What hurts NATO the most is not the troop reductions. It’s the divisive approach to Europe. – Atlantic Council

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US President Donald Trump and Germany's Chancellor Angela Merkel hold a bilateral meeting at the sidelines of the NATO summit in Watford, Britain, December 4, 2019. REUTERS/Kevin Lamarque

11,900. That was the number European analysts had been waiting for with bated breath. On July 29, US Secretary of Defense Mark Esper confirmed that the United States would reposition 11,900 of the 36,000 military personnel stationed in Germany.

Changes in the United States force posture are always followed with heightened attention. This time, however, it is different. Coming after months of acrimonious debate about Germanys defense spending, tweets by US President Donald Trump, and mounting pressure by Congress and think tanks, the new European force posture is not just about troop numbersits a political statement, and a piece in the debate about the value of alliances.

Diving into numbers, the reduction of the US presence in Europe is not as stark as it appears. The figures are higher than many expected. However, about half of the troops pulled out of Germany (5,600) will remain stationed in Europe, albeit in different countries. Of the 6,400 soldiers going back the United States, a good part will return to the European continent on a rotational basis. Moreover, there is some amount of repackaging, such as suspending the relocation of the KC 135 squadron from the UK to Germany, which had already been postponed to 2027 anyway.

Looking at the details, the new force posture is a mixed bag. Some of the moves are not necessarily bad ideas. Shifting the 480th Fighter Squadron South to provide greater flexibility on the Southern flank and the Black Sea region makes sense. These are, after all, areas of renewed tension. Others are more questionable, such as recalling the 2nd Cavalry Regiment to the United States, which had been specifically upgunned to face armor in higher intensity settings, and replacing it with a rotation of other Stryker units.

Of course, European security is not just about the number of troops in Europe. Reactivityunderpinned by military mobilitythe ability to counter hybrid threats, or the robustness of arms control arrangements are just as important. Greater clarity on the type of units returning to the United States, the status of prepositioned stocks, or the organization of the rotations is needed to fully assess the impact of the new force posture.

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Zooming out, the United States re-evaluating its force posture in Europe is not, by itself, an issue. It makes sense for the Pentagon to take into account the lessened operational tempo in the Middle East (though ISIS is not yet fully defeated) or the greater focus on the Asia Pacific. This logically flows, after all, from the US National Defense Strategy.

Europeans by now should have realized that they need to step up to bear a greater share of the burden of collective defensethe writing has been on the wall long enough. The reduction of the US presence on European soil is part of a long-term trend, though partly reversed in the last few years.Washingtons exhortations on burden sharing have been relatively consistent over the last two decades.

As all Combatant Commands are undergoing a review, there is a need for a deeper reflection about the architecture of burden sharing. What kind of capabilities is the United States expected to deploy abroad? Should it focus on key enablers to allow partners to carry on the fight, as is currently the case in Africa? How much can it realistically expect allies to do? Does the Pentagon favor a geographic vision of burden sharing (i.e. Europeans handle their immediate neighborhood while Washington focuses on increases its focus on Asia) or is it about allies acting together at a global level?

What hurts the Alliance the most is the divisive rhetoric embodied in the new posture. President Trump has been relatively clear that this is about punishing Germany, claiming on July 29 that were reducing the force because theyre not paying their bills. Its very simple. Most of changes in the force posture vindicate this reading: they are essentially about moving troopsor even EUCOM itselfto another European country.

Framed in such a transactionalist way, the new force posture appears less like the result of careful strategic planning and more like a political message, designed to extract concessions from a partner. Worst, the Pentagons presentationhighlighting who among Italy, Belgium, or the United Kingdom gets the spoils of the relocationsand President Trumps press conference with Polish President AndrzejDuda in June, are staging a competition among allies for the White Houses favors.

This divisive approach to Europe is what really hurts European security. At the end of the day, the strength of the Alliance lies less in the number of troops deployed than in the trust among allies. American troops matter to Europeans. Trust in the United States benevolence and willingness to be there in a crisis matters even more to their security. Rebuilding that trust should be the main task of those who care about transatlantic relationsand the first step might be restoring the predictability of American foreign policy.

Olivier-Rmy Bel is a visiting fellow at the Atlantic Council. He previously served as a European Affairs staffer to the French Minister of Defence as well as head of the EU desk at the Ministrys Directorate General for International Relations and Strategy.

