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#HIMSS14 Highlights: Enthusiasm for Patient Engagement

Patient engagement solutions abounded at HIMSS14, though their levels of sophistication varied. Like many other commentators, I felt this was a big jump in interest over last year. It will be interesting to see if this level sustains into 2015, and how the same products will mature come HIMSS15 in Chicago.

The theme of engagement was heard most loudly in several educational sessions I attended. I was happy to pre-register for an Orion Health / ePatient Dave event; and make time at the last minute to attend a live demo of the new Blue Button Connector, and a brief presentation by Regina Holliday, founder of the Walking Gallery.

I believe ePatient Dave (aka Dave deBronkart) has been at this awhile, but the Orion Health lunch and learn I attended was my first opportunity to hear him tell his story live. And what a compelling story it was! It certainly resonated with the audience of about 75, and I couldn’t help but wonder why he wasn’t up on stage in a “From the Top” session. The theme that ran throughout his presentation and audience questions was the need for online patient communities, and the subsequent need for providers to let their patients know about them. Websites like PatientsLikeMe.com and Sharecare.com were brought up as interesting resources.

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I headed from there to the exhibit hall, where HIMSS had set up a very nice learning gallery, complete with comfy chairs, swivel desktops and a nice presentation area. Lygeia Ricciardi spent a good 20 minutes going through the new Blue Button Connector website, which you can find here: http://bluebuttonconnector.healthit.gov/. While not a true, live demo, she did offer several screenshots, and was very forthcoming about the ONC’s plans and goals for the site. Apparently they see it as almost a marketing tool, similar to the Energy Star label you see on just about every appliance these days. The Blue Button symbol will hopefully come to be recognized as an endorsement of easy access to patient data. She was frank in saying that it’s not a panacea, but will be a powerful tool in the hands of consumers, and developers who choose to take advantage of its open source code and bake it into their own apps.

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It is literally a connector. The new website simply allows patients to connect to third parties that may house their medical records, such as payers, pharmacy, labs, physicians or hospitals, immunization registries and health information exchange portals. Knowing I already have a provider that participates in Blue Button via their athenahealth patient portal, I went through the “Physician or Hospital” steps to see how the Connector worked. I didn’t see my physician listed, so I’ll likely send an email to bluebutton@hhs.gov. The Connector is in beta right now, and Riccardi mentioned they are very interested in gathering as much user feedback as possible during this process, so I encourage you to check it out and drop them a comment or two.

I was back at the Learning Gallery the next afternoon to hear Regina Holliday of the Walking Gallery speak, and she did not disappoint. Like a preacher that just can’t stay in the pulpit, Regina passionately talked about the power patients have when they come together and demand change. It was my first time hearing her speak live and I was not disappointed. It was a powerful sight to see close to 30 Walking Gallery members stand up at the end of her session and show their jackets. Why they were not on a larger stage in front of a capacity audience is beyond me.

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That’s it for my notes from HIMSS. Next up on my conference dance card is the Healthcare IT Marketing and PR Conference, taking place April 7-8 in Las Vegas, and hosted by Healthcarescene.com. I hope to see you there!

March 7, 2014 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

My #BlueButton Patient Journey: PHRs & the Plight of Patient Surveys

Ah, the CAHPS Survey … how I love filling them out with a freshly sharpened #2 pencil. How I love digging through that kitchen junk drawer we all have to find a stamp. How I love placing that return envelope in the metal box at the top of my driveway (after I dust the cobwebs off, of course).

All jokes about the floundering postal system aside, my Blue Button patient journey has made me hyper aware of the potential for non-electronic processes to become digitized. In the case of patient satisfaction surveys, I ask not only, why not? But also, why hasn’t it already been done?

The CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey is produced by the Agency for Healthcare Research and Quality, and was designed to provide healthcare facilities with a way to measure and improve the patient experience. As an engaged patient (and a busy, working mom), my experience would be improved if I were offered the convenient alternative of taking CAHPS surveys online.

I realize I’m getting more into user experience than necessarily discussing the Blue Button initiative, but I feel the two are ultimately a means to the same end – more engaged patients, more effective care and better outcomes.

