About This Blog

 

Sherri Dorfman, CEO, Stepping Stone Partners, Health Technology Innovation & Patient Experience Strategist

My blog is designed to spotlight healthcare organizations with innovative uses of technology & data to drive Care Coordination, Collaboration, Patient Engagement & Experience.

These patient centric approaches may influence your product & service roadmap, experiences, partnerships and marketing strategies.

MY EXPERTISE:

While consulting, I leverage my extensive healthcare landscape knowledge (acute, ambulatory, virtual, home), patient data expertise and patient experience skills to help companies make the right strategic business, product and marketing decisions. Services include:

1. Strategic Business Planning: Conducts market assessment to guide business, product and marketing strategies. Identifies and evaluates digital health solutions across categories to drive mergers, acquisitions and partnerships.  Defines and validates new business models, data-driven solutions and services. 

2. Patient Experience Strategy: Evaluates current patient experience through best practices framework. Plans, conducts and analyzes stakeholder research and devises journey maps highlighting experience enhancement opportunities, encompassing people, process and technology. 

3. Product & Marketing Strategy:  Co-creates with cohorts (e.g. patient, caregiver and care team) on AI driven health tech solutions. Develops differentiated value proposition story with outside- in view (VOC insights), for marketing, sales and investors.

Find out how I can help you. Email me at SDorfman@Stepping-Stone.net to set up an exploratory discussion.

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Entries in educating consumers about health and wellness (50)

Premera Blue Cross Motivates Consumer Health Engagement with EveryMove

EveryMove Rewards for EngagementPremera Blue Cross’s subsidiary, LifeWise Health Plan of Washington has partnered with an innovative healthcare technology company, EveryMove to motivate and reward their members for being active.  

When the program launches early this year, members will be invited to join the EveryMove program and track their activity to receive points which accumulate for rewards. The EveryMove program gives members points when they are active in different ways; from walking, biking and swimming to playing the Wii Fit or Kinect to checking- in (i.e. gym, track, park, pool).

“By helping people be more active, EveryMove has the potential over time to lower costs and, in general, lower costs will lead to a positive effect on premiums,” Jeff Roe, CEO of LifeWise Health Plan of Washington recently shared in a Fox News interview.

Initially, Premera’s LifeWise will reward members for their physical activity with Amazon Gift Cards when reaching target point levels. “The great thing about EveryMove is that it applies to all of our members, whether they are part of an employer group or an individual plan. As part of our ongoing work with EveryMove, we are interested in becoming a companion in the day-to-day lives of our members”, explains Kent Marquardt, CFO at Premera Blue Cross.

EveryMove was launched last Fall at the Health 2.0 conference in San Francisco and is designed to make it easy for consumers to get both recognition and reward for their physical activity. EveryMove gives members credit for many different types of activity beyond the usual walking and running, such as biking, swimming and even dancing.

“Success for Premera, in terms of our relationship with EveryMove, is ultimately showing that our members’ healthy activities are reducing their healthcare costs and the healthcare costs for the entire system.  In the near term, our focus is on engagement. We want to make sure our members are responding to the opportunity to be recognized for their healthy lifestyle activities and that our members see us as a partner in obtaining better health”, adds Marquardt.

EveryMove Engagement

After reviewing the EveryMove program through the eyes of the consumer, here are some key engagement drivers that I see. Health Plans have the opportunity to customize these engagement capabilities to meet the needs of their specific members.   
Easy Tracking with Options for “Proof of Activity”: Consumers can automatically track and upload their activity on EveryMove with one of 10 different devices including FitBit, Nike+ and BodyMedia. Consumers are rewarded with additional points when using one of these “proof of activity” devices, although they also have the option to manually enter their activities.

Social Motivation & Gain: EveryMove gives users the option of tying into their Facebook network and inviting others via email for friendly competition. Currently, users can invite up to 50 friends with EveryMove to share their lifestyle changes with their select group. Unlike other wellness programs that I’ve seen, consumers can earn “Friends points” when their social network is active too. This is a positive spin on Christakis's “Connected” social influence.

Rewards for Reinforcement: Each participant can select the reward that she would like to work towards such as a gift card from the featured merchant or a donation to the Make a Wish Foundation.  When the member logs in, she sees an ongoing tracking of her points towards the selected reward for ongoing motivation.

