Top five stories of the week

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Credit: Dan Shirly

Credit: Dan Shirly

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Staffing intensive care units remotely

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tomsic (1)By Michael Tomsic, WFAE

Staffing An Intensive Care Unit From Miles Away Has Advantages

Recovering from pneumonia is an unusual experience in the 10-bed intensive care unit at the Carolinas HealthCare System hospital in rural Lincolnton, North Carolina.

The small hospital has its regular staff in Lincolnton, but Richard Gilbert, one of the ICU patients, has an extra nurse who is 45 miles away.

That registered nurse, Cassie Gregor, sits in front of six computer screens in an office building. She wears a headset, and her voice is piped into Gilbert’s room via computer speakers.

A doorbell sounds before the camera turns on, alerting Gilbert that the nurse is looking in. They chit-chat as Gregor monitors Gilbert’s vital signs. The nurse asks how he’s feeling and if there’s anything he needs.

Carolinas HealthCare System monitors ICUs in 10 of its hospitals from this command center near Charlotte. The command center is staffed 24-7 with a rotating crew of seven to nine nurses and doctors who specialize in critical care. Everyone on the team also does bedside shift.

Carolinas HealthCare started this project about two years ago and says it’s good for staff and patients.


For one thing, medical staff at the command center can maintain a constant focus on patients. The command center is quiet — none of the alarms are going off that most ICUs need to alert nurses and doctors down the hall that they’re needed. Dr. Scott Lindblom says it’s a nice change of pace.

The peace, he says, “makes it a much more pleasant environment actually to work in than what we’re used to — the usual chaos of the ICU.”

 (Photo by Kevin McCarthy/Carolinas HealthCare System) Continue reading

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Free Women’s Health Seminars in June – PacMed

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pacmedPacMed will host two free Women’s Health seminars in June

Topics:

    •  5 things women are too embarrassed to talk about
    • Migraine headache relief: tips and treatments
    • 14 things your eyes say about your health
    •  Heartburn and hemorrhoids

When and where:

Saturday, June 6, at PacMed’s Renton clinic
9–11 AM (8:30 registration)
601 S Carr Rd, #100, Renton, WA 98055

Saturday, June 20, at PacMeds Canyon Park clinic
9–11 AM (8:30 registration)
1909 214th St SE, #300, Bothell, WA 98021

There will be free Health Risk Assessment Screenings at the Canyon Park event

Registration for the event can be found here: http://www.pacmed.org/index.php/womens-health-seminars

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Waiting to call ambulance delays heart attack treatment | Reuters

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red-telephoneHalf of heart attack patients fail to immediately call an ambulance for help, delaying diagnosis and potentially worsening their survival odds, a Swedish study suggests.

Patients who called an ambulance right away were typically diagnosed about 81 minutes after symptoms started, a timeline that stretched to 119 minutes for people who found another way to the hospital or made other calls first.

Source: Waiting to call ambulance delays heart attack treatment | Reuters

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M&M Maker Wants Labels for Added Sugar – WSJ

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m-mThe maker of the world’s best-selling chocolate candy is advocating that people eat less added sugar.

Mars Inc., maker of M&M’s and Snickers, is throwing its support behind a proposal by U.S. regulators to include measurements of added sugar in the mandated Nutrition Facts labels for food, a move that bucks broad opposition to the proposal by big food companies.

Source: M&M Maker Wants Labels for Added Sugar – WSJ

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Despite law, mental health still gets short shrift

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Illustration of the skull and brainBy Michael Ollove
Stateline

Under federal law, insurance plans that cover mental health must offer benefits that are on par with medical and surgical benefits. Twenty-three states also require some level of parity.

The federal law, approved in 2008, and most of the state ones bar insurers from charging higher copayments and deductibles for mental health services.

  • Insurers must pay for mental health treatment of the same scope and duration as other covered treatments.
  • They can’t require people to get additional authorizations for mental health services.
  • They must offer an equally extensive selection of mental health providers and approved drugs.