I think it would be great if I could check a box during the set up of my profile in the patient portal that alerts my provider to the fact that I do or don’t want to take surveys online. The paper option will still be preferable to some, but it would be nice to have the choice right off the bat. Perhaps this is already being done and I just haven’t experienced it yet in my neck of the woods. Let me know in the comments below if you’ve taken patient satisfaction surveys online, and/or via your patient portal, and if it was more convenient/easier to fill out.

In other news, I had a great conversation with David Goldsmith at Dossia about the evolution of that personal health record, which is currently being rolled out through employers. It seems like a really intuitive tool whose only hangup is keeping users engaged once they switch jobs and lose that connection to payer data that originally populated their profile.

Beth Friedman, founder of Agency Ten22 (a founding sponsor of HealthcareScene.com’s upcoming Healthcare IT Marketing & PR Conference), was kind enough to comment on one of my previous Blue Button blogs alerting me to AHIMA’s MyPHR.com, which provides information about getting started with personal health records. (I was happy to find that AHIMA has taken the Blue Button pledge, and has a section devoted to it at this site.)

I found the article, “Quick Guide to Creating a PHR” helpful. It was easy to understand and seems to be written for the average healthcare consumer. I’m surprised that it leans so heavily on paper-based processes, but that’s probably a first step that most people would be comfortable with before moving on to digital processes. I was disappointed that it didn’t offer suggestions for Internet-based PHRs. I’d feel more confident using a particular product if it was endorsed by an association like AHIMA. I’m hoping Beth will let me know if that’s something AHIMA plans to do in the future.

February 7, 2014 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Will Healthcare Ever Solve These Issues?

On James Ritchie’s post on EMR and HIPAA extolling the virtues of Patient Portals, Bill made the following comment:

I visited an ENT practice today for the first time. I was referred by my primary care physician. Guess what? NO PATIENT PORTAL! And this is a large multi-location group. Here’s the really strange part…they bought an EHR 10 years ago and are still using paper charts!!! Flabbergasted!

A couple of days ago, I went to their website, downloaded and filled out the forms. (Yes, I typed them). I then called the practice to ask if they wanted me to fax them so they could get my info entered into their system, the girl replied “no, that’s ok, we don’t create your chart until you get here”. That’s how I found out they are still using paper charts. Unreal!

When I arrived for my appointment today, (NOT 30 minutes early) I could tell the girl at the window was ready to jump on me for being “late”, until I handed her my completely filled out forms. She looked at me in utter amazement. She took my drivers license and insurance card (no, they did not have a scanner for either) so I didnt get them back until I was called back and the nurse gave them back to me. So I had to ask the doctor, “why are you not using your EHR”, he replied, “yeah, we need to start using it” He even commented that he couldnt remember any of his patients that actually typed and then printed the PDF forms. Am I the weirdo here?

Earlier, while in the waiting room, I sat and watched patient after patient go up to the window and get the “high tech” clipboard. They then sat down to fill out their forms…all the while stopping from time to time to text or perhaps reply to an email on their smartphones. The irony. I watched sadly as an older woman was trying to get the forms filled out with what appeared to be great difficulty because it was obvious she didn’t have all of the information with her that she needed. But she had a smartphone. More irony.

Just think if my primary care provider and this ENT group were both using EHR and PP. Perhaps I would of had to fill out NOTHING!! All of my info would of been readily available to the ENT doc. I could view the notes from both of the docs..see my reports and tests results and even forward it to another provider of care if necessary. The study is encouraging, but there are going to be so many benefits once PP’s become mainstream.

I responded to Bill with the following comments:

Such a sad story and far too repeated in healthcare today.

I’ve often said if someone could figure out a way for patients to not have to fill out those dang intake forms, they’d have a golden business. Turns out, it’s a really complex problem to solve because of how many parties are involved and the non-standard way they do it.

Yes, we still have a long way to go to solve even some of the most obvious healthcare issues.

January 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

My #BlueButton Patient Journey – Laying the Groundwork

After taking the Blue Button Pledge, my next step is to get proactive with my medical records. As I may have mentioned in a previous post, I currently see four different doctors throughout the year. Three of those offer a patient portal. Two of them are in the same practice, and therefore use the same portal. Confused yet?

