The Health Care Blog – Page 169 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

A Dream Deferred? Price Transparency in the American Healthcare System

Apr 21, 2020• 1

By JOANNE RODRIGUES-CRAIG

Financial well-being, or the state of an individual’s personal monetary affairs, is one of the six core indicators of wellness in the Gallup-Healthways Well-Being Index. Poor financial well-being can lead to a whole host of short and long term mental and physical health issues, including depression, anxiety, troubled relationships and chronic stress.^[1] ^[2]

It is surprising how American hospitals and other health providers have neglected financial well-being when considering their patients’ health. In a recent study by the American Cancer Association, 56% of Americans suffer from hardships related to the cost of care.^[3] Medical costs are the primary cause of 67% of all bankruptcies in the United States.^[4] To think that health care costs are not having a deleterious effect on American’s general well-being is a complete fallacy.

Even as a former health technology data scientist, I was largely in the dark about how health provider pricing works. Finding health provider pricing is like pulling teeth; it’s extremely time0consuming, frustrating (and sometimes painful) to get a health estimate for even the simplest procedures. Having poor or inadequate insurance can feel like a weight holding you down during your most vulnerable time, in the midst of a major health crisis.

Nursing Students and Educators Must Be Part of a National Public Health Surveillance Strategy

Apr 20, 2020

By KAREN JOHNSON PhD, RN

Shortly before our world was turned upside down by COVID-19, I visited Space Center Houston with my family. We marveled at the collective ambition and investment it took to move from space travel being an aspirational dream to setting foot on the moon. I thought about my favorite scene from the movie Apollo 13, when Gene Kranz overhears the NASA Director saying “This could be the worst disaster NASA has ever experienced,” and candidly replies, “With all due respect, sir, I believe this is going to be our finest hour.”

Just months later, our entire planet is on a mission to turn tragedy into triumph. Only this time, Americans have not led the way in proactively translating science into action for the benefit of humankind. Instead, we ignored scientists who warned about the inevitability of a pandemic and now lead the world in most confirmed cases (which, due to our testing debacles, underestimates actual cases). As a public health nurse, this is not a race I want to see us leading. Future outbreaks are all but certain while we wait for a vaccine. Every single one of us must start preparing now, for we will all have a role to play.

To be sure, it is imperative that we all stay the course with current physical distancing efforts to prevent spread, minimize death, and avoid the collapse of our healthcare system and its ability to care for patients with COVID-19 and other life-threatening conditions that do not pause just because of a pandemic. But social distancing cannot be the only public health tool used to bring the pandemic under control.

Public health experts agree we need a coordinated national public health surveillance strategy that includes widespread testing in order to identify and isolate infected people early (this is crucial given how many contagious people are asymptomatic), contact tracing to figure out who has been exposed to infected individuals, and quarantining everyone who tests positive or has come in contact with an infected person. We must leverage technology to ensure testing provides fast and accurate results, and that we are able to safely and comprehensively track exposures. Without accurate, detailed, and timely data about the epidemiology of COVID-19, we cannot make scientifically sound decisions about how to ease social distancing or ethical decisions about how to equitably allocate scarce healthcare resources to communities of greatest need.

The Official Estimates of COVID-19 Deaths Are Way Too Low

Apr 17, 2020• 1

By KEN TERRY

While President Trump mulls whether to reopen the country again in May, and as Fox & Friends host Brian Kilmeade suggests that “only” 60,000 people will die from the coronavirus, there are some warning signs that the White House COVID-19 Task Force’s prediction of 100,000-240,000 deaths may be way too low.

That isn’t surprising, considering that Administration officials said this projection depended on us doing everything right. Of course, it appears that large sections of the country have done many things wrong—whether it’s Florida Governor Ron DeSantis’ reluctance to close houses of worship or the refusal of several state governors to issue stay at home orders. That doesn’t include Trump’s own refusal to admit the seriousness of the COVID-19 outbreak until mid-March and the continuing failure of the federal government to ensure an adequate supply of test kits, PPE and ventilators.

So here’s what all of this may be leading up to: a minimum of 600,000 COVID-related deaths in the U.S. over the next two years.

Wait — Robots Work But I Get Paid

Apr 17, 2020• 1

By KIM BELLARD

We’re not through the COVID-19 pandemic. We’re probably not even near the end of the beginning yet. That hasn’t stopped many pundits to start speculating about how our society (and our healthcare system) are likely to be permanently changed as a result, such as continued reliance on telecommuting and telemedicine.

OK, I’ll play too: I believe we need to greatly expand the role of robots, and begin something that resembles Universal Basic Income (UBI). They’re not the only changes that may result, but they are two that should.

Robots

We’ve been seeing robots infiltrating the workforce for many decades, such as in manufacturing but also in many other industries.

Still, though, as our economy pares down to “essential businesses” during the pandemic, I’ve been alarmed at how many of the jobs remain done by humans. Not just healthcare workers on the front lines but also all those people doing the cleaning for essential businesses, all those people in the supply chain of food and other vital materials, all those people making deliveries, all those first responders, all those people all those people keeping the power on, the water running, and the internet streaming, among others. And so on.

