

One of the top-rated options for law firms, Bill4Time integrates with a variety of payment gateways. These include PayPal, Quickbooks, and other credit card processors. Clients have plenty of flexibility in payment options.

How Does Clio Benefit a Firm?

Clio might be the perfect management tool for law offices. It is designed to provide an array of benefits. Users can effortlessly organize case details, create workflows, and set schedules. It allows firms to take control of their finances with accounting system integration.

Its multiple features streamline nearly all of a law office’s processes. It enables the performance of accounting, client, case, documentation, and information management, office finance, time-tracking, and scheduling with one dynamic platform. Plus, it is compatible with Android, iOS, Mac, and PCs.

How Would HoudiniEsq. Improve a Law Practice?

A legal practice management solution, HoudiniEsq runs both Windows and MAC operating systems. This software includes client management, customizable workflow automation, email management, invoicing, and trust accounting. It comes in both desktop and cloud-based versions.

What Does MyCase Offer?

MyCase is a comprehensive, web-based practice management option for lawyers. This software offers procedures that are easy to use, as well as online payment, and a secure client portal. It also resolves the generally inefficient communication between clients and their legal counsel by providing a single platform for information sharing.

Since many legal users prefer mobile options, this software provides android and IOS apps for its users. MyCase offers legal practice management assistance to their customers by way of certified consultants. This ensures successful software use.

Why Should Lawyers Choose PracticePanther for Their Firm?

A management and billing software tool, PracticePanther is designed to be easy to use for those in the legal profession. In an all-in-one automated and secure software, it combines time tracking and billing, expense management, and payment processing.

Additionally, PracticePanther offers the following features and functions:

• API Access
• Custom Fields
• Daily Agenda Emails
• iPhone, iPad, and Android Apps
• Money-Finder Report
• Online Payment Processing
• Quickbooks Accounting Integration
• Secure Client Portal
• Trust Accounting
• Unlimited Data Storage
• UTBMS Coding & LEDES Billing
• Zapier Integration

This software is designed to help users save many hours per week while managing their practice. This results in a better, more lucrative bottom line.

How Can Tabs3 Be of Service?

This is desktop-based, Windows-only software designed specifically for law firms. Tabs3 is one of the most innovative and intuitive software options. It features advanced compensation formulas, client status reports, customizable billing, and time tracking. Plus, with particular additions, it supports electronic billing formats, such as LEDES. It also seamlessly integrates with Tabs3 accounting, financial, and custom report writing software.

In Conclusion

Many law offices have fewer than five employees. However, they still offer the same services as larger firms do. This means they require software that provides the same comprehensive functions as do bigger practices.

Several of the top practice management software options offer free trials or demos. This allows firms to basically “test-drive” a variety of systems. Then, they can compare the features of each before committing to their favorite.

 

As a seasoned business traveler, you already know that flying through JFK, Newark, or LaGuardia can be a bit challenging—even on a good day. Between dealing with security, flight delays, and hordes of obnoxious fellow passengers, what is supposed to be a smooth transition to your destination can easily turn into a mess of inconvenience and annoyance. Add in a lack of free internet and an ordinary three-hour layover can seem like an eternity with no way to send email, check the weather, or even tackle a little bit of out-of-office paperwork.

Thankfully, the powers that be have come up with a solution to ease the burden on passengers and make it easier to surf, stream, and work remotely. Effective immediately, all New York City travelers have access to four hours of free high-speed Wi-Fi at major terminals. Here’s what you need to know to take advantage of the program.

Which Airports in New York City Offer Free Wi-Fi?

Three major airports in New York City—JFK, LaGuardia, and Newark—now offer free wireless internet. Additionally, New Jersey’s Stewart Airport is also taking part in the program. For business travelers who regularly venture outside of the New York City area, the word that these locations are finally joining the rest of the world by offering free high-speed internet is good news.

