Tag Archives: lack

For Sale – iMac 21.5 inch Late 2015

For sale due to lack of use and collection only.

Specs :

i5 1.6ghz
8GB Ram
1TB Hard Drive
Intel HD Graphics

Comes with Magic Mouse ( no lightning cable supplied ) and wireless keyboard ( 2 battery Version ) and is running OSX Catalina.

There is a mark on the bottom left corner and small chip at top right corner. The foot also has a dent at the front and small chip at the rear. Damage is shown in the pictures.

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For Sale – iMac 21.5 inch Late 2015

For sale due to lack of use and collection only.

Specs :

i5 1.6ghz
8GB Ram
1TB Hard Drive
Intel HD Graphics

Comes with Magic Mouse ( no lightning cable supplied ) and wireless keyboard ( 2 battery Version ) and is running OSX Catalina.

There is a mark on the bottom left corner and small chip at top right corner. The foot also has a dent at the front and small chip at the rear. Damage is shown in the pictures.

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Value-based care models hung up on lack of resources

A survey of more than 1,000 healthcare providers finds a lack of resources to be the biggest hurdle when shifting to a value-based care reimbursement model.

A value-based care model pays providers based on patient outcomes rather than the amount of services provided. The Centers for Medicare & Medicaid Services began promoting value-based care in 2008. Support for the initiative quickly followed with legislation, including the Affordable Care Act, which passed in 2010.

Despite the push, the shift to a value-based care rather than fee-for-service model has been slow — but steady. Indeed, data analytics company Definitive Healthcare LLC found that the number of U.S. states and territories with value-based care programs has risen from three in 2011 to 48 in 2018.

This year, the company surveyed more than 1,000 healthcare leaders to determine the state of value-based care, as well as what implementation will look like in 2020.

Value-based care: Barriers and accelerators

Kate Shamsuddin, senior vice president of strategy at Definitive Healthcare, said she was surprised that 25.3% of respondents pointed to lack of resources as the biggest barrier to implementing a value-based care model, given the initiative dates back to 2008.

Definitive Healthcare senior vice president of strategy Kate ShamsuddinKate Shamsuddin

“We would’ve anticipated that the number of resources required to support value-based care would’ve been increasing over time to support the success of these programs and initiatives,” she said. “So that was pretty surprising to see that at the top of the list as a barrier.”

Survey takers also pointed to “gaps in interoperability” and the “unpredictability of revenue stream” as barriers to implementing value-based care programs. “Changing regulations and policies” was another barrier identified by 16.2% of respondents.

Shamsuddin was struck by the “changing regulations and policies” barrier because of the amount of visibility the federal government has provided into policy implementation. Additionally, Shamsuddin said that while changing policies is listed as a barrier, 16.1% of respondents also selected it as a factor that is accelerating the adoption of value-based care.

Almost half, 44.8%, of survey respondents cited “appropriate provider compensation and incentives” as the biggest reason why adoption of a value-based care model moved forward within their organization. In a value-based care model, providers can receive bonuses for performing above-quality care standards. Yet they can also be penalized if their performance falls below those standards.

Shamsuddin said being able to adjust provider compensation and incentives is one way to ensure all stakeholders are “growing in the same direction” when implementing a value-based care program.

“That is one I think we’ll continue to see as an accelerator, especially with healthcare systems being a little bit more, let’s call it experimental, in how they’re willing to move away from the fee-for-service model,” she said.

What CIOs should pay attention to in 2020

As value-based care model implementation evolves in 2020, Shamsuddin said it will be important for healthcare CIOs to keep an eye on federal regulation and policy, which survey takers said was both a barrier and an accelerator.  

Additionally, one of the main areas that will cause change in value-based care program implementation is a growing understanding among providers of how accountable care organizations (ACOs) and bundled payment models such as the Medicare Shared Savings Program work, according to 31.1% of survey respondents.