I think the key to being an engaged patient is to first make sure I can log in to each of these portals. I create bookmarks for them as well. I also make sure I know how to navigate through them and that all of my information is correct and up to date. I take care of the first two items by either looking back at papers given to me during my last office visit, or calling my PCP’s office to ask for a pin code.

Once I’ve looked through my information in each portal (powered by Cerner and athenahealth, respectively), I decide to go even further by messaging my PCP to let her know how my visit to a specialist went. If I don’t let her know now, I might forget many of the details when I see her again towards the end of the year. While I’m in there, I decide to look at my past bills to see why I’m still getting one for a balance I’m pretty sure I paid at my last office visit.

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Once those details are seen to, I decide to check out the portal used by two of my other doctors because I seem to remember seeing a Blue Button icon on one of the screens during my last log in. Sure enough, there is a link to “View, download or transmit health data.” Clicking this link takes me to a screen where I can “Support the Blue Button® initiative by downloading your health data and storing it in your personal records.”

I hit download and save them on my computer, but then I’m left wondering, “Now what?” I suppose uploading them to a thumb drive and taking them to whatever provider I see next might be helpful. But I have the sneaking suspicion they’d still prefer paper. Since my PCP’s portal doesn’t offer a Blue Button link to download my data, I decide to message my PCP again to let her know I’d like to see this offered. I wonder if she’ll appreciate the comment, and if she’s gotten the request from other patients.

I feel like my next step should be uploading my health data into some kind of personal health record, but which one? Where do I even start when it comes to selecting something like that? Honestly, the data entry involved with PHRs is off putting to me, which is probably why I haven’t created one up to this point.

What has worked for you and your family? Providers, are there PHRs you find easier to work with (assuming you interact with them at all?) I’d appreciate any reader suggestions and advice you’d care to give via the comments below.

January 16, 2014 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

New Year’s Resolution: Take the #BlueButton Pledge

I rarely make New Year’s resolutions, but 2014 finds me ready and willing to finally take the Blue Button pledge. Perhaps my impetus stems from the healthcare I received in 2013 (more than I would have liked), and the fact that I have logged onto to at least two different patient portals (not including my kids’) that of course can’t communicate with one another.

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I’m even more anxious to give Blue Button a go after reading that the ONC has recently announced it is working towards incorporating the following Blue Button features:

  • the Blue Button Connector: a tool that will help patients find out which providers, health plans, and others offer Blue Button
  • OpenNotes, giving patients access to their providers’ notes
  • images such as EKGs
  • lab, medication and patient-generated data
  • vaccination records
  • Explanation of Benefits forms from payers and
  • a tool that will match eligible patients to clinical trials.

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As a patient, I decided to take the non-data holders’ Blue Button Pledge, whereby I “pledge to engage and empower individuals to be partners in their health through information technology.” I’ll do this by actively trying to bring all of my health data into one digital repository, and blogging about it along the way. Hopefully, I can paint a picture of how having this information at my fingertips benefits my care in some way. I already foresee it helping me to become more engaged.

I’ll also make it a point to bring up the Blue Button initiative with all of my providers. I’ll be interested to see who has heard of it, who thinks it’s a good idea, and who is so overworked they don’t have much time for it. Look to future posts for the nitty gritty of what it takes to actually gather disparate health data and put it in one place.

Have you taken the Blue Button pledge? How has it impacted your care, or that of your patients? Let me know in the comments below.

January 3, 2014 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Don’t Count on Your EMR to Master Patient Engagement

So said one tweet in the recent stream from the Health IT Leadership Summit, an event I’ve been heavily involved in organizing for the last 10 months.

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That particular statement came from the morning keynote by Jeff Arnold, CEO of Sharecare. Arnold, who also founded WebMD, spoke to the power of social networking and analytics as part of a broader patient engagement strategy. It was a sentiment expressed in nearly every session I attended that day, by hospital and vendor executives alike.

Perhaps I shouldn’t have been surprised by the importance engagement played in the Summit’s sessions and networking discussions. It’s certainly the topic du jour of industry media and seems to weigh heavily on the minds of healthcare providers. Everyone wants to know, how do we do this? How can we get patients to truly engage, beyond tracking a few numbers on the latest digital health gizmo? How can we get providers to engage as well? Sending and receiving secure emails is great, but effective patient engagement that directly affects outcomes could be so much more than that.