And there really is no catch. Passengers are allowed up to four hours of high-speed use per session. The internet works with laptop computers, smartphones, tablets, and other Wi-Fi enabled devices deemed safe for terminal use by the TSA.

How Do You Login to Airport Wi-Fi in New York?

According to the Port Authority, signage was placed inside the terminals with instructions on how to connect to the public network. However, in most cases the setup is similar to connecting at a local hotspot in your neighborhood: select the appropriate connection in your Wi-Fi options, agree to the terms of service, and watch a short advertisement. The connection will reset after four hours, but travelers are allowed an unlimited number of four-hour blocks.

Can You Only Get Wi-Fi in Certain Terminals?

Previously, JetBlue’s Terminal 5 in JFK was the only area with free high-speed internet for travelers. The only option in other terminals included a service called Boingo, which was free for thirty minutes before requiring additional payment and was often frustratingly slow. Thankfully, this new system expands the coverage to all areas of the four airports listed above.

How Fast is the Wi-Fi Connection?

According to the Port Authority’s Robert Galvin, the free airport Wi-Fi connection offers download speeds ranging from 20 Mbps and up to 50 Mbps. This is comparable to most public connections at hotels or your favorite corner Starbucks. And it certainly is fast enough for a quick video chat, downloading a large file, or binge watching a couple of episodes of your favorite television series on Netflix.

Staying Safe While Connected to Public Wi-Fi

Officials at all New York City airports agree that data safety is important. However, business travelers need to adhere to a few additional personal rules to keep their information secure while on a public network.

For example, save viewing sensitive data such as online banking, medical, or sensitive business information for a time when you are on a private connection. Hackers have been known to use large public Wi-Fi networks to mine identity data, so it really is best to not put yourself in a bad situation unnecessarily.

Also, when you can, try to stick to websites with the “https” prefix. This signals that the site is secure, making it much more difficult for tech-savvy travelers on the same connection to snoop on what you’re looking at on your screen. And be wary of any popups that suddenly appear while on an airport connection that ask you for personal information other than the first setup screen when connecting according to the instruction signage.

Are you traveling through JFK, LaGuardia, Newark, or Stewart Airport soon? Look for more information and signage from the Port Authority on-site as to the login process, how to connect, and what to expect when using free airport Wi-Fi in New York City.

While a growing number of businesses are embracing the power of improving technologies, entities like government agencies are still catching up to speed. But why?

Given that government organizations should be striving for deeper engagement and more transparent communications, they haven’t always been as quick to seek ways to improve operations overall. This includes IT initiatives. Failure to keep up with IT trends has become problematic because citizens expect a modern government to implement some of the same innovations being made in the private sector. This takes form in mobile services, enhanced security and the ability to deploy government assistance faster and more efficiently.

Some countries, like Canada, are leading the way. The Treasury Board of the Government of Quebec recently published “Rénover l’état par les technologies de information”. This global modernization strategy has become the first comprehensive review of the organization’s IT workforce. Its publishing has paved the way for the organization to implement best industry practices. This has allowed for greater transparency and better continuity of services provided to Canadian citizens. Most notably, the report has encouraged the Government of Quebec to make the switch to a “Cloud first” strategy that will unlock the door to greater efficiency and functionality for the organization’s IT services.

Canada Embraces Cloud Computing

Cloud computing is one of the many technological advances government agencies are embracing. According to some studies, global spending on public cloud services and other improvements to infrastructure is expected to increase over 20% by the end of 2018. Tools like Microsoft 365 and other advanced services can hold a range of benefits for organizations in the public sector. Some of these benefits include connecting better with citizens, collaborating more effectively across departments and agencies, and increasing mobility.

Due to the success found in the Rénover l’état par les technologies de information, the National Assembly approved the implementation of a Cloud Broker, which was created to ensure an efficient and transparent process for obtaining cloud services.

Adopting a cloud-first strategy can be a big move for any organization. This rings truer for government agencies. It’s important that stakeholders fully grasp the variety of risks, challenges, and opportunities associated with a cloud-first strategy.