ACOs and bundled payment models, or alternative payment models that require providers to take on risk and share in the losses and benefits of patient care, will “evolve and become easier to understand,” making it more likely for providers to transition to a value-based care model, according to the survey.

ACOs are associations of hospitals, providers and insurers that assume medical and financial responsibility for their patients; the Medicare Shared Savings Program is a voluntary program that encourages healthcare providers to come together as an ACO. The program provides different participation options to ACOs and allows them to take on varying levels of risk and responsibility for patients.

Consolidation within healthcare will also create what Shamsuddin called a “wild card” in how effective value-based programs will be. When two health systems are thinking about combining, Shamsuddin said it will require healthcare providers to be “open and strategic” around how they’re going to bring in value-based care initiatives during a merger.

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For Sale – 13″ MacBook Air 2017

Putting my MacBook air up for sale due to complete lack of use! It’s the 128GB 8GB RAM model. In pretty good condition except for the ding on the back. A few scratches here and there but generally decent – can’t see any scratches on the screen.

Comes boxed and with the charger – the battery cycle count is only 49!

Asking for £475 posted or £450 collected for it – collection definitely preferred.

Price and currency: 475
Delivery: Delivery cost is included within my country
Payment method: BT or Cash on collection
Location: Weston-super-Mare
Advertised elsewhere?: Not advertised elsewhere
Prefer goods collected?: I prefer the goods to be collected

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Experts say there’s still a long road ahead for the FHIR standard

A major issue hindering interoperability in healthcare is a lack of data standardization, something federal regulators are trying to change by pushing adoption of the Fast Healthcare Interoperability Resources standard.

FHIR is an interoperability standard developed by Health Level Seven International (HL7) for the electronic exchange of health data. The FHIR standard has gone through multiple iterations and taken five years to develop. It sets a consistent description for healthcare data formats and application programming interfaces that healthcare organizations can use to exchange electronic health records.

In a set of proposed rules for interoperability from the Office of the National Coordinator (ONC) for Health IT and the Centers for Medicare and Medicaid Services (CMS), the agencies would require healthcare organizations to use FHIR-enabled healthcare APIs that would allow patients to download their standardized electronic health information into a healthcare app on their smartphones.

During a panel discussion on the future of interoperability at ONC’s 3rd Interoperability Forum in Washington, D.C., Thursday, panelists including Kisha Hawthorne, CIO of Children’s Hospital of Philadelphia, focused on the reality of using the FHIR standard, and whether the standard will help achieve interoperability in healthcare.

The reality of FHIR standard use today

Will the FHIR standard be a key facilitator of interoperability in healthcare? Panelists agreed that it will — in time. Right now, though, the standard still needs work in the implementation department.

In the provider space there’s a ways to go. But we’re excited and we think it will take hold.
Kisha HawthorneCIO, Children’s Hospital of Philadelphia

Hawthorne said her team at Children’s Hospital of Philadelphia is looking to use the FHIR standard in the provider space to bridge the gaps between the different software vendors with which the organization works.

The hospital uses an Epic EHR, and Hawthorne said that while she thinks vendors like Epic are beginning to implement and use the FHIR standard, she hopes to see that work “fast forward” with Epic and other vendors to make it easier to gather and share, as well as use, data in the provider space. FHIR standard use is something that’s not quite there yet, she said.

“In the provider space, there’s a ways to go,” Hawthorne said. “But we’re excited and we think it will take hold.”

The potential of the FHIR standard is exciting and it will “open a lot of doors,” but the reality is that the standard is immature, said Kristen Valdes, CEO of personal health app b.well Connected Health.

Valdes said that although she thinks the FHIR standard will create a push toward interoperability in healthcare, challenges associated with implementation of the FHIR standard are hindering progress.

A significant number of providers and organizations aren’t “using a fraction” of the implementation guidelines that have been made available for the FHIR standard, she said. While organizations are thinking about the operational impacts of using FHIR on behalf of users, she said there continues to be ongoing debate about the proper HIPAA rules to provide consumers access to their own data, which also hinder its implementation.

