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Feds to pay Highmark $571 million in partial coverage of past healthcare.gov losses – LancasterOnline

One of Pennsylvania's biggest health and insurance organizations is expecting a massive check from the federal government in partial payment of healthcare.gov losses it suffered years ago.

"The ruling affirms that the federal government must fulfill its legal promises, which preserves the trust that makes successful public-private partnershipsincluding the ACA marketplace," Perri wrote, noting that the payment will not cover all of Highmark's losses under the health care law.

Asked if other insurers here will be receiving payments, Pennsylvania Insurance Commissioner Jessica Altman said in a written statement, "There are multiple lawsuits related to this topic and there is also the potential for additional lawsuits to now be filed, so it is difficult to say for certain which Pennsylvania carriers will be reimbursed and for how much."

Since then, the market has stabilized, a change evident in Highmark's overall financials.

After an overall loss of $85 million across its entire book of business in 2015, Highmark reported surpluses of $59 million for 2016, $1.06 billion in 2017, $570 million in 2018 and $843 million in 2019. The $1.06 billion surplus in 2017 was driven in part by a one-time gain from the sale of part of a vision business.

Asked about the payment's impact on members, Perri said Highmark is assessing that.

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Feds to pay Highmark $571 million in partial coverage of past healthcare.gov losses - LancasterOnline

Asa Hutchinson: For the higher calling of health care – Searcy Daily Citizen

Recently, I met with doctors, nurses and respiratory therapists at Washington Regional Medical Center in Fayetteville who have been on the front line of saving lives during this coronavirus pandemic. They were tired and stressed, but their work makes me grateful for their services and sacrifice.

Today, Id like to talk about the need to find more people such as those to enter the field. I am hopeful that the sight of their heroic service will inspire others to choose a career in health care.

The numbers of those in the health care profession nationally and in Arkansas have been declining for years. This worldwide health crisis has highlighted the shortfall and the urgent need to correct it. There never has been a greater need for young people to enter the health care profession.

The reasons for the decline are many, but the result is that as health care professionals retire, there arent enough people to replace them. Americans are living longer, which means the number of people in need of medical care is growing as the number of providers shrinks. In the rural areas of Arkansas, the situation is even more challenging.

As the coronavirus has billowed across our nation like a toxic fog, the illness has illustrated the complicated nature of our health care system. We have seen how various medical specialties intersect, and that each is essential: Medical doctors and doctors of osteopathic medicine. Paramedics. Emergency room doctors and registered nurses. Respiratory therapists and licensed practical nurses. Home health caregivers. Researchers. Medical technicians. That is a very short list of the many important jobs in the health care field.

A health care career offers many benefits. You can find a job almost anywhere you want to live, and the jobs pay well.

But there is more to it than the personal benefit. Health care is a higher calling, much like any other public service. Those who choose that path often are called upon to put the good of others before personal comfort and convenience, as thousands have done during the pandemic.

The hours are long, the work can be difficult. But there are the bright moments when someone saves a life or a homebound patient rewards a health aide with a smile of gratitude.

Arkansas is growing and in need of more people who are willing to commit to that level of service. Our state needs young professionals with fresh perspectives to help us figure out new and better ways to deliver health care. We need tech-savvy professionals who elevate our health care system, which benefits all Arkansans: A tech-savvy health care system attracts high-quality business and industry and enhances Arkansas general quality of life.

COVID-19 has changed everything about our lives. We have no idea how long we will be fighting the current battle, but the health care professionals who are guiding us through this time inspire confidence and hope. My hope is that their inspiration will attract a new generation of professionals to accept the call.

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Asa Hutchinson: For the higher calling of health care - Searcy Daily Citizen

The death of Joseph Costa and the risk of being a health care worker during the COVID-19 pandemic | COMMENTARY – Baltimore Sun

That means wearing a mask, social distancing and limiting gatherings, even with family members. Stay away from states with large outbreaks, as well. As we learn more about the disease, a growing body of evidence shows these preventive measures work, and more than we even once thought. As much as we are inconvenienced and miss the old way of life, most of us are not sacrificing as much as those workers taking care of COVID-19 patients in hospital wards and intensive care units. Many of these workers choose to live separately from their families to protect their spouses, children and other relatives from the virus. The least we can do is skip the crowded birthday party or summer cookout and wear the annoying mask. The social media photos of large outdoor gatherings of maskless guests is disconcerting to say the least. We can have dinner with our loved ones each night, and that is something to be grateful about.

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The death of Joseph Costa and the risk of being a health care worker during the COVID-19 pandemic | COMMENTARY - Baltimore Sun

It’s The Two-Week Anniversary of Trump’s Latest Lie About Health Care – HuffPost

Two weeks have passed since President Donald Trump proclaimed he would be signing a big health care reform plan in two weeks. Dont hold your breath for a Rose Garden ceremony.

Almost exactly three years ago, the Republican Senate failed to pass a bill that would have repealed the Affordable Care Act and replaced it with a law that would have snatched health coverage from 16 million people. In the 10 years since Obamacare became law, thats as close as the GOP has gotten to fulfilling its promise to scrap the ACA and pass its own health care bill.

Theres been zero action on the issue in Congress, where Republicans seem tired of talking about it and confronting their own failure. Trump himself has never articulated a vision of what he thinks the health care system should look, and has been making empty, ludicrous and false promises since his campaign for the presidency began.

Hes still at it, and its still complete hogwash.

In a FOX News interview taped July 17 and aired two days later, Trump told Chris Wallace:

Were signing a health care plan within two weeks, a full and complete health care plan that the Supreme Court decision on DACA gave me the right to do.

Lets break that down. First, its been two weeks. Have you seen a health care plan? Has Trump? Just weeks before that, Health and Human Services Secretary Alex Azar admitted they have no plan. Thats because there isnt one and there never has been. Second, the Supreme Court ruling on the Deferred Action for Childhood Arrival immigration program DACA did no such thing.

Weve seen this before, time and time again. In 2015, he declared he would replace the Affordable Care Act with something terrific. That was about as specific as he ever got. Last year, Trump announced on Twitter that Republicans would become the Party of Healthcare! and pass a big bill. Then he took it back. Those two examples bookend innumerable vows in between.

Of course, looked at from another perspective, Trump does sort of have a health care plan.

Since hes taken office, his administration has undertaken a multifaceted campaign to sabotage the Affordable Care Acts health insurance marketplaces. They have attempted to place onerous new burdens on Medicaid recipients (although the courts struck those down). It has invited states to adopt Medicaid reforms that would slash enrollment. It has overseen a purge of more than 1 million children from the Medicaid rolls. It has shepherded a rise in the uninsured rate. It expanded access to junk insurance plans that leave patients on the hook for massive medical bills.

But the cornerstone of Trumps health policy agenda is a lawsuit pending at the Supreme Court that would wipe the entire Affordable Care Act from the books, leaving nothing in its place, wreaking havoc on the health care system and creating 20 million newly uninsured people.

Conveniently for him and other Republicans, no high court ruling on this will come until after Novembers election.

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It's The Two-Week Anniversary of Trump's Latest Lie About Health Care - HuffPost

Governor Cuomo and Northwell Health Announce New York State Healthcare Personnel to Travel to Utah to Support State’s COVID-19 Response – ny.gov

Governor Cuomo and Northwell Health Announce New York State Healthcare Personnel to Travel to Utah to Support State's COVID-19 Response | Governor Andrew M. Cuomo Skip to main content

Intermountain Healthcare Previously Sent Dozens of Healthcare Workers to New York State During Time of Need

Governor Andrew M. Cuomo today announced that New York State and Northwell Health will deploy at least 30 healthcare personnel to Utah to supportIntermountain Healthcare - the state's largest healthcare provider. Intermountain Healthcare previously sent dozens of healthcare workers to New York to support Northwell and other hospitals. New York State will provide PPE and equipment as needed, and the first group of healthcare workers will travel to Utah this Sunday.

