The clothing, skin, and personal protective equipment (PPE) of healthcare workers (HCW) are often contaminated with respiratory viruses after they care for patients, according to US Centers for Disease Control and Prevention investigators. Their conclusion, published in the December issue ofInfection Control & Hospital Epidemiology, reinforces the need for complete hand hygiene and frequent changing of PPE to prevent virus transmission.

Investigators found viruses on 31% of glove samples, 21% of gown samples, and 12% of face mask samples. In addition, 21% of bare hand samples, 11% of scrub samples, and 7% of face samples tested positive for respiratory viruses.

The data were collected from 59 healthcare workers at a 465-bed acute care academic hospital in the Chicago area who volunteered to have their skin, cloths and PPE swabbed for virus measurement. The swabbing took place from March to June 2017 and again from September 2017 to April 2018.

Investigators wanted primarily to characterize the presence and magnitude of viruses on healthcare workers after they provided routine care for patients suffering from respiratory infection and who had been placed under droplet and/or contact isolation. But they also wanted to measure the connection between how healthcare workers can contaminate themselves through faulty doffing practices.

Our findings of viral contamination on PPE, clothes, and skin of HCWs emphasize the significance of appropriate PPE use, PPE doffing practices, and hand hygiene in infectious transmission prevention via the contact route, the study states.

The 52 patient participants provided written informed consent and authorized access to use and disclose health information for the study. Investigators observed the care given to patients during a 3-hour period, typically between 8 a.m. and noon.

To our knowledge, our study is the first to evaluate the association of self-contacts by HCWs and virus contamination on their PPE and bodies, the study states.

They found an association between the number of self-contacts by HCWs with their gloves, gowns, or masks and the concentration of virus on those pieces: the more self-contacts, the more virus.

The strongest correlation identified was between self-contact with the gown (torso) and virus concentrations on a personal stethoscope, which is often draped around the neck, the study states. Investigators were unable to discern the direction of virus transfer upon contact between the healthcare workers hands or gloves and a surface, but results suggest that those contacts contributed to virus dissemination.

Investigators also said that they observed doffing practices that deviated from CDCguidelines.

Exposure modeling and quantitative microbial risk assessment should be used to evaluate the importance of the presence and magnitude of different viruses at different locations in the environment and on HCWs for occupational and patient health impact, the study states.

Originally posted here:

Respiratory Viruses Cling to Healthcare Workers - Infection Control Today

The healthcare industry continues to have a cyber target on its back.

The inherent value of patient health records means hospitals and other healthcare organizations continually fall victim to a deluge of ransomware, spear phishing, and other cyberattacks. The costs of such assaults are substantial. These data breaches result not only in HIPAA violation fines and recovery costs, but also significant losses in community trust and patient satisfaction.

A security operations center (SOC) provides a focal point for security operations, but providing 24x7 SOC coverage is beyond the means of most organizations due to people and technology costs. Healthcare organizations face multiple challenges in proactively responding to threats. These challenges include protecting different legacy medical systems that are difficult to patch and maintain, locating and retaining security personnel, and managing with constrained cybersecurity resources.

Thats why Todd Thiemann, a product marketing director at Arctic Wolf, said healthcare organizations can benefit from investing in a security operations center (SOC)-as-a service instead of maintaining an on-premises SOC.

Creating your own SOC requires you to monitor all the telemetry from your various systems, detect and investigate anomalous activity, and remediate the security issues that you find. For larger organizations, that generally takes nine to 12 people with cybersecurity experience working 24x7, which is an expensive proposition, Thiemann said.

For smaller- and medium-sized organizations, standing up a SOC is beyond their means. But SOC-as-a-service, which provides everything required for security monitoring and related compliance obligations, offers healthcare organizations the protection they need at a more reasonable cost.

Thiemann said many healthcare organizations do not even realize that SOC-as-a-service is an option. But, he argued, this kind of service offers healthcare organizations a timely, responsive, and affordable way to manage threat risk, detection, and response. Healthcare organizations that enter into such arrangements should also expect an ongoing vulnerability management process in addition to the monitoring services that detect and respond to threats.

A good managed services team will ask about and understand where your crown jewels are and can identify the handful of systems with vulnerabilities where you need to focus disproportionate attention. And if something does occur, the security team can engage with you to resolve the issue, he said.

The right SOC-as-a-service partner, Thiemann added, can offer a personalized concierge approach that appreciates your organizations IT environment, inside and out. That team should also have the knowledge and experience to understand when a threat is truly significant so that you are not inundated with unnecessary false-positive alerts.

SOC-as-a-service is an ongoing relationship, an extension of your own internal IT team, that can help you tighten your security ship in a reliable and affordable way, he said. With a threat landscape that continues to evolve, its not a matter of if, but when youll encounter a cyberattack. SOC-as-a-service allows healthcare organizations a way to refine their security posture so they are ready for to effectively deal with whatever comes their way.

To learn more about SOC-as-a-service and how it can help protect your healthcare organization from cyberattacks, visit Arctic Wolf.

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Confront cyberthreats to healthcare reliably and affordably: Leverage a security operations center-as-a service - Healthcare IT News

By Letter to the Editor on December 4, 2019.

Re: the Conscience Rights Protection Act, Nov. 23 Herald. What I simply read into this proposed act is to protect health-care providers from having to forward patients to other health-care providers, or institutions, when those procedures are contrary to their beliefs.

Now I have a question: are all procedures really considered health care? About eight months ago my wife and I witnessed the awesome care given in the Lethbridge hospital when a granddaughter delivered a set of awesome twins prematurely. They were loved and cared for, first in the incubator, then loving and nurturing and caring until they were able to go home with Mommy and Daddy.

Then my sad news: about three months ago my wife was hospitalized with an incurable brain tumour. First one week in the Lethbridge hospital, she received awesome loving care from doctors and staff, then one week in the palliative care unit in Taber, the love and care was awesome, then she passed into glory.

But sad to say in todays Canada, it is within our laws to snuff out life, both for the pre-born and the medical assisted in dying. If that would not be the case, then the health-care providers would not have to deny their service to anyone. So what is real health care? Yet now on a positive note, I am so thankful for the awesome care, both in the hospital and seniors homes. Thank you so much for all our caregivers.

From a Taber volunteer.

Hans Visser

Taber

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What is real health care? - Lethbridge Herald

Fewer than 40% of the population will be covered by private health insurance by 2030 unless reforms are made, according to a report from the public policy thinktank the Grattan Institute.

The report, led by the health economist Stephen Duckett, recommended partially deregulating premiums to allow insurers to charge younger people less than older people for the same level of coverage, but said premiums should remain regulated and should not vary by age for people 55 and over.

The system faces a death spiral younger and healthier consumers get a bad deal so theyre dropping their insurance, which means premiums need to rise, so even more young and healthy people drop out, and the cycle continues, the report, published on Tuesday night, said.

This youth exodus means the recent moderation of premium increases is likely to end, and premiums will probably return to increasing at 5% or more each year. Young peoples premiums have to get cheaper.

The report proposed a number of other reforms, including redirecting the private hospital insurance rebate towards older patients. The report also recommended that the rebate not be increased, it be withdrawn from low-coverage policies, and the extras insurance rebate be withdrawn.

Part of the proceeds should fund dental care and part should keep hospital insurance premiums for older people at acceptable levels, it said.

The chair of the Australian Health Care Reform Alliance, Jennifer Doggett, said the proposed reforms were not substantial and would merely tweak the numbers to make insurance slightly more attractive to young people.

My biggest criticism is that the paper assumes that the current system of private health insurance is a system worth saving which, in my opinion, is not the case, Doggett, a health policy analyst, said.

They dont address many of the fundamental problems with private health insurance: that it is overly complex, cost-inflationary, has high administrative costs, leads to over-servicing, is inequitable, doesnt help those most in need, and disadvantages people in rural areas although some of these issues are addressed in other Grattan papers.

For the reforms to succeed, enough young people would have to join to effectively cross-subsidise the cost of older people. Consumer behaviour in this area was difficult to predict accurately as peoples decisions about private health insurance and healthcare were not often economically rational.

The paper relies on some significant assumptions about how young people will respond to the reforms. If these are wrong, the changes are not going to have the effect they predict, Doggett said.

However, redirecting the dental component of the rebate into public dental services is a positive as this would deliver much better value although overall the removal of the rebate from ancillary services means that the out-of-pocket costs for allied health and dental services are likely to rise.