“We really have to think about the operational workflows and how it’s going to affect the people who are expected to implement and deploy FHIR,” she said.

The problem with the FHIR standard isn’t the technical aspects of the standard, but the process and people implementing it, said Vik Kheterpal, principal of interoperability product vendor CareEvolution.

As a technology standard, Kheterpal said it makes sense and has already seen relative success in the launch of programs such as CMS’ Blue Button 2.0 program. Blue Button 2.0 uses the FHIR standard for beneficiary data, such as drug prescriptions, primary care cost and treatment. Yet, the problem with the rest of healthcare often lies in misinterpretation of policy when it comes to sharing patient data.

Anil Jain, chief health informatics officer at IBM Watson Health, said he thinks the value of the FHIR standard is real, and organizations already need to think about what’s next once the standard matures.

As use of the FHIR standard grows among healthcare organizations, Jain said it’s important to create businesses cases and models for sharing data that will work using the standard. Otherwise, providers and patients will continue to lack trust in the data, something a standard like FHIR alone won’t give healthcare.

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‘There are great things out there for you’: Q Johnson went from having to hide parts of herself to helping others embrace who they are – Microsoft Life

The Microsoft retail store employee faced a lack of acceptance until she found a community and the support to be herself 

By Natalie Singer-Velush

Q Johnson knows what it’s like to not be fully accepted for who you are. She felt the tension as a teenager, growing up in a family that didn’t tolerate the idea of same-sex love. After she graduated high school, her mother found out she was gay. “She told me, ‘That’s not allowed in my house. If you’re going do that, you need to leave,’” Johnson said. When Johnson returned from a trip out of town, she found that she’d been locked out of the house. She couldn’t get her belongings, and she had nowhere to go.

Then Johnson had to conceal her reality while she was homeless, living in her car and trying to get back on her feet after being rejected by her family. When few people were around, she would shower at night at her 24-hour gym, hiding her homelessness, and she ate meals at her job at a fast-food restaurant.

Not long after that, Johnson met the love of her life and joined the military. But in 2011, prior to the US Supreme Court’s 2013 reversal of the federal Defense of Marriage Act, her marriage to her wife wasn’t recognized. So, she was required to live on base in the barracks with other unmarried soldiers. She kept an apartment off base with her new family—her wife and daughter—walking a tenuous line between desperately wanting to be fully herself and having to be the pretend version of herself that was required to do her job.

Eventually, her hidden life was discovered, and to be with her family Johnson left the military and her identity serving her country behind.

She decided she would try to reinvent herself in Oklahoma City, where she grew up, and maybe this time things would be different.

“Technology’s always been a passion of mine,” Johnson said. “I saw an inventory control position open at a Microsoft store, and I applied. I’ve been here two years. Coming into a new job, you’re nervous; you don’t know what to expect. Right when I interviewed I learned someone I would be working closely with is a lesbian. So I was like, it’s ok. I was relaxed—at ease, you know? I later learned other people working around me were gay, too. It was a relief.”

It was the first time in a very long time that she felt accepted for who she was, that she felt like she could just be Q.

“I felt like I could come in and be myself. I didn’t have to worry about judgment from my family anymore.

“You shouldn’t have to go to work pretending to be something you’re not. I shouldn’t have to be ashamed of being married to someone of the same sex. I should be able to come in and say, ‘This is my wife. This is my daughter.’ Here, I’m comfortable being myself.”

Now Johnson speaks to groups of LGBTQ+ military members and veterans, who often attend anonymously, telling them her story and helping them see that it’s possible to come out of hiding, to live a happy life and be fully accepted.

“There are people out there facing similar things. Talk to them; get that support. Don’t give up on your life because there are great things out there for you.”

“There are people who suffer from PTSD of all different types, who face the same things I face. I can go share my story and just, you know, just be human,” she said.