"We're taking new steps in New York State's continuing effort to repay the gratitude that we've been shown by people all across the country, and also on a practical level to keep us safe--an outbreak anywhere is an outbreak everywhere,"Governor Cuomo said."We will be sending health staff to Utah to the Intermountain Healthcare Hospital System, Utah's largest hospital system. Utah and that hospital system were very generous to New York when we needed help, sending dozens of staff to the Northwell Hospital System which was a major provider for us during COVID. So, we are going to be sending primarily Northwell personnel and Department of Health personnel, about 30 people, as well as any PPE, and equipment that is needed. I thank Governor Herbert and all the people of Utah, and as I've said on behalf of New Yorkers, we won't forget and we will do for them what they did for us, because that's the American way."

"During the height of the pandemic here in New York, we were grateful for the extraordinary support provided by the Intermountain Health System who sent us over 60 front-line staff including physicians and nurses,"said Michael Dowling, president and CEO of Northwell Health, New York's largest health care provider which treated the most coronavirus patients in the US."We are now delighted to be able to reciprocate by sending staff to assist them in their current battle against this disease."

New York's Commitment to Helping Cities and States Fight COVID-19

During the fight against COVID-19, New York State has provided PPE and equipment to Florida, Georgia and Texas. In addition, the state has provided the following resources:

The State of New York does not imply approval of the listed destinations, warrant the accuracy of any information set out in those destinations, or endorse any opinions expressed therein. External web sites operate at the direction of their respective owners who should be contacted directly with questions regarding the content of these sites.

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Governor Cuomo and Northwell Health Announce New York State Healthcare Personnel to Travel to Utah to Support State's COVID-19 Response - ny.gov

There is light at the end of the tunnel: New York health care workers share lessons from COVID-19 frontlines – Yahoo News

Dr. Hugh Cassiere is the director of critical care services at Northwell Healths North Shore University Hospital (NSUH) in Manhasset, N.Y. Hes been a doctor for 24 years and says hes used to treating the sickest of sick patients.

But nothing prepared him for what he calls the tsunami of [COVID-19] patients that hit the hospital this spring, when New York quickly became the epicenter of the global coronavirus pandemic.

This was surreal ... in terms of the sheer number of critically ill patients, and every single patient was sick beyond belief, Cassiere told Yahoo News.

The experience, he said, pushed me to my limits and skills. It also taught him valuable lessons, and that knowledge is now being passed on to other physicians currently battling the disease in other areas of the country.

From a medical perspective, Cassiere said, learning that the use of steroids specifically dexamethasone early on in patients with low oxygen levels is of paramount importance.

If I could go into a time machine and go back, I would tell myself to start using steroids freely, dexamethasone on all critically unstable COVID-19 patients. I did use steroids in the beginning, but I had a lot of trepidations for it. I didnt use it on all patients because of the concerns about harm. Those fears are gone, Cassiere said.

Severe COVID-19 illness can result in excessive inflammation throughout the body, including the lungs, heart and brain. This inflammatory response to the virus has been shown to be equally if not more damaging than the virus itself.

Since steroids have been used for decades to reduce inflammation in a range of conditions, including cancers, dexamethasone a corticosteroid thats used specifically to treat inflammation was one of Cassieres go-to therapies early on.

Its the only therapy thats been shown to date to save lives, Cassiere said.

Results from a University of Oxford clinical trial released last month show that dexamethasone can indeed reduce mortality. According to Oxfords report, for patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth.

Story continues

The drug, which has been on the World Health Organizations essential drugs list since the 1970s, is affordably available in most countries, according to the agency.

Another treatment currently being used by physicians to treat COVID-19 patients is the antiviral drug remdesivir. Cassiere said theres not enough data yet supporting that it can save lives. However, if administered early on, it may help shorten the duration of symptoms. I dont want to minimize that at all. Its just not the blockbuster that we thought it was going to be, he said.

When asked about the antimalarial drug hydroxychloroquine, which President Trump has touted for months as an effective treatment, Cassiere issued a warning: Hydroxychloroquine just doesnt work for patients with severe COVID-19 disease. Thats just a science fact. I dont use or would not recommend it for treatment.

Another complication from severe COVID-19 infections that is playing a major role in mortality is excessive blood clotting. Many patients in the ICU develop blood clots in small and large vessels, as well as in the lungs, legs and even the brain. These can lead to more serious issues such as strokes, pulmonary embolism, kidney failure and heart inflammation. In some patients, the lack of blood flow to the extremities is so severe that amputations have been necessary to save their lives.

To treat this hypercoagulable state, anticoagulants, or blood thinners, are being administered by doctors in some hospitals, and they seem to be helping patients in many of the countrys ICUs.

Unfortunately, some doctors have also reported that this COVID-19-related clotting does not always respond to standard blood-thinning treatments.

Ive had many patients who Ive gotten them through their lung injury and hyperinflammatory response, just to die from blood clots, Cassiere said.

When it comes to treating low oxygen levels in patients, pulmonologists like Cassiere were relieved to learn that high-flow nasal oxygen therapy is effective and safe.

The method, which is a traditional technique used to provide high levels of oxygen through the nose, was avoided at the beginning of the pandemic for fear that the virus would spread in the ICU and infect health care workers. But Cassiere says they now know that is not the case, and urges doctors to not shy away from using this approach.

Youll probably prevent not everyone from being intubated or being put on ventilators, but maybe 10 to 20 percent of patients, he said.

Many patients across the country with severe COVID-19 will unfortunately still need to be put on a ventilator. Luckily, doctors are now equipped with better methods to improve patient-ventilator interaction. Using blood thinners to prevent blood clots, flipping patients on their belly to improve oxygenation and keeping fluid levels low are a few methods Cassiere highlighted for the treatment of intubated patients.

Aside from the medical lessons, Mikaela Wolf, a critical nurse practitioner at NSUH who worked hand in hand with Cassiere during New Yorks surge, told Yahoo News that the value of teamwork is one of the most important takeaways from this experience.

It takes every all of the hands you can get. All the support you can get ... it doesnt matter what your title is because you all have the same goal, and thats to save patients.

Both Wolf and Cassiere believe that when dealing with a crisis like the one presented by COVID-19, leaning on colleagues, family and friends is crucial.

Communicate your feelings and what youre going through with your colleagues. Theyre feeling the same things you are. You can decrease the stress and the burden by doing that, Cassiere said.

Be resilient. There is light at the end of the tunnel, Wolf added.

_____

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There is light at the end of the tunnel: New York health care workers share lessons from COVID-19 frontlines - Yahoo News

Newton sheriff’s office earns correctional health care reaccreditation award – Covington News

The Newton County Sheriffs Office was awarded its third National Commission on Correctional Health Care (NCCHC) Reaccreditation Award during the Newton County Board of Commissioners meeting July 21.

The Newton County Sheriffs Office, in partnership with NaphCare, met 100% of the 37 essential standards and 19 important standards required to receive its third reaccreditation, effective June 11, according to a news release.

The accreditation provides the Sheriffs Office with evidence of a standards-based system of care for inmates; improved health status and outcomes; and reduced public health risks when inmates re-enter the community. There are 59 individual standards, with close to 400 compliance indicators, required for full accreditation.

In February 2014, the Newton County Sheriffs Office met the standards to be awarded its first accreditation by the NCCHC. There are an estimated 500 NCCHC accredited facilities out of 3,100 counties across the nation.

Sheriff Ezell Brown said the National Commission on Correctional Heath Care accreditation is a component of the National Sheriffs Association Triple Crown Award.

He said his office was to receive the reaccreditation in early May in Atlanta before being canceled due to COVID-19.

The Newton County Sheriffs Office was awarded the National Sheriffs Association Triple Crown Award on June 26, 2017. A total of 48 facilities across the nation have obtained Triple Crown status, with 46 of those being Sheriffs Offices.

Out of the 159 Sheriffs Offices in the state of Georgia, Newton County Sheriffs Office is one of six to obtain Triple Crown status.