Catholic Health Australias chief executive, Pat Garcia, said deregulating premiums for those under 55 would mean junking a fundamental tenet of Australias health system. This risked increasing premiums for young people with chronic disease and mental health issues, leading to those with chronic disease dropping their private health insurance and moving into the public system.

This is the last thing public hospitals need right now.

The chief executive of Private Healthcare Australia, Dr Rachel David, said health funds were prevented from discriminating against members based on health status or claims history.

The latest report from the Grattan Institute highlighted issues of concern in the private health sector previously identified by government and stakeholders, however it failed to offer any workable solutions, she said.

While maintaining a system of community rating [which means the same service is available to everyone for the same price] posed challenges for Australias health system, it was also one of the features which helped Australia maintain its international reputation for fairness in healthcare.

Community rating underpins Australias private health insurance regulations, and changes to a risk-rated system would severely destabilise premiums for older Australians and threaten the future of fair and equitable healthcare.

Generational transfer of risk would mean a lot of Australians would have a very uncertain future.

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Up to 60% of Australians will drop private health by 2030 without reform, report finds - The Guardian

Historically, the first disease to be totally eradicated by vaccines was smallpox. This vaccine was first introduced in 1796 by Edward Jenner. He had noted that milkmaids who had caught cowpox did not catch smallpox. He lanced a cowpox lesions from Sarah Nelms, a young dairymaid and inoculated an eight-year-old boy, James Phipps, with it. The boy developed a mild fever discomfort but recovered. Two months later Jenner inoculated Phipps with a fresh smallpox lesion. The boy did not come down with smallpox.

Before 1980, the disease killed three out of every 10 people infected. It killed hundreds of millions of people worldwide before it was eradicated.

From 1966 to 1977, the World Health Organization undertook a global campaign to eliminate the disease via a worldwide vaccination program. The last known naturally occurring smallpox case was seen in October 26, 1977, in Merka, Somalia. By 1980, WHO declared smallpox eradicated.

There are two known stockpiles of variola, the virus that causes smallpoxin Atlanta, Georgia, at the U.S. Centers for Disease Control and Prevention (CDC) and the Russian State Center for Research on Virology and Biotechnology in Koltsovo, Russia.

Another human disease that has been eradicated, is rinderpest, or cattle plague, which was eradicated in 2011.

Modern vaccines have been used, and are being developed, to control, prevent or, hopefully, eradicate some diseases. They often use a weakened or dead virus or bacteria, or antigens found on their surface, to trigger a protective immune response. However, increasingly, vaccine technology utilizes other approaches to vaccinate against not only infectious diseases, but also diseases like cancer.

14 Diseases that Vaccines Control or Have Eliminated

The CDC prepared a list of 14 diseases that people have almost forgotten about, because of vaccines. They include:

Vaccine Pipeline

According to the Pharmaceutical Research and Manufacturers of America (PhRMA), there are 264 vaccines in development to prevent and treat diseases. These include infectious diseases (137), cancer (101), allergies (10), autoimmune disease (8) and Alzheimers disease (4).

Here are some recent stories about vaccines:

In May, the U.S. Food and Drug Administration (FDA) approved Sanofis Dengvaxia, a vaccine for all four serotypes of dengue. The disease, a hemorrhagic fever, is endemic in the U.S. territories of Puerto Rico and the U.S. Virgin Islands. The vaccine has a controversial history. It was pulled from the Philippine market in 2017 over safety concerns. However, it has been approved in 10 countries in Latin America and Asia where the disease is endemic. It was approved in Europe in December 2018.

On November 7, Takeda Pharmaceutical announced that its dengue fever vaccine hit its primary efficacy endpoint in its Phase III clinical trial. The trial evaluated the vaccine in 20,000 patients in Latin America and Asia.

In October 2019, 4D Pharma, based in Leeds, UK, partnered with U.S.-based Merck to develop Live Biotherapeutics vaccines. Outside the U.S., Merck & Co. is known as MSD. 4D Pharma focuses on the microbiome, the trillions of microorganisms that live in the human body. Live Biotherapeutics are a new class of medicines made up of strains of gut long-term bacteria originally isolated from healthy human donors. They are then encapsulated and administered orally, where they are selectively delivered to the gut where they can interact with the patient to exert therapeutic effects.

Under the terms of the deal, 4D will use its proprietary MicroRx platform with Mercks expertise in novel vaccine development and commercialization to discover and develop Live Biotherapeutics (LBPs) as vaccines in up to three currently undisclosed indications.

Also in October, researchers with the Washington University School of Medicine developed a technique to improve on cancer immunotherapy and vaccines. Currently, cancer vaccines and immune checkpoint therapies rely on a knowledge of MHC class I genes that activate killer T-cells. The new research looks at another group of genes, MHC class II, that activate the helper T-cells. One of Schreibers co-authors, Maxim N. Aryomov, an associate professor of pathology & immunology, developed a computer program that predicts which mutant proteins (antigens) on a tumor will specifically activate helper T-cells.

The idea of giving checkpoint inhibitors along with a tumor-specific vaccineespecially a vaccine that activates both killer and helper T-cellsis just beginning, said Robert D. Schreiber, the Andrew M. and Jane M. Bursky Distinguished Professor, and senior author of the study. But based on our study, the combination is likely to be more effective than any of the components alone. Today, when we treat a particular tumor type with checkpoint inhibitors, maybe 20% of the patients respond well. Were hoping that with a vaccine plus checkpoint inhibitors, the number of patients who respond well will go up to 60 to 70%. We havent tried that yet in patients, but thats the hope.

In July 2019, Cambridge, Massachusetts-based Neon Therapeutics announced top-line results in its Phase Ib clinical trial of NEO-PV-01, its personal neoantigen vaccine candidate. NEO-PV-01 was being evaluated in combination with Bristol-Myers Squibbs Opdivo (nivolumab) in advanced or metastatic melanoma, smoking-associated non-small cell lung cancer (NSCLC) and bladder cancer.

In all three cancer types, data showed prolonged and consistent improvements in progression-free survival (PFS) that is similar to that seen with checkpoint inhibitor monotherapy. In 27 patients with metastatic NSCLC, median PFS was 5.6 months. In 21 patients with metastatic bladder cancer, median PFS was 5.6 months. At 13.4-month median follow-up in 34 patients with metastatic melanoma, median PFS hadnt been reached yet.

The War on Antibiotic-Resistant Infections

A recent CDC report, Antibiotic Resistance Threats in the United States, 2019, found that more than 2.8 million antibiotic-resistant infections occurred in the U.S. each year, killing more than 35,000 people. In 2017, the agency found that there were 223,900 cases of Clostridioides difficile (C. diff) infections, resulting in at least 12,800 deaths.

The report underlines the importance of funding the development of new antibiotics and the effectiveness of vaccines. The U.S. government does fund quite a bit of research into anti-infectives, largely through the Department of Defense and Health and Human Services Biomedical Advanced Research and Development Authority (BARDA). Moderna, for examples, receives quite a bit of funding for its mRNA vaccines and anti-infectives programs, as well as the Bill & Melinda Gates Foundation, which invests heavily in companies working on vaccine and antibiotics research.

CARB-X is a program led by Boston University and funded by BARDA, the Wellcome Trust, the Gates Foundation and U.S. and European government agencies. Between 2016 and 2021, CARB-X plans to invest more than $500 million into vaccine and antibiotic research and has already made 44 awards totaling $126.1 million.

Vaccines provide an unusual return on investment. Not only have vaccines eliminated or minimized some of the most serious infectious diseases the world has ever known, a 2016 Johns Hopkins University study found that for every dollar invested in vaccination in the 94 lowest-income countries in the world, $16 were expected to be saved in healthcare costs, lost wages and lost productivity. Taking into consideration healthier and longer lives and the long-term burden of disability, the net return increases to $44 per $1 invested.

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Vaccines: A Healthcare Revolution and High Return on Investment - BioSpace

The following article is an opinion piece and reflects the views of only the author and not those of AllOnGeorgia.

By: Colt Chambers a native Northwest Georgian and current State Chairman of the Georgia Young Republicans.

In todays news cycle, its hard to break through the noise with the real issues that matter to the average American. Headlines throughout the country are catching the most incendiary, partisan topics, when in reality voters are trying to voice their support for the issues that affect them every day. Take health care. Partisan talking heads might point one way, but what the voters really care about is affordable and accessible care, and what Congress is doing to make that happen.