Federal and state regulators have an easy time keeping track of copayments and deductibles, and insurers typically follow those rules. Compliance with parity requirements for the actual delivery of medical services is another story.

A Seattle attorney said that some of her clients whose insurance companies denied their mental health or substance use claims appealed to the state of Washington for help, but did not receive any.

The responsibility for enforcing parity laws is divided between the federal government and the states. Under the federal parity law, states are supposed to police commercial insurance plans and Medicaid, although the federal government can step in if it determines states aren’t doing enough. The federal government is responsible for overseeing self-insured plans.

But among states, only California and New York consistently enforce the rules, mental health experts say.

As a result, Americans with mental illness and addictions “don’t have a right to mental health and addiction treatment that the law promises,” said Emily Feinstein of CASAColumbia, a nonprofit organization focused on drug addiction.  Continue reading

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Cataract surgery is fast and safe, but many patients still get costly test before their operation

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EyeBy Michelle Andrews
KHN

Requiring patients to get blood work and other tests before undergoing cataract surgery hasn’t been recommended for more than a dozen years.

There’s good reason for that: The eye surgery generally takes less time than watching a rerun of “Marcus Welby, MD” — just 18 minutes, on average.

“It’s so low risk it’s almost like saying you’re going to get your nails done.”

It’s also incredibly safe, with a less than 1 percent risk of major cardiac problems or death.

Yet more than half of Medicare patients received at least one pre-operative test in the month before undergoing surgery to remove cataracts in 2011, a recent study found. Continue reading

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Job: Insurance commissioner seeks health care policy advisor

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From the Washington State Office of the Insurance Commissioner

OIC seeks smart, savvy health care policy advisor

Seal_of_WashingtonThe OIC is hiring a highly skilled Senior Health Policy Advisor to acts as Commissioner Kreidler’s primary advisor on all issues related to health care and health insurance issues, including the Affordable Care Act (ACA).

This position is the Commissioner’s trusted advisor and designee on ACA policy matters and other matters related to health insurance.

This position is responsible for developing policy options for the resolution of health insurance issues.

Once executive decisions are made concerning the purpose and scope of an initiative, this position will develop programs or initiatives reflected in work products such as reports, legislation or regulations. Continue reading

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Federal funds for charity care at risk in states that refuse to expand Medicaid

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Flag-map_of_Florida.svgBy Christine Vestal
KHN

The federal government is quietly warning states that failure to expand Medicaid under the Affordable Care Act could imperil billions in federal subsidies for hospitals and doctors who care for the poor.

In an April 14 letter to Florida Medicaid director Justin Senior, Vikki Wachino, acting director of the U.S. Centers for Medicare and Medicaid Services (CMS) wrote: “Uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion.”

Federal money to support low-income clinics and hospitals is slated to decline under the Affordable Care Act as more people become insured.

Medicaid is the joint federal-state government health insurance program for the poor. Under the Affordable Care Act, states can choose to expand coverage to more people, with the federal government paying the entire costs of expansion through next year.

Florida has asked CMS to renew $1.3 billion in federal funding for its 2016 “low-income pool,” even though the state has rejected Medicaid expansion.

CMS maintains that any extension must take into account the more than 800,000 residents whose medical bills would be covered by Medicaid were the state to expand the program.

Photo courtesy of Darwinek via Wikimedia Commons CC Continue reading

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Losing a hospital in the heart of a small city

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By Sarah Jane Tribble, WCPN

In a leafy suburb of Cleveland, 108-year-old Lakewood Hospital is expected to close in the next two years.

Mike Summers points to the fourth floor windows on the far left side of the historic brick building. He recalls spending three weeks in one of those rooms. It was Christmas 1965 and Summers had a broken hip.

“I remember hearing Christmas bells from the church across the street,” he says.

