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Your Front Desk Is You

Posted on January 30, 2018 I Written By

Is your front desk welcoming, or repelling your patients, your customers?  Yes, patients are your customers, they are the ones that create your income by coming to your practice.  And whom do your customers first encounter” Your front desk staff. Are they a reflection of what you want your practice to be, representing you, or are they something you really don’t want to think about, low paid, marginal help that you have to have? High turnover, “you can’t get good help”, not worth paying more than minimum wage, staff?

That glass window that you installed for HIPAA privacy in the patient’s view is a device that allows them to hide from their view, to avoid eye contact, avoid dealing with them, the patient. Behind the glass window, are the people that greet your patients, expected to make them feel “welcome”, instruct them on the necessary registration materials to be signed, and most importantly, set the tone, and culture of the office for your patients?  This is critical to your practice’s success.

Such people should be a positive contact point for your practice, yet a study published in the Journal of Medical Practice management reported that 96% of patient complaints about a practice have to do with customer service. It’s not the clinical care, the physicians care, but how they are treated in the experience of visiting your practice.  And the first point of contact in the office is your front desk staff.

Is Your Practice Perfect or Does It Need Improvement?

Now you need to look at your scheduling process as well to see if that is a point of friction, online or by phone, but the human aspect once in the office is your front desk staff.

How is the reception configured, and how are the staff trained?

If that glass window is a barrier that hides the staff, that allows them to ignore the patients, then your message is that they, your customers are secondary to everything else.  If the patient has to ring a bell or tap on the window, or even read a hand-written sign that says sign in and take a seat, this is for the benefit of your staff, not your patients.  Now if you have an alert on the door when it opens and that signals staff to open the window and welcome the patient, inviting them to start the registration process, you have a very different tone to kick off the patient visit.

And that welcoming staff person has to be hired for personality, a welcoming personality, and then trained to do the job, the tasks that need to be performed at the time of registration.  Even if it requires more than minimum wage to fill the slot, the right person sets the cultural tone for the office and set you as the physician up for a better encounter with the patient. The glass window when opened, should not be to simply thrust a clipboard into the hands of the patient saying “fill these out”.  The exchange between your staff and the patient would be welcoming and appreciative.  In other words, make the exchange about the patient.

Take a look at your waiting room as well, is it inviting, clean, up-to-date, and comfortable? If not, take some time to make sure your waiting room reflects the kind of quality care you provide your patients.

About Alex Tate
Alex Tate is a Healthcare IT Researcher and writer at CureMD who focus various engaging and informative topics related to the health IT industry. He loves to research and write about topics such as Affordable Care Act, Electronic Medical Records, revenue cycle management, privacy, and security of patient health data.

Ensuring Patient Comprehension

Posted on October 31, 2017 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Erin Gilmer recently posted a very interesting “Literacy Comprehension” form from an Endoscopy Center. Check out the form below:

You have to applaud this effort by a practice to make sure that the patients understand the information being presented to them as part of the procedure. The cynic might argue that the clinic is just trying to cover their backside. However, Erin asks the more important question, “Is this an effective way to prove comprehension?”

I do like how this can open the patient up to the option to have a discussion about something they don’t understand. It sends a good message to the patients in that regard which could make the patient feel more appreciated and help the patient feel comfortable asking a question about something they would have just previously kept to themselves.

However, for those that aren’t literate, I don’t think this form will do much. I expect that many patients that aren’t literate likely get into a zone where they just sign whatever the medical practice gives them regardless of what it is and regardless of whether they can read it or not.

I think the idea is a good one but could be executed better. Could this be done verbally and have a bigger impact? What other ideas have you seen implemented? Do you like this approach or are their better ways to accomplish it?

Better Performing Practices More Efficient with IT Spending According to MGMA

Posted on October 23, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

The Medical Group Management Association (MGMA) recently released its 2017 MGMA DataDive Better Performers data, a report that provided a glimpse into the health of US medical practices across four key performance categories:

  1. Operations
  2. Profitability
  3. Productivity
  4. Value

Of the 2,941 physician practices that provided their performance data for the report, only 32 were found to be “better-performing” than their peers in three of the four categories. No practice was considered better-performing on all four categories.

For a deeper dive into the report, check out this post from Anne Zieger.

The report’s most surprising results were in the Operations – Information Technology category:

  • Physician-owned practices spent more than 2x on IT Per FTE Physician than their hospital-owned practices
  • Better performing physician-owned practices spent LESS on IT than their peers
  • Better performing hospital-owned practices spent MORE on IT than their peers

At first glance these results run counter to what many would expect. How could independent physician practices be spending more than 2x hospital-owned practices on IT – especially when you consider that a hospital has many more IT systems and applications.

