Monthly Archives: March 2015

Week Eleven 3/29 to 4/4: Characteristics of Innovators and Change Agents in the Healthcare Sector


Innovators and Change Agents

This week we will talk about those who innovate and change. When I hear the words innovator and change agents, I immediately think of people who think outside the box to make necessary changes. They are the producers of the world; and they have the uncanny ability to lead and inspire others. They are true visionaries. Obvious people (to me) who come to mind are Steve Jobs, Bill Gates, Florence Nightingale, George Washington, and Barack Obama.

Innovators in the Healthcare Sector

Innovators in the healthcare sector have a hard job of leading those to accept new ideas. When it comes to health, many people don’t like change. Speaking of change, the person who chanted that word in the year 2008 was Barack Obama. He is a perfect example of an innovator in the healthcare sector. Although the Affordable Care Act (2010) has its fair share of opposition, it was President Obama’s primary platform; and he campaigned heavily for the bill to pass. His vision was for every American to have affordable, quality healthcare.

An interesting addition of the ACA was the creation of the Innovation Center (section 3021), which is a component of the Centers for Medicare & Medicaid Services. It was formed by Congress to perform the following :

  • Evaluating new payment and service delivery models
  • Evaluating and advancing best practices
  • Engaging stakeholders to participate in developing new models for testing (Centers for Medicare & Medicaid Services (CMS), n.d.)

This agency was created to assist in developing and evaluating methods to provide high quality, lost cost care for medicare beneficiaries. It would be interesting to see a productivity report since its inception. I did find a new ACA initiative (2-12-2015) for better oncology care that was developed from feedback from the oncology community, patient advocates, and the private sector (CMS, n.d.).

linda lopez

Change Agents and Death with Dignity

In the state of AZ, former Representative (and former State Senator) Linda Lopez introduced the Aid in Dying bill multiple times. Lopez was a supporter of the bill due to her own father dying an uncomfortable death (Fifth Freedom Foundation, 2003). Although the bills never passed, it shows the tenacity Ms. Lopez had; and her passion about supporting a cause she believed in (from her own personal experience). Regardless of your party beliefs, It is refreshing to observe a politician who rallies behind a cause (and not for political gains).


Final Thoughts…Innovate and Lead

I invite you to listen to the following TED talk by Simon Sinek. It may inspire you to be a change agent. What is your Why?



Centers for Medicare & Medicaid Services (n.d.). About the CMS innovation center. Retrieved from

Centers for Medicare & Medicaid Services (n.d.). New Affordable Care Act Initiative to encourage better oncology care. Retrieved from

Fifth Freedom Foundation (2003). Newsletter. Retrieved from

Simon Sinek (2009, September). How great leaders inspire action. Retrieved from


Week Ten 3/22/15 to 3/28/15: Change Theory


Kurt Lewin and the Change Theory

Kurt Lewin  immigrated from Germany to the United States in the 1930s; and dedicated his entire career on the study of human behavior. He was deemed by his peers as the founder of social psychology (The Atlantic, 2015). During World War II there was a meat shortage; and the government needed help. Their goal was to change the eating habits of stateside Americans in consuming (the plentiful) organ meats instead of the popular (familiar) cuts of meat that were in shortage. This was a difficult task since the majority of Americans considered organ meats as taboo and a marker of poor social status (The Atlantic, 2015).

The way Lewin (and his partner in the experiment, Margaret Mead) approached this task was to understand the reason why people avoided organ meat; and the answer they came up with was unfamiliarity (The Atlantic, 2015). Meaning, if people are unfamiliar with what organ meats are then why would they consume it? The first step in familiarizing the public was in titling organ meat as “variety meat” and deeming one “patriotic” for eating variety meat. Also, print campaigns, community group cooking lessons and cook books (to teach how to prepare variety meats) were heavily marketed by the government to propagate the variety meat message (The Atlantic, 2015). Did the variety meat experiment work? Well, it did last throughout the war; and helped the meat shortage efforts, so it those terms it was successful.

This type of work led Lewin to creating his Change Theory (1947) that was a three-step model in organizational change:

  1. Unfreezing Stage: Those in a group need to unfreeze or let go of old ways (or prior thinking) in order to accept the new change.
  2. Change Stage: This stage is the actual change in the groups thoughts or behaviors; and the movement into the intended change.
  3. Refreeze Stage: This is the final stage which is cementing the change as now permanent (Burns, 2004).

change theory

How Does the Change Theory Apply to Death with Dignity?