Intensity- Driven Rewards: With EveryMove, users are given more points when completing a more intense workout. This differs from most wellness programs which reward consumers based on the number of steps regardless of their pace.

Milestone Rewards: EveryMove presents a Facebook like personalized page with a timeline format to display their activity information and that of their friends on EveryMove. Just by moving, the user can be rewarded with bonus points and thumbs up; for “moving for an hour”, an “active day” and the “4th active day this week”. EveryMove plans to introduce more milestone driven recognition in the coming year.  

Gamification & Unlocking Rewards: Within EveryMove, the user sees the opportunity to unlock a new reward which generates curiosity and motivation to continue coming back for more. (Notice the big lock in the picture above)

Health Plan Opportunity for Member Engagement

With health reform and insurance exchanges around the corner, health plans are actively searching for ways to build relationships with their members and to be viewed as a health partner and not just an insurance company. Health plans also want to provide wellness initiatives that will attract and support consumers who are interested in maintaining their health.

Although they can sign up online for EveryMove without going through their health plan, consumers have an opportunity to gain more value if their health plan incorporates rewards into a comprehensive wellness program. I can envision health plans using a platform like EveryMove to motivate and reward members for every type of healthy behavior including taking an assessment, getting a screening, participating in a social activity challenge with co-workers, going to the gym or working with a health coach to lose weight or manage diabetes.

This is in fact the direction that I see innovative health plans moving in this new year. Payers are most interested in engaging consumers in their health and are looking for ways to sustain engagement through motivation and rewards. A few enlightened health plans want to tap into and leverage their member’s social network to influence and reinforce healthy behaviors.  

Walmart Drives Consumer Health Engagement Through Partnerships with HumanaVitality & SoloHealth  

SoloHealth Station
Recently, Walmart announced new collaborations in the Health & Wellness space; extending Humana’s Vitality Program to reward members for healthy eating and bringing a SoloHealth station into select stores for health screenings and assessments. 

Walmart & HumanaVitality- “Vitality HealthyFood” Program

Last month, Walmart collaborated with Humana to launch “Vitality HealthyFood”, a “first of its kind healthier food program” which incentivizes HumanaVitality members to make healthier food choices. 

“We are dedicated to exploring innovative ways to bring down the cost of healthcare in America. This program offers a new way to help us accomplish this goal”, shares Danit Marquardt, a Walmart spokesperson. 

Over a million members of the HumanaVitality program receive a 5% savings for buying healthy foods and beverages at Walmart with the ‘Great for You’ icon. This program is designed to inspire Americans to eat well and increase their awareness around healthy, affordable food and beverages. 

Humana members interested in participating in the program sign up online. After completing a health assessment, members receive a Vitality HealthyFood Shopping Card to begin saving on ‘Great For You’ items throughout Walmart stores. The shopping card leverages gift card technology at the point of sale, but also captures transaction details for tracking the reward and reinforcing healthy behaviors when a member views their participation in the program online.

“We ran focus groups with our members and talked about ways to improve their wellness. We heard a strong interest in a ‘supportive health plan making healthy foods more available’ ”, explains Stuart Slutzky, Chief of Product Innovation, HumanaVitality.  ”We modeled this Vitality HealthyFood program after a similar, successful program run by Discovery Vitality in South Africa, with whom Humana originally partnered with on the joint venture to develop HumanaVitality. “We have purposely designed the program to be personal and relevant to each person and have issued separate program cards to track the shopping behavior of each adult”, adds Slutzky.
 
Currently, program members can view a list of the items purchased through the program and the savings. “In the future, we are looking to bring more value to the program with recommended recipes which tie- in with the member’s health issues and with the capability to view a shopping list with the ‘Great For You’ items”, describes Slutzky. 

With insurance exchanges around the corner, Humana is motivated to partner with an innovative retailer to build consumer awareness and interest in their brand as well as better serve their existing plan members.

Walmart & SoloHealth – Health Station with Free Assessment & Screenings
 
At select Walmart stores throughout the country, shoppers in the pharmacy area are invited by the virtual assistant on the SoloHealth kiosk to screen their vision, measure their blood pressure, weight and body mass index and take a free health assessment. 
 