While there are a number of significant benefits to making the transition to the cloud for your organization’s IT, such as cutting costs, increasing scalability and providing more secure infrastructure, there are also areas that need to be evaluated beforehand. These include potential security, financial and legal issues. Once organizations make the decision to transition to a cloud-first strategy, it’s important they understand that cloud computing must operate under a shared responsibility model, with different parties responsible for different aspects of operations. This means that cloud initiatives must be run with top-down support. If all the moving parts fail to work together, you may run the risk of data breaches, missed deadlines, cost overruns, and other consequences.

Cloud Services Catalog

Implementing a cloud-first strategy is quite the undertaking and not one to be taken lightly. With projects of this scope, security is always an issue. To ensure a smooth transition for all parties involved, the CSPQ created a Cloud Services Catalog that would allow agencies to contract pre-qualified cloud services or vendors. These vendors are obligated to meet a mandatory set of requirements set forth by the Government of Quebec. These requirements contain a set of rules regarding privacy, operations, security and the protection of personal data.

Mass E-mail Migration

Microsoft Canada was among the first on the approved list of vendors. Since then, the company has joined forces with the Canadian agencies to provide guidance and coordination with the goal of streamlining operations and making the government’s IT operations more efficient. The organization has been working closely with government stakeholders to increase privacy, mobility, security, and capacity. In just 6 months, Microsoft has helped migrate 190,000 mailboxes to Office 365. The migration is among the fastest in the history of the organization. Since then, there has been a noticeable improvement and a range of benefits, including lower costs.

Canada isn’t the only country embracing Microsoft’s cloud services, and it’s certainly not the first. Major government agencies across the world have already made the switch. In June of 2014, Los Angeles County announced it would be deploying Microsoft’s cloud-based Office 365 program across over 100,000 employees spanning 30 departments. At the time, this transition marked one of the Microsoft’s largest state and local government implementations.

Making the switch to a cloud-first strategy is only the beginning. It marks the start of a long process of assessments and decision making. This shift, while arduous to implement, can pave the way for big benefits for large and small businesses alike. Cloud computing is the wave of the future, and a growing number of organizations are bound to reap the benefits by embracing this technology.

Libraries of legal tomes, rooms of cabinets full of case files, dusty desks, and ink-stained fingers—no longer do these images represent the legal profession. Modern law practices continue to evolve to meet current and potential demands. The use of IT is one of the primary ways in which they have adapted to an advancing society.

Legal clients frequently require more intuitive service. They want to ensure that the legal counsel they hire is equipped to protect their data. The legal sector has heard their requests and has scrambled to comply.

There are many ways in which contemporary law firms can utilize technology to improve their practice. Better, more user-friendly communication platforms ensure that clients can easily reach their attorneys. Security software that is updated as needed keeps their personal information out of the hands of criminals. Plus, there are many different managerial aspects that can be streamlined with the use of technology.

Law practice management software is quickly outdated though. Here are the basic categories of essential software for the modern law practice.

Productivity Software: What Does It Do?

Productivity software handles all of the basic tasks that an office assistant would do. These include—but are not restricted to—the following:

• Building databases and spreadsheets
• Creating digital presentations
• Drafting documents
• Typing and sending emails

Although Microsoft Office has long reigned supreme as the ultimate—and for a while, the only—productivity software, there are now several to choose from. The top contenders include Corel’s Word Perfect Suite and Google Apps for Work. In a range of price points and capabilities, the right software is available to meet the needs of any law firm.

How Does Customer Relationship Management Software Improve a Law Firm?

Customer Relationship Management (CRM) allows firms to collect data about how they convert leads into clients. It tracks phone-calls and social-media interactions. CRM also provides basic contact management tools, as well as the ability to add notes to existing files for better record-keeping.

Additionally, the reporting function presents data in the form of charts and graphs to make it usable at a glance. Lawyers can then use the data collected to analyze their marketing platform and improve their strategies. Investment in this type of software pays off in a larger client base.