To obtain the National Sheriffs Association Triple Crown Award, agencies must obtain accreditation from the Commission on the Accreditation of Law Enforcement Agencies (CALEA), the American Correctional Association's Commission on Accreditation for Corrections (ACA) and the National Commission on Correctional Healthcare (NCCHC).

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Newton sheriff's office earns correctional health care reaccreditation award - Covington News

First responders, healthcare workers focus of upcoming retreat – Norfolk Daily News

SCHUYLER The St. Benedict Center here will host a variety of late-summer events designed to enrich the faith of participants.

On Saturday, Aug. 1, a one-day retreat called The Lord Took Me from Following the Flock: The Message of the Prophet Amos will offer participants a chance to look at how Amos gave shape to the word of the Lord. The event will be facilitated by the Rev. Joel Macul.

I Dont Remember will be a weekend retreat held Friday, Aug. 14, through Sunday, Aug. 16. Led by the Rev. Donald. W. Shane, the presentations will highlight Jesus meetings with Mary Magdalene, Peter, Paul, Matthew, Dismas and others and reflect on the real meaning of the Sacraments of Reconciliation and Anointing of the Sick with personal experiences. The theme points to the total forgiveness the Father offers through His son. The event will begin at 7:30 p.m. Friday and continue until after lunch on Sunday.

The Rev. Andrew J. Vaccari and a team of pro-sanctity members will lead Praying with the Gospel of Matthew Hope in Daily Life as a Disciple during a weekend retreat beginning at 7:30 p.m. Friday, Aug. 28, and continuing until after lunch on Sunday, Aug. 30.

Participants will learn about the Gospel of St. Matthew, pray with it and will explore the gospel used for the current liturgical year, reflecting on writings from the saints to deepen hope coming from the gospel of Jesus Christ.

The weekend includes personal and community prayer, opportunity for individual spiritual direction and the sacrament of reconciliation, adoration of the Blessed Sacrament and Mass both Saturday and Sunday.

A time away for health care providers and first responders will be offered beginning at 9 a.m. Tuesday, Sept. 8, and continuing until after lunch on Wednesday, Sept. 9. The event will be led by Patrick Davis and Deborah Sheehan.

Health care providers and first responders are on the front line of care in dealing with the coronavirus. Long work hours, the suffering of patients and families, potential threat to their life and family, uncertainty and little relief can take a toll on the spirit.

This retreat will be a space for paying deeper attention to what has happened beyond the surface details. It will be a time to renew and recharge for the days ahead. Spiritual direction will be offered.

A weekend retreat on how to live a balanced life in the midst of the many demands of everday living is set to begin at 6 p.m. Thusday, Sept. 17, and will continue until after lunch on Sunday, Sept. 20. In his Rule, St. Benedict offers helpful hint for how to find the right balance between prayer, work, human relationships and rest.

Program fees, as well as fees for room and board, apply for each of these events. To learn more or to register, visit http://www.StBenedictCenter.com or call 402-352-8819.

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First responders, healthcare workers focus of upcoming retreat - Norfolk Daily News

Clinician burnout correlates with volume of EHR patient call messages – Healthcare IT News

It's no secret that health IT-associated clinician burnout especially where electronic health record usage is concerned is widespread. But a new study seeks to identify which individual EHR elements might be most associated with burnout.

The study, published this week in the Journal of the American Medical Informatics Association, found that clinicians with high volumes of patient call messages had almost four times the odds of burnout compared to those with the fewest.

Researchers Dr. Ross Hilliard, Jacquelyn Haskell and Rebekah L. Gardner also found that EHR-based efficiency tools except for the ability to copy and paste were not associated with decreased odds of burnout.

HIMSS20 Digital

"In fact, these suggested efficiency tools may not provide for or measure efficiency at all," wrote the research team.

WHY IT MATTERS

Researchers examined the EHR usage data from Epic for 422 physicians, advanced practice registered nurses and physician assistants who had also responded to the 2017 Rhode Island Department of Health Physician and Advanced Practice Provider Health Information Technology Survey.

Noting that prior studies have linked inbox management volume, data entry tasks and documentation with burnout, study authors defined measures of workload to include the number of daily appointments; minutes spent reviewing patient charts; medication and non-medication orders authorized by the clinician; patient call and results messages received; and note length per visit in characters.

Using those measures, the team found that on average, primary care clinicians had a higher workload than non-PCPs. PCPs and older clinicians were more likely to report symptoms of burnout.

The team found that the number of patient call messages per week was significant in terms of burnout. Such messages included patient requests and questions, but also refill requests (that didn't come in through an electronic interface), patient care forms and other tasks.

"In many systems, these patient call messages are the workhorse tool for communication and coordination of care between visits," wrote the researchers.

When it came to efficiency measures such as precharting of notes, use of the Chart Search function, number of SmartPhrases and percent of orders placed from preference lists or SmartSets none were associated with burnout, though top users of copy and paste were significantly less likely to report it.

Importantly, the study points out that "reading copy-and-pasted note content was independently associated with increased stress and burnout in a [separate] large study of ambulatory clinicians, suggesting that a decrease in burnout for the note writer may be offset by an increase in the note reader."

"Neither a higher proportion of SmartTools use in notes nor use of transcription or voice recognition technology was associated with lower burnout prevalence," wrote the researchers.

The study authors suggested that call volume measure might be correlated with increased burnout because "virtually all" of the tasks are uncompensated. They also suggested the connection could be related to lack of control over workload; an excessive amount of at-home EHR time; and a high proportion of work not requiring physician level skills.

THE LARGER TREND

As the researchers point out, unraveling the link between EHR use and burnout has been the subject of much intrigue, with researchers pointing to messaging improvements, training, usability and clinician buy-in as just a few strategies to improve satisfaction.

But other indicators suggest that other improvements are both possible and forthcoming.

"Cerner has set out to make the physician experience easier with our AI technology," said Dr. Jeffrey Wall, director and physician strategy executive at Cerner, during HIMSS19.

According to Wall, the vendor has been innovating uses of analytics and real-time feedback to continuously optimize systems for a more person-centered user experience.

ON THE RECORD

"In addition to delegating appropriate inbox messages to nonphysician staff and improving EHR usability, we recommend that future studies explore prospectively testing a model of EHR use characteristics predictive of burnout, so that individual institutions could provide customized assistance to clinicians," researchers concluded.

Kat Jercich is senior editor of Healthcare IT News.Twitter: @kjercichHealthcare IT News is a HIMSS Media publication.

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Clinician burnout correlates with volume of EHR patient call messages - Healthcare IT News

Riverside, Sentara: Health care workers testing positive for the coronavirus – WYDaily

(WYDaily file/Courtesy of Unspalsh)

As local health districts deal with the spike in coronavirus cases in Hampton Roads and on the Peninsula, health care workers treating coronavirus patients in hospitals are also putting themselves at risk for the virus.

And in some cases, testing positive for COVID-19 themselves.

Gov. Ralph Northam signed an executive order Tuesday to stop alcohol sales at 10 p.m. limit indoor dining to 50 percent capacity and reduce gatherings from 250 people to 50.

The guidelines affect Williamsburg, James City County, York County, Virginia Beach, Chesapeake, Norfolk, Suffolk, Portsmouth, Hampton, Newport News and Poquoson.

This is about stopping the spread of COVID-19 in Hampton Roads, Northam said Tuesday. It happens when too many people gather together, when too many people are non-compliant and as Ive said before when too many people are selfish.

The governors order starts Thursday at midnight and is expected to last at a minimum two weeks.

But even with restrictions that protect the public, health care workers on the frontlines of the pandemic have to be extra careful to protect themselves.

According to theOccupational Safety and Health Administration, health care employees with a high risk exposure are those who enter the rooms of patients infected by the virus or provide care for infected individuals. Those with very high risks are employees performing aerosol-generating procedures, such as intubation, and employees that are collecting or handling specimens from known or suspected coronavirus patients.

Medical staff at Sentara Healthcare have a number of precautions to protect themselves from the virus, such as enhanced cleaning protocols, mask mandates and extra social distancing measures.

Sentara also encourages patients and doctors to engage in telehealth practices whenever possible and requires all employees who enter the hospital to take part in a no-touch temperature check.