“It took me a long time to be able to share my story without crying. And it was my wife who told me, ‘You know, if you let it out you might feel better.’ And I thought, well if I’m going to let [my feelings] out, maybe there are other people who feel like me. Talking about these experiences with veterans is so important. It’s giving something back to them, after they serve their country.

“Being able to walk into a room and not be judged is so important. Because that’s who we are at the end of the day.”

Nowadays, Johnson says, she finds strength from her struggles and feels empowered to help others around her as much as she can. And she’s done hiding.

“I would say to anybody going through the same types of things I went through: Just one day at a time. It may be tough, whatever the situation is. But don’t get your hopes down, because it gets better. There are people out there facing similar things. Talk to them; get that support. Don’t give up on your life because there are great things out there for you.”

For Sale – Macbook Pro 13 Early 2015 – 8gb – 256gb – AppleCare

Due to a lack of use it seems silly to keep this when I have a perfectly good work laptop I can use.

I’m in no rush to sell and given the value involved I’d prefer any buyer to be fully satisfied in advance of any sale so I’m happy to answer any questions to take photos of any thing specific.

Purchased direct from Apple in June 2015, it has the remainder of its 3yr AppleCare plan until end of May 2018.

It will come boxed with all original accessories and is in excellent condition having always been in a hardshell case. There are no marks that I can see, but given the brushed aluminium body it’s reasonable to expect their may be some very small marks somewhere (I’ll check again under better light and take photos). There are no marks on the screen and no dead pixels.

Battery cycle count is on 66 and battery health is reported as normal.

Specs:
Early 2015 MacBook Pro 13 with Retina display and Force Touch track pad.
2.7Ghz Intel Core i5
8GB Ram
256GB SSD
Intel Iris 6100 Graphics

Priced at £750 delivered by fully insured courier.

Price and currency: £750
Delivery: Delivery cost is included within my country
Payment method: BT or PPG
Location: Towcester
Advertised elsewhere?: Not advertised elsewhere
Prefer goods collected?: I have no preference

______________________________________________________
This message is automatically inserted in all classifieds forum threads.
By replying to this thread you agree to abide by the trading rules detailed here.
Please be advised, all buyers and sellers should satisfy themselves that the other party is genuine by providing the following via private conversation to each other after negotiations are complete and prior to dispatching goods and making payment:

  • Landline telephone number. Make a call to check out the area code and number are correct, too
  • Name and address including postcode
  • Valid e-mail address

DO NOT proceed with a deal until you are completely satisfied with all details being correct. It’s in your best interest to check out these details yourself.

For Sale – Macbook Pro 13 Early 2015 – 8gb – 256gb – AppleCare

Due to a lack of use it seems silly to keep this when I have a perfectly good work laptop I can use.

I’m in no rush to sell and given the value involved I’d prefer any buyer to be fully satisfied in advance of any sale so I’m happy to answer any questions to take photos of any thing specific.

Purchased direct from Apple in June 2015, it has the remainder of its 3yr AppleCare plan until end of May 2018.

It will come boxed with all original accessories and is in excellent condition having always been in a hardshell case. There are no marks that I can see, but given the brushed aluminium body it’s reasonable to expect their may be some very small marks somewhere (I’ll check again under better light and take photos). There are no marks on the screen and no dead pixels.

Battery cycle count is on 66 and battery health is reported as normal.

Specs:
Early 2015 MacBook Pro 13 with Retina display and Force Touch track pad.
2.7Ghz Intel Core i5
8GB Ram
256GB SSD
Intel Iris 6100 Graphics

Priced at £750 delivered by fully insured courier.

Price and currency: £750
Delivery: Delivery cost is included within my country
Payment method: BT or PPG
Location: Towcester
Advertised elsewhere?: Not advertised elsewhere
Prefer goods collected?: I have no preference

______________________________________________________
This message is automatically inserted in all classifieds forum threads.
By replying to this thread you agree to abide by the trading rules detailed here.
Please be advised, all buyers and sellers should satisfy themselves that the other party is genuine by providing the following via private conversation to each other after negotiations are complete and prior to dispatching goods and making payment:

  • Landline telephone number. Make a call to check out the area code and number are correct, too
  • Name and address including postcode
  • Valid e-mail address

DO NOT proceed with a deal until you are completely satisfied with all details being correct. It’s in your best interest to check out these details yourself.