What Are the Leading Document Assembly and Management Software Options?

Document assembly software is designed for adding specific details to customize existing templates. It allows for the addition of client information or even non-generic clauses. Some of the premiere standalone or integration options include the following:

• Draft Once
• FileMaker Pro
• HotDocs
• LEAP
• Outlook Signatures
• Pathagoras
• Smokeball
• Turner
• XPressDoc

Although many of these offer some level of document management, standalone tools provide more comprehensive control. Some of the top functions for these types of applications are check in and check out features, offline access, matter management, version control, global search capability, integration with related software, and integration with existing folder systems.

What Does Accounting and Billing Software Provide to a Law Practice?

Time and billing/accounting software is vital to the modern law office. Generally, even the most rudimentary options should perform a few basic tasks. It should have a convenient time-capture method and an invoice construction feature. It should also provide reporting tools that either are customizable or able to be integrated with trust account reconciliation management. Being able to track time and export that info to an invoice template that can be sent for billing is also a perk.

More comprehensive software offers more. Computerized spreadsheet tools like Quicken, Intuit, and GnuCash are well-known business accounting management options. These are useful in law firms. Legal-specific time, billing, and accounting tools, however, are more helpful. Tabs3/Practice Manager and PCLaw handle the basic tasks that the others do, but they have trust accounting features and other law-specific tasks as well.

What Are the Leading Case Management Software Options?

Case management software—or practice management software—provides a bit of an all-in-one for law firms. Many are cloud-based systems that require no additional purchases to supplement them.

Most include management features to handle calendars, contacts, documents, time, billing, and accounting features, as well as an email archive. There are a large number to choose from. Some of the top options are Action Step, Case Fox, Clio, Legal Files, Practice Panther, Pro Law, Tabs3/Practice Master, and Zola Suite.

Since many of these are cloud-based, users are able to access any updates or new features as soon as they are released.

In Conclusion

With comprehensive case management, document management, billing and accounting software, among others, a law office runs more smoothly. The monotonous and time-consuming daily tasks are handled effortlessly. The data is compiled for review without human interaction.

Using intuitive software and cloud-based tools, they can continue to adapt to the most advanced technology. By implementing a strong system of office management software, lawyers can focus their efforts on the aspects of the job they are passionate about instead.

Today people are busier than ever. Whether you are overloaded at work or have mounting commitments away from the office, facing a long list of to-dos can quickly overwhelm even the most productive person. Luckily there is a way to get things done when the number of tasks you need to complete seems never-ending. The next time you begin to feel anxious about how much you need to get accomplished, try a few of these simple tricks to keep up your spirit and conquer your anxiety of a full schedule.

Ways to Become More Productive

Write a daily agenda. Even if you keep a monthly calendar or a weekly planner, invest 5 or ten minutes in the morning to physically write the day’s plan. Throughout the day, after finishing a task from your list, cross it off. Many people find that it is more effective and satisfying to create your daily agenda with a pen and paper, but you may prefer using your computer or phone.

Prioritize the tasks and your time. Everything is essential, but not everything is equally important. Separate your daily agenda tasks into different categories based on how essential they are for you to complete by the end of the day. Some tasks may have a real deadline, such as enrolling your child in school or paying a bill, while others may have an artificial deadline like finishing a book or going to the gym. Tackle the tasks with real deadlines first, and only when they are completed, move start working on assignments with artificial deadlines.

Break longer projects into smaller tasks which are easier to complete. Sometimes just thinking about the enormity of a project is enough to stop you from starting it. When you are facing such a task, try to break it down into chunks which you can tackle more easily. Ideally, you can break the longer projects into daily or weekly tasks, or even into smaller mini-tasks which you can complete in under 30 minutes.