To help make sense of the results, we sat down with David N Gans, MSHA, FACMPE – Senior Fellow, Industry Affairs at MGMA.

Why are hospital-owned practices spending less overall on HealthIT?

Gans: The raw numbers that we received from the practices was a bit deceiving. What we found was that not all IT costs borne by the hospital are filtering down to the practices owned by that hospital. Server costs, IT department salaries, support costs and network infrastructure costs, for example, did not appear as line item costs for the practices. Only equipment and the EHR licenses used by the practice’s staff were considered IT costs. Independently owned practices, however, bear all the costs associated with IT including licensing, servers, support and ongoing maintenance. Thus, it only appears that hospital owned practices are spending less than their counterparts. It is a quirk of the way costs are allocated in a hospital setting.

Why are better performing physician-owned practices spending less on HealthIT than their peers?

Gans: The scoring system we used for this report rewards efficiency. The more efficient you are in any category, the higher you will score. Using that lens, practices that were more judicious with their IT spending achieved higher efficiency scores. What you are seeing in the report results is an associative effect – the more effective you are with IT, the more efficient your practice is considered.

Gans was quick to point out that the survey did not measure the impact of or the outcomes achieved from the implementation of HealthIT. There was also not linkage between overall IT spend and practice profitability.

Why is it important that practices strive to be efficient. Isn’t that an antiquated notion?

Gans: It’s actually more important than ever for practices to focus on being efficient. If you go back to 2001 and look at three key economic indices it becomes painfully obvious why efficiency is the key to practice survival. Just look at this chart we have compiled:

The red line is the % increase in practice operating costs per FTE Physician relative to what it was in 2001. By 2020, costs will be 116.7% of what they were in 2001. The blue line is the consumer price index. The green line is the rise in Medicare reimbursements. There is no way a physician practice can stay in the black without taking a serious look at their operational efficiency. If you do nothing, costs will eat up your practice.

Gans is hopeful that new technologies and changes to the reimbursement mechanisms will help reduce the performance gap for practices. According to Gans, Artificial Intelligence, like IBM’s Watson, could make practices exponentially more efficient. It can crunch numbers much faster than a human ever could, which would allow physicians to offer more personalized care or care via less expensive channels (ie: telehealth).

“One thing is clear,” says Todd Evenson, Chief Operating Officer at MGMA. “As we change from volume to value, the financial metrics we track in this report will have to change. We will need to de-emphasize the production-style metrics we have used in the past to more value based ones. We will also need to find a way to measure the quality of care provided by practices. This will make this report even more important and relevant in the years to come.”

WorkFlow Wednesday: Patient Satisfaction and West’s Patient Experience Survey

Posted on July 5, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

Providers can improve patient experiences and revenue. So much of what improves satisfaction is outside the clinical setting.  West’s Insights and Impact Study titled “Prioritizing the Patient Experience” examines the gaps in patient value perception in the current healthcare marketplace.

West recently conducted a survey of patients providers to get more insights into what patients and providers value.  With value based payment models and consumer focused health providers are increasingly motivated to provide high quality service. Today’s patient is more aware of choice in provider options and will shop around for a provider that matches their needs.

Patients and Value Based Care Provide More Awareness of Choice in the Healthcare Marketplace

Patient experience using current technology and workflows is the space West has been working in for 25 years, including patient reminders for large hospital systems. As a company that specializes in patient experience, they used an outside firm to get insight about how well provider and patient perceptions were aligned. It was impressive to see an engagement company practicing what they preach and being proactive about feedback and improvement.

The most interesting takeaway from all of the statistics and research and report is that we know what the drivers of a good experience are. If you ask patients and providers what their motivation are answers are not usually aligned. This gap in what providers and patients value in terms of healthcare experience can cost providers revenue and patients. Patients value a high level of communication and transparency about cost of care more than providers believe.

Looking at the study, 78% of patients with a Chronic condition are likely to say that their provider cares about them as a person. Personally I’ve experienced this with my son that has a Chronic condition. We researched providers to ensure that we had similar values about communication and follow-up. Social Media groups like mom groups on Facebook have a lot of feedback about provider value. I know his provider gives great care and cares about him.

Patients with a Chronic Condition are Likely to Receive Personalized Care.

