The Health Care Blog – Page 159 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Silence Can Be Deadly: Speak up for Safety in a Pandemic

Jun 30, 2020• 1

By LISA SHIEH MD, PhD, and JINGYI LIU, MD

There have been disturbing reports of hospitals firing doctors and nurses for speaking up about inadequate PPE. The most famous case was at the PeaceHealth St. Joseph hospital in Washington, where Dr. Ming Lin was let go from his position as an ER physician after he used social media to publicize suggestions for protecting patients and staff. At Northwestern Memorial Hospital in Chicago, a nurse, Lauri Mazurkiewicz warned colleagues that the hospital’s standard face masks were not safe and brought her own N95 mask. She was fired by the hospital. These examples violate a culture of safety and endanger the lives of both patients and staff. Measures that prevent healthcare workers from speaking out to protect themselves and their patients violate safety culture. Healthcare workers should be expected to voice their safety concerns, and hospital executives should be actively seeking feedback from frontline healthcare workers on how to improve their institution’s Covid-19 response.

Share power with frontline workers

According to the Institute for Healthcare Improvement, it is common for organizations facing a crisis to assume a power grab in order to maintain control. As such, it is not surprising that some hospitals are implementing draconian policies to prevent hospital staff from speaking out. While strong leadership is important in a crisis, it must be balanced by sharing and even ceding power to frontline workers. All hospitals want to provide a safe environment for their staff and high-quality care for their patients. However, in a public health emergency where resources are scarce and guidelines change daily, it’s important that hospitals have a systematic approach to keep up.

And We Thought Pandemics Were Bad

Jun 29, 2020

By KIM BELLARD

Those of us of a certain age, or anyone who loves classic movies, remember the famous scene in “The Graduate” when Benjamin Braddock is given what is intended as a helpful clue about the future. “Plastics,” one of his father’s friends says. “There’s a great future in plastics.”

Well, we’re living in that future, and it’s not all that rosy. Plastics have, indeed, become an integral part of our world, giving billions of us products that we could never otherwise have or afford. But our future is going to increasingly be driven by an unintended consequence of the plastics revolution: microplastics.

And that’s not good.

Microplastics are what happens to plastic after it has gone through the wringer, so to speak. Plastic doesn’t typically decompose, at least not in any time frame we’re capable of grasping, but it does get broken down into finer and finer particles, until they reach microscopic levels (thus “microplastics”). We’ve known for some time that plastics were filling our landfills, getting caught in our trees and bushes, washing up on our shorelines, even collecting in huge “garbage patches” in the ocean. But it wasn’t until more recently that we’ve found that plastics’ reach is much, much broader than we realized, or could see.

The ocean full of microplastics, and fish are as well. They’re in our drinking water. Indeed, “There’s no nook or cranny on the surface of the earth that won’t have microplastics,” Professor Janice Brahney told The New York Times.

Dr. Brahney was coauthor on a recent study that found microplastics were pervasive even in supposedly pristine parts of the Western U.S. They estimated that 1,000 tons of “plastic rain” falls every year onto protected areas there; 98% of soil samples they took had microplastics. Dr. Brahney pointed out that, because the particles are both airborne and fine, “we’re breathing it, too.”

Community Organizations Can Reduce the Privacy Impacts of Surveillance During COVID-19

Jun 26, 2020

By ADRIAN GROPPER, MD

Until scientists discover a vaccine or treatment for COVID-19, our economy and our privacy will be at the mercy of imperfect technology used to manage the pandemic response.

Contact tracing, symptom capture and immunity assessment are essential tools for pandemic response, which can benefit from appropriate technology. However, the effectiveness of these tools is constrained by the privacy concerns inherent in mass surveillance. Lack of trust diminishes voluntary participation. Coerced surveillance can lead to hiding and to the injection of false information.

But it’s not a zero-sum game. The introduction of local community organizations as trusted intermediaries can improve participation, promote trust, and reduce the privacy impact of health and social surveillance.

Balancing Surveillance with Privacy

Privacy technology can complement surveillance technology when it drives adoption through trust borne of transparency and meaningful choice.

Gastrointestinal Diseases in America: The Costly Impact on Employers and Patients

Jun 25, 2020• 2

THCB Gang Episode 15

Jun 25, 2020

Episode 15 of “The THCB Gang” was live-streamed on Thursday, June 25th!

Joining Matthew Holt were our regulars: health futurist Ian Morrison (@seccurve), writer Kim Bellard (@kimbbellard), WTF Health Host Jessica DaMassa (@jessdamassa), radiologist Saurabh Jha (@RougeRad), policy expert Vince Kuraitis (@VinceKuraitis), and THCB’s Editor-in-Chief, Me (@zoyak1594)! We got into increasing COVID-19 rates, updates in health policy, what is the future of hospitals, and how the new generation is dealing with the health care industry. All while keeping an eye on the politics of the US.

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

Health in 2 Point 00, Episode 130 | DispatchHealth, BrightInsight, Cedar, Big Health, Redox & Plume

Jun 24, 2020

Sadly conferences have all gone digital, but Jess and I are still here covering deals on Health in 2 Point 00. On Episode 130, DispatchHealth gets $136 million, providing in-home health care by sending a tech to your house, BrightInsight gets $40 million to help biopharma and medtech companies leverage connected devices and develop digital health tools, Cedar raises $102 million for their medical billing software, Big Health raises $39 million for digital mental health tools Sleepio and Daylight, Redox lays off a quarter of their staff, and Plume raises a $2.9 million seed round, providing telehealth for trans individuals. —Matthew Holt

How Traditional Health Records Bolster Structural Racism

Jun 24, 2020

By ADRIAN GROPPER, MD

As the U.S. reckons with centuries of structural racism, an important step toward making health care more equitable will require transferring control of health records to patients and patient groups.

