The Health Care Blog – Page 156 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

COVID herd immunity: At hand or forever elusive?

Jul 30, 2020• 4

By MICHEL ACCAD, MD

With cases of COVID-19 either disappeared or rapidly diminishing from places like Wuhan, Italy, New York, and Sweden, many voices are speculating that herd immunity may have been reached in those areas and that it may be at hand in the remaining parts of the world that are still struggling with the pandemic. Lockdowns should end—or may not have been needed to begin with, they conclude. Adding plausibility to their speculation is the discovery of biological evidence suggesting that prior exposure to other coronaviruses may confer some degree of immunity against SARS-CoV2, an immunity not apparent on the basis of antibody seroprevalence studies.

Opposing those viewpoints are those who dismiss the recent immunological claims and insist that rates of infections are far below those expected to confer immunity on a community. They believe that the main reason for the declining numbers are the behavioral changes that have occurred either under force of government edict or, in the case of Sweden, more voluntarily. What’s more, they remind us that the Spanish flu pandemic of 1918-1919 occurred in 3 distinct waves. In the summer of 1918 influenza seemed overcome until a second wave hit in the fall. Herd immunity could not possibly have accounted for the end of the first wave.

The alarmists may have a point. However, recent history offers a more instructive example.

Until early 2015, epidemiologists considered Mongolia to be exemplary in how it kept measles under control. In the mid-1990s, the country instituted a robust vaccination program with low incidences of outbreaks, even by the standards of developed countries. In the early 2000s, it adopted a 2-step MMR immunization schedule and, after 2005, its vaccination rates were upwards of 95%. From 2011 through 2014, not a single case of the virus was recorded, leading the WHO to declare measles “eradicated” from Mongolia in November 2014.

THCB GANG, Episode 20

Jul 30, 2020

Episode 20 of “The THCB Gang” was live-streamed on Thursday, July 30th! Watch it below!

Joining Matthew Holt were some of our regulars: writer Kim Bellard (@kimbbellard), MD & hospital system exec Rajesh Aggarwal (@docaggarwal), health futurist Ian Morrison (@seccurve), WTF Health Host Jessica DaMassa (@jessdamassa), and guest Jennifer Benz, communications leader at Segal Benz (@jenbenz). We discussed how employers & health plans need to build trust in order to improve engagement data, how health consumers’ are changing the way they interact with health care, and how to support patients when they are accessing the system.

If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

Robert Wood Johnson Foundation Innovation Challenges Blog Post Announcing Semi-Finalists

Jul 29, 2020

Health in 2 Point 00, Episode 138 | Health Tech Funding in Late July?

Jul 28, 2020

There is still health tech funding going on in late July? Wow! On Episode 138 of Health in 2 Point 00, Jess asks me about Ro getting $200M from General Catalyst to expand their telehealth platform, Indigo Diabetes raising 38M Euros to develop its CGM Sensor, Angle Health landing $4M to create a health plan for startups, and Sidecar Health closing a $20M for their point-of-service payments! — Matthew Holt

Too Many Small Steps, Not Enough Leaps

Jul 28, 2020

By KIM BELLARD

I was driving home the other day, noticed all the above-ground telephone/power lines, and thought to myself: this is not the 21st century I thought I’d be living in.

When I was growing up, the 21st century was the distant future, the stuff of science fiction. We’d have flying cars, personal robots, interstellar travel, artificial food, and, of course, tricorders. There’d be computers, although not PCs. Still, we’d have been baffled by smartphones, GPS, or the Internet. We’d have been even more flummoxed by women in the workforce or #BlackLivesMatter.

We’re living in the future, but we’re also hanging on to the past, and that applies especially to healthcare. We all poke fun at the persistence of the fax, but I’d also point out that currently our best advice for dealing with the COVID-19 pandemic is pretty much what it was for the 1918 Spanish Flu pandemic: masks and distancing (and we’re facing similar resistance). One would have hoped the 21st century would have found us better equipped.

So I was heartened to read an op-ed in The Washington Post by ReginaDugan, PhD. Dr. Dugan calls for a “Health Age,” akin to how Sputnik set off the Space Age. The pandemic, she says, “is the kind of event that alters the course of history so much that we measure time by it: before the pandemic — and after.”

Can Community Be a Medicine?

Jul 27, 2020

By ARAS TOKER

Analysis on peer accountability focused community building efforts in making lifestyle changes through digital therapeutic programs

Before we jump ahead to the medicine piece, what the heck does a community even mean? In the past, communities were more likely associated with a group of people living in the same physical location such as a neighborhood, school, or a town. I remember my neighborhood soccer community very well, for instance. Instead of being born into or trying to fit in, community is something we choose for ourselves and express our identities through. With the advancement of accessing the high-speed internet globally, today’s community has no physical or geographical boundaries.