Health in 2 Point 00, Episode 117 | Wellthy, Lionrock Recovery, Datos and Gaido

Apr 16, 2020

On Episode 117, we bring you the late-night edition of Health in 2 Point 00. Jess asks me about Wellthy Therapeutics raising $4 million—they’re a digital therapeutics company I’ve been working with out of the Bayer group, definitely a space to watch. Lionrock Recovery raises $7 million, lots of activity in this area of telehealth for recovery and rehabilitation. Also getting $7 million is Datos Health, an Israeli company with a remote monitoring platform. Finally, Biofourmis acquired Gaido Health, expanding into the oncology space. —Matthew Holt

Rationale for Testing Anticoagulants Against COVID-19

Apr 16, 2020

By ETHAN WEISS, MD

We have seen and heard about the classic symptoms of COVID-19 at UCSF Medical Center, where I work as a cardiologist. Patients keep coming in with pulmonary distress, pneumonia, and ultimately, Acute Respiratory Distress Syndrome (ARDS) – the life-and-death situation that requires ventilators.

However, I’m beginning to learn about other symptoms that some doctors are noticing. There are numerous reports of other complications, especially in advanced disease.

One of the most interesting involves disruption of the blood’s coagulation system. New anecdotal reports have described clotting in test tubes and lines, derangements of clinical clotting assays, pulmonary emboli, large clots in the heart, as well as microvascular thrombosis.

Elevation in D-Dimer, (a biomarker of coagulation system activation) has been associated with dramatically increased risk of death from COVID-19. This has led some to speculate that empiric treatment with anticoagulants might improve outcomes in these critically ill patients. Indeed, there was this recent publication of a retrospective analysis of anticoagulation with heparin or low molecular weight heparin showing an association with improved outcomes in COVID-19 patients in China.

InTouch Health’s CEO on B2B Telehealth Demand & Post-Covid Virtual Care Market | WTF Health

Apr 16, 2020

By JESSICA DaMASSA, WTF HEALTH

“I never anticipated — and no one did — the level of uptake and the level of scale.”

It says a lot that Joe DeVivo, CEO of Intouch Health, who’s worked with hospitals and health systems on standing up B2B-focused telehealth programs for years (and whose company was acquired by Teladoc Health for $600-million dollars in January) is surprised about the uptake of virtual care during the COVID-19 pandemic.

“Historically, I look at virtual care as a bell curve,” says Joe. “On one side of that small tail of the bell curve are the virtual care companies. Teladoc dominates that space for D2C. There’s millions of consultations a year, and we’re seeing a subset of that. On the opposite side of the bell curve is high-acuity, and what InTouch has been doing for critical care.”

“This crisis, and the changes in reimbursement, have opened up the middle of that bell curve. The core, everyday transaction of healthcare is now being impacted by virtual care. And the big question that everyone has is, “is this going to stick? Is this a crisis management tool and we’re going to go back to the ways of the past, or is that genie out of the bottle?”

We put Joe on-the-spot with his own question, find out what he thinks it will take to enable the permanent shift to virtual care at-scale, and dig in on how demand for telehealth within hospitals has changed as a result of the pandemic, where its not only being used to expand access to specialists, but has also been adapted into a PPE-hack to help frontline hospital workers distance themselves from infected patients.

And what of working with Teladoc? While waiting for the paperwork to finalize (all on-schedule for the end of Q2 as originally announced), the two have organized a co-selling agreement to be able to “hit the market fast” and bring their “hospital-to-home” end-to-end virtual care offering to those who need it now.

The Important Role of Faith-based Organizations in the Context of COVID-19

Apr 16, 2020• 2

By KATHRYN P. DEROSE and REV. MICHAEL A. MATA

As Christians experienced Holy Week 2020, the week commemorating the trial, suffering, and death of Jesus, the somber tone such remembrances evoke took on new meaning in the midst of the COVID-19 epidemic with the catastrophic loss of life and livelihoods. Many churches remained physically closed, some already outfitted with sophisticated systems for live streaming and others scrambled, along with their congregants, to create meaningful virtual worship and fellowship opportunities. Finding ways to maintain physical distancing while still providing social and spiritual connections.

These challenges face people of other faiths as well since the current guidance regarding social distancing affected those observing Passover, April 8-16 and will likely affect Orthodox Easter, April 19 and Ramadan, which will start April 23.

Maintaining social and spiritual connections in the midst of COVID-19 are not the only challenges facing our communities of faith. For centuries if not longer, religious congregations have played critical roles in providing and supporting social services within communities. There are over 345,000 religious congregations in the US of various faiths and denominations and, despite declining rates of religious affiliation and attendance, national surveys still find a sizeable proportion – about 45% – of all adults report attending religious services at least monthly. Religious congregations play even more important roles in particular subgroups, such as low-income communities and among certain racial-ethnic minority groups and immigrants, the elderly, and other vulnerable groups, making faith-based organizations critical to the COVID-19 response in the short and long terms.

The THCB Gang: Episode 5

Apr 15, 2020

Episode 5 of “The THCB Gang” was live-streamed Thursday, April 16 at 1pm PT- 4pm ET! 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the sh*t about health care business, politics, practice, and tech. It tries to be fun but serious and informative! If you miss it, it will also be preserved as a weekly podcast available on our iTunes & Spotify channels.

Deven McGraw (@healthprivacy), Kim Bellard (@kimbbellard), Grace Cordovano (@gracecordovano), Michael Millenson (@MLMillenson), and Dave deBronkhart (@ePatientDave) all discussed the recent news surrounding COVID-19, and their guesses on how it will impact the landscape of health care; from policy to practice — Matthew Holt