Coronavirus could financially cripple many Americans

Americans’ health may not be the only thing at stake as the coronavirus continues its unrelenting spread in the U.S. The virus could also prove financially crippling for many individuals.

“There are all kinds of pathways for people to be financially affected by this,” said John Graves, an associate professor of health policy at Vanderbilt University.

There are more than 114,000 confirmed cases across more than 100 countries and regions. The U.S. has more than 750 confirmed cases of COVID-19 — the name of the disease — and at least 26 Americans have died.

The full CNBC article can be viewed at this link.  

Why you’re more likely to see a physician assistant than a doctor

Dr. Aziz Nazha, the oncologist in charge of the Cleveland Clinic’s Center for Clinical Artificial Intelligence, has a controversial opinion about what kind of training the next generation of doctors should undergo. “Physicians of the future should know how to program,” he said, “but I know I won’t win that battle.”

The fact that there are even discussions about whether coding should be a requirement of medical school is just one of the many changes at hand for the millions of clinicians who make up the U.S. health care workforce.

Not only are there predicted shortages of nurses and physicians that are expected to worsen over the next decade, industry attempts to shift from a fee-for-service reimbursement model to a value-based system have called for more efficient clinicians and better care for patients.

At the same time, hospitals are increasingly turning to artificial intelligence tools like chatbots and digital scribes and machine-learning models that aim to predict readmission rates and examine mammograms for breast cancer. (Even the tech giants are starting to dabble in health care. Apple Inc. is trying to improve nursing workflow, while Alphabet Inc.’s Google is testing whether digital voice assistants can reduce the amount of time doctors spend entering patient information into the electronic health record.)

All of these trends are influencing how care is delivered and by what kind of clinician. In the exam room of the future — which may be your living room — the doctor may ask about your feelings or know how to code, a physician assistant may be virtual or human, and a nurse may be assisted by a robot.

The full MarketWatch article can be viewed at this link.  

Insurers promise to cover coronavirus tests, relax coverage policies

A major health insurance trade group is pledging its member plans will cover doctor-ordered testing for the coronavirus amid rising confusion and concern about who will bear the cost of care in an outbreak.

America’s Health Insurance Plans made the commitment Thursday, although it's still unclear when insurers might have to start paying for tests. So far, the Centers for Disease Control and Prevention has picked up the tab for COVID-19 testing. The cost picture is expected to become more complicated as more private labs and academic medical centers launch their own testing. Thursday alone, commercial labs Quest Diagnostics, LabCorp and BioReference Laboratories announced they'd launch testing for the virus.

The full Politico article can be viewed at this link.  

Preparing for Coronavirus to Strike the U.S.

As the new human coronavirus spreads around the world, individuals and families should prepare—but are we? The Centers for Disease Control has already said that it expects community transmission in the United States, and asked families to be ready for the possibility of a “significant disruption to our lives.”

Be ready? But how? It seems to me that some people may be holding back from preparing because of their understandable dislike of associating such preparation with doomsday or “prepper” subcultures. Another possibility is that people may have learned that for many people the disease is mild, which is certainly true, so they don’t think it’s a big risk to them. Also, many doomsday scenarios advise extensive preparation for increasingly outlandish scenarios, and this may seem daunting and pointless (and it is). Others may not feel like contributing to a panic or appearing to be selfish.

Forget all that. Preparing for the almost inevitable global spread of this virus, now dubbed COVID-19, is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.

Best Practices

1. Get a flu shot - The flu shot helps decrease the odds of having to go to the hospital for the flu, or worse yet, get both flu and COVID-19; comorbidities drastically worsen outcomes.
2. Stock up on supplies -Stock up supplies at home so that you can stay home for two or three weeks, going out as little as possible.
3. Help people stay at home - If you are in a position of authority, that means figuring out how to help people stay at home, by preparing for and allowing for remote work, or allowing for future work to make up for missed days and other similar plans.
4. Keep your hands clean - Washing your hands often, using alcohol-based hand-sanitizer liberally and learning not to touch your face are the most important clinically-proven interventions there are.
5. Keep a reserve of prescriptions and medications - If you need prescription or other medications, it’s a good idea to stock up if possible—if for no other reason than to avoid pharmacies, both to reduce their burden and also to not be in the same line as people who may be ill.