Sara, a Walmart shopper, sits down at the kiosk and touches the screen. She answers a series of demographic and healthcare related questions about her age, gender, ethnicity, lifestyle and behavior to make her experience more relevant. Since she has hypertension, Sara uses the kiosk to measure and capture her blood pressure and body mass index and then learns what these measures mean through educational content and videos. Then Sara reads about what to do next and who to contact with a list of accredited local clinicians either within or nearby the Walmart store. “We are trying to provide access and convenience to help consumers identify health issues and then direct them to the appropriate health experts for care”, explains Bart Foster, CEO of SoloHealth. 

When Sara is done with her assessment and screenings, she has the opportunity to either save her information for a future in store kiosk visit, or she can receive her information via email, text or online. “We enable her to take a picture of a QR code on the kiosk screen to access the online area at any time”, describes Foster.  
 
Any Walmart shopper in these select stores can use the HIPPA compliant SoloHealth station to get support for their hypertension or other health issues such obesity. “We will be rolling out a pain management module next, that will walk a user through various questions to help identify pain and provide educational health information”, adds Foster.

“From our experience with the SoloHealth Station in other retailers across our network, consumers typically spend over four minutes interacting with the station and about 38% return to use the kiosk a second time”, Foster shares. 
  
The SoloHealth station, also in Sam’s Club stores, enables shoppers to self -serve. The consumer’s strong interest in self- service and having access to their own health information is a key trend that Accenture confirmed in their Connected Health Pulse Survey earlier this year. 
 
Great for Walmart, Their Health Partners & Consumers
 
By strengthening their positioning as a Health & Wellness destination, Walmart has an opportunity to build a relationship with their shoppers and generate sales for relevant products and services. 
 
Walmart has so much to offer healthcare companies at the same time. While shopping in their store pharmacy, consumers have a healthcare mindset which is a perfect time to help support their care needs. As B.J Fogg, founder of the Persuasive Technology Lab at Stanford University espouses, why not put health behavior triggers right into the consumer’s path to motivate positive behavior change?
 
Imagine the value to the shopper who sits down to measure their blood pressure at the SoloHealth station, learns that he has hypertension and is directed to a nearby clinician. Or think about the Humana member who is determined to eat more healthy and is now incentivized through the HumanaVitality Program to purchase more nutritious food for her family. 

As Walmart presents more opportunities for better health to their shoppers, it is a win-win all the way around.

Patients Engage with Data & Tools for Better Health Decisions and Health Management @ Partners' Connected Health Symposium

During the 9th Annual Partners’ Connected Health Symposium, several speakers shared examples about how consumers are taking responsibility for their health by using online and mobile tools. Given the changes in health reform, Providers and Payers welcome patients taking on a more active role in both monitoring and managing their health.

 1. Trackers for Self Management: 

Susannah Fox presented findings from the latest research by the Pew Internet Project and the California HealthCare Foundation which focused on self-tracking. One interesting insight is the segment of adults who track a “health indicator or symptom”; “62% of adults living with two or more chronic conditions is self- tracking”.

The research also revealed that only one third of all self trackers shared this information with someone and half of those shared with a clinician and the other half with a member of the family, group or a friend.

2.  PHR with Mobile Capture of Observations of Daily Living (ODL):

Patricia Flatley Brennan, Professor, School of Nursing, University of Wisconsin, discussed the insights that can be gained by “listening in the moment”.  Patricia provided an overview of the Project HealthDesign’s five projects for this second round. I was particularly interested as she described how these projects capture the “words of the patient” about their observations of daily living.

Imagine the tremendous value in sharing the patient’s words not only to help the clinician communicate in a way that resonates with the patient but also to discuss the observation data patterns and their impact on the patient’s live.

After the conference, I reviewed the projects on the Project HealthDesign website to get a better understanding about the tools that were being used by patients. Several projects entail having the person enter the observations into their mobile phone; symptoms for Asthma, pain and energy levels for Crohn’s disease, caregiver stress for high risk babies and moods for Obesity. For the project focused on elders, I was interested to see sensors being used to collect information to monitor their cognitive decline.  

3. Online Patient Communities

Right from the beginning, I knew this panel was designed to be provocative- “Online Patient Communities are an effective way to Deliver Care”. Alex Drane, moderator and CVO at Eliza explained the panel's focus on peer to peer patient communities without clinicians. 