We are at the point where we are experiencing a rural health care crisis. Reliable health services are moving further and further away from rural communities. In the last ten years, Georgia has seen seven rural hospitals shutter their doors, with 41% at imminent risk of closure.

Filling this access gap are air ambulances. These services are often the last connector between communities and the types of trauma centers they need in dire circumstances. Air ambulances have become hospitals-on-wheels that can get a patient to the type of treatment they need in the amount of time necessary. When you are dealing with a matter of seconds, air ambulances save lives.

Knowing the problems facing rural communities and the work air ambulances are doing, it is confusing that Congress is looking at legislation that will actually make the lives of emergency first responders harder. The Lower Health Care Costs Act attempts to solve billing issues associated with air ambulances, but instead puts their entire operation at risk.

Its true: air ambulance operations are expensive. It is also true that a patient should not be put in the middle of these surprise billing negotiations. Unfortunately, the current legislation ignores that we still need to cover the operating costs of emergency health services. By setting an improper rate of reimbursement, the Lower Heath Care Costs Act threatens Americans access to quality health care.

Rural communities like Rome, GA cannot afford hospital and base closures. Such repercussions will strand Americans from lifesaving health care services.

We need to find a solution that can resolve billing issues for patients while protecting theservices that rural Americans rely on. We need a balanced proposal that accounts for theimportance of both accessibility and cost. Such a solution would be a true victory for ruralGeorgians and Americans alike.

I hope Congress can put down the partisan fights and focus on the issues affecting Americans every day. Georgia is lucky to have sound leaders in Washington representing our interests and it is my hope they can remember that access to health care is top of mind here at home.

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COLUMN: Congress is Threatening Rural Health Care Access - All On Georgia

DAVENPORT, Wash. It is hard to get work done without broadband these days.

From economic development to health care, ensuring that small towns are connected to high-speed internet is vital to their sustainability.

Dr. John Tomkowiak, dean of WSUs Elson S. Floyd College of Medicine, said during a recent meeting in Davenport that the health care industry relies upon broadband to ensure that the doctors and doctors-in-training at WSU, treating patients in rural communities, have access to internet.

Tomkowiak showed a map of 104 hospitals and clinics that WSUs medical school is partnering with to train students, noting that students use tablets that contain their core curriculum. For some elements of their coursework, they need to be connected to the internet, he said, emphasizing the need for broadband in rural communities.

The vast majority of physicians use the internet in their daily practice at work for tasks such as cataloging electronic patient records or communicating with patients. Even for emergency care, telemedicine can be used to triage cases, allowing a physician to remotely diagnose based on symptoms.

Numerous studies show that timely diagnosis in critical injuries can make life-or-death differences, Tomkowiak said.

Despite what broadband maps and surveys say, not all areas in rural Washington have high-speed access, let alone the internet. And even some communities that are connected have such slow speeds that businesses are affected.

Chewelah Mayor Dorothy Knauss said her town is challenged because some areas have broadband and others dont. At one time, the golf course could not process credit card transactions because of slow connectivity, she said. So community leaders formed a broadband action team and met with Charter Communications to forge an agreement to install more fiber optic cable. But its not always that easy.

Other community leaders shared challenges with adding fiber in the ground because of geographically difficult routes, such as on the Colville Reservation, where rocky terrain can make such work impossible.

Justin Slack, a Seattle transplant and interim mayor of Harrington, shared his towns story of achieving broadband connectivity in a simple four-block stretch of town. Slack, who works remotely, needed the broadband to do his job. He and his wife created a co-working space and coffee shop so others in Harrington could come work remotely, too.

If you build it theyll come, and thats what happened, Slack said.

Tomkowiak echoed the same need for physicians to have broadband in order to feel connected, citing health worker shortages in rural areas.

When you ask them why they dont serve in those areas its because they are the only ones, and they feel isolated, he said.

Funding for broadband connectivity at a federal and state level is mainly available through loans, with some grants, too. This year, Washington state lawmakers approved a law to create a statewide broadband office that will approve and distribute grant and loan funds to local governments, tribes, public, private and nonprofit entities working together to expand broadband in the state.

The program has $21.5 million available, including $14.5 million for loans and and $7 million for grants. The state will prioritize funding to public-private partnerships, with a focus on underserved areas in the state.

John Flanagan, a policy adviser in Gov. Jay Inslees office who worked on the legislation, said access to broadband is only half the problem. Quality and affordability are important, too. He also emphasized that the legislation is intended to bring broadband providers and community members together.

Broadband is local, only the community involved in the project and the provider will know how to do that project, he said.

The states ambitious broadband connectivity goals are spelled out in the new law.

The most pressing goal set by lawmakers is that by 2024, all Washington businesses and residences have access to high-speed broadband.

In Davenport, leaders from rural counties in Eastern Washington shared stories of students issued school laptops but having no internet at home to do their homework. So students sit outside the library or other free Wi-Fi zones in order to get their work done.

Lisa Brown, the director of the Department of Commerce, said she had visited several counties and found that broadband would help with economic growth, students trying to do their schoolwork and providing access to health care.

This is essential to the future of our state, Brown said.

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Getting connected: where broadband, rural prosperity and health care intersect - The Spokesman-Review

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Employers and workers will shell out more cash for health insurance in 2020.

Large companies predict the total cost of workplace health-care coverage to reach an average of $15,375 next year, according the National Business Group on Health. That's up from $14,642 in 2019.

This figure combines workers' and employers' spending on insurance. Employees are expected to shoulder about $4,500 in costs next year, including out-of-pocket spending, the group found.

The organization, which represents large employers' perspectives on health-care policy, polled 147 large employers to get their perspectives on health-care trends.

Employees with families face even steeper costs.

In 2018, employers spent an average of $15,159 in premiums to cover a family of four, according to the Kaiser Family Foundation.

Those workers paid a total of $7,726 in 2018. Of that, $3,020 came from cost-sharing, including deductibles, coinsurance and copayments.

"Employer premiums are going up; they pay more each year," said Cynthia Cox, vice president at the Kaiser Family Foundation. "But so do the employees and their families."

JGI/Jamie Grill | Blend Images | Getty Images

Deductibles the amount you must pay before the insurance company provides benefits now account for more than half of workers' out-of-pocket spending, Kaiser found. That's up from 26% in 2008.

Indeed, among workers in a plan with an annual deductible, the average for single coverage in 2018 was $1,573, Kaiser found.

The average was even higher for high-deductible health plans: $2,349 for single coverage.

High-deductible plans, however, often come with a health savings account or HSA that is, a tax-advantaged account that allows workers to save pretax dollars, grow their money free of tax and use the money for qualified health expenses.

Employers have noticed that these deductibles can be steep for employees, leading some to shy away from offering exclusively high-deductible plans.

In 2018, about 4 in 10 of the employers polled by the National Business Group on Health offered exclusively high-deductible plans.

Only a quarter of employers say they will follow this tack next year. They are reintroducing options, namely a preferred provider organization plan.

So-called PPOs allow you to visit any in-network provider without getting a referral from your primary care physician.

damircudic | E+ | Getty Images

With employee benefits season around the corner, workers should expect to see a few changes for 2020.

Narrowing provider networks: Depending on the employer's location, companies may decide to limit the providers a worker can access in a given geographical area. In exchange, employees may get lower premiums and deductibles, Kaiser's Cox said.

Using accountable care organizations: Employers coordinate with insurers to create a network of primary care physicians and specialists that work together to manage a patient's care from start to finish.

This is known as an accountable care organization.

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Greater use of virtual care: Telemedicine, or virtual care, puts employees in touch with a nurse or doctor for different conditions, allowing them to skip a costly visit to the emergency room.

More than half of the respondents in the National Business Group on Health survey said they will offer more virtual care programs in 2020.

"Virtual care solutions bring health care to the consumer rather than the consumer to health care," said Brian Marcotte, CEO of the business group.

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Your health insurance costs are about to go up in 2020 - CNBC

TALLAHASSEE, Fla. -- State Attorney General Ashley Moody is calling on state health care regulations to take action, after I-Team Investigator Kylie McGivern revealed a fake nephew signed off on a local veteran's cremation without telling his family.

Moody's office is now asking the Florida Agency for Health Care Administration (AHCA) to review allegations against four hospitals and nursing homes where the veteran stayed before his death, earlier this year.

"If the allegations are true, that have been presented on, I agree that's abhorrent, it's something as a state we need to examine further," Moody told the I-Team in July.

