Congratulations to Susan Bloomfield, Deborah Clark, Dina McKelvy and Lucinda White on their excellent article, Health Sciences Libraries, featured in the Maine Policy Review. The article highlights ways health sciences libraries support clinicians, work with patients and consumers, keep administrators informed of changing industry trends, health care regulations and the latest research, and support technology including mobile devices and EMRs. Read the article at: http://bit.ly/10VzkmI.

US Citizenship and Immigration Services (USCIS) is the US Government branch of the Department of Homeland Security responsible for providing immigration services and benefits. I am a community relations officer in our Northeast Regional office in South Burlington Vermont. My jurisdiction includes New England, NY, and south to VA and WV.

USCIS works with local governments, libraries and qualified immigration service providers to ensure immigrants receive accurate information about immigration benefits. To ensure health information providers are aware of USCIS and our resources, in addition to the attached I have prepared the following snapshot:

1) Need help with your USCIS forms?

You can file USCIS forms yourself, but many people choose to have help. You may need help writing in the answers to questions on USCIS forms or translating documents into English. You can get this type of limited help from anyone. This person should only charge you a small fee and not claim to have special knowledge of immigration law and procedure. Not sure what immigration benefit to apply for or which USCIS forms you need to file? Then you may need immigration legal advice. Only attorneys or accredited representatives can:

• Give you legal advice about which forms to submit
• Explain immigration options you may have
• Communicate with USCIS about your case

See: http://www.uscis.gov/legaladvice

2) Are you getting the right immigration help?

Many people offer help with immigration services. Unfortunately, not all are authorized to do so. While many of these unauthorized practitioners mean well, all too many of them are out to rip you off. This is against the law and may be considered an immigration services scam. If you need help filing an application or petition with USCIS, be sure to seek assistance from the right place, and from people that are authorized to help. Going to the wrong place can:

• Delay your application or petition
• Cost you unnecessary fees
• Possibly lead to removal proceedings

See:
http://www.uscis.gov/avoidscams
http://www.uscis.gov/eviteestafas

The attached “UPIL Brochure…” is available in several languages here.

In addition to reporting an immigration scam to your State Attorney General or Consumer Protection office anyone (including those reporting a complaint on behalf of someone else) can and should report immigration scams to the Federal Trade Commission (FTC). See:https://www.ftccomplaintassistant.gov/

More information on immigration is provided by the FTC here:
http://www.consumer.ftc.gov/articles/0142-immigration-help

Submitted by Ted Albers, USCIS Northeast Regional Community Relations Officer,
South Burlington, VT 802-660-5007 william.e.albers@uscis.dhs.gov

On Monday, March 25, 2013, I attended the Healthcare Experience Design Conference (hxd) in Boston, MA. The conference was attended by designers, technologists, product managers, researchers, entrepreneurs and patients who are passionate about improving the health care experience. This post is part two of a summary of the sessions I attended.

The Happiness Project

Gretchen Rubin, author of Happiness at Home and the Happiness Project, offered her advice for happiness. Her resolutions are to get enough sleep, get exercise, jump, and enjoy your sense of smell. She said possessions are a source of joy and frustration. She asks herself: Do we use it? Do we love it? Do we need it? Her key to happiness are strong, long term relationships. She declared “Happy families have fun traditions.” You can discover more about Gretchen Rubin’s Happiness Project, and her experiments in the practice of everyday life at: http://bit.ly/10a4QZU

Considering the Whole Individual

Alexandra Drane of the Eliza Corporation discussed the challenges of life and how hard it can be to make important healthy behavior changes. Certain concerns that are the root of health conditions, but rarely get discussed at the doctor’s office. These “unmentionables” include sex, drugs, and a crappy boss. She said the top health problems in the US are in fact stress, sleep, care giving, money concerns, lack of support, relationship problems. People who report 4 or 5 unmentionables have the most health issues. Buffers, such as a strong network of peers, spirituality, and exercise, help. Patients who felt more vulnerable were less healthy, and felt less powerful. Her message encouraged attendees to apply this information as an industry and to build programs that increase buffers like social supports, spirituality, and exercise. Learn more about the unmentionables at: http://bit.ly/WWF6kQ

Calming Technology

Neema Moraveji, from Stanford University, informed us that calm isn’t just about being relaxed. Calm is a restful alertness. He teaches a Designing Calm class at the Stanford Institute of Design. He led a guided meditation for the audience. He talked about Grok design, which means to understand or comprehend something. More on this at: http://en.wikipedia.org/wiki/Grok He recommended identifying stressors, mitigating stressors, and designing with avoiding stress. He showed a variety of student projects, including a meditation, relationship, and mindful eating apps. He showed us Breathwear, a new technology to stream breathing data to your phone.