Work in quick sprints, not marathon sessions. Since the vast majority of people do their best work in short bursts of time, don’t force yourself to concentrate for more than an hour or so at once. Working in this manner highlights the benefit of creating mini-tasks can help your productivity. Set a timer between 30 to 60 minutes, and work without interruption on one or two mini-tasks. When the timer goes off, take a quick break to refresh yourself. You will be amazed at how many mini-tasks you can through during the day.

Focus on the task at hand. Smaller tasks and shorter work sessions mean that it should be easier for you to focus all of your energy on the job at hand. Give your undivided attention to what you are doing. That means eliminate distractions including as a messy desk, chatting with co-workers, browsing online or chatting on your phone. If you can, try to clear from your head any thoughts which are not directly related to the task. In the beginning, this may seem impossible, but over time it gets easier.

Create rewards and consequences. Some people are motivated by carrots, while others by sticks. Discover which type of motivation factor works best for you and use it to your advantage. If you are someone who works better when you know a treat is waiting for you at the end, use your break between work sessions to reward yourself with something you want, a cookie or checking social media. If you are the type of person, who needs a good scare to get you to finish things, design a penalty for not completing a task like giving ten bucks to your office mate.

Be realistic when it comes to your expectations. Face it. Things are not always going to go as you plan. Deadlines get moved up; people get sick; appointments are missed — life happens. When the unexpected occurs, what makes the difference between a smooth recovery and huge issue is your ability to recover and make the changes necessary on-the-fly. Learning to adapt when things don’t go smoothly is critical for staying productive while busy. So never overpromise results and always give yourself enough extra time in case of a disruption.

Be kind to yourself. Whatever you do, don’t wind up pushing yourself too hard physically or emotionally. Control your stress levels, take care of your needs, and always remember there is still tomorrow.

Staying productive no matter is a skill even the most talented businesspeople isn’t born knowing is, but the tips above can help.

As a business owner, executive or manager, you may use a lawyer for many different reasons. You may need a lawyer to look over your business contracts, to help when you buy or sell a business, to help you with any tax issues that may arise or to help with any personal injury lawsuits that may arise within your business. Friday, November 2, 2018, is Love Your Lawyer Day. This is a day that is set aside to honor lawyers and all that they do for individuals and businesses. On this special day, you may be looking to celebrate your lawyer, but you may not be sure how. Here are a few of the different ways you can recognize and celebrate your attorney on Love Your Lawyer Day.

Give Them a Phone Call

One of the simplest ways that you can celebrate Love Your Lawyer Day is by giving your lawyer a phone call on this day. The phone call does not have to be long and the conversation does not have to be in depth. Simply let them know that you appreciate the work that they are doing for you and you are grateful for the services they provide. A simple compliment and nice words can go a long way in brightening someone’s day and making them feel appreciated.

Send Them a Card

If you do not like to talk on the phone or you want to send something to your lawyer, you can send them a card. A thank you card or other similar note that lets them know that you are thankful for their hard work has the same impact as a phone call that praises them. If you want to do something a bit more than a card, you can always include a gift card to their favorite coffee shop or restaurant, or you can send flowers along with the card.

Post a Positive Review Online

Online reviews are important to businesses. When someone is seeking out a lawyer, they may do a Google search to see feedback on an attorney or law firm. You can help the lawyer who helps you by leaving a positive online review for the attorney this Love Your Lawyer Day. Unless we are mad or upset, many of us do not leave online reviews. Take the time to let other people know just how wonderful your attorney is and all of the positive things they do for your business.

Order Something for Their Business

Another gesture you can make when you are looking to celebrate Love Your Lawyer Day is to order something for their business. Have you ever spent time with your lawyer and noticed that they don’t have something that could help them get a little more organized? Or have they complained that they recently lost or misplaced something? It can be as simple as a business card holder or a Bluetooth speaker for their work desk. Personalized gifts that you put thought into are always appreciated.