That was after the I-Team discovered a fake nephew signed the death certificate for U.S. Navy Veteran Robert Walaconis and authorized his cremation.

"I had no idea who that was and my father was an only child. And it said 'nephew next to the name," said Michael Walaconis, Robert's son.

In the complaint Walaconis wrote to the attorney general's office, one he described as "lengthy and detailed" with attachments to his father's medical records, he wrote, "The hospitals, nursing home, hospice, funeral home all failed to protect my father while he was paying them for their services."

Walaconis told the I-Team, "I'm trying to do the right thing and basically make sure this doesn't happen to other people."

The attorney general's office is now calling on AHCA to review the allegations "and take whatever action may be deemed appropriate by the agency," according to a letter sent to AHCA.

In an emailed statement, AHCA told the I-Team, "The Agency is in the process of reviewing the information provided by the Attorney Generals Office. Any provider who fails to meet requirements established by their licensure with the Agency will be held accountable."

Since the I-Team's first investigation, other families have come forward.

"When I first saw your report I was first just like wow, almost shocked that this happened to someone else," said Ana Maria Anselmi, who discovered a fake niece listed on her father's death certificate signed off on his cremation. "How could this have happened?"

RELATED: I-Team investigation into fake nephew cremating Navy veteran prompts other families to come forward

After the I-Team got involved in both cases, the state agency overseeing funeral homes has also opened its own investigations into what happened.

This investigation all started with a call to our I-Team tip line. If you have something you'd like us to investigate, you can call 1-866-428-NEWS or email kylie.mcgivern@wfts.com.

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AG calls on health care regulators to take action after fake nephew authorizes veteran's cremation - ABC Action News

Cara Sterling is the Director of the Health Care Initiative at HBS with over 20 years of experience in the health care industry. Cara is passionate about the industry and dedicated to recruiting even more ambitious, smart, and results-oriented innovators to work in a sector that is full of possibility.

I had the privilege and good fortune to help launch the Health Care Initiative (HCI) at HBS in 2005. It still energizes me every day to be able to design a program that I would have wanted to participate in when I was an MBA and MPH student many, many years ago. The Initiative began simply with a group of students who lobbied the Dean to include more health care courses and programs in the curriculum. It is incredible how much it has evolved since that day. It often surprises people to hear how broad and deep the interest is in the health care sector at HBS. From any perspective be it students, alumni or faculty HBS has amazing resources around this critical topic.

Opportunities for students

From a student perspective, the best way to get involved is to join the student-run Health Care Club. The club organizes everything from the large annual health care conference, to small coffee chats with CEOs, and treks to New York and San Francisco to meet with cutting edge companies. The club is one of the largest at HBS, and in my perhaps biased opinion, one of the most well-organized clubs on campus. I love meeting with former students, now working in leadership roles, and hearing stories about how they are making a difference in health care.

Alumni involvement

Over 8,000 alumni work in every health care industry and function you can imagine, and the opportunity to connect with them is surprisingly easy. Alumni gatherings are held on campus, in Boston, and around the world at industry conferences like BIO, ASCO or JP Morgan. In fact, as I write this, we have a student and alumni gathering tonight at The MedTech Conference taking place in Boston.

Faculty and curriculum

HBS faculty offer numerous health care electives every year and are prolific publishers of health care research with over 100 cases, books, and articles about the topic. The school also offers several joint programs related to health care including an MD-MBA, DMD-MBA, MPP-MBA and two MS-MBAs, one with a focus on biotech and life sciences and one with a focus on engineering.

Bridging health care resources across the community

The role of the HCI is to bridge and bring together all these tremendous resources while also adding to the mix. Right now, we host several annual activities including:

Another crucial role of the HCI is to make it easier to navigate the tremendous health care resources around Harvard that are available to students, faculty, and alumni. From opportunities at the Pagliuca LifeLab and i-Lab, to sponsoring events in conjunction with Harvard Medical School. We recently launched the Harvard Health Innovation Network website in collaboration with ten other health care organizations around Harvard. I encourage you to check it out.

As you can see there are nearly endless ways to learn more about health care during your time at HBS, and we are continuously looking to improve and expand. Please check out the HCI's website to learn more about health care at HBS.

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The Health Care Initiative at HBS - MBA - Harvard Business School

Even with sophisticated analytics and data, not all clinical interventions can be predicted and avoidedthere will always be a need for acute care, and health systems benefit from reexamining those processes as well. One powerful case study is Manatee Memorial Hospital in Bradenton, Florida. Manatee is a 295-bed facility with more than 800 healthcare professionals. Its Structural Heart acute care unit offers procedures including transcatheter aortic valve replacement (TAVR) for patients with aortic stenosis, LAAC for patients with non-valvular atrial fibrillation, and transvenous mitral valve repair (TMVR) for patients with mitral valve leakage.

Like many cardiac care centers, Manatees team was tasked with establishing a high-performing, market-differentiated program to manage these emerging therapies. They wanted to reduce patient wait times between referral and treatment. They also faced labor-intensive clinic workflows, and a fragmented approach to connecting patients with specialists.

Seeking a value-based solution, Manatees medical directors, device implanters, IT staff and physicians partnered with our team of clinical and operational experts. Together, we standardized referral forms, upgraded tracking tools for those referrals, and developed better provider education materials. Today, Manatee offers pre-admission tests to better understand patients needs and steer them to specialists whose roles are well-defined within the structural heart program.

Better coordination made a meaningful impact: referrals grew 65 percent, and the center was able to provide care for more patients with 60 percent more procedures over the year before. As a result of patients shorter stays and increased team productivity, Manatee realized about $175,000 in annual cost savings for certain case types.

Delivering on the promise of value-based care and addressing the growing burden of chronic conditions, staggering costs of care and rising global healthcare spending will require a multi-faceted approach. The only way we can achieve better patient outcomes in a more accessible, equitable and efficient manner is by working together to shape a better future.

Safety information for the HeartLogic Heart Failure Diagnostic is available here.Safety information for the WATCHMAN Left Atrial Appendage Closure Device is available here.

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The Many Faces of Value-Based Healthcare - ModernHealthcare.com

Cuyahoga Community College (Tri-C) has been selected to help develop and implement a plan to provide a local pool of skilled labor and create opportunities for careers with family-sustaining wages in health care.

The Cuyahoga County Workforce Funders Group, a public-private partnership that announced a $2.5 million commitment in 2018 to support workforce system realignment, named Tri-C as the lead health care sector intermediary for Workforce Connect, a workforce development effort led by a number of public and private partners in the county, according to a news release.

Workforce Connect, based on successful sector intermediary models in other major U.S. metro areas, coordinates a designated organization or sector intermediary that brings together businesses within an industry to identify talent needs. The intermediary then works with those businesses, workforce development boards, job development providers, educational institutions, social service providers and others to help develop potential short- and long-term solutions.

The goal is to provide employers with a well-developed pipeline of qualified, skilled talent and to help job seekers understand how they can continue to move forward in their careers, according to the release.

"Based on our research and analysis and engagement with local stakeholders, Tri-C emerged as clearly the best choice to serve in the health care intermediary role, given it is a well-established educational institution with the appropriate resources, infrastructure and access to potential employees," said Deborah Vesy, chair of the Workforce Funders Group and president and CEO of the Deaconess Foundation, in a prepared statement. "We believe there is great opportunity for many more residents of Cuyahoga County to establish careers in the health care sector and this is the right partnership to facilitate that progress over the next three years."

Cuyahoga County approved in September 2018 up to $1 million for Workforce Connect over the next three years. These funds are supplemented by a combined commitment of up to $1.5 million from additional members of the Cuyahoga County Workforce Funders Group, which includes, according to the release: the City of Cleveland, Cleveland Foundation, Deaconess Foundation, Fund for Our Economic Future, Greater Cleveland Partnership, The George Gund Foundation, Cleveland/Cuyahoga County Workforce Development Board, Team NEO and United Way of Greater Cleveland.

Workforce Connect worked with key health care providers to consider the nuances of the industry and ensure provider participation in the partnership. The focus will initially be on talent development to support hospital systems. The initial engagement group includes Cleveland Clinic, University Hospitals, The MetroHealth System and the Veterans Health Administration. To start, Tri-C will conduct a search for a dedicated staff person to manage the employer partnership, according to the release.