Community builder Fabian Pfortmüller brilliantly explains the difference between communities and other groups. He asserts that unlike project teams or companies who are optimizing for external purposes (collective goals); communities optimize for internal purposes (the relationship and the shared identity). His definition of a community deeply resonated with me and the communities that I had the opportunity to build.

Image for post — *Pfortmüller’s definition of community*

THCB Gang, Episode 19, July 23, 2020

Jul 23, 2020• 1

This episode of the THCB Gang included regulars Grace Cordavano (@GraceCordovano) , Deven McGraw (@HealthPrivacy), Ian Morrison (@seccurve), and special guest patient entrepreneur Robin Farmanfarmaian (@Robinff3). We talked about patient experiences, the state of play in health care business, and about new technologies and more. And after tomorrow it gets preserved as a podcast on Itunes & Spotify Enjoy! – Matthew Holt

Stop Rolling Back Expanded Practice Licenses for Nurse Practitioners

Jul 23, 2020

Katie Wolf

By DALLAS M. DUCAR, MSN, PMHNP-BC, RN, CNL and KATIE WOLF, MBA

We’re not in Kansas anymore. Kansas has rescinded an executive order that dramatically empowered and expanded its healthcare workforce as COVID-19 cases soared. In the best interest of patients now and in the future, other states must not follow Kansas’ example.

The story of coronavirus is far from over in the United States and the impacts to our healthcare systems continue. America’s clinical workforce began this battle at a deficit and, in certain states, continues under those conditions. For years, studies outlined shortages of medical doctors and predicted gaps to worsen over time. Prior to the presence of COVID-19, a contentious debate emerged as to how to address the deficit of physicians. Nurse practitioners (NPs) lobbied for broader clinical autonomy to help bridge this gap. At present, rapid influxes of critically ill patients have strained our healthcare systems to a breaking point laying bare the resource constraints in our healthcare system.

Alex Azar, the Secretary of Health and Human Services responded to this need by sending a letter to governors to expand the 290,000 NPs in the United States, bolstering our provider workforce during this time of crisis. Empowering NPs to independently treat patients has needlessly been a long-standing point of contention in healthcare. Increasing the breadth of NP autonomy makes sense in the face of COVID-19. Wisely, since the start of the pandemic, the number of states allowing NP autonomy jumped from 22 states to 48. This structural change to healthcare is long overdue and should remain in perpetuity. However, at the end of May, Kansas became the first state to expire this expansion of NP authority.

NPs are independently licensed and trained to diagnose and prescribe medications and treatments. This role grew organically out of the field of nursing, to provide holistic and patient-centered care to their communities. Nurses become nurse practitioners by choice, honing their skills through years of training at patients’ bedsides, and are part of the most trusted profession in the United States.

Health in 2 Point 00, Episode 137| $10M in Seed Rounds, AI & Chatbots, and a New Meditation App?

Jul 22, 2020

Today on Episode 137 of Health in 2 Point 00, Jess questions if “Jack in the Bean Stalk” is actually abut how VCs are growing into the health tech space. Listen to Jess’s take on the comparison as she asks me about Sprout getting $10M in a seed round to grow its Autism platform, Gyant securing $13.6M to improve its AI & Chatbot functions for providers, Meditopia receiving $15M for its medication app, Caption Health raising $53M to help people conduct ultrasounds, and Kind Body raising $32M for its fertility care platform. Enjoy! — Matthew Holt

Collective State Action Is Needed to Fight This Pandemic Right Now

Jul 22, 2020

By KEN TERRY

As COVID-19 cases soar across the country, the federal government has lost control of the situation. Amid the Trump Administration’s happy talk and outright dismissal of the crisis, the U.S. is experiencing a forest fire of contagion and hospitalizations, and an upsurge in COVID-related deaths has already begun.

Other countries like Taiwan, South Korea, Germany, Australia and New Zealand have controlled their outbreaks, which is why their COVID-19 infections and deaths have been minimal or trending downward in recent months. To replicate those nations’ strategies of testing, contact tracing and quarantining, the U.S. Congress would have to appropriate about $43.5 billion, according to one estimate. But as we know, Senate Republicans won’t pass such a bill without Donald Trump’s prior approval—and that’s unlikely as long as his main focus is on reopening the economy.

We can hope that electoral victory by the Democrats in November will change this equation, but Joe Biden won’t take office until January if he wins. Meanwhile, the coronavirus is chewing up America. We can’t afford to wait six months to blunt the impact of this horrible disease. However, there is a solution that doesn’t depend on federal leadership: states can form compacts that would form the basis for collective action to get us out of the trap we’re in.

Interstate compacts are very common in the U.S. Various pacts cover everything from clean water and clean air to medical licensure, mental health and interstate transportation. For example, under the Middle-Atlantic Forest Fire Protection Compact, which includes Ohio, West Virginia, Virginia, Pennsylvania, New Jersey, Delaware, and Maryland, member states assist one another in fire prevention and suppression and firefighter training.