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If sessions and conversations at the Summit were any indication, the key will be to combine traditional patient data (like that found in an EMR), with data mined from social networks, and then filter that through big data tools for predictive analysis. Much easier written or tweeted about than achieved, I assume, but it’s a positive sign all the same.

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That’s very true, and I think you’d be hard pressed to find a CIO who says they DON’T care. After listening to several hospital executives speak at the Summit, I got the impression that they care immensely, but aren’t quite sure where to turn for technology and processes that will enable their organizations to interpret engagement data into actionable knowledge.

Take a look Storified Twitter insight from the Summit via “#HealthITSummit Sessions Spotlight Social’s Role in Patient Engagement,” and then let me know via the comments below which healthcare organizations seem to be heading in the right direction when it comes to social analytics and patient engagement.

November 14, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Study Suggests That Health IT Can Boost Doc Productivity

We’ve all heard stories about medical practices whose productivity crashed when they brought an EMR on board, for reasons that range from workflow problems to training gaps to problems with a wonky system.  But if the following study is right, there’s reason to hope that health IT will actually improve productivity over time, according to a story in Medical Practice Insider.

According to research published in journal Health Affairs, physicians with health IT on board will be able to serve about 8 percent to 15 percent more patients than they could without health IT tools. And in practices where doctors have higher levels of EMR or portal adoption, the spike could be higher, according to the research, whose team includes former national coordinator David Blumenthal.

Meanwhile, practices that adopt emerging technologies such as remote care could allow doctors to perform 5 to 10 percent of care to patients outside of the office visit, and 5 to 15 percent of care could be performed asynchronously, reports Medical Practice Insider.

Another study cited by the article, done by the National Center for Health Statistics, notes that EMRs can offer varied clinical and financial benefits, such as greater availability of patient records at the point of care. And adjunct tools like e-prescribing capabilities and the ability to retrieve lab results can save time and effort, the NCHS study concludes.

These studies are encouraging, but they don’t say much about how practices can manage the workflow problems that keep them from realizing these results. While I have little doubt that health IT can increase productivity in medical practices, it’s not going to happen quickly for most.  By all means, assume your medical practice will eventually leverage health IT successfully, but it won’t happen overnight.

P.S. In the mean time, take a look at this list of factors in creating satisfied EMR users. It might help you speed up the day when productivity climbs.

November 11, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.

AHIMA Plans To Promote Blue Button

This week, at its annual conference, AHIMA announced that it’s launching a drive to get its members and state organizations to push use of Blue Button technology.  The idea behind the push is to improve consumer access to personal health records, according to a report in iHealthBeat.

For those who aren’t familiar with it, the Blue Button dates to 2010, when the Department of Veterans Affairs launched the tool to help veterans access and share their personal health data in a standardized manner. Consumers who click on the Blue Button get human-readable personal health data in ASCII format.

Since its inception, both private organizations and federal agencies have implemented the Blue Button. According to ONCHIT, almost 500 healthcare organizations have joined the Blue Button Pledge Program, which encourages providers to make personal health records available to individuals and caregivers. Almost 80 million Americans can now access their health information through the program.

Now, AHIMA is encouraging wider expansion of Blue Button use. The association is urging members and state AHIMA chapters to inform employers, families, healthcare providers and other health professionals of the benefits of the Blue Button format, according to iHealthBeat.

This effort should be enhanced as providers move toward Blue Button+, the next generation of Blue Button efforts, which meets and builds on view, download and transmit requirements in Meaningful Use Stage 2.

Neither Blue Button nor Blue Button+ programs magically transform patient data into something everyone can see and use, but they’re steps in the right direction.

So, what’s the next step when Blue Button functionality becomes common?  Will it help patients manage their data, or is it unrealistic to expect them to download and transfer information? I think the jury’s still out on this one.

If nothing else, though, we can look too the Automated Blue Button Initiative, which will probably evolve away from ASCII into more universal standards like XML. I’m keeping my eye on #ABBI to see where that goes, for sure.