Sentara is also implementing practices recommended by theOSHA which includes limiting the opportunities for touch contamination and differentiating clean areas covered in personal protective equipment from potentially contaminated areas.

And so far, those techniques seem to be working.

Weve actually had low minimal exposure to staff from patients, saidKelly Kennedy, spokeswoman for Sentara. Were very fortunate in that respect because weve put very robust protocols into place.

Kennedy said more often than not, staff are exposed to the virus when theyre out in the community rather than in any medical facilities. If a staff member is exposed to the virus, they report the exposure to their supervisor who will give them direction on how to move forward.

Sentara doesnt keep data on the number of staff who have had the virus, Kennedy said.

WYDaily asked Riverside in an email how many health care workers, specifically doctors, were in direct contact with COVID-19 patients and how many health care staff members tested positive for the virus.

As more people in the area are diagnosed positive, Riverside, like all healthcare organizations, is seeing more employees affected by community spread of the virus, Shannon Shumate, spokeswoman for Riverside Health System, wrote in an email Wednesday. When we learn of one of our staff who has been diagnosed, we utilize a central exposure team that does detailed contact tracing within all our facilities to ensure that risks to patients are minimized.

She said Riverside can test its staff quickly in-house.

This has been an ongoing effort for many months at Riverside, and at most larger health care organizations, Shumate said. The only meaningful change over the past few weeks is that we are seeing increasing utilization of the central exposure team and our use of in-house testing due to the increased presence of the virus in the Hampton Roads area.

Shumate said the number of health care workers who tested positive is low.

With regards to the number of employees at Riverside who have tested positive since the start of the pandemic, we can confirm that the percentage of team members who have tested positive has remained extremely low, and of those who have tested positive, because of our detailed contact tracing, we have identified that the majority of those were as a result of community spread, she said.

She did not elaborate.

As of Wednesday there are 87,993 cases, 7,738 hospitalizations and 2,125 deaths statewide, according to the Virginia Department of Healths COVID-19 Daily Dashboard.

The Peninsula Health District numbers are as follows:

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Riverside, Sentara: Health care workers testing positive for the coronavirus - WYDaily

Race and Health Care in New Jersey: Addressing Inequities in the COVID-19 Era – NJ Spotlight

Racial disparities in health care due to factors such as unequal access to health insurance, income inequality, and bias in the health care system have long been known.

These inequities have been magnified by the COVID-19 pandemics disproportionate impact on communities of color that frequently face high-risk working and living conditions.

As New Jersey proceeds with reopening plans, there are opportunities to incorporate measures to improve health outcomes for minority groups and to address social determinants of health more broadly. Equity actions being examined include:

On July 29, NJ Spotlight and NJTV News convened a virtual roundtable with health care leaders, public officials, and administrators to explore how progress can be made toward alleviating racial inequities in health outcomes as New Jersey recovers from the pandemic.

Keynote address:

Michellene Davis, Esq., Executive Vice President and Chief Corporate Affairs Officer, RWJBarnabas Health

Panelists:

David A. Ansell,MD, MPH, Senior Vice President for Community Health Equity, Rush University Medical Center, Chicago; Associate Provost for Community Affairs, Rush University, Chicago

Assemblyman Herb Conaway Jr., MD, Chair, Health Committee; Member, Appropriations and Science, Innovation and Technology Committees, New Jersey State General Assembly; Director, Burlington County Health Department

Shereef M. Elnahal,MD, MBA, President & Chief Executive Officer, University Hospital

Denise V. Rodgers, MD, FAAFP, Vice Chancellor for Interprofessional Programs, Rutgers Biomedical and Health Sciences; RBHS Chair in Interprofessional Education, Rutgers-Robert Wood Johnson Medical School

Moderator:

Lilo H. Stainton, Health Care Reporter, NJ Spotlight

Sponsors:

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Race and Health Care in New Jersey: Addressing Inequities in the COVID-19 Era - NJ Spotlight

Containing Rising Healthcare Costs in the Wake of COVID-19 – ModernHealthcare.com

Growing numbers of unemployed Americans face a health insurance crisis. The Urban Institute has predicted that between April and December 2020, over 10 million people will lose employer-sponsored health insurance due to the pandemic. As a result, millions are likely to enroll in Medicaid as a safety net.

COVID-19 has also demonstrated that income and racial disparities in healthcare are alive and well. Researchers have found, for example, that African Americans are dying from COVID-19 at 2.5 times the rate of whites. Individuals who are eligible for both Medicare and Medicaid are also at higher risk for more severe cases of COVID-19. This population often has multiple chronic health conditions, in addition to being low income. The Centers for Medicare and Medicaid Services (CMS) has reported that this group has been hospitalized for COVID-19 at a rate more than 4.5 times higher than individuals who are eligible only for Medicare.

All of these factors create a perfect storm of challenges for states. They must trim budgets as revenues fall, while preserving Medicaid programs for growing numbers of citizens. NASBO estimated that in fiscal year 2019, Medicaid accounted for close to 29% of total state spending. Since Medicaid represents a significant share of state budgets, experts worry that states may be forced to consider cuts to healthcare programs, services, and benefits in response to COVID-19-related pressures.

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Containing Rising Healthcare Costs in the Wake of COVID-19 - ModernHealthcare.com

How Zero Trust in Healthcare Can Keep Pace with the Threat Landscape – HealthITSecurity.com

July 31, 2020 -Healthcare has and will likely always be a prime target for cyberattacks, given its valuable data and the need for constant data access to ensure continuity of care. While awareness around these issues has drastically improved, the need for a zero trust in healthcare will be crucial moving forward given the sectors staffing gaps, limited resources, and other challenges.

Recent reports have spotlighted the industrys security challenges and its failure to keep pace with the ever-evolving threat landscape.IBMfound healthcare leads in annual data breach costs at $7.13 million, a rankingitsheld for 10 consecutive years.

Meanwhile,Ordr researchshows that many IoT and medical devices allow for the use of social media platforms, which were recalled by the Food and Drug Administration. Many providers and COVID-19 vaccinedevelopersare operating on platforms with serious, unpatched security vulnerabilities, while the sector, as a whole, continues to feverishly struggle with adequatepatch managementand inventory.

Buthackersarent waiting for providers to catch up: as healthcare continues to struggle with often basic security challenges, the threat actors are simply moving the needle at a much faster pace.

The COVID-19 pandemic, in particular, has truly highlighted theseverityof the situation. Threat actors are actively targeting those developingtreatments and vaccines, often pairing withforeigngovernments forespionagepurposes.

DHS CISA, theFBI, and security researchers are continuously working to keep the industry informed, urging quick remediation. But speed and healthcare cybersecuritydontoften align.

Given the disparities,itsimperative that the sector address these challenges now. Ideally,zerotrust infrastructure could remediate issues with credential theft,authentication, authorization, and even a heavy reliance on Virtual Private Networks (VPNs).

But with limited staffing and resources,itsimportant to ask: just how feasible would a zero trustmodelbe in the healthcare sector?

NIST describes zero trustas an evolving set of network securityparameters designed to narrow defense perimeters from its current wide state, to more individualized resources. The model focuses on protecting resources, instead of network segments.

Zero trust was designed in response to enterprise trends, such as remote users and cloud-based assets not located directly within the enterprise network.

Azero trustarchitecture (ZTA) uses zero trust principles to plan enterprise infrastructure and workflows, according to NIST. Zero trust assumes there is no implicit trust granted to assets or user accounts based solely on their physical or network location (i.e., local area networks versus the internet).

Authentication and authorization (both user and device) are discrete functions performed before a session to an enterprise resource is established, it added. Zero trust focus on protecting resources, not network segments, as the network location is no longer seen as the prime component to the security posture of the resource.

The first US federal Chief Information Security Officer, GregTouhill, an adjunct professor at Carnegie Mellon University's Heinz College, explained the model first came about in 2004 with a lead researcher with the Jericho Forum, a group of multinational user companies dedicated to the development of open standards.