Shouldn’t this panel really have been titled “Online Patient Communities are an effective way to ‘support’ care”? So much has been written about the strong value that patients receive sharing their experiences.

Taking patient communities to the next level, it would be interesting to consider how one type of patient community differs from another.  Is there the same intensity of involvement for different types of conditions? Do patients participant in them mostly when they are diagnosed or do they stay on to give back? Are patients using the tracking tools and sharing with others in the community? Are there examples where clinicians are successfully participating in these patient communities?

Opportunities to Empower Patients with Data & Tools

Healthcare organizations have any opportunity to provide data and tools as resources to support consumer health management. Here are some areas that I am closely watching.

Connecting the Data Dots on Health: As a patient gathers information from the various tracking tools, how can this information be combined with other data about him to provide a more comprehensive picture to guide their collaborative care decisions? As Joseph Coughlin, Director MIT Age Lab asked during his Symposium keynote “Data, data everywhere but where are the drops of actionable knowledge?”

Interjecting Data into the Discussion: When can the patient discuss this information with their care team and get the needed guidance for behavior change? How can this information be incorporated in to a coaching session as the patient discusses the management of her chronic condition? During an intervention, how can this information support the decision discussion?

Measuring the Impact of the Tools: Each organization will need to think about measuring the elements that make the tool actionable. During her keynote on “e” is for Engagement, Susannah Fox shared a few key measures that they captured for the self trackers including the percent that said their data collection “affected a health decision”,  led them to “ask a doctor new question or seek a second opinion” and “changed their overall approach to health”. 

As organizations continue to evolve their business models and approaches, these data and tools become more important because they effectively engage patients in their own health. In recent discussions with leading organizations, I have heard about their increasing investments in connecting data and tools to bring more insight to the patient to better manage their health with the support of their care team. What is your organization doing to provide truly engaging online and mobile resources for your patients?

Independence Blue Cross Leverages Connected Mobile Health to Drive Employee Engagement

Healthrageous! engagement platform
Independence Blue Cross is moving quickly with their mobile connected health initiatives. Last fall, Independence partnered with Healthrageous to run a pilot with their own employees before expanding the program to their plan members. Now, Independence is rolling out the mobile connected health program to plan members. 

During the initial six month pilot, 677 Independence employees were invited to join the pilot and 270 employees or about 40% participated in the pilot. Each employee received an email describing the “Walk the Talk” Wellness Challenge. The email was from the head of the division personally inviting their employee to participate, along with a teaser and information about the program. 

“By participating in this challenge, you’ll get a sneak preview of Healthrageous, which we may offer to our customers in the future. Healthrageous makes it easy to view your progress and has interactive features to keep you motivated. It will help you set personal wellness goals, monitor your weight and blood pressure, and log your activity so that you’ll know you’re staying on target.”

Employees signed up for the program to improve their health and received educational messages delivered through the portal, email communications and mobile texts. Employees were offered a pedometer and a blood pressure cuff as tools to manage their health.  Independence also placed kiosks, two in the headquarters and one in two different satellite offices to enable employees to access program information and upload their activity and health information. 

“At Independence, we don’t just say we care about health and wellness — we walk the talk.  The Healthrageous! platform is a fun way to set personal wellness goals and take simple steps toward better health. It easy to track progress and has fun, interactive features to keep associates motivated", explains Kim Eberach, Vice President of Wellness & Community Health, Independence Blue Cross. 

Positive Pilot Results With Healthrageous Program 
Independence has taken an in-depth look at the pilot results gained from both employee participation and engagement. 

“We have been able to sustain high engagement rates throughout the duration of the program and have seen many users make changes in their daily behaviors.  Blood pressure rates are on a steady decline and activity is still up five months into the program.  We’ve seen the most engagement from individuals who identified themselves as having one or more chronic conditions,”  explains Mike Yetter, Director of eBusiness at Independence.