The Workforce Connect Healthcare Sector Partnership with Tri-C is the second such collaboration for Workforce Connect, which announced in December 2018 that it had selected Magnet and the Greater Cleveland Partnership to implement a manufacturing sector partnership.

The health care sector partnership will benefit from the manufacturing work through shared best practices. The Workforce Funders Group plans to announce the third sector intermediary, for information technology, next year, according to the release.

"Cuyahoga County is recognized regionally, nationally and internationally as being a hub for world-class health care," said Alex Johnson, president of Tri-C, in a prepared statement. "That level of exceptional care begins with the skilled workers who devote themselves to the well-being of their patients. We have the opportunity to build on that reputation of excellence with our partners in Workforce Connect while providing Northeast Ohio residents a clear path to family-sustaining careers in health care."

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Tri-C named health care intermediary for Workforce Connect - Crain's Cleveland Business

General Motors says the company will now pay for striking workers' health insurance, nine days after saying coverage would be cut off.

In an email to the United Auto Workers union, GM said that it will keep benefits in place due to what it called significant confusion among members. The letter says employee health and well-being are GM's top priorities.

"GM has chosen to work with our providers to keep all benefits fully in place for striking hourly employees, so they have no disruption to their medical care, including vision, prescription and dental coverage," the letter says.

After the strike began on September 16, the company said it would end benefits, to the fury of workers and politicians alike.

It's standard procedure for health care costs to shift to the union in a strike. The United Auto Workers' website says the union would pick up the cost of premiums.

Jason Kaplan, a spokesperson with the UAW, painted the company's turnaround as a victory: "General Motors thought they could leverage healthcare for tens of thousands of UAW GM workers to force the union to concede to unfair concessions. The only thing GM gained was a tarnished reputation," he said in a statement.

The strike by about 49,000 factory workers has shut down production at more than 30 GM factories. Talks continued Thursday.

The company's health benefits had been one of the major areas of discussion before the strike. GM spends about $900 million on health benefits for the roughly 49,000 hourly employees and their 69,000 dependents, the company has previously stated.

GM's initial offer had called for workers to cover 15% of their health costs, well beneath the national average of 28% but about five times higher than the 3% to 4% that autoworkers now pay, accordingtoAutomotive News, which cited sources familiar with the talks.

The UAW balked at the proposal, prompting GM to step back and offer to maintain the status quo, the industry publication reported.

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GM strike update: Company tells UAW it will now cover health care for striking workers - CBS News

There's little evidence wellness apps and fitness trackers help consumers reach their health goals, but that hasn't stopped wearables companies from being bullish on the U.S. healthcare industry. Big names like Fitbit and Apple see lots of potential to monetize health management, especially in the sectors of chronic care and population health.

Fitbit has been especially gung-ho.The San Francisco-based wearables giant has seen disappointing device sales of late but its health division reported a year-over-year uptick in the second quarter. Fitbit Health Solutions sales increased 15% to $24 million, a fact its CEO, James Park, attributed to partnerships with traditional healthcare companies like insurers.

The 12-year-old company is realigning its business model from one-time hardware sales to enterprise-level health and wellness services which, given a large enough subscriber base,can bring in a steady stream of repeat revenue. The company rolled out a paid health membership called Premiumin August, which includes personalized wellness reports and health coaching for roughly $10 a month.

Fitbit's acquisition of care management platform Twine Health last year means it can leverage existing in-house resources to scale in the sector. Coupled with its size, brand recognition and built-in consumer base of 27 million active users, that experience could make Fitbit a force to be reckoned with in care management.

Healthcare Dive sat down with Amy McDonough, general manager and SVP of Fitbit Health Solutions, to talk about competitors, its Premium offering and how the wearables giant has always been a healthcare company at its core.

This interview has been edited for clarity and brevity.

AMY MCDONOUGH: Fitbit Health Solutions is our B2B business. We're working with employers, health plans, health systems and researchers to help further integrate into the healthcare system to drive outcomes and savings and we've seen some great momentum. We're on track for a $100 million revenue target for the 2019 year and we saw 42% growth in the first half of the year versus 2018.

We go to market by partnering with leading brands. We work with 100 health plans, including most of the national health plans Humana, UnitedHealthcare, the Blues and regional health plans as well. We also work with 1,700 enterprise customers and employers, and we're the leading wearable in research efforts. More than 700 research studies have been published using our wearables.

MCDONOUGH: We do integrate with some EHRs already through our partnership with the Google Cloud platform. We integrate with some Epic and Cerner instances, and since we have an open API infrastructure that allows, with a user's permission, for data to be streamed into other EHRs as well.

The challenge with the EHR ecosystem is that it's pretty fragmented. Even in the larger players, like an Epic or Cerner, each instance is highly configured and customized for that individual client or user group. So we've found that you can put data into that, but it's not necessarily in the most usable format for the physician.

While we do have those integrations, we found the wellness report is a little bit more constructive in terms of actionable guidance to be able to provide that data. I would just caution that putting data into the EHR that is maybe only glanced at by a physician in a 15-minute visit may not be the most effective way, though we're certainly open to those conversations.

MCDONOUGH: So that's essentially what health solutions is all about, right? Battling the most common and costly chronic conditions. Diabetes, hypertension, cancer those are things that we're focused on.

Our approach to that is bringing together devices, data and insights. With Fitbit Premium, within the app, you're able to securely message with a healthcare coach who has access to your data. The health coaches are provided by Fitbit and range in specialty from health coach certification to nutritionists, to dietitians, to registered nurses. And they can pull in a care team for support.

For example, if an individual is managing Type 2 diabetes, they can work with a coach to create an action plan. The patient may say, 'I'm not willing to test my blood glucose three times a day, but I'm willing to do it once a day.' So the team would work on an action plan that the user felt like he or she could commit to, with milestones and goals that change over time. If the user wanted to focus on food and the impact that can have on their blood glucose level, a nutritionist could come in and help create a meal plan. So it's really providing touchpoints on a regular basis based on the willingness and readiness for change of that individual to help improve healthcare outcomes.

We acquired our Twine platform about a year and a half ago, now rebranded as Fitbit Care, and we've seen some really stellar results in utilizing that platform across diabetes and hypertension in terms of lowering glucose levels.

MCDONOUGH: We are in the behavior change business and have been since day one. We've got 10 years of experience of this behavior change philosophy and we're applying that to common and costly conditions, right? So we look at the whole person and we meet them where they are on their personalized journey to health.

When you look at the partner landscape, they've taken a different philosophical approach by focusing on a specific condition. Some of the ones that you mentioned, you know, are focused on a very specific condition. But often they're also our partners. They're also using Fitbit data and devices to power a lot of their programs. Livongo, for example, has talked about how they integrate Fitbit data into their coaching and their platform.

MCDONOUGH: You used the word disrupt. I think that's a great term that a lot of people use. But we see it as deepening integrations by working with the existing healthcare system and figuring out how we can provide meaningful value to both the member and to the health plan. And I think that's where you've seen us become the partner of choice in this system.

We have devices and data and programs as part of embedded benefits across commercial programs for health plans as well as across Medicare Advantage programs. So a real-world example is UnitedHealthcare's Motion program. It's a commercial health plan program that employers can bring to their employees and it's powered by a wearable. If you meet certain metrics throughout the day around frequency, intensity, and tenacity of activity level if you hit 10,000 steps a day, if you are active for about 30 minutes a day and you move every hour you're able to earn up to $3 a day and up to $1,500 a year as an individual (and more as a family) back into your HSA or FSA account.

And their actuarial science has shown there are benefits to getting people to move more, and take more proactive action towards our health. I think that program has given out $43 million worth of rewards over the past couple of years in commercial and Medicare Advantage plans through UnitedHealthcare as well.

MCDONOUGH: Our focus has been around around helping support good healthy behaviors throughout the day. The other core tenets of Fitbit are around accessibility and affordability. So by accessibility, I mean cross-platform compatibility, which is really important in the healthcare landscape. Can we work across iOS and Android? Are we requiring someone to have a certain operating system or software to be able to use our products? And then affordability. Our product line starts at $69, which is important when you think about the socioeconomic factors contributing to health. And then the last is community, supporting large communities like an employer or a small community, like your friends or family.

We really lead in sleep. We have an extended battery day life: four to seven days, depending on the product. That allows us to be able to capture sleep metrics, which is honestly a really important value proposition.

The number of times we hear about people switching to Fitbit from Apple Watch it's a really important user value proposition. Sleep impacts everything from weight loss to like glucose control, so it's really important to be able to capture that on a regular basis. That's a core differentiator.