The same threat actors who bricked the Ukrainian power grid are able to use that same tactic and procedure to brick medical devices.

Theoverall enterprisenetwork was initially designed with a perimeter-based model, protected by antivirussoftwareand firewalls. But those researchersconcludedthat the traditional perimeter has been rapidly overcome by events, mobile computing, laptops, and now, iPhones and tablets.

Administrators weremerely attemptingto getall ofthese devices to workandconnect, as well asauthenticated: security was not always top of mind.

OPAQ Chief Technical Officer Tom Cross explained that in the early years, security was primarily a security guard sitting at a front desk, stopping people from getting into the building. As it progressed, and more items were connected to the network, those security efforts have evolved in an attempt to keep pace with the decentralized network.

The model continued to evolve through 2010, when the term zero trust truly landed,Touhillexplained. From that strategy, user profiles are designed to authenticate and only provide access to what the user is authorized to see.

Mobility was poking too many holes in the perimeter,Touhillnoted. Jericho came in and said we need anew model, that doesnt presume everything is trusted a model that authenticates first, and then only connects to what youve allowed it to see.

At its core, the idea is to go in and assume everything is not rosy, he continued. Dont trust from the inside and dont trust from the outside. Authenticate before granting access andtake an identity-centric control to granting access to information.

Many organizations have moved to the cloud or are leveraging SaaS applications. Often,employees are not in the office,although the appstheyreaccessing exist on the enterprise network, Cross explained. As a result, traffic is routing through the office network,evenwhen the user is physically located elsewhere.These issues can lead to a host of authentication issues and increase the risk of exploit.

Chris Williams, Cyber Solution Architect, Capgemini North America explained that the core concept of zero trust is to treat the enterprise network like its the internet, assuming there are compromised machines or users on your enterprise network, as well as malicious actors all of the time.

Enterprises must assume those actors are constantly working to gain access to the rest of the enterprise for further exploits.

So, you dont trust anything: The network doesnt trust the machine unless the machine has been identified and authenticated. The applicationdoesnttrust the user unless the user has been identified and authenticated. The database doesnt trust the transaction unless the transaction has been properly authorized and approved, Williams said.

There is an audit trail for everything, so you can perform analysis for incident detection and response, he added.

However,SaifAbed, Cyber evangelist and Clinical Cyber Defense Systems CEO, explained that this model can only be done effectively when the organization understands who their users are, their assets,and how they interactwith each device during normal business operations and exceptional circumstances.

At its core, the idea is to go in and assume everything is not rosy.

The first step will be the most time-consuming, but it involves mapping environments, explained Abed. Enterprises must risk assess different assets from medical devices to network infrastructure, while categorizing usergroups and critically understanding their behaviors and interactions.

Healthcare organizations cant move further along in thezero trustprocess until this process is adequately accomplished, he added. Only then canleadership consider making bigger investments in technology that could support azero trustmodel: people and processes must first be understood.

Touhilladded that healthcare has a trove of devices, surgical robots, IoT, and computers, among other devices, which are usually unpatched or unmanaged. An inventoryand assetmanagementof these devices are crucialto begin azero trustprocess.

But many providers are drastically wrong about just how many devices exist on the network. In one example,Touhillexplained thata sample hospital said they have about 7,000 devices connected on the network. With an automated solution, they found 90,000 connected devices.

Its literally impossible to do asset management manually,Touhillstressed.

Williams explained networks must be configured to control access on a connection-by -connection basis, which include deployed authentication services that can identify users and devices on an individual basis.

In particular, modernhealthcare networks have seen explosions in the use of IT technology on clinical networks where care is delivered, Williams said. Healthcare organizations should have some segregation of clinical capabilities from IT and Internet-connected capabilities, so that Internet-based issues cannot interfere with patient care and safety.

Situations where devices and users are trusted simply because they are connected need to be identified, isolated, and locked down to the greatest extent possible, he added. Above all else, you should assess your environment to lay out a prioritized roadmap for implementation, so the most significant vulnerabilities can be addressed, and the environment can be hardened against a possible attack in a prioritized manner.

In healthcare, thezero trustprocess should center around device health and identity andaccessmanagement, explained Chace Cunningham, vice president and senior analyst at Forrester. In that way, if an attacker gains access through the network using stolen credentials, the attack cant proliferate across the network.

Attackers in healthcare whether they are exfiltrating data or launching a ransomware attack increasingly focus on scale, explained Abed. The more they can move across a network and compromise it then the more options they have in terms of the impact of their attacks.

Doing this often requires spoofing behaviors and identities to take advantage of existing trust paradigms, he added. By implementing azero truststrategy you effectively shrink the scale of opportunity for attackers to exploit existing interactions between users/devices because identities and transactions are constantly being monitored and challenged.

Zero trust also makes the IT environment more robust against smaller breaches and failures that tend to be the start of headline-grabbing compromises,Williams explained. Major cyberattacks areactually aslow process, beginning with a single server or endpoint exploit that gives control to an attacker.

Its literally impossible to do asset management manually.

The hacker can then exploit the foothold to proliferate across the network and even escalate privileges, until gaining control and accomplishing the objective.But if an organization has accomplished azero trustmodel,Williams saidthe ability toproliferate becomes increasingly difficult, as the hacker will need to obtain proper privileges and connectivity along every step of theway.

In addition, with zero trust, every step that the attacker takes will be logged for later investigation, leaving them vulnerable to detection by cyber defense monitoring systems, he said.

Its clear, all industries should be working to move into azero trustmodel to combat serious risks and cybercriminal activity. But given healthcares current struggles to keep pace, there will be a long journey ahead when attempting to make the shift.

And some organizations will find the process easier than others.

For example, Williams explained that many of those with almost entirely cloud-based environments, minimal on-premise networks, or datacenters do have many zero trust principles implemented into their IT environment, as cloud services are typically delivered over the internet and hardened using those principles.

Highly distributed environments with limited centralinfrastructure, where it is easy to isolate sites and capabilities from one anotherare ideal for zero trust, as well, he added.

Zero trust tends to be most difficult in high-tech, highly collaborative environments, like product design, where large numbers of people need access to each others applications and systems, Williams said.

In those situations, zero trust requires a high level of discipline and mature underlying infrastructure and processes, he added.Once in place, zero trust can provide excellent protection against targeted professional cyber attackers, by thwarting their ability to target sensitive data or to unleash ransomware attacks.

Zero trust is not a tool,itsa process to go through to get to the secured destination. Cross explained that an organization can never hope to eliminate every risk to create an ideal state. But the idea is to make progress to create the most secure environment possible.

For healthcare, it will begin with understanding your people, identity, and authentication,aswella full understanding of groups within the enterpriseto build a strong foundation. At the end of the day, zero trust is the way to respond and where networking is going in the future, Cross added.

The future of networking and security looks like apps in the cloud, which means strong authentication must begin now.

The feasibility of zero trust will boil down to leadership,Touhillexplained. Board members and C-level leadership must commit to solving the problem. While costly, the process of shifting into azero trustmodel will save organizations resources and money, over time.

Reports show that with ransomware,the healthcare sector has spent more than$160 millionon ransomware recovery in the last four years.

In healthcare, its not going to happen overnight,Touhillstressed. But given the spate of targeted cyberattacks on healthcare and COVID-19 data, the process needs to start as soon as possible. There are tools that can support the process, including a software-defined perimeter and single packet authorization, which complements a software-defined perimeter and is kind of like a hall pass.

Control policy enforcement will be crucial, as well. But healthcare is currently just employing blocking and tackling. With threat actors like Cozy Bear, which are known for doing more than espionage, the need for zero trust is paramount.

The same threat actors whobricked the Ukrainian power grid are able to use that same tactic and procedure to brick medical devices, saidTouhill. More and more people are wearingWi-Fi-enabled devices, and this same zero trust concept can be employed to protect that tech and all devices not originally created to be hooked up to the internet.

We're getting to a place where technology is more adaptable and more affordable, saidCunningham. To move toward this model, it requires a commitment from leadershipsaying,heres how were going to approach this thing.