The Black Lives Matter movement calls upon us to review racism in all aspects of social policy, from law enforcement to health. Statistics show that Black Americans are at higher risk of dying from COVID-19. The reasons for these disparities are not entirely clear. Every obstacle to data collection makes it that much harder to find a rational solution, thereby increasing the death toll.

In the case of medical research and health records, we need reform that strips control away from hospital chains and corporations. As long as hospital chains and corporations control health records, these entities may put up barriers to hide unethical behavior or injustice. Transferring power and control into the hands of patients and patient groups would enable outside auditing of health practices; a necessary step to uncover whether these databases are fostering structural racism and other kinds of harm. This is the only way to enable transparency, audits, accountability, and ultimately justice.

A recent review in STAT indicates that Black Americans suffer three to six times as much morbidity due to COVID-19. These ratios are staggering, and the search for explanations has not yielded satisfying answers.

Will the Public Health Emergency Policy Changes for Telehealth & Remote Monitoring Stick?

Jun 24, 2020• 1

By JESSICA DaMASSA, WTF HEALTH

With about one month left on the existing 90-day Public Health Emergency that’s eased regulations and improved reimbursement to help make telehealth, remote monitoring, and other virtual care services easier for providers to implement and patients to use, health tech companies across the US are wondering what it will take to make these changes permanent. One of digital health’s few ‘DC Insiders,’ Livongo Health’s VP of Government Affairs, Leslie Krigstein, gets us up-to-speed on what’s happening on Capitol Hill and what we can expect moving forward. What changes will (literally) require an Act of Congress? And what can be handled by HHS and CMS? From codes and co-pays to e-visits and licensing, Leslie breaks it down and tells us whether or not we can continue to expect a ‘health tech-friendly’ agenda in Washington DC.

TikTok Teen’s Time

Jun 23, 2020• 2

By KIM BELLARD

I knew about TikTok, but not “TikTok Teens.” I was vaguely aware of K-Pop, but I didn’t know its fans had common interests beyond, you know, K-Pop. I’d been tracking Gen X and Millennials but hadn’t really focused on Gen Z. It turns out that these overlapping groups are quite socially aware and are starting to make their influence felt.

I can’t wait for them to pay more attention to health care.

This is the generation that has grown up during/in the wake of 9/11, the War on Terror, the War on Drugs, the 2008 recession, the coronavirus pandemic, and the current recession — not to mention smartphones, social media, online shopping, and streaming. Greta Thunberg is Gen Z, as is Billie Eilish, each of whom is leading their own social movements. This generation has a lot to protest about, and a lot of ways to do it.

They were in the news this past weekend due to, of all things, President Trump’s Tulsa rally. His campaign had boasted about having a million people sign up for the rally, only to find that the arena was less than a third filled. An outdoor rally for the expected overflow crowd was cancelled.

It didn’t take long for the TikTok Teens/K-Pop fans to boast on social media about their covert — to us older folks — campaign to register for the rally as a way to gum up the campaign efforts. Steve Schmidt, an anti-Trump Republican strategist, tweeted: “The teens of America have struck a savage blow against @realDonaldTrump.”

Long-Term Telehealth Expansion Should Be Planned Intelligently

Jun 22, 2020

By KEN TERRY

Telehealth has been a lifeline for many doctors and patients during the pandemic, and the decisions of CMS and many private payers to cover telehealth visits—in some cases, at full parity with in-person visits–has helped physician practices stave off bankruptcy. Assuming that these policies remain in effect after the pandemic, I agree with the commentators who assert that telemedicine will become a much larger part of healthcare.

Nevertheless, what that means is still far from clear. To begin with, telehealth visits may be adequate for some purposes but not for others. Historically, the technology has been used mostly for diagnosing and treating minor acute problems. Physicians were generally reluctant to take on more complex cases or treat chronic conditions without seeing patients in person.

Pre-pandemic, most telehealth encounters took place between patients and doctors who had never treated them before, using services such as Teladoc, American Well and Doctor on Demand that usually didn’t communicate with the patients’ personal doctors. Some larger physician groups had begun to use the technology with their own patients; but even in those groups, certain doctors were often assigned to conduct virtual visits with patients who were not necessarily their own.

Clearly, the latter barrier has been broken down, with nearly half of U.S. physicians in an April survey saying they were using telemedicine in patient care. While it’s unclear what kinds of cases these doctors are diagnosing and treating, it’s likely that the scope of practice for telehealth has been expanded to include some chronic disease care.

The main barrier to this expansion is that, in telehealth encounters, physicians don’t necessarily have the data they need to make sound medical decisions. To manage hypertension, for instance, the physician needs to be able to measure a patient’s blood pressure. If the patient has a digital blood pressure cuff at home, that data can be transmitted to a physician’s office; in fact, a smartphone app could show the trend of the patient’s hypertension over time. Right now, however, only a small fraction of patients have this kind of remote monitoring equipment.