This post began with a meat shortage story; and now I am asking you to apply this to the Death with Dignity law. Seems odd, but the point of the meat story was to highlight the importance of understanding your audience before broaching the word change. For most people, change does not come easily; and it can be a slow process. For instance, Death with Dignity was passed in Oregon in 1997. Here we are, almost two decades later, still trying to convince people that Death with Dignity is a good idea.

In Arizona, the Change Theory would definitely need to take hold in the state government. This will take an aggressive legislator to campaign for the bill; and to convince the majority of voters that mentally competent, terminally-ill patients have the right to choose how they want to die.


How can one person start change? In past posts, I have mentioned a grassroots movement starting through organizations like the Death with Dignity National Center. These dedicated volunteers have been campaigning and educating people across the country on what Death with Dignity means; and how others can be involved. This movement has been effective and there are many states that have drafted bills that mimic the Death with Dignity law in Oregon (e.g., New York) (Death with Dignity National Center, 2015).

Like I stated with the meat story, it is a good thing to familiarize and educate people about your mission; and hopefully change will come.


Burnes, B. (2004). Kurt Lewin and the planned approach to change: A re-appraisal. Journal of Management Studies, 41(6), 977-1002.

Death with Dignity National Center (2015). Death with dignity around the U.S. Retrieved from

The Atlantic (2015). The World War II campaign to bring organ meats to the dinner table. Retrieved from

Week Nine 3/15/15 – 3/21/15 Policy Governing Access to Data and Privacy Protection in an Electronic Age


HIPAA and Privacy Protection

Privacy protection in the healthcare world revolves around the acronym HIPAA. It is a term you hear often from patients to providers, but what exactly does HIPAA entail? To start, HIPAA stands for the Health Insurance Portability and Accountability Act (1996). Below is a quick summary of some key points:

  • Protection of healthcare coverage in terms of job termination, divorce, separation, etc; and coverage regarding preexisting conditions.
  • Privacy and rights protection through the creation of Protected Health Information (PHI).
  • PHI must be observed by health care providers (e.g., physicians, pharmacists, nursing homes, clinics, etc), health plans (e.g., insurance companies, Medicare, HMOs, etc) and a health care clearinghouse.
  • National provider identifiers (NPIs) for individuals instead of social security numbers to ensure privacy and protection.
  • Patient access to medical records and the identification of those who can access the records; and the capability of making changes to medical records (U.S. Department of Health and Human Services, n.d.).

The one disclaimer about HIPAA: It is observed by those covered entities who conduct healthcare transactions electronically (Centers for Medicare & Medicaid Services, n.d.).

Privacy and preserving a patient’s rights are imperative in the today’s healthcare world. With the advancement of technology, patients are worried about who has access to their information.  Where the federal government ends with HIPAA and privacy laws, state laws are in place to take over. For instance, if state laws are more stringent in areas of privacy they will take precedence over HIPAA. Congress has mentioned a preemption of state privacy laws with a single federal health privacy standard, but a majority of politicians do not want to be associated with taking away citizens’ privacy rights (Pritts, 2007).


Privacy Protection and Death with Dignity

We all value our health; and most importantly we value keeping our information private. Most people do not want their medical history, lifestyle choices, lab results, prescriptions, procedures, etc., made public. This rings true for a terminal diagnosis. For instance, Steve Jobs, the genius behind Apple, kept his pancreatic cancer diagnosis a secret for some months. The media assumed it was because the diagnosis would have hurt Apple stock prices (CNET, 2015). Some terminal disease processes, like cancer, can bring a stigma that a person is weak; and those diagnosed are given a death sentence by public opinion. As a hospice nurse, I cared for patients who placed shame upon themselves for “giving up” for choosing comfort care in lieu of aggressive treatments. Regardless if a person chooses aggressive treatments, hospice, or death with dignity, the decision should be a private matter between the affected person and their loved ones.

Other Thoughts…About Rights…and Privacy

In the United States (U.S.) there is ongoing dialogue about respecting one’s rights. This week the focus was on the right to privacy in an electronic age. Supporters of Death with Dignity would say that people of the U.S. are being stripped of their human rights. Also, those participating in Death with Dignity are being condemned by opponents in a public forum. If one if choosing to end their life with dignity, shouldn’t we all respect their decision and privacy in this matter? I guess this is the ongoing debate (not only with healthcare rights) but also reproductive rights, gay rights, etc. The debate goes on!


Centers for Medicare & Medicaid Services (n.d.). HIPAA: General information. Retrieved from

CNET (2015). Jobs his cancer diagnosis for nine months. Retrieved from

Pritts, J. L. (2007). Federal efforts to impose uniformity on state health information and privacy laws. Health Law & Policy, 2007, 20-23.

United States Department Health & Human Services (n.d.). Understanding health information privacy. Retrieved from