Health Navigation

Dan Brousseau of Emperia, asked, “are we ready to innovate the healthcare experience?” He said innovative organizations embrace risk and failure, show a natural bias towards customer needs and expectations, demonstrate extraordinary levels of collaboration across function and discipline, and experiment. Service experience values make people feel comforted, involved, safe, trusted, and important. Using a customer transformation model, Emperia sought to improve the experience for customers and employees, raise efficiency of experience delivery and align service design with hospital strategy. They shadowed service employees, and discovered that it is the health navigators who determine the experience. Cultivating the health navigator experience created one central contact to help coordinate the clinical experience.

Patient Innovators and Instigators

A panel of three patients shared their health journeys and the tools they created to advocate for their health. Ken Spriggs, a patient with Crohns Disease was inspired by ePatient Dave’s Ted Talk (Give Me My Damn Data, http://bit.ly/YTLDtb). It inspired him to get all of his medical records and scan and make them searchable. Then, he compiled key data and charted it. The next patient, Lana asked what is needed – empathy, education, community and creativity. She cleverly mashed up social media sites to track her moods and maintain her health. She combined Social Me with Facebook to see what affected her moods, explored Four Square to see what places she loved the most, and used Instagram to card sort experiences. She left us with a powerful message – everyone can repurpose. Katie McCurdy shared her story of living with Myasthenia Gravis. She created a paper timeline of symptoms, medications and memories. She insightfully said, “memories are data, too”. Her closing remark encouraged us to assemble and visualize our patient stories.

Designing Work for Health and Profit

Martin Adler of Healthrageous, asked us, “Do we have a disease management problem or do we have a time management problem?” Since work is where most people spend the majority of our time, why not start at the workplace with healthy design solutions. He said the greatest health return is to reduce sitting time. He showed the workplace of the future, with treadmill and cycling desks. His vision for a healthy workplace includes increased access to windows and plants, access to free and convenient snacks, and a casual dress atmosphere to encourage more physical activity throughout the day. There was literally a picture of an elephant in his picture of the workplace of the future, which represented the possibility of sensors and tracking the health and physical activity of employees at the workplace. In my opinion, it would be great if more workplaces encouraged flexible work plans, gave daily wellness breaks, and provided healthy atmospheres with windows and plants. I’m not a fan of the tracking.

Patients Like Me

Jamie Heywood, chairman of PatientsLikeMe, delivered the final Keynote of the day. PatientsLikeMe helps patient share information on their health conditions to compare treatments, symptoms, and outcomes. It is a wealth of personalized research. He discussed different ways to measure medicine and interacting domains. He talked about the evolution of the site how measuring patients at the point of care for characteristics of intervention, environment, severity, and impact should be used to inform and help the next patient. http://bit.ly/16Y7WVT

Inspiration

I left this conference feeling inspired. I left with dreams for the innovation of the healthcare experience. I left with a deeper understanding of the complex issues at the intersection of design and the healthcare experience. Design is not just for designers. Design is for everyone. Design helps us understand what motivates people, how to call people to action, and how to create an outstanding experience. I highly recommend this conference for anyone interested in a cross-disciplinary exploration into improving the healthcare experience. Thanks hxd 2013 for an amazing experience!

By Michelle Eberle, Consumer Health Information Coordinator

On Monday, March 25, 2013, I attended the Healthcare Experience Design Conference (hxd) in Boston, MA. The conference was attended by designers, technologists, product managers, researchers, entrepreneurs and patients who are passionate about improving the health care experience. The conference’s tagline was “where healthcare and design intersect.” It was an amazing day full of insights on how to improve the health care experience. It made me reflect in new ways about the intersection of design and provision of health information. It made me think about how to take better care of my own health and the health of my family. I would like to share what I learned at the conference.