Wed, Jun 24, 2020

German Defense Minister Annegret Kramp-Karrenbauer has warned that the US President Donald J. Trump administrations planned withdrawal of 9,500 American troops from her countrya move announced by the US president earlier this monthmust not send Russia the signal that the US is less interested in Europe.

New AtlanticistbyLarry Luxner

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What hurts NATO the most is not the troop reductions. It's the divisive approach to Europe. - Atlantic Council

NATO: Russia has significantly increased number of frigates and submarines in Black Sea – MENAFN.COM

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(MENAFN - UkrinForm) Russia has lately significantly increased the number of its frigates and newest submarines in the Black Sea.

Commodore Jeanette Morang, Commander Surface Forces NATO made this statement on the air of Ukrainian DOM TV channel.

According to her, the Black Sea is of great value for international trade and, therefore, freedom of navigation and access to trade routes and coastal infrastructure remains an urgent need of the Black Sea countries and a necessary condition for their economic well-being. "As you probably know, about 80% of all trade operations are carried out by sea, and our goal is to ensure that every nation has a right to free access to the sea," Morang added.

At the same time, she noted, the Black Sea has its own peculiarities. "First of all, it should be mentioned that the passage of vessels is regulated by the Montreux Convention. Pursuant to the Convention, the countries lacking access to the Black Sea cannot remain in it for more than 21 consecutive days. Another feature is Russia's desire to change existing borders and rapidly build up its military presence in the region. The Russian Federation has lately significantly increased the number of its frigates and newest submarines in the Black Sea. This activity came as no surprise to the Alliance. We are convinced that it is important to strengthen our presence in the region as well," Commander Surface Forces NATO said.

She added that the Alliance stood for stability in the region and the economic well-being of the countries bordering the Black Sea. NATO is convinced that all countries of the Black Sea region share these views, Morang stressed.

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NATO: Russia has significantly increased number of frigates and submarines in Black Sea - MENAFN.COM

2021 Unicorn IPO: Unqork, The No Code Movement & Offending People With The Future – Forbes

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Turns out, predicting the future can offend people. In 2017, I asserted in an article in Quartz that, Learning to code will eventually be as useful as learning Ancient Greek. I argued that later this century coding as we know it would become irrelevant for most purposes. Meanwhile, learning to code is being over-promised as a silver bullet for long-term career success.

A couple of Greek gods chat... likely in Ancient Greek. As the No Code Movement advances, later this ... [+] century knowing how to code will eventually become like knowing Ancient Greek.

Many of the tech industrys best minds agreed. (Shoutout to Vivek Wadhwa!) Others hated the notion. In addition to some well-reasoned pushback and caveats, I received a few foul retorts to my LinkedIn re-post of the article. (A reliable metric of success.)

One response for which Im grateful came from Gary Hoberman. Youre right on, and were doing exactly that, stated his out-of-the-blue LinkedIn message. Turns out provocative statements about the future also provoke the people who are creating it.

Gary Hoberman soon after founding Unqork. The smile on his face reflects his approach to life... ... [+] curious, engaged and eager to make life better.

In 2017, Hoberman had just departed his role as CIO of MetLife and founded Unqork. At that time, Unqork was just a vision of what has today become a completely visual, no-code application platform that helps large enterprises build complex custom software faster, with higher quality and lower costs all without a single line of code. (My emphasis.)

Thats right enterprise quality applications without writing any code. Hoberman and team were launching the No Code Movement alongside pioneers such as iRise and Webflow. (See my interview with iRise founder Emmet Keeffe, now a partner with global venture firm Insight Partners.)

Unqork hit the Zeitgeist. Since founding in 2017, theyve raised nearly $160 million from investors such as Goldman Sachs and Alphabet investment fund CapitalG, with revenues up 320% in Q1 2020 alone. Then the pandemic accelerated digital transformation initiatives economy-wide.

Mark my words Unqork will be a unicorn IPO of the next couple of years. (Solely my prediction... no indications from Unqork leadership.)

Last month, Hoberman and I caught up via a pandemic-inspired Zoom call.

Unqorks purpose, he told me, is not to displace engineers but to render software invisible and seamless. To enable software engineers to do what they really aspire to do. Unqork seeks to enable the art and practice. Many coders get into the game out of fascination regarding what they can create with technology. Instead, they often end up turning cranks in virtual sweatshops.

Hoberman reframes the role of software engineers. Im an engineer. Its a skill. Its an art form. If you look at engineers as chefs, right now many of them are flipping burgers instead of creating Michelin-star meals.