MCDONOUGH: So we have a third party software development kit. It allows for third parties to build custom clock faces and apps that can be downloaded and sit right on the device. So the Motion app for UnitedHealthcare will show you right on wrist how you're doing towards your goals. Humana's doing something similar with their Go365, which is their wellness initiative.

Whether that will extend to direct medical claims, benefits on the wrist that's certainly an opportunity. The software development kit and our API would allow for those types of integrations. We're certainly exploring it, as we work with our employer and health plan population on health analytics, with the user's permission, today.

MCDONOUGH: We believe in an easy-to-read, non-legalese statement to help explain what data is being collected and how it's being shared or used, which is always with the direct consent of the user. When it comes to working with our employers and health plans and even with our researchers, we have pledges.

We have a corporate wellness pledge that we use with all our partners that discusses best practices for data sharing. So, it should be voluntary. Consent should be opt-in. It should be transparent about what data's being shared and how it's being used. And we have a similar pledge for researchers on how data should be used, always use deidentified data, et cetera.

MCDONOUGH: We're excited to be chosen as one of the nine companies for the software as a medical device pre-certification program. So we're looking at, for things that are noninvasive, how to speed up the slow FDA approval process while keeping safety in mind. In parallel, we continue to work with the FDA on a early detection of AFib and apnea as something that Fitbit would bring to market as well. So they're two separate but parallel paths. And we're excited to see what comes next.

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Disruption or integration? Fitbit's health leader on the role of wearables in healthcare - Healthcare Dive

Presidential candidates and other politicians have talked about the rural health crisis in the U.S., but they are not telling rural Americans anything new. Rural Americans know all too well what it feels like to have no hospital and emergency care when they break a leg, go into early labor, or have progressive chronic diseases, such as diabetes and congestive heart failure.

More than 20% of our nations rural hospitals, or 430 hospitals across 43 states, are near collapse. This is despite the fact that rural hospitals are not only crucial for health care but also survival of their small rural communities. Since 2010, 113 rural hospitals across the country have closed, with 18% being in Texas, where we live.

About 41% of rural hospitals nationally operate at a negative margin, meaning they lose more money than they earn from operations. Texas and Mississippi had the highest number of economically vulnerable facilities, according to a national health care finance report in 2016.

As rural health researchers, were well aware of the scope of rural hospitals woes, which span the entire country. Struggling rural hospitals reflect some of the problems with the U.S. health care system overall, in that the poor often struggle to have access to care and there are few obvious solutions to controlling rising costs.

If 20% of America lives in a rural county, why is the nation so slow to address rural health disparities?

Each time a rural hospital closes, there are tragic consequences for the local community and surrounding counties. While the medical consequences are the most obvious, there is also loss of sales tax revenue, reduction in supporting businesses such as pharmacies and clinics. There are also fewer professionals, including doctors, nurses and pharmacists, and fewer students in local schools.

The closing of a rural hospital often signals the beginning of progressive decline and deterioration of small rural towns and counties. Hospitals often serve as financial and professional anchors as well as source of pride for its small rural community. It also often means loss of other employers or inability to recruit new employers due to lack of nearby health care. When a rural hospital closes its doors, unemployment often rises, and average income drops.

There are no nurses, doctors, pharmacists or ERs for local farmers, ranchers, growers and assorted men, women and children who love living and working in Americas vast rural regions. Rural communities and rural citizens are often left with no options for routine primary care, maternity care or emergency care. Even basic medical supplies are often hard to find.

Residents in these communities have had to take their chances living in Americas heartland, finding alternative options for basic health care services.

Those rural hospitals that have remained open are facing increasing legislative, regulatory and fiscal challenges. Some policy analysts have noted that the states with the most closings have been in states that did not expand Medicaid.

And, many of the towns in which they are located suffer from an apparent leadership vacuum. There are typically few experts within small towns who are prepared to address ways to avoid the loss of rural health care services and rural hospitals.

Small, rural communities are also less likely to have conducted formal comprehensive health needs assessments or invested in strategic planning to strengthen the ability of the community to adapt more quickly to changes in the local economy as well as changes in financing health care at the federal level. Health care services planning is often limited to input from the rural community leaders and power brokers rather than a cross-section of the greater community.

For example, community leaders may want to have an orthopedic surgery option, but if they had input from the community, they would know that prenatal/maternity care was more of a priority and these patients dont have transportation so they also need a bus or van to pick up for appointments.

There are also cross-cutting rural community challenges such as:

Declining reimbursement levels

Shrinking rural populations

Health professionals moving to bigger cities for higher compensation

Increasing percentage of uninsured leading to rising uncompensated care

Increasing operating costs

Older and sicker rural dwellers with complex multi-system chronic diseases.

The result is that rural hospitals often lack a dependable economic base to operate. In addition, changing processes, payment strategies and regulations coming from state and federal regulators place the small rural facility at particular risk because keeping up with changing payment or reporting rules often requires a full time person.

The continuing closures have accelerated the urgency to understand and address the problems faced by rural Americans seeking access to care. Each rural region of the country has its own industry, economy, cultures and belief systems. Therefore, rural solutions will be unique and not an urban solution downsized to a smaller population.

At Texas A&M Health Science Center, we are among several researchers focused on rural disparities by researching causes of socio-economic inequities and by working within those rural communities to give a leg up to distressed rural communities and counties nationally, and in Texas.

Weve come to see that providing health care services in rural counties may not include maintaining a full-service hospital, but rather right-sizing care to match the resources, demographics, geography and availability of providers in the community.

For example, the ARCHI Center for Optimizing Rural Health is currently working with hospitals and their communities to determine feasible health care options that will be supported by the community, meet community needs, and most importantly, offer local, high-quality care. Using tools like ARCHIs DASH a quarterly dashboard that shows performance of the hospital in financial, quality and patient satisfaction arenas may help hospital boards, communities and local leaders better understand their status and need for change from business as usual.

While it may be that the changing health care delivery systems are altering what health care delivery looks like, change can almost never be instant. Communities may need to envision alternatives to hospitals.

In some communities, urgent care with radiology and lab services may be able to service the majority of health care needs. In other communities, a micro-hospital with an ER and swing bed options which allow rural hospitals to continue to treat patients who need long-term care or rehabilitation may be the better fit. Telehealth, or providing care through televideo virtual face-to-face from remote sites to rural residents, can also be an option.

Challenges specific to the dilemma of rural hospital closure will take a national, state and local effort focused on the plight of rural communities struggling to maintain availability of essential health care services. Our nations vulnerable rural communities deserve a focused, coordinated effort to address this compelling problem before any more rural hospitals close their doors.

This article is part of a collaborative project, Seeking a Cure: The quest to save rural hospitals, led by IowaWatch and the Institute for Nonprofit News, with additional support from the Solutions Journalism Network.

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Rural hospital closings reach crisis stage, leaving millions without nearby health care - The Conversation - US

Health care premiums

continue to skyrocket

A quiet event happens in our homes at this time every year. We open our mail to find notices that our health insurance premiums are increasing. The rate of increase seems to grow larger every year. Next year my drug premium will go up 32 percent and my wife's will go up 20 percent. These amounts are always way, way beyond the rate of inflation. And there's not a thing we can do about it.

I notice the cost for a health care plan for a family has now surpassed $20,000 annually.

The insurance companies and drug companies can pretty much do to us whatever they want. They have bought all of our legislators (that includes you, Arkansas Congressional delegation), who are highly dependent on their huge campaign contributions for their reelection. For our legislators it's all about getting re-elected, and they know how they're going to pay for this.

Isn't capitalism wonderful? At least we don't have that God-awful "socialized medicine" that attends to the health needs of all of the citizens in all of the other nations on this planet.

Americans keep paying more and more for worse and worse health outcomes. How much longer before this whole thing collapses?

Sandy Wylie

Bella Vista

Tom Cotton hasn't done

anything for Arkansas

In the last week there have been several letters extolling the virtues of Sen. Tom Cotton. How about some facts to go with your Kool-aid? Cotton was wined and dined, bought and paid for by the Koch brothers and the NRA. This man is very greedy, arrogant and aggressive. As a junior senator he saw fit to write a letter to a foreign dignitary, expressing views that were way above his pay grade. He will vote as the president and the money people tell him to vote. He has not done one single thing for the state of Arkansas.