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How Zero Trust in Healthcare Can Keep Pace with the Threat Landscape - HealthITSecurity.com

KDMC named a Best Place to Work in Healthcare – Daily Leader – Dailyleader

Kings Daughters Medical Center has been selected by Modern Healthcare as one of the 2020 Best Places to Work in Healthcare.

Since the list was introduced in 2008, KDMC has earned the distinction 10 times.

It has been an especially trying year for the world, and healthcare in particular, as COVID-19 ravages our communities and your workplaces, said Modern Healthcare editor Aurora Aguilar.

But the organizations recognized on this years list rose to the top and continued to be a source of strength for their teammates. They have seen their colleagues fall ill to the virus and struggled with the economic impact of the pandemic, Aguilar said. The loyalty and trust between employers and their workers is being put to the test now more than ever. We congratulate the Best Places to Work in Healthcare for continuing to serve their workforce and communities during such an unprecedented time.

KDMC CEO Alvin Hoover is proud of the people with whom he works.

Im honored that KDMC has been selected as a best place to work for the fourth year in a row, and eight of the last nine years, Hoover said. We have a workforce dedicated to our mission of always providing quality health and wellness in a Christian environment.

Throughout the COVID crisis, our employees have shown they know why they chose to be in healthcare, working with purpose, knowing their work is worthwhile and that they are making a difference, he said. They have selflessly taken care of our community and have encouraged each other through the toughest of times.

Proud doesnt begin to describe the incredible feeling of family, teamwork and community I think of when I say KDMC, said Celine Craig, KDMCs chief regulatory and human resource officer. They are my people and they are who make KDMC the Best Place to Work in Healthcare in Mississippi.

The award program identifies and recognizes outstanding employers in the healthcare industry nationwide. Modern Healthcare partners with the Best Companies Group on the assessment process, which includes an extensive employee survey.

KDMCs employees will find out their ranking on the list and be celebrated at the virtual awards gala Oct. 8.

The complete list of 2020 winners is available at ModernHealthcare.com/bestplaces.

Originally posted here:

KDMC named a Best Place to Work in Healthcare - Daily Leader - Dailyleader

‘Hearts for Healthcare Workers’ raises thousands of dollars for hospitals – WAND

SPRINGFIELD, Ill. (WAND) - Two Springfield companies found a way to give back to those who put their lives on the line every day.

The Executive Director for Memorial Medical Centers Foundation, Melissa Hansen-Schmadeke, said a meaningful message directed at the Springfield community's health care workers took the community by storm.

"You can drive down any subdivision and see [the signs] in many yards," Schmadeke said. "Many cars are displaying the 'Hearts for Heath Care Workers' decals in their cars and of course the T-shirts. You can see those about anywhere walking down the streets of Springfield."

"Hearts for Healthcare Workers" - it's a simple, but powerful, message.

"This really started as a simple pink heart,"Schmadeke said. "It was originally on a sheet of paper and people were printing it out and putting it in their windows."

Months later, that message expanded to so much more than just paper in people's windows. Ace Sign Company and Primo Designs joined together to support front line workers in their community.

Manager of Primo Designs, Jay Capriotti, said he wanted to give back to those who were at the forefront of the pandemic.

"When many people were nervous and scared to go out in the community, the health care workers were front and center," Capriotti said.

Todd Bringuet of Ace Sign Company said the company created and sold the signs for about $9 each and thousands of them were distributed throughout the community.

"There were over 6,000 signs produced and distributed," Bringuet said.

According to Capriotti, Primo Designs created and sold more than 1,000 T-shirts.

"Going out there to see something you produced and see how well it took off, it really made me feel special," Capriotti said. "It really made me and our company feel like we were able to do something to help."

On Friday, money collected from the sales was given to both Memorial Medical Center and the HSHS. St. John's Foundation.

"We had about $15,000 raised from the signs that were sold, and Ace Sign Company decided to add another $5,000 to that," Bringuet said.

All together, the two companies donated $24,000.

Schmadeke said it means the world to have so much support from the community.

"We are thrilled and humbled by the support we have received from our communities throughout the global pandemic," Schmadeke said.

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'Hearts for Healthcare Workers' raises thousands of dollars for hospitals - WAND

Advanced analytics align nursing resources more accurately – Healthcare IT News

Like many hospitals, MercyOne Des Moines Medical Center in Des Moines, Iowa, typically found itself in crisis mode when it came to staffing. It constantly was understaffed because of regional nursing shortages.

THE PROBLEM

In response, a culture of unit-level staff protection had developed, where units held back on sharing staff because of the uncertainty of unexpected changes. The organization often was forced to float core staff to meet patient care needs. All of these factors led to a high level of premium pay to ensure appropriate coverage.

We knew we had to take an entirely new approach to staffing as a business process, said Shawna Gunn, RN, manager of operations at MercyOne Des Moines Medical Center. The old ways simply didnt work. It was chaotic and exhausting for staff and costly for our organization.

MercyOne Des Moines relied on manual processes to manage nursing resources across the acute care units. Each week, managers built staffing plans in Excel. It was a time-consuming process, and despite best effortsthe daily staffing plan ultimately was only a best guess of what was thought would be true for a given day.

Staffing is a lot like trying to assemble a puzzle, Gunn explained. Who is on duty? What are their skills? To which unit are they assigned? What is our flex pool? What is the patient demand and staff level for each unit? Where can we put people? There are a lot of different pieces that come together to create a single picture. What we lacked was the ability to see all of those pieces at any given point in time in order to match our nursing staff to our patients.

This is problematic because hospital environments are fluid. Change is expected. However, without a consolidated view of nursing resources, the healthcare organization struggled to adjust staff plans to in-the-moment changes.

Shawna Gunn, RN, MercyOne Des Moines Medical Center

Hours were spent each day refining the plan based on actual patient need. Staffing managers spent a large part of their day rounding units, constantly updating numbers, exchanging close to 100 texts. Charge nurses were pulled from patient care activities to address staffing issues.

Our staffing situation had evolved into a 24/7 process, Gunn said. Our goal was to get out of crisis mode by finding a tool that would improve the efficiency and accuracy of how we deployed nursing resources. We wanted a solution that would allow us to collaborate in real time to evaluate our staffing needs and available resources. We also wanted a solution that allowed us the ability to plan ahead, and to work beyond the moment.

Finally, the organization wanted to create a better work/life balance for nurses. Gunn began her career as a resource pool nurse. It wasnt uncommon to find her on three different floors with three different patients during a 12-hour shift.

On a national level, nurses feel the burden of being asked to stay longer to cover staffing gaps. It was important that MercyOne Des Moines improve efficiency to allow staff to have a better work/life balance.

PROPOSAL

MercyOne Des Moines opted for health IT-vendor Hospital IQs predictive analytics and workflow system, Workforce, to automate and streamline the allocation of telemetry, med-surg and float pool nurses to ensure appropriate patient coverage each day.

Hospital IQ would integrate with the healthcare organizations existing systems and provide a single source of truth to help adjust nursing resources in line with forecasted patient census. The system would automate the manual processes that staff had been relying on to help coordinate and validate staffing needs in real time.

Beyond the automation, the solution would give us the insight to adjust staffing levels for both day-of activities and up to seven days in advance, Gunn explained. The system would notify staffing managers of potential issues, giving us the opportunity to proactively staff up units that needed support, while avoiding overstaffing on other floors.

MEETING THE CHALLENGE

Staffing coordinators and managers, unit directors, charge nursesand department secretaries all use the Workforce system. Each user can access the system from anywhere inside or outside of the hospital via desktop or mobile device.

Each morning, our teams meet for 15 minutes, Gunn said. During that meeting, we pull up Hospital IQ and make sure that everything is accurate. We can see updates from the units, evaluate where we are at, and make any necessary adjustments. Staff members use Hospital IQ to see the plan for each floor. All the confusion and ambiguity, all the back and forth, is gone.