Unqork's Halloween Party, 2019. Hoberman is the one in the front without a costume... riding the ... [+] unicorn.

Visions Faster To Reality

Indeed, we are all at an inflection point. If we re-envision our roles with respect to technology not just users or victims we see the promise of platforms like Unqorks and visions like Hobermans.

The No Code Movement promises to bring anyones ideas closer to reality. Individuals with little to no coding experience will increasingly be able to manifest their ideas via IT systems without the time, cost, complexity and layers of miscommunication that often arise during traditional software development. Imagine generating new workflows supported by software in a matter of days.

Hobermans approach at Unqork is to render app development and business workflows as seamless as possible, without touching code at all. Coding melts into the background.

Platforms like Unqork might help us and not just software engineers level up from short order cooks to sous chefs.

Software In Days Rapid Covid-19 Response

Covid-19 hit New York hard in early 2020. Unqork had already been working with the City of New York on automating workflows, so the City asked Unqork if they could help. Within 72 hours, the company provided the NYC Covid-19 Engagement Portal. Theyve since rolled out other systems to help with donations of medical supplies and food to at risk populations all within the first month of the crisis.

A dashboard from New York City's pandemic response Food Services Delivery Program created within ... [+] days by Unqork.

Compare that to traditional enterprise software development, where a month gets you a rough draft business requirements document at best and thats typically before any coding occurs.

Germaine to the moment, Hoberman and team are rolling out Unqork Forward, a philanthropic digital resilience program to support small and mid-sized businesses (SMBs) battling Covid-19. Theyre offering grant recipients licenses to the Unqork platform and access to technical resources capable of helping them digitalize their operations, return employees to work and drive revenue.

While Unqorks clients are generally large corporations and governments from Goldman Sachs and Liberty Mutual Insurance to the cities of New York and Washington, D.C. Unqork Forward focuses on sectors where SMBs have been hardest hit: restaurants, for example. Restaurants must develop no-touch delivery and pickup while their workforce navigates awkward cultural battles over masks and sanitation.

Unqorks all-in approach to supporting businesses and governments with crisis response reflects an epiphany Hoberman shared with me during our chat. For years Ive looked forward to giving back in big ways, perhaps in retirement. When the crisis hit, Hoberman recalled, I realized one morning we should give back right now, when people need it most and Unqorks platform lets us do it in a big way.

Gary Hoberman with members of the Unqork team at their Union Square HQ in Manhattan, January, 2020. ... [+] He's the one in the Unqork hoodie barely visible in the middle of the photo. Leading from the front!

The right technology in the right place at the right time can be life-changing. What I want is for us as engineers to get back to Michelin-star meals instead of flipping burgers. That would be an amazing place to be.

Never Leave Serendipity To Chance

Because of entrepreneurs like Hoberman and team, our no-code future advances faster than even I predicted. While its early days, imagine the power to which well all have access in a few years. Or in a decade.

One of the reasons I publish articles is to discover others exploring the future. As we say in our innovators connective, TWIN Global, Never leave serendipity to chance. With this in mind, Hoberman and I agreed to gather a group for dinner in-person after the pandemic subsides, and hell speak for TWIN Tech 2020, Digital Rubicon, in September online, of course.

Sharing visions for the future attracts criticismsome helpful, some knee-jerk but it can also light up like minds, expand your horizons and lead who-knows where?

Hoberman will speak for TWIN Tech 2020, September 22 - 24 online, worldwide.

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2021 Unicorn IPO: Unqork, The No Code Movement & Offending People With The Future - Forbes

Alanis Morissette: Fans would take my underwear. It was invasive – The Irish Times

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Jagged Little Pill made Alanis Morissette an icon of female rage and 25 years later, with a brand new album, theres still plenty to be angry about

In the video for her new single, Reasons I Drink, Alanis Morissette appears in a group addiction meeting. The song, set to stabbing piano, traces the difficulty of being in recovery when succumbing to addiction feels so freeing. Im such an addict, says the 46-year-old Grammy-winning firebrand, howling down the phone from her home in the San Francisco Bay Area.

Morissette ticks off her top three addictions: Work addiction, love addiction and food addiction, she says. She traces her work addiction back to when I was single digits (she was always a driven performer) and her eating disorders to her teenage years and 20s, during which she was always yo-yoing. In the video she portrays herself as multiple characters: a businesswoman; the 1990s MTV star in the same scarf and hat she wore in the video for her biggest hit, Ironic; a mother; the chairperson holding space for others.