My Takeaways From the West Report

  • Current Systems do not always create a seamless workflow. Smooth workflow and patient communications improve patient experience.
  • Patients really want to know about what to expect in appointments. Sending a notification about costs including copays and obligations improves patient satisfaction.
  • Wait times are a huge cause of concern for patients. Electronic messaging or text information about waits can improve patient satisfaction even in cases where delays cannot be avoided.
  • Making payment as easy for patient as possible improves patient healthcare experience. A reminder about a bill with information about how to pay will improve practice revenue and patient experience.
  • Simple workflow improvement and automation improves clinical outcomes and patient retention in an increasingly consumer aware healthcare world.
  • Providers can focus on using the technology to better measure that for further strategy for improvement.

Well developed workflow can ensure that physicians have fewer patient surprises. Rather than waiting for an HCAP you can proactively collect data and brief surveys on specific topics before you are doing emergency triage. Contact recently discharged patients via an automated phone message or email. Have the questions tie back to HCAP survey questions so they can see what they will get.

What can systems do? Select Key measures for patient satisfaction.

What can physicians do? Tell patients that what to expect.

West is following their own advice and getting feedback about the value of communications and technology The survey is a connector for patients and for technology companies in the HealthIT space. Great ideas about Workflow improvement and best practice for business from West.

The report can be accessed online here and these key takeaways and is a great read for providers.

Retail Clinics Are Not the Enemy, Inconvenience Is!

Posted on June 16, 2017 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Check out this incredible insight that Gabriel Perna shared on Twitter:

What a great insight and something that most of the entrenched healthcare people don’t understand. Retail clinics are not the enemy, inconvenience is.

In many ways, it reminds me of the approach that taxi cabs took to Uber and Lyft. Taxis described them as evil as opposed to understanding why consumers wanted to use Uber and Lyft instead of a taxi cab. If the taxi cab industry would have understood the conveniences that Uber and Lyft provided customers, they could have replicated it and made Uber and Lyft disappear (or at least they could have battled them more effective than they’ve done to date).

Gabriel Perna further describes the issues of retail clinics and AMA’s approach to retail clinics in his article and this excerpt:

There are many reasons for this phenomenon [growth of retail clinics], but more than anything though, retail clinics are convenient and many physician offices are not. Because of this, the AMA shouldn’t be trying to treat the retail clinics as some kind of foreign invader, but rather use their rise to prominence as a way to guide physician practices forward. For instance, getting in to see a doctor shouldn’t be a three-week endeavor, especially when the patient is sick and needs attention immediately. However, that’s what has happened. Personally, I’ve been told “the doctor doesn’t have anything open for at least a month” more times than I can count.

It’s simple supply and demand. If you or your child needs to see someone immediately because of an illness and your doctor’s office can’t take in you for a week, and there happens to be a retail clinic down the street, guess where you’re going? Any hesitations you may have over your care being fragmented, the limited ability of your retail clinic physician, or anything else will go out the window pretty quickly.

I agree completely with the idea that convenience is key. However, what Gabriel doesn’t point out is that the fact that doctors have a 3 week waiting list for patients is why they don’t care about offering convenience to their patients. They have enough patients and so they don’t see why they should change.

You can imagine the taxi cab industry was in a similar position. They had plenty of people using their taxi service. They didn’t see how this new entrant could cause them trouble because they were unsafe and whatever other reasons they rationalized why the new entrant wouldn’t be accepted by the masses. Are we seeing the same thing with retail clinics vs traditional healthcare? I think so. Will it eventually catch up to them? I think so.

What’s even more interesting in healthcare is that retail clinics are just one thing that’s attacking the status quo. Telemedicine is as well. Home health apps and sensors are. AI is. etc etc etc. All of these have the potential to really disrupt the way we consume healthcare.

The question remains: Will traditional healthcare system be disrupted or will they embrace these changes and make them new tools in how they offer care? It took the taxi cab industry years to adapt and build an app that worked like Uber and Lyft. However, it was too late for them. I don’t think it’s too late for healthcare, but it’s getting close.

Finding New Patients for Your Practice

Posted on May 9, 2017 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In many practices, one of the biggest challenges they face is finding new patients for their practice. In some ways, technology has helped the situation, but in many ways technology has made this a real challenge for doctors.

Some recent data from Accenture Health provides an interesting look at one element of how patients find a medical practice.

When I saw this number I was shocked that it was so low. In the past, this number has been so much higher since finding a doctor from your health insurance company was the simple, logical way to make sure you were choosing a doctor which would take your insurance. Times are a changing.