At the end of the pilot, Independence conducted research with the employee participants. Here are some of their comments:
“It is keeping me so motivated to be healthy and aware of my physical activities, weight and blood pressure.”
“The BEST part of this is the automatic recording of results.  Most people don't have time to add more things to their schedule, so not having to worry about going onto a website and logging in results is amazing.”
“Seeing the numbers on a daily basis is helpful.” 
“I truly feel this program has had a positive impact on focusing on my health. The program made me accountable to myself on keeping track of exercise, blood pressure and weight.”
“Walk the Talk has challenged me to get moving! I love it.  It's like having a real personal trainer, gently pushing you to do the right things; like drink more water, put the salt shaker down, get enough sleep each night, but also to have fun/unwind for at least 30 minutes per night.  These are all things we know to do.” 
“Once I got on track with the amount of steps I wanted to take every day, my main use for this has been weight management and seeing my weight gain/loss in front of my eyes.  It has been a source of great encouragement to visually see my weight decrease...  I can't fool myself with how much I think I weigh, it is all right there on the website.”

In addition to their marketing research, Independence is evaluating the program based on metrics and observations about how the features are being used:

Program Usage: Employees were much more likely at least once to log in (90.0%) or upload steps (88.5%) than upload weight (63.0%) or a blood pressure reading (62.6%) 

Continuous Effort: On an going basis, the percentage of employees that logged in or logged their steps (including automated upload) was significantly higher than those employees who entered their weight or blood pressure.  

Within the first two months of the pilot, overall engagement remained above 60%. 
 
Increased Activity: Approximately 20% of the program participants improved, increasing their step count by 2k step per day more than their baseline readings. 

Social Community Usage: Within the Healthrageous platform, participants have the option of specifying who sees their messages to their coworkers. 

Several employees have decided to nudge their colleagues to get them motivated for change:
“You are kidding me…. Less than 5k steps today?!”
“Looks like you are crushing me on steps this week”
“I don’t see any scale readings.  Too much partying?”
“Wow!  You have really kept up your activity. Nice job even with all the travel!!”

If you think back to the start of the year, my colleague Lynne A. Dunbrack from IDC Health Insights outlined the top 10 top predictions in the Healthcare IT Landscape for 2012  which included “Health and Wellness Programs Will Become Social and Mobile to Engage Consumers”.  This direction has certainly contributed to the success of Independence’s Healthrageous program. 

Factors Driving Employee Engagement
As I reviewed Independence’s Healthrageous program in detail, I identified five key factors that are driving employee engagement. In order to share these factors within context,  I will describe their value for an employee named Debbie who has Diabetes and is overweight. 

1. Personalized Approach.  When signing up for the program, Debbie can determine how she would like to participate from specifying her goals such as eating 5 fruits and vegetables each day, joining her coworkers for a walk over lunch 3 days a week to completing two dance classes each week. Based on Debbie’s specific goals, she receives messages through online, email and text which are educational and motivational. She can always go to her personalized page to see all of her information in one place. 

2. Virtual Coach.  After becoming a member of the program, Debbie receives frequent personalized communications to both remind and reinforce the goals that she selected. Debbie’s last message shared ways to increase her exercise throughout the week to see decreases in her weight. Each communication lists her recent activity and the dates that each activity was done. Debbie sees that she walked 10,000 steps most of the week of October 1st but only 5,345 steps on October 8th and 3,256 steps on October 15th which she realizes was when she was working on her big presentation. 

3. Social Community Support. When logging in and viewing her personal page on the Healthrageous platform, Debbie sees messages from her online social community which includes a message from a co-worker about an upcoming walking challenge as well as encouraging messages from her husband and daughter. Each participant is in control of her own social community and sends out invitations to friends and family to join.

4. Automated Activity Tracking.  Many of the wellness programs require the employee to enter the number of steps or time spent on an activity. Independence has placed sensors around the work site to automatically upload the activity information. This means that Debbie can walk by one of these spots and have her latest activity information reflected on her personalized page moments later. After all, Debbie is anxious to know how her team is doing in the latest competition.

5. Recognition & Rewards. For each Challenge round, participants who have achieved their goals are entered into a raffle drawing.  Prizes have varied from an IPod Shuffle and a Kindle Fire, to gift cards depending on the overall length of the challenge. All participants who achieved their goals also receive a branded athletic workout shirt for their achievement. Debbie proudly wears her shirt as she walks with her team at lunch. 

Future of Connected Health 
Connected Health continues to be an emerging and evolving space as organizations tie their mobile initiatives into key strategic programs. 