Nothing on gun control. The EPA is a total joke nationally and state-wise. He likes to kill things. He has done nothing about the pig farm on the Buffalo River. We are encouraged to carry a gun every where we go. It is OK to hunt in any national forest or park. This is so shameful.

Arkansas is a beautiful state, but it won't stay beautiful if the people don't take better care of her and her resources.

Susan Hamilton

Bella Vista

Why can't the two parties

work together for nation?

I want to talk about Mr. [Steven] Trulock's letter published Sept. 18, 2019. He talks about the Republicans doing nothing and letting the Democrats have a chance.

Well, all the Democrats have done ever since Trump announced he was running for president is nothing but try to get him out of office. They were stunned when Trump won. And now they want to bring Judge Kavanaugh up before the Senate again. In fact, Kamala Harris says both he and Trump should be impeached.

This is all the Democrats can think about. They are not doing anything to help run the country. Don't think the foreign countries are not watching all of this. Don't think they are not watching all the mass shootings that take place nearly every day now. They are just waiting for their chance to come in here and take over.

My point is, why can't the Democrats and Republicans work together to protect this country? Also, they should try together to think about how we are going to repay all the trillions of dollars that we owe China.

Glannis Mason

Fayetteville

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Letters to the Editor: Health care premiums; Tom Cotton; Political parties work together - NWAOnline

On-campus and Austin community health organizations gathered in the Shirley Bird Perry Ballroom in the Texas Union and threw the Healthcare Fair to promote inclusivity in health care Monday evening.

UTs Students for Planned Parenthood hosted the Healthcare Fair. The organization operates out of the Planned Parenthood Action Fund to educate the community on sexual health, intersectionality and universal health care through a variety of petitions and events, said Mireya Trevino, president of Students for Planned Parenthood.

Trevino said she wanted to make health care accessible to all people, especially underrepresented groups who feel as though their concerns are not taken as seriously.

Health care can be scary, especially for folks who are minorities, said public health Trevino. There are definitely some perceived barriers.

Healthy Horns, Austin Public Health and the Gender and Sexuality Center tabled at the event, and the event advertised guest and student speakers, a live paint show and a drag show.

We wanted to make (the event) fun and accessible, Trevino said. We figured discussing health care in a laidback setting would help folks connect.

Rameen Razzaq, public health senior and Healthy Horns peer educator, said Healthy Horns participated in the event because it supports Students for Planned Parenthood for embracing inclusivity.

One thing that Healthy Horns likes to do is to be inclusive of everyone, all gender identities (and) sexualties, Razzaq said.

Shannon Doyle, vice president of Students for Planned Parenthood, said there are always various obstacles which restrict marginalized students from getting the health care they need.

We all have various needs when it comes to health care, and just being generic about it is not reaching out to everyone, said Doyle, a history and womens & gender studies senior. Thats why I think its interesting to have all of these community partners and student organizations who are specific to a group of people and their needs.

Trevino said Texas has the highest rate of uninsured residents in the United States.

If we prioritize those with the least amount of access, we can ensure that everyone has access to health care, Trevino said.

History senior Allison Grove said she attended the event to get information on her health care options.

Im a student who doesnt have health insurance, so I like to get an idea of the different services that are offered on and off campus, Grove said.

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Students for Planned Parenthood promotes intersectionality through Healthcare Fair - UT The Daily Texan

In the middle of Californias fire season, its hard not to think about the role healthcare organizations can and must play when it comes to providing and coordinating care for patients during a natural disaster. These events will become more frequent and intense as the impacts of climate change increase.

Natural disasters like the fires emerging here in California serve as a strong reminder of how complex and fragmented our healthcare system is not only in times of disaster but in everyday life, tooespecially for those who are most vulnerable.

These disasters shine a spotlight on the importance and value of being able to access patient recordsincluding both clinical and claims datain real time. And these disasters highlight the role health information exchanges (HIEs) can and must play in connecting all facets of care, from first responders to clinicians to patients and families in search of their loved ones.

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In 2018, 6.7 million acres of land in California burned in unplanned wildfires. Areas like Paradise were especially hard hit. The Camp Fire forced Feather River Hospital in Paradise to close, and its estimated that the fire destroyed over a third of the healthcare infrastructure overall.

At the time, organizations like SacValley MedShare played a mission-critical role in ensuring information was available to care teams looking after patients from Paradise who were displaced due to the fire.

From heroic stories of evacuations at hospitals like Adventist Health Feather River to desperate moments where people tried to ensure their friends and family were safe, the important role healthcare organizations played in collaborating and providing patient care was undeniable as these fires raged.

RELATED:California HIE to use $4.9M grant to connect ambulances with hospital patient data

Today, nearly all healthcare organizations have a preset plan for a variety of crisis situations, including fires. Still, natural disasters can prove particularly difficult for providers given the complexity of accessing, sharing and getting patients health records when time is of the essence. To streamline this process, Californias largest health information network, Manifest MedEx, is facilitating health record sharing between ambulance service providers and hospitals to ensure first responders have relevant patient data when they are in the field.

Working with six local emergency medical services (EMS) agencies, 13 EMS providers and 16 hospitals acrosseight counties, Manifest MedEx will give first responders serving 7.6 million Californians the ability to look up a patients health record from the ambulance. Before the trip is over, first responders will push critical information to the emergency department so clinicians can act quickly to treat patients when they arrive. When natural disasters strike, healthcare systems are stressed, and responding rapidly is paramount.

When asked about the impact of this partnership, Chuck Martel, a licensed and practicing emergency medical technician (EMT) in Minneapolis and a senior data and analytics executive with Anthem, had this to say: As a first responder, I know that every second counts when it comes to saving a persons life. This important collaborative will ensure that first responders have near-immediate access to patient information and that we can then share this insight with the emergency department before the patient arrives. Seamless information sharing like this ensures all members of the care team are fully prepared to provide personalized patient care under pressure.

The recent hurricane in Florida further showcased the value of an HIE in times of natural disaster. Together, Florida Health Information Exchange and its health IT partner, Audacious Inquiry, activated the states emergency census service to help expand response efforts amid Hurricane Dorian. With the emergency census service, both acute and post-acute healthcare providers were connected through the same information network that Florida health agency officials can access. The network was used to update information on individuals believed to be missing after the hurricane.

RELATED:U.S. better prepared to handle health emergencies, but there are gaps: report

In addition, a new command center approach was tested in Florida by AdventHealth. The center keeps track of every patient at one of the health systems nine hospitals in central Florida, as well as every patient that is transferred to and/or discharged from the hospitals.

When natural disasters put stress on our distributed and fragmented healthcare system, HIEs stand ready to provide life-saving information and infrastructure to support collaboration for providers, patients, and families on the front lines of a crisis.

Claudia Williams is CEO of Manifest MedEx, a California nonprofit health data network. She was previously senior adviser, health innovation and technology at the White House where she led data sharing, care transformation and precision medicine efforts.

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Industry VoicesDuring natural disasters, HIEs on the front lines of addressing fragmentation in healthcare - FierceHealthcare

BOSTON--(BUSINESS WIRE)--The U.S. Food and Drug Administration has awarded a contract that may reach $220 million over the next five years to the Harvard Pilgrim Health Care Institute to continue to lead the Sentinel Operations Center and to develop a new Sentinel Innovation Center. This contract builds on the Institutes 10 years of experience developing and operating the Sentinel System, a national program that uses electronic health care data to monitor the safety of FDA-regulated drugs and other medical products. The addition of the Sentinel Innovation Center, which will be led by Sebastian Schneeweiss, MD, ScD of Brigham and Womens Division of Pharmacoepidemiology and Pharmacoeconomics, signals FDAs commitment to keeping the Sentinel System a robust and cutting-edge national resource. The Institute will partner with over 60 technology, health care and academic organizations across the nation on this important undertaking.

The Institute has led the Sentinel System since its inception in 2009, creating a national electronic system for monitoring the performance of FDA-regulated medical products. Using this national data network, FDA regularly conducts safety analyses of the billions of hospital stays, outpatient visits, and pharmaceutical dispensings.

We are very pleased to continue leading the Sentinel System along with our collaborating partners. The program now regularly informs FDAs guidance to physicians and the public about the safety and safe use of medical products, said Richard Platt, MD, MSc, Professor and Chair of the Department of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School and Principal Investigator of the FDA Sentinel System. Such post-marketing studies typically require years to design and complete, each at a cost of millions of dollars. We look forward to continuing these efforts and enabling Sentinel to grow in scope and scale over the next five years adds Dr. Platt.