Recovery is a complex, lifelong endeavour, and lockdown has been triggering, says Morissette, who is juggling life at home as a mother of three with promoting her ninth album, Such Pretty Forks in the Road. At 3pm I might feel: Wow, this is a huge gift, Im so overwhelmed with gratitude. By 3.15pm Im raging. By 9pm Im despondent. Isolation is the lighting of the match.

Medication has helped. Most recently she has been dealing with postpartum depression. Her youngest child, Winter, was born last August, a brother to her nine-year-old son, Ever, and three-year-old daughter, Onyx, her children with the rapper Souleye, whom she married in 2010. She has endured the condition after every birth. Previously, she delayed dealing with it; this time she sought to expose it as it happened, appearing on TV after the birth to tell viewers it is like being covered in tar and underwater.

She also headed to the studio for the first time in eight years to record her new album. Songwriting is an exercise in letting the unconscious out, she says. I live my whole life, then I take 10 minutes to write the story of it. The songs are rooted in guitar and piano-based rock; sometimes anthemic (Smiling, Ablaze), often gentler and pensive (Diagnosis, Her). They are not as abrasive as her definitive early songs, but just as she travelled novel ground back then, foregrounding a young womans anger, she is still covering topics that rarely appear in mainstream rock. The song Nemesis documents the mental gymnastics she faced with an unplanned pregnancy. Im excited yet Im filled with despair, she sings. This metamorphosis closed the door and opened a window.

The album also tackles what Morissette terms financial abuse in the music business. In 2017 her former business manager was sentenced to six years in prison for stealing $7 million, or about 6 million, from her, a violation that factors in the songs Pedestal (You grabbed my crown and got everything you wanted) and Reckoning (I hope you enjoy these drawings in your jail). They hark back to Right Through You, from her seminal third album, Jagged Little Pill, particularly the frequently cited verse in which she addresses a man who took me out to wine, dine, 69 me / But didnt hear a damn word I said.

Alanis Morissett lyrics quiz

Morissette has been singing about being leeched off by men, economically and sexually, for 25 years. Thats the most depressing thing in the entire world, she admits, laughing. The themes of pain and division, trust, exploitation, misogyny, lack of integrity, sociopathic personality disorder and narcissism. These are themes I cut my teeth on as a child. To this day, she says, she is still healing from the theft, and from past sexual trauma that she doesnt detail. She feels she could still fall victim to abuse; it is a pattern she wants to break. She is disarmingly fluent in psychology, including the work of Carl Jung and more contemporary academics. If I didnt have a whole team of therapists throughout my life, I dont think Id still be here, she says.

Morissette, who is from Ontario, started a record label by the time she was 10. After a teenage pop career as the Debbie Gibson of Canada, she ran off to Los Angeles in 1995 and cowrote the rockier Jagged Little Pill. No label would sign her, then Madonnas imprint Maverick did. The album sold more than 33 million copies worldwide, making her the youngest artist to achieve diamond-certified status in the US. She moved the needle but felt the drag. I couldnt even leave my hotel room, she says of the claustrophobic spotlight. If I walked by the window and my shadow hit the drapes, people would be screaming outside because they saw movement. She recalls fans rummaging through her room when she wasnt there. Theyd take my underwear. Theyd know it was under my pillow. It was invasive.

When Morissette appeared on the cover of Rolling Stone in November 1995, at the age of 21, the magazine billed her as the Angry White Female. Her songs were misinterpreted as combative and pretentious in their fury. She recalls radio DJs looking at her entering stations like they thought I was going to bite their heads off. Her success meant she was treated as an industry saviour, yet one manager shamed her for asking about money. Oh, youre one of those clients, he responded. Today she stands her ground. Youre not going to gaslight crazy-make me when Im on a journey of empowerment.

Two decades before a whimper of the #MeToo movement had even been heard, Morissettes voice allowed listeners to wail louder. But that also backfired as she became a vessel for others projections. If they had issues with an ex-girlfriend, or unfinished stuff with their mom or a horrifying divorce, I became that person theyd show resistance to, she says. The discourse around her felt almost physical, as if it was being thrown at her. Even the solace she offered appreciative fans became burdensome. She equates the loss of anonymity to grief. I used to sit on park benches and watch people. But when I became the watched it was debilitating.