October 31, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.

Many US Consumers Would Switch Doctors To Gain EMR Data Access

Evidence continues to mount that consumers not only accept EMRs, but want to have access to the data they contain. The latest on this subject comes in the form of a new Accenture survey, which concluded that 41 percent of US consumers would be willing to switch doctors to obtain online access to their EMR data.

To get a sense of how consumers are responding to the EMR revolution, Accenture surveyed more than 9,000 people in nine countries.  The survey sought to assess consumer perceptions of their doctors’ electronic capabilities across nine countries: Australia Brazil, Canada, England, France, Germany, Singapore, Spain, and the United States. (The survey included 1,000 US consumers.)

Researchers with Harris interactive, which fielded the study, found that at present, roughly one third of US consumers (36 percent) have full access to their EMR. However,  57 percent of consumers surveyed are self-tracking their personal health information, keeping data on items such as their health history (37 percent), physical activity (34 percent) and other health indicators such as blood pressure and weight.

Other survey results suggest that consumers on something of a collision course with doctors when it comes to access to medical data. While roughly four out of five consumers (84 percent) believe they should have full access to the EMR data, only one third of doctors (36 percent) agree.  The same study found that the majority of US doctors (65 percent) believe patient should have only limited access to their records.

These results strongly suggest that sharing full EMR data with patients is likely to become common practice in the future. After all, it seems that engaged patients are most of the way there already, and will continue to put pressure on doctors to open up the kimono for the foreseeable future.

P.S.  This data dovetails nicely with another recent report by independent research firms Aeffect and 88 Brand Partners which concludes that almost 50 percent of patients take EMR access into account when they consider choosing a  healthcare provider.

September 17, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.

Putting Paper Charts into Perpsective

It was with a sigh of relief that the nurse at my daughters’ new pediatrician’s office handed me my youngest’s immunization records just minutes after I requested them. This was her first well visit at the new doctor’s office, and I wasn’t sure how easily everything would transfer over from her previous doctor. Thankfully, the nurse was able to pull them up within seconds via their EMR, and I was happy to see they were in a format I could easily understand. The fact that my youngest had previously seen a pediatrician within the same health system certainly helped record retrieval.

I had to jump through quite a few hoops to make sure my oldest’s were faxed from the old provider to the new provider. Consent and release forms had to be filled out and faxed. Multiple phone calls had to be made to each provider. It was just so time consuming! Oh, how I look forward to the days when health information exchange can make this process a little easier.

For all the complaining and nit picking I might do when it comes to the absence, delayed use  or misuse of electronic medical records, I (and pretty much everyone else in a first-world country) really have no reason to bellyache. This realization was driven home when I came across a recent Bill & Melinda Gates Foundation blog by Orin Levine. The title, “Records for Life: Saving Lives by Design,” made me think I was about to read an opinion piece of the importance of user experience in EMRs. The subject turned out to be much simpler, and so much more important, than my initial impression.

Levine, who provided aid in refugee camps while working for the CDC some years ago, was astounded that more than 60% of parents in the camps had their children’s paper health record with them. “What struck me was that these mothers and fathers,” he writes, “who were able to bring so little with them when they fled their homes, chose the child health record as one of the few possessions to take.”

His observation certainly puts things into perspective. How many of us would grab the folder filled with our children’s medical history, rather than the scrapbooks gathering dust in some rarely opened chest? Many of us, I’m sure, would assume these records are resting safe somewhere in the cloud, waiting to be accessed at our convenience.

Things aren’t so simple in other parts of the world, and it comes as no surprise that developing countries still rely on paper charts.

“These cards are particularly important in the developing world,” Levine explains, “where electronic health record systems are almost non-existent. Historically, these cards have been developed for national immunization programs by health care providers who have little, if any, design experience to maximize the cards’ utility.”

Perhaps the next time we watch our providers suffer through an extra mouse click, or toggle back and forth between screens, we can remind ourselves – and them – how fortunate we are to be receiving care with a roof over our heads and records at our fingertips.

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The Bill & Melinda Gates Foundation is launching an international contest to redesign the child health record. Guidelines for the contest are available here.

June 6, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.