Plans for the next phase of the Sentinel project include enhancements to increase efficiency and responsiveness, to develop new data sources and more sophisticated methods, to broaden the community of users, and to enhance the Centers extensive expertise by bringing on additional specialized collaborators.

About Harvard Pilgrim Health Care Institute's Department of Population Medicine

The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first appointing medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and teaching.

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Harvard Pilgrim Health Care Institute Funded up to $220 Million for the Next Phase of FDA Sentinel System - Business Wire

Since 2016, as Bernie Sanders has risen in national prominence and his Medicare for All proposal has gained increasing momentum, corporate America has been gearing up for a war over the policy. And now, as the health and pharmaceutical industries align themselves with Joe Bidens presidential campaign, we have a clearer idea of what their battle plan will look like.

As Bloomberg first reported Monday, the neoliberal think-tank Third Way has been polling Americans to figure out which attacks will be most effective in a coming public relations campaign against the policy. The survey builds on documents leaked to the Intercept in 2018, detailing the contours of a planned campaign by the private health care sector to change the conversation around Medicare for All and prevent it from becoming part of a national political partys platform in 2020.

While billing itself as a national think tank that champions modern center-left ideas, Third Way is a conduit for a panoply of corporate interests that campaigns against left-wing policies in 2013, two of its highest-ranking officials wrote a Wall Street Journal op-ed warning that economic populism is a dead end for democrats. One of those officials, Executive Vice President Jim Kessler, the former longtime aide of Wall Streets favorite Democrat Chuck Schumer, has admitted the majority of Third Ways financial support comes from Wall Street, which views the health insurance industry as a great investment. At least as far back as 2013, it was staffed with Republicans and fundraising from a variety of corporations, donations that the companies themselves sometimes listed as part of their lobbying budgets.

Today, one of its leadership team once worked for the National Association of Manufacturers, a Republican-aligned business group that, among other things, fights climate action and in its earlier years was one of the earliest forces to organize against Franklin Roosevelts New Deal. Meanwhile, Third Ways board of trustees currently features a former private equity titan, a former Goldman Sachs executive, the head of a major corporate lobbying firm that has counted pharmaceuticals as its clients, and several other private equity and bank executives.

Third Way has openly said it views Sanders alone among the Democratic field as an unacceptable choice for the nomination, so threatened by his campaign that theyve now come around to even longtime nemesis and Sanders rival Elizabeth Warren. In 2018, the organization convened a meeting of 200 elected Democrats, political operatives, and donors to launch a serious, compelling economic alternative to Sanderism, as Kessler put it.

Although health insurers and the pharmaceutical industry are funding a variety of Democratic candidates all of whom are now either attacking or backed away from their earlier support for Sanderss Medicare for All bill the primary conduit for their campaign against the policy appears to be Biden. Health insurers were thrilled when Biden entered the race, seeing his campaign as a bulwark against Sanderss plan for Medicare for All, and an In These Times investigation from July found that Biden received the most money in the Democratic field from insurance and pharmaceutical employees, while Sanders received the least. He kicked off his campaign with a fundraiser hosted by a health insurance executive, and one of Bidens campaign aides is a former health care lobbyist.

Not only that, but Bidens advisor and chief pollster John Anzalone is the president of the firm that authored Third Ways survey, Anzalone Liszt Grove Research (Anzalones partner, Lisa Grove, conducted the polling). Anzalone joined Trade Works for America earlier this year, an organization co-founded by Vice President Mike Pences current chief of staff thats partly funded by the pharmaceutical industry and is pushing for Trumps sequel to NAFTA.

The results of the survey, which found majority support for Medicare for All among those polled, including 75 percent of Democratic primary voters, potentially give us a sneak preview of the negative campaign the health care industry and the candidates it funds will embark on.

Polling showed that solid majorities thought statements arguing that Medicare for All would end Medicare as we know it (54 percent), produce lower-quality care and longer wait times for seniors and the disabled (60 percent), and that it would cost an extravagant amount and require doubling payroll taxes (59 percent), were all convincing arguments against the policy. Most potent were statements pointing to issues with the chronically underfunded Veterans Affairs health care system (64 percent), and fearmongering about the wait times of the United Kingdoms far superior (and deliberately underfunded) government-run health care system (61 percent). Deemed least convincing were arguments that Medicare for All would empower bigoted politicians to control Americans health care (39 percent) and that it would be a giveaway to employers (49 percent).

Weve already seen the Biden campaign and other candidates deploy some of these arguments. Biden has made the ten-year $30 trillion cost of Medicare for All a core part of his attack on the bill, saying that the tax hikes needed to fund it are too expensive, that it would mean Medicare goes away as you know it and that all the Medicare you have is gone, and, as he told a forum hosted by seniors advocacy organization AARP, that it would create hiatuses in care. He even briefly deployed the argument that the policy would let employers off the hook. There is a remarkable convergence between Bidens talking points and those tested by the organizations survey.

In spite of the motivation behind the poll, some of its results should actually hearten Medicare for All proponents.

Even after hearing only the arguments against Medicare for All, 48 percent of Democratic primary voters still supported the policy, versus 40 percent who opposed it. After hearing both the positive and negative statements about it, 58 percent of this group still supported Medicare for All. (Seventy-two percent did after hearing only positives.) All of this suggests that Medicare for All, brought into the political mainstream by Sanders after the 2016 campaign, has robust support among Democratic voters.

Perhaps more significantly, even as respondents gave high approval to doctors (83 percent) and, especially, nurses (95 percent), they were uniformly unfavorable toward health insurance (57 percent), pharmaceutical (69 percent) and prescription drug companies (67 percent). In fact, independent voters were markedly less favorable to those industries than Democratic primary voters were. While the road to persuading the public about Medicare for All is far from over, there is clearly little sympathy for the private sector companies that currently control the US health care sector and bankroll Third Way.

Meanwhile, 28 percent of respondents said premiums were their largest financial worry, while 23 percent named deductibles, and 16 percent singled out co-payments. Forty-three percent said somebody in their immediate family had gotten a surprisingly high health care bill in the last five years and when asked how much they thought was fair to pay for health insurance each month, a majority (68 percent) chose between $0 and $200.

Given that Medicare for All not only eliminates those costs, but is actually tipped to save households money overall a family of three on $60,000 a year would pay just $930 annually, or $77.50 a month, according to a 2018 analysis by the University of Massachusetts Amhersts Political Economy Research Institute this could present an avenue of persuasion for the bills proponents. Fifty-eight percent of respondents in the Third Way poll thought the bills elimination of these costs was a convincing argument in support of it. Of course, Third Way didnt mention Medicare for Alls cost savings to its respondents; a plurality thought the description will lower health care costs applied more to Third Ways health care plan, which simply caps out-of-pocket costs to a percentage of household income.

The 2020 election is less a contest between different candidates and more a battle between big business and the working class, with the issue of health care the number one concern among voters at its center. On one side is Joe Bidens campaign, which, whether hes conscious of it or not, is in reality one part of a multifront operation by the private health care sector to derail Medicare for All. On the other side is Bernie Sanderss campaign, which has sworn off big money donors, is aligned with a variety of grassroots groups pushing for Medicare for All, and has emerged as a nationwide tribune of working-class anger.

Somewhere between these two fronts is Elizabeth Warren, who is now genuinely surging in the polls after months of artificial elevation by a sympathetic media. Though Warren holds similar policy positions to Sanders, she has been inconsistent in her support for single-payer health care, calling it the most obvious solution in a 2008 book, before refusing to endorse it in her 2012 Senate run, and repeatedly waffling on her support for Sanderss bill to the point that even mainstream news outlets have taken notice. She also continues to rely on big money donors, anchoring her current run in a $10 million transfer from her Senate coffers that was raised from wealthy fundraisers and tapping a major big-dollar fundraiser to be her treasurer, and she refuses to rule out funding her general election campaign with big-money donors. Should Warren win the nomination, now a distinct possibility, this could offer another point of leverage for the health care sector to defeat Medicare for All.

Defeating Joe Bidens campaign, an unabashed electoral channel for all manner of corporate interests hoping to defeat Medicare for All and other left-wing policies, should be the number one priority of the broad left. But even after Bidens gone, well have to exert all the pressure we can to keep Medicare for All on the table in any future Democratic administration.

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In Joe Biden, the Health Care Industry Has Found Its Guy - Jacobin magazine