Have Lunch Delivered

Speaking of items that are always appreciated, the last way you can celebrate Love Your Lawyer Day is by having lunch delivered to your lawyer. Who doesn’t love food being delivered right to their desk? If you know what kind of food your lawyer enjoys, consider ordering them a meal and having it delivered. Give them a heads up that you have a treat arriving and at what time to make sure they will be in the office though before you place the order.

This Friday, November 2, 2018 is Love Your Lawyer Day. This is the perfect day to recognize all of the hard work that your lawyer is doing for you or your business. There are many way you can recognize your lawyer, including giving them a phone call, sending a card, posting a positive review online, ordering something for their business or having lunch delivered. No matter how big or small, take the time to recognize your lawyer and let them know how appreciated they are this Love Your Lawyer Day.

We’ve read the hype about algorithms before. Now we’re reading the hype about artificial intelligence. Much of the real-world work falls under the umbrella of trade secrets, so we have very few examples of either making a difference. A health system in Wisconsin gives us a glimpse into a real-world application with some very positive results.

How Prevea Health Used Algorithms

Prevea Health is a large multispecialty practice with a rural patient population. It has 350 primary care physicians and specialists, 46 health centers, and it runs 26 employer-based clinics.

Many of its patients do not have an established relationship with one provider. Prevea Health was looking for a way to allow patients to schedule appointments 24/7/365. What it wanted was one solution that handled patient-driven appointment scheduling and directed the patient to the right provider. It also wanted the solution to produce enough data to allow redesigning patient and provider flows to eliminate inefficiencies and reduce costs.

Prevea worked with DocASAP to develop a system which allows patients to schedule appointments after querying them about their health needs. DocASAP handles a number of different scenarios.

Prevea found that in one of these, patients were coming to their providers through a Google search. If they click on the link (provided by DocASAP) for the individual provider’s booking, they are taken directly to the scheduling module. If not, they are queried about their health needs. This allows DocASAP’s algorithm to pick a set of providers and locations for them. It takes the patient to that provider’s scheduling page once they have selected one. Depending on the patient’s initial responses and provider preferences, the patient may be asked to provide additional information.

The database that is produced as a result of this scheduling process allows Prevea’s analysts to looks at the patient flows that are generated so they can continuously refine the algorithms to get the patient to the right provider. Once the appointment is booked, the patient gets appointment reminders as well.

Is the algorithm working? Prevea’s no-show rate has been driven down to four percent, which is very low and compares to a national average of 18 percent. Thirty-eight percent of appointments are booked after hours. While other metrics are still under development, it certainly looks like the effort is producing results.

What Can We Learn From The Prevea Experience?

“Information engineering” refers to the process of asking what information is flowing into an organization, who is getting it, what is being done with it, what the results are, and how the process can be improved. In this case, information is flowing into the system.

The patient needs an appointment for problem X – and flowing out – here are the providers best suited to treat him/her. The available appointment times are presented. The results of those two information flows generate data that Prevea can use to fine-tune the process and to provide further services, such as reminders. One of the lessons learned is that patients, when provided with the right information, will usually pick providers who are the appropriate ones to treat their problems.

The fact that a patient does not need to interact with the provider’s office staff is another advantage. Office staff may or may not be qualified to assess things like:

• Whether the reason the patient wants to see the provider is appropriate
• Whether the provider handles that sort of problem
• Who to refer the patient to

The algorithm, in contrast, knows all of this, and provides the right information without bother. If there are problems in the algorithm, they can be detected in the data generated, and the algorithm can be refined. Try doing that with a medical office staff and dozens of physicians.

The one possibly problematic link in the whole setup is the integration with Google. That makes a lot of sense if Prevea knows that a majority of its patients will use the system. But it has to rely on DocASAP to create and place the appropriate links to its scheduling system on its Google page. What about Bing or Facebook? Apparently, they are not integrated with the system the way Google is.

Conclusions

Scheduling is a major time-consuming operation in physicians’ offices. When the patient is in the wrong location, the office staff has very little ability to get them to the right one. Prevea and DocASAP have solved that problem by building the referral process into an algorithm. Judging by the no-show rate, it works. The weak point is its reliance on Google.

