AT THIS HOUR

July 29, 2022

1 In 100,000: Prevalence of Addison’s Disease, which Professor Jiwa Moyez says is a good example of the difficulty physicians can have in diagnosing patient symptoms and over-alerting them without appreciating the stress. Particularly for rare conditions that often require multiple tests before a diagnosis can be confirmed, and that are in all likelihood going to rule out the condition eventually. “The patient has to live with the idea that the test is positive” – or going to be, says Moyez, the associate dean of health innovation at The University of Notre Dame, Australia. The diagnostic process ought to be a partnership between doctor and patient and give the patient ‘context’ and help them understand “why” you need to test.

Infection Caught Early: A new AI tool from Johns Hopkins has helped detect early signs of sepsis in real-time, reducing the likelihood of death by 20%, according to a new study. Sepsis causes the most in-hospital deaths in the country but in-hospital mortality, organ failure and length of hospital stay all declined in sepsis cases confirmed with the tool within 3 hours, especially in patients who were high-risk.

Where Art Thou ABA? Breann Gonzalez, the Clinical Director at Colorado ABA Therapy, says they’ve been adjusting to a Medicaid requirement that impacts their service providers making sure they “clock in and clock out” when providing ABA services in a patient’s home. Providers now have to give their GPS location and timestamp and Gonzalez, a BCBA, says they are having challenges adjusting. But the practice’s 4-hour minimum requirement has helped to control cancellations and staffing better than the more common approach by many Colorado providers who set a 20-hour per week minimum, which is an automatic disqualifier for kids in school. To read the full story, click here. 

Understaffed: A recent BRG survey of 25 hospital administrators and 30 nurses reveals persistent staffing challenges being experienced by hospitals across the country and limited overall change in travel nurse rates, despite some isolated reductions and pressures on agencies to lower pay. Even as COVID-19 hospitalizations have decreased, 90% of respondents say their hospital remains understaffed. For the full story, including insights on patient experience, click here.

Another Step Into Healthcare: Sort of like Aunt Theresa and Uncle Bobby moving into your dining room during Thanksgiving week, one of healthcare’s leading disrupters is moving into primary care as Amazon acquires One Medical, which offers patients 24/7 virtual and in-person care at its 200 clinics through a sleek app—think tele-prescriptions and same-day app-scheduled visits. Whether One Medical will actually refer patients with depression to Alexa is to be determined, but the acquisition is noteworthy. The company primarily focuses on direct-to-employer offerings, but also sells membership directly to patients at $200 per year, on top of normal care costs, which can be paid through insurance or out of pocket.

Tier 1 vs. 2: More specialists, therapists, behavioral health providers and diagnostic companies will be placed into tiers in the next 5 years and if you’re not paying attention your group may lose patient volume. A new ACO from UnitedHealthcare is using a tiering system to incentivize the use of certain providers. NexusACO launches in Wisconsin for the 2023 plan year, featuring Advocate Aurora Health, Froedtert Health, the Medical College of Wisconsin and Children’s Wisconsin as the lowest-cost providers in Tier 1. If member patients get care at other network providers, including Ascension Wisconsin and ProHealth Care, they pay more.

Extra Point: So, I learned pretty much everything I need to know about how to muster up enough courage to ask a girl to dance from Celeste, the angel who cut my hair in high school after 15 very sad years of an uncomfortable-looking bowl cut. Celeste lifted my self-esteem, helped me juggle anxiety, depression and fear before they were talked about. She gave me street cred, made me blush and she was my barber I suppose, and so I’m pretty sure the new “Deload” business of mental health-trained barbers from Gymshark is on to something. I’ve long since said physical therapists and little league coaches and physician specialists need this training, so why not the folks who style our hair? And if they’re looking for barbers or trainers, perhaps Eddie Murphy’s Coming to America character Clarence is up for the gig. Can’t you hear it? “Look sonny! This stuff - that’s got ya down - with your family and work – it ain’t nothing to worry about. Do what Joe Louis did. He was the greatest. He took punches—he came out of retirement at 137 years old to fight Rocky Marciano - but he hung in there and kept fighting.”