Lakewood Hospital, which opened its doors in 1907, is slated to close. Across the country, small hospitals are closing and redirecting residents to newer hospitals as patient populations shift with changing economies. (Photo by Sarah Jane Tribble/WCPN)

Lakewood Hospital, which opened its doors in 1907, is slated to close. Across the country, small hospitals are closing and redirecting residents to newer hospitals as patient populations shift with changing economies. (Photo by Sarah Jane Tribble/WCPN)

Summers was born at this hospital. His sister was born here. This hospital has a special place in his heart. But then he became mayor of Lakewood four years ago and realized the hospital was a financial liability for the small city, which has seen a sharp increase in poverty levels in the past two decades.

The hospital, operated for the city by the large nonprofit Cleveland Clinic system, has lost money since 2005. Executives say they need to close it and replace it with a smaller outpatient health center and emergency room.

“I’ve grown to understand the situation we are in is not unique. There are considerable forces at play and we are in the middle of all of them and a lot of communities are just like us,” Summers says.

Lakewood Hospital is this community’s biggest employer, with 1,000 workers. It has been a rich source of municipal revenues even as manufacturing jobs left the region.

But the hospital, operated for the city by the large nonprofit Cleveland Clinic system, has lost money since 2005. Executives say they need to close it and replace it with a smaller outpatient health center and emergency room.
Continue reading

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911 Best Call for Heart Attack Victims in Rural Areas: Study: MedlinePlus

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red-telephoneThe average time it took to get to the hospital was 38 minutes for patients who traveled in their own vehicles and 26 minutes for those brought by ambulance.

The average time it took from arriving at the hospital to receiving heart artery-opening treatment was 57 minutes for those who traveled in their own vehicles and 42 minutes for those who arrived by ambulance.

Source: 911 Best Call for Heart Attack Victims in Rural Areas: Study: MedlinePlus

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When Restaurants Offer Healthy Kids’ Fare, Children Eat It: MedlinePlus

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vegetablesThe Silver Diner, a family restaurant chain in the eastern United States, made changes to its children’s menu in April 2012.

Healthy options, including strawberries, mixed vegetables and side salads, were automatically included with orders.

French fries, soda and lemonade were taken off the kids’ menu, though these items were still available if requested.

After the change, almost half of orders from the children’s menu were for healthier options compared with just 3 percent before.

Source: When Restaurants Offer Healthy Kids’ Fare, Children Eat It: MedlinePlus

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An Uber for Doctor Housecalls – NYTimes.com

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Stethoscope DoctorHeal is a smartphone app similar to the on-demand car service Uber, but instead of a car, a doctor shows up at your door.

Users download the app and then type in a few details such as address and the reason for the visit.

After adding a credit card and a request for a family doctor or a pediatrician, the physician arrives in 20 to 60 minutes for a flat fee of $99.

 

Source: An Uber for Doctor Housecalls – NYTimes.com

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Patients Not Hurt When Their Hospitals Close, Study Finds

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By Jordan Rau
KHN

A hospital closure can send tremors through a city or town, leaving residents fearful about how they will be cared for in emergencies and serious illnesses. A study released Monday offers some comfort, finding that when hospitals shut down, death rates and other markers of quality generally do not worsen.

map-hospital-closures-050115

Researchers at the Harvard School of Public Health examined 195 hospital closures between 2003 and 2011, looking at health experiences in the year before and the year after the hospital went out of business.

Their paper, published in the journal Health Affairs, found that changes in death rates of people on Medicare — both those who had been in the hospital and among the broader populace — were no different than those for people in similar places where no hospital had closed.

While the researchers noted that some people might be inconvenienced by having to travel further for care, they found no significant changes in how often Medicare beneficiaries were admitted to hospitals, how long they stayed or how much their care cost.

The closed hospitals tended to be financially troubled, with revenues averaging 13 percent less than the cost of running the institutions.

“It’s possible that we didn’t see any change in outcomes because patients instead went to nearby hospitals that had better finances and may have had more resources to provide care,” said Dr. Karen Joynt, the lead researcher on the study.

She cautioned that the study looked at the average experience of a hospital closure and should not be interpreted to mean that every hospital loss is harmless. “I would be shocked if you couldn’t find an example where access is really threatened,” she said. Continue reading

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