Pregnant women often suffer with blood pressure problems. One of the responses to this is to have the patient return to their primary care physician or OB-GYN after birth for at least one blood pressure check. High blood pressure is common after pregnancy and is a frequent reason for readmission after delivery.

How Can We Change The Way We Handle This?

The University of Pittsburgh Medical Center (UPMC) and its affiliated Magee Women’s Hospital have found a solution. Send every patient who has had blood pressure problems home with a blood pressure monitor and text them on their smartphones, prompting them to measure their pressure and report it.

The information goes to a team of nurses who triage the problem and let the women know if they should keep monitoring it. They can also let them know if they should see their physician or go to the emergency room. This information is fed to the EHR system so that medical staff always knows what the results of the home monitoring were.

UPMC saw this as an opportunity to expand their existing chronic disease monitoring programs, which use similar concepts for those with chronic obstructive pulmonary disease (COPD). The period of monitoring for postpartum patients with blood pressure problems is about six weeks.

It is well integrated with the nurse call center and the electronic health record system. It is noteworthy that UPMC-Magee has achieved success through the use of futuristic wearable or implantable monitors and automatic telemetry with a simple blood pressure cuff and a smartphone. The ingenuity went into the parts of the system that had to work together, not just the technology. The pilot phase of the program, which involved 60 patients, was judged a success.

Both unnecessary visits to providers and visits to the emergency room were reduced from the baseline. The same framework is being considered for patients with gestational diabetes. Slightly more than half of the women were able to avoid their scheduled one-week visit for a blood pressure check, and 80 percent showed up for their scheduled six-week postpartum visit, compared to 30-40 percent nationally. The program not only reduces needless encounters but also appears to have a very positive effect on compliance.

What Are The Lessons Learned?

The UPMC-Magee personnel involved in creating the program stress most of all that such approaches have to be a team effort. Everyone at every level has to be involved in the planning and efforts. It is also important that, as the program is rolled out, everyone involved feels free to report when things are not going well.

Particularly with programs in development, it is important not to let dismissal of concerns “bake in” methods and approaches that are just not functional.

The other prominent lesson is that one can get high-tech results with low-tech means. Rather than waiting for the development of wearable or implantable automatic monitors, the team decided that the current generation of automatic blood pressure cuffs was more than good enough to give them the information they needed.

Text messages on smartphones and their already-existing patient portals were more than good enough to allow for effective communication. So a program that is futuristic in its results got implemented now, rather than twenty years from now.

Information Engineering: A New Way To Think About Processes and Procedures

Generally, this effort is another attempt to apply “information engineering” to the daily operations of a healthcare provider, admittedly in a limited area. The team realized that a large number of visits were being done for no reason other than to obtain information (the blood pressure), and that this was a very inefficient way to do it. It required a high level of patient effort and compliance.

They also saw that existing technology was sufficient to get them the same information at a much lower cost. What was done under the old system once the information was obtained? If the results were normal, nothing. If they were abnormal, it depended on the provider.

UPMC-Magee replaced this with an algorithm, developed specifically for nurses in their call center, to tell patients to do nothing, see their provider, or go to the emergency room, depending on the information gathered. This led to information dictating actions in a clinically relevant, evidence-based way. Finally, the team made sure that the information was not lost; they interfaced it directly with the existing EHR.

Conclusions

To sum up, the lessons from this project can be characterized as these:

1. Ask what you’re doing with the information. Why are you collecting it? Who is acting on it, and why?
2. What happens when they act? Is what happens what you want to happen?
3. If not, how can you change the information flow to produce the outcomes you want?

Applying these questions to the fields within medical care is likely to produce a number of positive changes. We have the technology today to provide better medical care at lower costs, but many organizations seem stuck doing things “the way they’ve always done them.” This results in poor efficiency and inflated healthcare costs.