The full Scientific American blog article can be viewed at this link.  

PRESCRIPTION PRICE TRANSPARENCY AND THE PATIENT EXPERIENCE

As stories about sticker shock and the cost of care dominate headlines and policy discussions, healthcare organizations are looking for cost-effective ways to improve patient outcomes and experience. Prescription price transparency tools hold particular promise. We already know that providers want greater price transparency for their patients. In fact, 74% of U.S. physicians say they want to see a patient’s medical benefit information before prescribing, and 59% want to compare the cost of similar medications. 

Are patients equally eager to talk medication costs and coverage at the point of care? Surescripts commissioned a survey of 1,001 U.S. patients to understand their prescription challenges, desires and behavior—and how their experience with their prescriptions affects the healthcare decisions they make.

The full Surescripts report can be viewed at this link.  

Bringing a Spotlight to the Influences of Social Determinants of Health

It is my distinct honor as President Elect for the American Association of Cancer Education (AACE) to write this editorial that highlights the importance of addressing social determinants of health (SDH) in cancer education research and practice, and to invite you to our upcoming conference. The 2020 International Cancer Education Conference (ICEC), held October 14–16, 2020, in College Park, MD, USA, centers on: “Using Cancer Education to Address Social Determinants of Health”. The conference, organized in partnership with three leading organizations: the AACE, the Cancer Patient Education Network, and European Association of Cancer Education, brings together multidisciplinary professionals to share transdisciplinary cancer education research, policy, and practice innovations across the cancer care continuum. Your participation in this meeting will further generate new ideas that consider “context” and transcend beyond individual factors in cancer prevention, early detection and diagnosis, treatment, survivorship, and end of life.

So what are social determinants of health and why should cancer education professionals care about them? The World Health Organization (WHO) defines social determinants of health as “the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. Social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.” This powerful definition, widely supported by leading health organizations worldwide, outlines a lofty mandate for all engaged in the health care of individuals, families, and populations. As such, the impact for the field of cancer education is significant. All involved must proactively collaborate and exchange ideas to escalate our impact.

The full editorial can be downloaded below.  

The health care crisis no one is talking about

There are certain issues that you’d expect to be top-of-mind for older Americans, whether it be Social Security, Medicare, or scams that target seniors. But as I traveled through my district this year and held workshops for seniors across Maryland, there was one topic that I was surprised came up again and again: loneliness.

The crisis of social isolation and loneliness currently affects almost half of our population, and seniors are front and center.

The full article from The Hill can be viewed at this link.  

How Virtual Reality Is Benefiting Seniors

It’s usually the youth that is associated with cutting-edge technology, but we’re seeing an unlikely group of early adopters emerge—the elderly. Virtual Reality (VR) is being used to better the lives of senior citizens all over the world by reducing loneliness, improving their mental health and transporting them to far-flung places without needing to leave the comfort of their home. 

The full Forbes article can be viewed at this link.  

Application of Blockchain to Maintaining Patient Records in Electronic Health Record for Enhanced Privacy, Scalability, and Availability

Electronic Health Record (EHR) systems are increasingly used as an effective method to share patients’ records among different hospitals. However, it is still a challenge to access scattered patient data through multiple EHRs. Our goal is to build a system to access patient records easily among EHRs without relying on a centralized supervisory system.

We apply consortium blockchain to compose a distributed system using Hyperledger Fabric incorporating existent EHRs. Peer nodes hold the same ledger on which the address of a patient record in an EHR is written. Individual patients are identified by unique certificates issued by a local certificate authorities that collaborate with each other in a channel of the network. To protect a patient’s privacy, we use a proxy re-encryption scheme when the data are transferred. We designed and implemented various chaincodes to handle business logic agreed by member organizations of the network.

We developed a prototype system to implement our concept and tested its performance including chaincode logic. The results demonstrated that our system can be used by doctors to find patient’s records and verify patient’s consent on access to the data. Patients also can seamlessly receive their past records from other hospitals. The access log is stored transparently and immutably in the ledger that is used for auditing purpose.

Our system is feasible and flexible with scalability and availability in adapting to existing EHRs for strengthening security and privacy in managing patient records. Our research is expected to provide an effective method to integrate dispersed patient records among medical institutions.

The full article can be downloaded below.