When you look at the full report and the graph on how people find doctors, we learn even more:

Coming as no surprise is that highly digital patients leverage social media, internet searches and health websites to find a doctor at a much higher rate than those whom are less digital. However, what’s shocking to me is how much less the highly digital patient trusts the medical professional versus those that are less digital.

Not surprising is that friends and family is one of the most important factors for finding a doctor regardless of digital skills. Of course, it’s worth noting that in many cases, social media is really synonymous with friends and family. Social media is just the next generation of friends and family influence and communication.

What’s important to realize about these charts is that patients are quickly shifting from the less digital to the more digital category. So, 5 years from now we’re going to see a massive shift with how people find doctors. Social media, internet searches, health websites, and online ratings and review sites are going to continue to grow and become more important to practices looking for new patients.

What are you doing to prepare for this future?

Various Medical Practice Model Types

Posted on May 3, 2017 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The EHR vendor (and many other services), Kareo, has put out a practice model guide which they call “Practice Models: The ABCs from ACOs to Concierge and Everything in Between.” With this guide they shared this picture that includes various practice models:

When I see an image like this I’m torn on if this is an extremely exciting time for physicians or if it’s a miserable time to be a physician. One thing is clear, times are a changing. The medical practice models of the past are going to be blown up by new models.

Take for example Telemedicine. Can you imagine any healthcare future where telemedicine is not part of that future? I can’t.

I’m still personally torn on concierge practices. I can see why they’re appealing to so many. I love the idea of unlimited primary care and getting insurance out of primary care. However, it’s not clear to me that this idea can scale across the entire healthcare system. Certainly the rich can do it no problem. Can the concierge model work for the middle and lower class? Many fans of concierge tell me it can. I’m still not so sure.

I know a lot of doctors that are part of ACOs. I don’t know very many that are excited by the work ACOs are doing. Most of them just feel like they need to be part of it to understand the future of medicine. They’re not joining ACOs because they think it’s something that shows a lot of promise for their patients.

I’m probably coming off a little more cynical than I am about these shifts. A number of these changes are really exciting to see happening. However, I’m also not blind to the challenges that many of these medical practice models face.

Needless to say, it’s an exciting and challenging time to be in medicine. The structure of how we pay for healthcare is being questioned and new models are being explored. This can be really exciting if you find yourself tracking the right wave. However, if you miss the wave, then you can be stuck out in the middle of the ocean wondering how you missed out.

The Physician – Patient Disconnect

Posted on April 13, 2017 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you’ve been in healthcare for a while, then you know that there’s often a disconnect between patients and healthcare professionals. However, this divide was illustrated pretty sharply in some research that Conduent (previously known as Xerox) put out about the relationship.

Plus, to add to this disconnect, there was an even bigger divide between patients from different ages. In fact, they’re a very heterogeneous group. However, so many healthcare organizations treat them the same.

For a good illustration of these differences, take a second to look at this infographic:

Is Quality Mutually Exclusive with Profitability?

Posted on March 15, 2017 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was browsing through some old notes today from past conferences and stumbled upon a really intriguing question from when I met with Infor back at ANI 2014. Thanks to technology I know that I met with Beth Meyers, Healthcare Industry Strategy Director, and Prakash Kadamba, Director of Healthcare Product Management at Infor. The question I jotted down from our discussion is the title for the blog post:

Is Quality Mutually Exclusive with Profitability?

In most industries, the company with the better quality often wins. There are a few exceptions, but for the most part, quality matters a lot in the choices we make. However, if I dive a little deeper I think that value wins out over quality in many industries as well. You know you have a breakout product which provides amazing quality and amazing value.

Unfortunately, I’m sad to say that this isn’t always the case in healthcare. The reason I think it isn’t the case is that patients don’t have a good way to measure quality and I’m not sure we’ll ever get to where we can measure quality. I’d be excited if we could, but I don’t see it in the foreseeable future. We have vague representations and indicators of quality, but none of them effectively represent quality.

The best measure of quality a patient can see is “I got better.” The irony of this statement is that just because you got better doesn’t mean you got quality care. You might have gotten better based on something other than the care you received.

Back to the original question, I think you can provide amazing quality healthcare and still be profitable. Those two ideas aren’t mutually exclusive. However, I also don’t think that all those doctors providing quality care are going to be profitable. Quality care does not directly determine how profitable your organization will be. What makes the difference then?