For Sale – Macbook Pro 13 Early 2015 – 8gb – 256gb – AppleCare

Due to a lack of use it seems silly to keep this when I have a perfectly good work laptop I can use.

I’m in no rush to sell and given the value involved I’d prefer any buyer to be fully satisfied in advance of any sale so I’m happy to answer any questions to take photos of any thing specific.

Purchased direct from Apple in June 2015, it has the remainder of its 3yr AppleCare plan until end of May 2018.

It will come boxed with all original accessories and is in excellent condition having always been in a hardshell case. There are no marks that I can see, but given the brushed aluminium body it’s reasonable to expect their may be some very small marks somewhere (I’ll check again under better light and take photos). There are no marks on the screen and no dead pixels.

Battery cycle count is on 66 and battery health is reported as normal.

Specs:
Early 2015 MacBook Pro 13 with Retina display and Force Touch track pad.
2.7Ghz Intel Core i5
8GB Ram
256GB SSD
Intel Iris 6100 Graphics

Priced at £750 delivered by fully insured courier.

Price and currency: £750
Delivery: Delivery cost is included within my country
Payment method: BT or PPG
Location: Towcester
Advertised elsewhere?: Not advertised elsewhere
Prefer goods collected?: I have no preference

______________________________________________________
This message is automatically inserted in all classifieds forum threads.
By replying to this thread you agree to abide by the trading rules detailed here.
Please be advised, all buyers and sellers should satisfy themselves that the other party is genuine by providing the following via private conversation to each other after negotiations are complete and prior to dispatching goods and making payment:

  • Landline telephone number. Make a call to check out the area code and number are correct, too
  • Name and address including postcode
  • Valid e-mail address

DO NOT proceed with a deal until you are completely satisfied with all details being correct. It’s in your best interest to check out these details yourself.

For Sale – Macbook Pro 13 Early 2015 – 8gb – 256gb – AppleCare

Due to a lack of use it seems silly to keep this when I have a perfectly good work laptop I can use.

I’m in no rush to sell and given the value involved I’d prefer any buyer to be fully satisfied in advance of any sale so I’m happy to answer any questions to take photos of any thing specific.

Purchased direct from Apple in June 2015, it has the remainder of its 3yr AppleCare plan until end of May 2018.

It will come boxed with all original accessories and is in excellent condition having always been in a hardshell case. There are no marks that I can see, but given the brushed aluminium body it’s reasonable to expect their may be some very small marks somewhere (I’ll check again under better light and take photos). There are no marks on the screen and no dead pixels.

Battery cycle count is on 66 and battery health is reported as normal.

Specs:
Early 2015 MacBook Pro 13 with Retina display and Force Touch track pad.
2.7Ghz Intel Core i5
8GB Ram
256GB SSD
Intel Iris 6100 Graphics

Priced at £750 delivered by fully insured courier.

Price and currency: £750
Delivery: Delivery cost is included within my country
Payment method: BT or PPG
Location: Towcester
Advertised elsewhere?: Not advertised elsewhere
Prefer goods collected?: I have no preference

______________________________________________________
This message is automatically inserted in all classifieds forum threads.
By replying to this thread you agree to abide by the trading rules detailed here.
Please be advised, all buyers and sellers should satisfy themselves that the other party is genuine by providing the following via private conversation to each other after negotiations are complete and prior to dispatching goods and making payment:

  • Landline telephone number. Make a call to check out the area code and number are correct, too
  • Name and address including postcode
  • Valid e-mail address

DO NOT proceed with a deal until you are completely satisfied with all details being correct. It’s in your best interest to check out these details yourself.