These technologies delivered through an online and mobile platform, offer an excellent opportunity to bridge the member’s experience between their insurance health program and their care team (e.g. physicians, nurses, coaches, caregivers, and other advocates). Connected Health will be most meaningful and engaging when data is gathered and shared to empower the consumer in ongoing behavior change towards their health goals. As Debbie discusses her progress in the Independence program with her Diabetes coach,  she not only receives encouragement and motivation but also ideas for continuing to challenge herself to reach her health goals.

Mass General’s Ambulatory Practice of the Future Engages Patients through Shared Decision Making

More than two years ago, Mass General launched their Ambulatory Practice of the Future, an innovative primary care clinic for employees and adult dependents. Developed as a Patient-Centered Medical home and ACO, today they support 3,000 enrolled patients with three doctors and two nurse practitioners.

This innovative practice was designed for and with patients for a better patient experience. Their experience begins with the initial greeting and extends through ongoing care interactions. There is a strong focus on patient education and empowerment. The care team collaborates to support each patient both in person and online. One of the goals of the practice is to reach patients where they are both physically and with their health.

Designed to Support Shared Decision Making

Once patients enter the welcoming and intimate care setting at The Ambulatory Practice of the Future (APF), they are ready to collaborate with their clinician. Sitting side by side, they review the medical record together and begin the discussion with health goals.

“We actually added a data field to the record called ‘Health and Life Balance Plan’ where we document  mutually agreed upon goal(s) for the coming weeks and months and then it is easily reviewed by the patient via their portal after the visit and in preparation for upcoming follow- up encounters”, explains Dr David Judge, Medical Director, Ambulatory Practice of the Future, Massachusetts General Hospital.

This collaborative approach has helped patients who have not historically been able to get engaged around a goal. Dr Judge shares a story about a 54 year old woman with diabetes who was reluctant to discuss next steps in management due to her fear of taking insulin. After allowing her to shape the goals with a focus on other areas of lifestyle management initially, coaching to realize some success and encouraging patience with the process, she has recently decided to proceed with insulin therapy.

Patient Engagement Tools

APF uses shared decision making videos developed by the Foundation for Informed Medical Decision Making to educate patients about screening tests and in managing specific medical issues such as prostate cancer.

Between their visits, patients can access the portal to view their medical information and communicate securely with their clinician. Although the care team can access the EMR from their mobile devices, APF expects that patients will be able to access their portal and records via mobile devices in the near future.

Patients can currently participate in an online visit with their care team. Dr Judge describes one of the complex patients that they monitor closely with frequent virtual visits.  “Mr. K is struggling with end stage renal failure, congestive heart failure and it has become difficult for him to come for office visits. Between scheduled virtual visits, emails from the patient and his wife and monitoring by visiting RNs, we are able to manage his needs fairly well with rare office visits.  We are on the verge of implementing true remote monitoring technologies but currently the patient or RN need to  report the measures (i.e. blood pressure, weight, blood sugar, PHQ 9 depression score, etc.).”

On the prevention side, several employees are using mobile apps to track their daily lifestyle choices regarding exercise and nutrition and sharing the information with their clinicians during their visits.

Future Path to Patient Engagement

During my panel at the recent Shared Decision Making Conference, Dr Judge spoke about some exciting new ways APF will be leveraging technology to engage their patients.

“We will be piloting the concept of 'apprenticeship' in which patients go through a more formal education process with coaching and demonstration of increased knowledge and skill to push the boundary on self management. We are developing programs tailored to specific medical conditions (i.e. HTN, DM and Depression). Goal setting for each patient helps the team to understand how to customize the program and to identify what specific barriers may be preventing success.”

“As we have done with diabetes, we expect that patients will learn not only to change their  lifestyle and make healthier choices but also adjust medication in the management of multiple chronic diseases. The care team will be able to monitor and assist but patients will truly drive their own care more effectively from day to day”, adds Dr Judge.

APF is starting a pilot soon using a mobile tablet that “allows very easy synchronous communication to transmit monitored blood pressure and to enable the patient and team to collaborate around lifestyle management and medication adjustment”. 

The term “apprenticeship” is being used by Dr. John Moore at MIT Media Lab. Dr Judge explains, “I think it appropriately describes the next step in the evolution of making shared decisions with patients. Beyond that is potentially a mastery of health and the potential for patient - to - patient support to grow.  We are hoping to launch both face- to -face and virtual peer to peer interactions in the near future.”  

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