Managers also use the system to communicate why changes are made. For example, perhaps one unit received three staff, while another did not receive additional staff. Managers can communicate about the specific unit needs so that staff members understand why a particular decision was made.

This transparency enables every unit to work collaboratively on staffing. Everyone can see the resources that are available each day and understand how and why those nurses were deployed.

After the daily plan is in place, we plan for the next 24 hours, Gunn noted. And from there we can look at the next week, up to seven days out. Hospital IQ lets us look at forecasted census, capacity, staffing plans, scheduled paid time off by unit all of those puzzle pieces that we bring together to create our single source of truth.

We can see the numbers overall for each unit and across the hospital, she added. We can make recommendations about switching someone from a day shift to night shift or from one unit to another.

Staffing coordinators can look at a problem area one week in advance, communicate with unit leaders, and determine ways to resolve the problem with next Thursday by applying or shifting the appropriate resources, she added.

We can look at real-time numbers how many staff on hand, who is where, who is staying late, Gunn said. Its all there. When staff demands shift or when we experience call-offs, its all in the system. We can see where everyone is at any time of the day.

MercyOne Des Moines has removed the back and forth in real time. For example, if a nurse calls in sick, or another nurse is added to the resource pool, charge nurses and department secretaries simply update the system. Staffing coordinators then receive real-time updates and use the system to communicate with charge nurses about the staff allocation for that shift.

The Workforce system integrates data from MercyOne Des Moiness Cerner EHR, Kronos scheduling system and TeleTracking bed management IT, and gives staff a complete picture about patients, census and capacity so managers can align nursing resources accurately.

RESULTS

The system gives MercyOne Des Moines a consolidated view of staffing resources that it could not get before. It has become the organizations source of truth across the hospital, Gunn said. It has broken down all of the silos data, processes andpeople that stopped the organization from working collaboratively, she said.

MercyOne Des Moiness entire staffing process has become more efficient, she noted. We know exactly which resources we have on hand and where they are located, and this saves a tremendous amount of time. The automation and efficiency has reduced the time spent aligning daily staffing by 70 hours per week.

Our staffing coordinators have re-focused their time looking for ways to improve the patient experience, she explained. Unit directors have re-focused their time on patient care-related activities at the bedside since they are no longer being pulled away by text or phone to address staffing issues.

When needed, staffing coordinators now can serve as a second set of hands in the units. In nursing, there can be periods when the floor is very busy, such as when staff coordinate discharges, Gunn explained. Those busy times only last for a short period of time, but nowstaffing coordinators can jump in and assist.They do not need to bring in another nurse for an 8-hour shift.

Hospital IQ has enabled our teams to work collaboratively to create a balanced staffing plan for all units, she said. In the past, it felt as though we were working against one another at times. Now, we know if we have staff to give and if we can assist other units by letting those resources go to another unit.

The system also allows managers to look beyond immediate bedside needs. For example, MercyOne Des Moines has a lot of open-heart surgery patients. If, in using the system, a manager is able to see that she will have three patients ready for discharge in two days, she can begin to align resources to facilitate those discharges in a timely manner. That, in turn, opens up a bed for a surgery patient.

The system has enabled us to improve patient care and staff satisfaction, Gunn said. Because we can shift schedules to meet patient demand days in advance, weve significantly reduced the frequency with which we ask nurses to either come in on a day off or stay late. As such, we are now using shift-based incentive pay programs and overtime pay in a more strategic way rather than as a last-minute solution to staffing gaps.

While there is surely a financial impact, she added, the main impact is a less chaotic environment and a more predictable schedule for nurses, which reduces exhaustion and ultimately leads to better patient care.

And finally, the technology has improved how the organization manages and deploys its resource pool. Shifts are divided into four-hour increments. With the system, resource pool nurses receive a notification informing them of where they will spend the next segment of their shift. They can begin patient care earlier, rather than waiting to find out where theyve been assigned. The improved efficiency also means that they are moving between units less often.

ADVICE FOR OTHERS

To meet the rising demands of healthcare, we are all challenged to continually improve efficiency, Gunn stated. Our ability to improve processes each and every day is what our patients and communities truly need and deserve. If a healthcare organization can identify an area for improvement, that should become a priority focus.

When it comes to staffing, where time and resources are already stretched to the limit, tackling one more project may feel overwhelming, she continued. Its tempting to put off investing in a new process or technology. The catch, however, is that innovation is the only way to achieve process improvements. We already know that manual methods arent working well.

In taking the step to embrace technology, MercyOne Des Moines has transformed its staffing processes, Gunn said.

In less than one month, we saw process improvements and eliminated a chaotic, manual workflow, she said. The technology helps us automate the cumbersome processes: phone calls, endless texts, staffing rounds and daily meetings. Our staffing coordinators and unit directors can quickly convey staffing changes and requests through the system in a matter of minutes. This comprehensive view of resources breaks down staffing silos and lets you work collectively to align nursing resources to the right patients and units at the right time.

The efficiency improvements gained through the technology those successes will allow for more time at the bedside, and even more time to focus on driving greater levels of care, she concluded; and thats always the end goal.

Twitter:@SiwickiHealthITEmail the writer:bill.siwicki@himss.orgHealthcare IT News is a HIMSS Media publication.

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Advanced analytics align nursing resources more accurately - Healthcare IT News

Brewers, Aurora Health Care give Brewers onesies to newborn babies – WTMJ-TV

WISCONSIN The Milwaukee Brewers are welcoming new fans into the world by joining forces with Aurora Health Care to provide special Brewers onesies to newborn babies.

That's right, Brewers' onesies! Whatever you're imagining in your head, we guarantee it's even cuter than that.

The new onesies are in celebration of the Brewers home opener which is scheduled for Friday against the St. Louis Cardinals.

On that day, Aurora Health Care birthing centers across Wisconsin will begin giving these onesies to all newborns. However, here's a sneak peek:

Families at the centers have waited nine months for their bundles of joy and an additional four months for baseball, so what better way to celebrate both arrivals than with a new onesie?

The onesies will be available while supplies last.

Also while supplies last, Aurora Health Care will be sharing photos of newborn babies in the onesies on their social media pages. So, if you need a pick me up this week, that's where you can find it.

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Brewers, Aurora Health Care give Brewers onesies to newborn babies - WTMJ-TV

Laurel Braitman: From Healthcare Workers To The Rest Of Us How Can We Better Cope? – NPR

Dr. Laurel Braitman speaks from the TED stage. Ryan Lash/TED hide caption

Dr. Laurel Braitman speaks from the TED stage.

About The Episode

Healthcare jobs are already stressful. Add a pandemic... and ongoing police brutality? And it's a lot. We hear from physicians of color and TED Fellow Laurel Braitman about taking care of ourselves.

About Laurel Braitman

Senior TED fellow Laurel Braitman is a writer, grief counselor, and anthropologist. She is a professor and the director of writing and storytelling at the Stanford School of Medicine, where she teaches free writing workshops to medical students and physicians.

Braitman's writing about science, nature, beauty, and loss has appeared in the New York Times, Guardian, National Geographic and more. Her forthcoming book, House of the Heart, is about "growing up, mortality and how we might live with the perspective of a terminal disease without the dire prognosis."

She has a PhD from MIT in History, Anthropology, Science, Technology and Society, and a BA from Cornell University.

Featured Speakers

Bren Brown: The Power Of Vulnerability

Vulnerability is a key part of being human. Social worker and researcher Bren Brown explores the role of vulnerabilityand connectionin processing difficult moments and managing our mental health.

Hailey Hardcastle: Why Students Should Have Mental Health Days

Teen activist Hailey Hardcastle fought for Oregon students to have mental health days in schools, just like sick days. She talks about how we all need to look after our mental health.

Andrew Solomon: Depression, The Secret We Share

Depression, grief, and sadness are each emotions that can take us by surprise. As a writer and psychology professor, Andrew Solomon knows how important it is to understand their differences.

Resources

If you or someone you know needs to talk to someone, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP. And the National Suicide Prevention Hotline number is 1-800-273-8255.