Reality is Broken, SuperBetter

In the Opening Keynote, Jane McGonigal, creator of SuperBetter, and the author of the book, “Reality is Broken: Why Games Make Us Better and How They Can Change the World,” shared how games can help solve the world’s most urgent problems, including hunger, poverty, climate change, and obesity. She wants us all to learn how can we take feelings from games and apply them to real life. She hopes we can take the superpowers we learn in games and integrate them in our lives and world. Superpowers from games – secret identify, power up, allies, bad guys, quests – teach us important life skills like how to take power of a situation, deal with trauma, bring support to our experience, become psychologically flexible, commit to action, and feel good every day. She said lessons learned in games strengthen positive emotions, make us happier, more confident, and more determined. View her inspiring TEDTalk, “Gaming can make a better world.”

Reader-Centered Design for Health Communication

Sandy Hilfiker and Molly McLeod of CommunicateHealth shared six strategies to create easy to use health websites and applications from the Office of Disease Prevention and Health Promotion’s Health Literacy Online Guide. Tips include: 1) Learn about your users and their goals; 2) Write actionable content; 3) Display content clearly on the page; 4) Organize content and simplify navigation; 5) Engage users with interactive content; and 6) Evaluate and revise your site. CommunicateHealth recommended involving users with limited literacy in formative research by partnering with community organizations to recruit special populations.

How to Design User Habits

Nir Eyal of Stanford University discussed how to use a hook to take people from states of low engagement to high engagement. He discussed the four parts of the hook – a trigger, action, reward and investment. He said, “habits aren’t created, they are built upon.” Some triggers are external, like alarms, calls to action, emails, stores, and authority. Internal triggers are in users heads. He discussed the Fogg Behavior Model and the six motivators of behavior. Nir referred to Skinner and how creating intermittent rewards increases response rate. Creating an endless search leads to rewards: for the tribe (social), for the self (mastery, consistency, completion and competency), and for hunt (food, money and information). Technology products that store value get better the more you use them. Eyal charged the audience to create preference and cultivate meaning.

Inclusion by Design

Dr. Ivor Horn of the Children’s National Medical Center and George Washington University School of Medicine shared that what matters is how we communicate with patients, families and parents. She said “trust and listening matter in the health and design process.” She taught two don’ts and one do. Don’t make assumptions. Don’t just take, give. Do collaborate. She told a moving story about how frustrations with helping her father navigate the healthcare environment inspired her to become a doctor to facilitate change. In her experience, parents who had a greater self-efficacy are the parents who talk a lot and ask questions. She said to always think, how can what I am designing help those that need help the most.

Health Behavior Change and Beyond: The Health Benefits of Success Experiences

David Sobel, MD, MPH, co-author of the book, “Living a Healthy Life with Chronic Conditions: Self-Management of Heart Disease, Arthritis, Diabetes, Asthma, Bronchitis, Emphysema and Others” asked us to think of a change we had made. What helped us make that change? Why did we make that change? He talked about roads to behavioral change including pleasurable change, breakthrough change, environmental change and incremental planned change. The key indicator to making a healthy behavior change is a sense of confidence, self control, and self efficacy. One approach to behavior change is to encourage patients to make small steps, which leads to a gradual increases in confidence, mood, and efficacy. He asked important questions: Do we really know what motivates people? Where should we focus? Which curve can we shift? How can we strengthen self-efficacy? His message urged participants to move beyond boring health education programs. He talked about Eliza’s research on the “unmentionables”—that what makes it hard to manage health conditions, and often results in them, are life issues like stress, sex, sleep and a crappy boss – the very things that don’t get discussed at the doctor’s office. There are many ways to increase self-efficacy including persuasion, modeling, cognitive reframing, and mastery experiences. However, many prescribe failure by their general, long term, unpleasant, and difficult delivery and nature. His recipe for prescribing success is to choose behaviors that are specific, personal, easy, rapid, and pleasurable. He urged the participants to celebrate successes. His three powerful final thoughts encourage us to: 1) Help people find their passions. Screen for pleasure. Discover what drives and motivates people. 2) Help people discover their own solutions. Ask – what do you think will work for you? 3) Celebrate successes! His final message — everything that feels good is not bad for you.

By Michelle Eberle, Consumer Health Information Coordinator