The big difference I see is how well an organization is run. How effective is your billing department? How effective is your documentation? Do you have tools that engage patients in their billing and in their care? Have you automated many patient experiences to free up time for your staff to work on the things that matter most?

Those clinics that are profitable and providing quality care are usually the ones that are looking beyond the EHR. They realize where the EHR fits into their larger strategy, but the EHR isn’t their entire strategy. That’s a big shift in mindset for many that were so myopically focused on implementing EHR as they chased after government handouts.

If you know you’re providing high quality care, but you’re not profitable, take a step back and evaluate your business. I’m sure you’ll find a lot of shortcomings on the business side that if you addressed would make you more profitable. Just don’t expect your EHR vendor to give you all the answers. They’re an important piece of the puzzle, but just one piece.

Make Your Medical Practice Website Patient-Friendly

Posted on March 9, 2017 I Written By

The following is a guest blog post by Yasmin Khan from Bonafide.

It’s a sad truth that many websites are simply not effective at being a resource for visitors, including most medical practice and healthcare service websites. The key element to a service-oriented business website is accessibility or ease of use.

Unfortunately, accessibility is the element most lacking in websites for healthcare organizations.

  • The content is written at the graduate school level.
  • There is too much jargon, unfamiliar acronyms, and unfamiliar words.
  • Too much in-depth medical knowledge is required to understand what is presented on the website.

An example of writing above the audience is using the term nosocomial infection instead of the self-explanatory hospital-acquired infection.

Optimizing your website requires you to look at it from the intended user’s point of view and using proven techniques to increase the probability your website will be found. The entire goal of your website is to attract and convert leads into patients.

Below are three areas of optimization you can use to improve your medical practice’s website to be more patient-friendly.

Provide Relevant, Well-Written Content, and Attractively Presented Content

Does your present website look just like the brochure at your front desk? If so, you are not leveraging the power of your website. You have at your fingers a tool that can be designed to appeal to a wide variety of information needs that is easily navigated.

Every piece of content on your website should be targeted to your ideal patient profile. You must also have content that speaks to each segment of the patient journey, written in the patient’s language and at their level of education.

Your content should be written to no more than the 11th-grade level to be accessible to most of your visitors. Communicate urgency without scaring or pressuring the reader. Above all, do not patronize.

Create clear calls to action to guide people where you want them to go and provide something of value that encourages them to share their contact information to obtain it.

Practice Search Engine Optimization (SEO)

You need to address two areas of SEO:

  • On-page: refers to everything within the website
  • Off-page: refers to SEO opportunities, not on your website

On-page SEO refers to the building and optimization of your website.

  • Indexable content, including images, videos, and plug-ins
  • Crawl-able link structures
  • Search engine friendly URL structures
  • Optimized pages, title tags, and meta-descriptions

Avoid duplicate content to avoid being penalized by Google and other search engines. Each page of your website should have unique content that adds value to the user while achieving a clear marketing goal for your practice.

Off-page SEO includes ways to attract attention to your website through link-building, sharing and promoting content, and optimizing for local and mobile search.

Building quality links is the first principle of successful SEO. The key is to build quality links, relevant links from authoritative websites, blogs, and other areas of the web back to your site. High-quality links are what Google uses to judge trust and confer higher search engine rankings.

Optimize for Localization

As a geographically based service, you need to optimize for local search. When patients search for a medical practice, they typically add the city name to the search:

Primary Care Physicians in Kansas City

Each of your location pages should be optimized with your city and other identifying information such as the name of the medical center your office is in.

If your website is not responsive, meaning it will display appropriately regardless of the device, you need to convert it. Mobile devices have blanketed the globe, and most are used to search for local businesses as well as serving as a primary device for online activity.

The mobile version of your site should have:

  • Large, legible fonts
  • A fast load speed
  • Bullet lists and less text
  • Simple navigation with few internal links
  • Fewer images

Don’t lose opportunities because you cannot be found via smartphone or tablet.

A Quick Summary

Your website is your marketing engine. Take full advantage of online technology to develop a patient-friendly website that:

  • Contains relevant, well-written content
  • Is optimized for search engines
  • Has high-quality sites linking to it
  • Is optimized for local search and mobile devices.

Building a medical practice is a business, just like any other. Today’s patients expect to be able to find you online and engage with you when they are ready. Make sure you give them the information they need to put you at the top of their list.

About Yasmin Khan
Yasmin Khan is the marketing manager for Bonafide, a digital marketing agency in Houston, Texas. She loves writing, tweeting, and positive change. She’s all about the big picture and the greater good.