Tag: COVID-19

Meditation Challenge

Stress, anxiety, depression and substance use have increased during the Covid-19 pandemic. This has a lot people thinking about better self-care.

I’m helping one of my employers with a four-week “meditation challenge.” It grew out of a recent lunch and learn for employees that included some material on mindfulness. The more the merrier, so I’m sharing this with my entire social network.

Here’s the challenge: Meditate three times per day, generally in the morning when you wake up; sometime in the afternoon; and again in the evening right before you go to bed. Start with 5-minute sessions, increasing the duration week-by-week as follows:

  • Week 1: 5 minutes, 3 times per day
  • Week 2: 10 minutes, 3 times per day
  • Week 3: 15 minutes, 3 times per day
  • Week 4: 20 minutes, 3 times per day

In terms of technique:

  • Assume any comfortable position. I personally like a semi-supine position (see below)
  • Set a timer (e.g., on your phone) with a soft alarm
  • Close your eyes
  • Direct your attention to your breath. This might be your nose, chest or belly
  • Follow your breath in and out. Some people use simple mental mantras for each in-breath and out-breath. Examples are: in-out, deep-slow and calm-ease

Internal and external distractions will occur. Just let thoughts, emotions and sensations pass without judgment. Return to your breath, using a mantra, if needed. On the flip side, don’t worry if you feel sleepy or even doze off. Allow that to pass without judgment, too.

And that’s it!

Please let me know how you feel during and after the challenge.

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I’ve greatly benefited from Alexander Technique lessons. One tip/trick is something called constructive rest, which involves the semi-supine position depicted below.

1. Head slightly supported by a softcover book (or two)
2. Arms slightly away from body (abducted), palms down (pronated)
3. Shoes off; feet about hip-width apart
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Photo: Ayden Frenz

I’m also a fan of Muse, the brain-sensing headband, but that’s a post for another day. ✸

Telehealth Addiction Care

Mike Max interviewed me on WCCO Radio this morning about telehealth addiction care. Allina Health’s work that began at New Ulm Medical Center was the context

WCCO Radio

Here are some of my source documents

Many thanks to Sarah Jackson with Media Minefield for her partnership on this timely and important subject! ✸

Happy Camper

I appeared on KMSP Television yesterday morning to discuss happiness. Please see my earlier post for the context. I was again representing Allina Health

KMSP Television

Many thanks to Sarah Jackson with Media Minefield for her partnership on this timely and important subject! ✸

Be Here Now

[ Updated with links to the resulting on-air segment / and here ]

WCCO Television

I’m scheduled to appear on WCCO 4 News This Morning on Monday, June 22nd, at 5:45 a.m. The subject will be happiness. I’ll be representing Allina Health

We’ll be discussing a recent NORC at the University of Chicago study that found a historic decrease in happiness. NORC has been surveying Americans since 1972 with the following question:

Taken all together, how would you say things are these days—would you say that you are very happy, pretty happy, or not too happy?

Only 14% of people reported feeling “very happy,” which was a sharp drop from the usual run rate. In contrast, 23% of respondents indicated that they are “not too happy.” Both findings are unprecedented (red oval)

Norc at the University of Chicago

Correlation does not imply causation, however, the investigators pursued some provocative Covid-19-related explanations dealing with viral hotspots, loneliness and income. And while George Floyd was not mentioned in NORC’s report, his senseless death on May 25th occurred right in the middle of the survey period. I’d speculate that tragedy and the national reckoning which has followed was also on respondents’ minds

Regardless of the causes, what are some ways to improve happiness?

I generally recommend making peace with the present. This perennial wisdom that has strong, contemporary scientific support. For example, a seminal study by Matthew Killingsworth and Daniel Gilbert tracked happiness in real time using iPhone surveys. They found that people were happiest when their minds weren’t wandering—that is, when they were totally present in the now

In conclusion, a human mind is a wandering mind, and a wandering mind is an unhappy mind. The ability to think about what is not happening is a cognitive achievement that comes at an emotional cost

Science 2010;330:932

You can prove this to yourself by enrolling in the study, which is still running

Present moment awareness is sometimes called mindfulness, a trendy, frequently misunderstood word that I’ve avoided up until now. If you’re intrigued, I suggest snagging a copy of The Power of Now, the classic book by Eckhart Tolle. I often point people to “Wherever You Are, Be There Totally” (section), which starts on Page 82 in Google Books

I’ll try to mention other tips and tricks on the air, and hope to add them to my profile page at Allina Health later this week. ✸

Wild West of Waivers

Thank you for joining us for today’s legal/regulatory webinar related to the Covid-19 pandemic. This post contains links to the various resources that we discussed. Additional resources will be added after the event based on your questions

Disclosures
The webinar represents a partnership between Allina Health (David Frenz’s employer) and the Center for Practice Transformation. Please review Dr. Frenz’s disclosures, especially that bit about seeking counsel from experienced health lawyers like our panelists, Teresa Knoedler and Kit Friedemann


in partnership with

Questions to Ask Yourself

  1. Is the health care service permitted by law? (if yes, then go to #2)
  2. Is the health care service permitted by the patient’s health plan? (if yes, then go to #3)
  3. What is the claims submission process? For example, what CPT code and place of service code (Item Number 24B in the 1500 Health Insurance Claim Form) should be submitted for payment?

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Introduction
High-level Explainer by Kit Friedemann, J.D.

Emergency Declarations
Federal
Minnesota
#StayHomeMN

HIPAA Enforcement
Office of Civil Rights resource page
Telehealth and Telemedicine Tool Kit

Medicare
Expansion of telehealth with 1135 waiver
CMS Interim Final Rule
MLN Booklet — Telehealth Services [requirements prior to Covid-19]
Medicare Coverage of Substance Abuse Services [prior to Covid-19]

Minnesota Department of Human Services
Waivers and modifications
MHCP Provider Manual

42 CFR Part 2
Substance Abuse and Mental Health Services Administration (SAMHSA)
Relationship to HIPAA enforcement discretion

Ryan Haight Act
Use of Telemedicine While Providing Medication Assisted Treatment (MAT)
Drug Enforcement Administration (DEA) Covid-19 Information Page

Free Telehealth Training

Allina Health is pleased to be partnering with the University of Minnesota’s Center for Practice Transformation on a free telehealth training this Friday, April 3rd, at 12 p.m. The webinar is an adaptation of trainings that John Sutherland, Ph.D., and I have been conducting at Allina in response to the Covid-19 pandemic.

I will cover a broad range of topics including the logistics of conducting a telehealth encounter. I will also address regulatory issues such as documentation requirements, exceptions to the Ryan Haight Act, deferred enforcement of HIPAA and waivers and modifications granted by the Minnesota Department of Human Services.

Please consider Zoom for Healthcare if you haven’t already landed on a telehealth platform. It is device and operating system agnostic, and many patients are already using it for other reasons (e.g., distance learning for their children). Solo practitioners and small groups are able to purchase licenses on a onesie-twosie basis though resellers like LuxSci, which brings the cost down.

Many thanks to Julie Rohovit, Ph.D., Joe Curtis and the whole gang at the Center for Practice Transformation for spinning up this webinar on very short notice. ✸

Coronavirus Response

Our response to the novel coronavirus is based on recommendations from the Centers for Disease Control and Prevention and Minnesota Department of Health. Our primary strategies are:

A virtual visit is an online appointment that supports social distancing, that is, unnecessary, in-person contact with others. These visits occur via Zoom for Healthcare, a secure, HIPAA-compliant platform.

Please consider converting your existing in-office appointments to virtual visits. ✸