This month the FCC approved 988 to be the national three-digit number for the National Suicide Prevention Hotline, similar to 911 for emergency services. As of this date of publish, the 988 is not currently active nationally but will be soon. In the meantime, please use 1-800-273-8255.

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Laurel Braitman: From Healthcare Workers To The Rest Of Us How Can We Better Cope? - NPR

Discrimination and Disparities in Health: Examination of racial inequality in Nashville | Opinion – Tennessean

Bill Frist, M.D. and Andre L. Churchwell, M.D., Guest Columnists Published 10:00 a.m. CT July 31, 2020

While to some, Confederate monuments are memorials to the dead, to many others they are glorifications of slavery, racism and oppression. Nashville Tennessean

No one should feel discriminated against when seeking care, and quality healthcare should be available to everyone.

As city and community leaders across the country wrestle with their own roles and responsibilities in addressing racial inequality, we believe specific attention to health equity and health disparities will lead to dismantling structural racism and a roadmap for a healthier future for all.

An example of how we are beginning that focus and journey can be found inNashville, Tennessee. But it could just as well be any town or city in the nation.

Weve known for years that minorities face health disparities nationally, and in our own experiences as physicians, weve seen first-hand how health inequities unfairly persist in communities of color when it comes to access and quality.

In Nashville, the simple zip code of your residence could lead to a six-year decrement to life expectancy, twice the rate of unemployment and five times difference in poverty.

The challenges of unconscious bias and racism that enable health inequities must be addressed to improve health outcomes.

Thanks to the recent Nashville Community Health and Well-Being Survey, we have a clearer picture of the challenges facing vulnerable populations, especially African Americans here in Davidson County, for the first time in 20 years.

Former Senate Majority Leader Bill Frist(Photo: Submitted)

The personal, pervasive stories of discrimination that have captured our nations attention are keenly present in our survey data.African American respondents were nearly five times more likely (14.6%) to report feeling discrimination when seeking healthcare in Metro Nashville compared to white respondents (3.1%). And nearly one in three (31.5%) African Americans felt discriminated against at work in the past year, compared to only 6% of white respondents.

Moreover, one third of African American respondents reported feeling emotionally upsetangry, sad, or frustratedin response to treatment based on race. Only 7% of white survey-takers reported similar emotions. For African Americans, such treatment was more likely to have physical manifestations: nearly 18% experienced headache or stomach ache, a pounding heart or muscle tension. Those symptoms were only felt by 3% of white respondents.

The chronic stress of being an African American has a clear, compounding effect on the chronic medical conditions they face and are part of the answer for the life-expectancy discrepancies seen between people of different races.

For example, white American males live on average 77 years while African Americans live on average 72 years. White females live on average 81 years compared to 78 years for African American women.

Hear more Tennessee Voices: Get the weekly opinion newsletter for insightful and thought provoking columns.

Tennessean Opinion Editor David Plazas spoke to Dr. Bill Frist, former U.S. Senate majority leader Nashville Tennessean

Our region is a national leader in health care services, with Middle Tennessee often referred to as the Silicon Valley of Health Services. We now need to do the hard work of figuring out how to lead the nation in health equity. And it starts by gathering data and understanding where inequities exist.

The Nashville Community Health and Well-being Survey was developed and implemented by NashvilleHealth and the Metro Public Health Department. It explored specific health conditions, access to care, and health behaviors across Davidson County residents between October 2018 and April 2019.

More than 1,800 responses were gathered online and by mail. The assessment was extensive, and while findings were not limited to comparisons between Black and white populations, we highlight thedata to emphasize the work we have ahead of us to ensure health equity for African American Nashvillians.

The survey found chronic conditions like diabetes, hypertension, respiratory conditions, and obesity were all much more common in African American than white residents. Of survey takers who self-identified as African American, 22.1% have diabetes. Only 8.3% of survey takers who self-identified as white, non-Hispanic have the condition.

Whereas 47.8% of the African American respondents are obese, 24% of white respondents are obese. 47.6% of African Americans reported hypertension; only 27% of white respondents reported hypertension. And 24.7% of African American registered respiratory conditions; 17.4% of white respondents reported the same.

Dr. Andre L. Churchwell, (Photo: Mary Donaldson)

No physician or nurse wakes up each day with the intention to treat patients differently the overwhelming majority of us called to healthcare genuinely want to help all people.

But unintentional, unconscious implicit bias in delivering clinical care has been demonstrated in numerous studies, with minorities more likely to receive lower quality care, regardless of income or insurance.

And when it comes to social supports, our Nashville communities of color disproportionately feel unsupported. In responding to the survey, 15% of African Americans reported that they rarely or never get needed social support, and a startling 23.1% of Hispanic respondents shared the same sentiment. Only 7.8% of white respondents said the same.

As physicians we know that to achieve true health equity we must also address systemic racism in our criminal justice system and create paths to improve public education, transportation, and many non-medical society challenges.

The change needs to start with us.In Nashville, but indeed in every community in America.

We want to add our voices to the collective call-to-action to city leaders across America and those of us in medicine and healthcare, to fully engage, and honestly and openly address the issues that continually lead to disparate health outcomes for so many.

Accountability in these matters, like free speech, is to be shared amongst allof us.

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Senator Bill Frist, M.D. is a heart transplant surgeon, founder of the Vanderbilt Transplant Center, and former U.S. Senate Majority Leader.

Andre L. Churchwell, M.D. is the Vice Chancellor of Equity, Diversity & Inclusion and Chief Diversity Officer at Vanderbilt University. He also serves as a Professor of Medicine (Cardiology) and the Chief Diversity Officer at Vanderbilt University Medical Center.

Read or Share this story: https://www.tennessean.com/story/opinion/2020/07/31/examination-racial-inequality-nashvilles-healthcare/5540680002/

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Discrimination and Disparities in Health: Examination of racial inequality in Nashville | Opinion - Tennessean

UK health secretary says GP consultations should be remote by default – Healthcare IT News

In a speech on the future of healthcare and lessons for the NHS from the coronavirus pandemic, health secretary, Matt Hancock, said all GP appointments should be done remotely by default unless a patient needs to be seen in person.

Hancock admitted that while some mistakes were made, so many things went right in the response to the pandemic, and remote consultations should continue.

However, the Royal College of GPs have expressed concern, with some arguing remote consultations increased stress levels for patients and doctors and that removing face-to-face appointments could take the human touch out of general practice.

WHY IT MATTERS

Seventy-one per cent of routine GP consultations in the four weeks leading up to 12 April were delivered remotely. This represents a significant increase from just 25% for the same period a year ago.

AGPonlinepoll revealed thatmost GPs think more than half of consultations should continue to be delivered remotely after the pandemicsubsides.

Despite this, the research also showed that there are still concerns around the harm to relationships with patients and the risk of missing serious conditions, with many patients needing physical examinations and vaccines.

THE LARGER CONTEXT

According to the Digital health: the changing landscape of how we access GP services report, online GPs could save employers 1.5 billion in lost working time.

In this report, researchers estimated that if virtual GP appointments had been offered as a first point of call across all public GP practices in 2019, face-to-face consultations could have been reduced by 50 million.

Thestate of telehealth in Europe before COVID-19was also analysed by HIMSS,parent company of Healthcare IT News,and the findings were presented in an eBook.

Meanwhile, Medicspot has announced a partnership with British supermarket chain, Asda to offer in-store GP video-consultations in the latest expansion of digital primary care services.

ON THE RECORD

Hancock said: Before coronavirus there was a view advanced by some people which held that anyone over the age of 25 simply could not cope with anything other than a face-to face-appointment.

This process has shown that patients and clinicians alike, not just the young who want to use technology. [People] don't want to sit around in a waiting room, if that service can come to them at home.

So from now on, all consultations should be teleconsultations, unless there's a compelling clinical reason not to.

He added: Of course, if there's an emergency the NHS will be ready and waiting to see you in person. But if they are able to patients should get in contact first by the web, or by calling in advance.

See the rest here:

UK health secretary says GP consultations should be remote by default - Healthcare IT News



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