Her isolation deepened when she found herself pitted against other women. I was sold that fame would be a panacea to solve all problems, that Id be singing Kumbaya with my celebrity friends, she says. Morissette was rejected by her peers. I thought I was going to phone Bjrk and Tori [Amos] and all of us were going to love each other. I reached out to a lot of people. Often I was met with: Why are you calling me? She doesnt want to stoke division by naming names.

After Jagged Little Pill, Morissette returned to Canada to work on the follow-up, Supposed Former Infatuation Junkie, with the producer Tim Thorney. There, supermarket checkout staff would ask her when the album was coming. I wanted to cry, she says. I remember saying: I dont want to make music any more. When Thorney replied, Sounds good! and took her for dinner, she returned to the studio feeling revived and began writing immediately: His freedom took the pressure away.

Released in 1998, that album debuted at No 1 in the US and broke first-week record sales by a female act, a record previously held by The Miseducation of Lauryn Hill. Yet the 1990s wave of unadulterated female-fronted rock would soon be crushed by teen pop. By 2000 Britney Spears had broken Morissettes diamond record and almost tripled her sales. It was a relief. The white-hot heat of fame waned, which is what made everything okay, actually, she says. Fame is not a circumstance I want to sustain.

Not that Morissette disappeared. Her 2001 single Hands Clean from fifth album, Under Rug Swept, was an international hit, although her next single failed to match its success. She began acting, cropping up in Sex and the City and Curb Your Enthusiasm, and in the movie Dogma, in which she played God. She even had a short stint as an agony aunt for the Guardian. There has been a steady cultural reclamation of the kind of female anger that Morissette was vilified for in the 1990s. Seven years in the making, a Broadway musical inspired by Jagged Little Pill has been a huge success. It includes a character who is raped at a high-school party and later gaslit over the experience. The actor Kathryn Gallagher recalls Morissette reminding her that the character was meant to be angry: The thing that Ive taken away from her in her guidance is the importance of feeling everything and going through every single emotion, even the sticky spots, she says.

Queer artists, including Halsey and Perfume Genius, have cited Morissettes importance in their own self-emancipation. This year Morissettes 1990s peer Fiona Apple similarly demonised as an angry girl back then received acclaim for a new album that delved into those formative industry traumas. Curiously, Morissette hasnt heard about it. Shes focused on her own efforts. Having my worth dictated by how relevant I am in the zeitgeist pop culture is a recipe for disaster, she says. I dont ride that roller coaster.

Despite this cultural course correction, Morissette remains sceptical: she worries about the enduring vapidness that plagues the entertainment world and thinks its foolish to consider that talented women are favoured for reasons beyond marketability. The patriarchy only pays attention when theres a financial shift, she says. It became bankable to have a female artist so it was embraced, and then, off to the races! Yet she acknowledges that some things have improved. In the past Morissettes desire to understand the human condition was a source of mockery by press and public. I used to feel like a freak in every room I was in, she says. Now I dont feel strange. Guardian

Such Pretty Forks in the Road is released by RCA on Friday

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Alanis Morissette: Fans would take my underwear. It was invasive - The Irish Times

Australian Jews’ Israel ties sorely tested by saga of alleged sex abuser Leifer – The Times of Israel

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The Australian Jewish communitys frustration with the State of Israel reached near boiling point in late February.

The breakdown centered around one woman, former high school principal Malka Leifer, who is wanted in Australia on 74 charges of child abuse. Many in the community saw Jerusalem as dragging its feet on an extradition process that has long been in the works. Some felt the Jewish state was even protecting Leifer from facing the charges against her in Australia.

In 2008, the 53-year-old Israeli mother of eight fled to Israel as allegations emerged that she had sexually abused pupils at Melbournes Adass Israel ultra-Orthodox girls high school. Police complaints against Leifer were submitted by three sisters in 2011, Australia filed for extradition in 2013, and Israel arrested her in 2014.

But in the four years that followed, Leifer managed to convince Israeli courts that she was too mentally unstable to even leave her bed, let alone remain in jail or be sent back to Victoria to stand trial.

Adass Israel ultra-Orthodox girls school headmistress Malka Leifer (left) with her students, among them Nicole Meyer (center) in 2003. (Courtesy)

In 2018, after being filmed appearing to lead a fully functional life, Leifer was rearrested, and shes remained behind bars since. But in the two and a half years that followed, no decision has been made to extradite her, as the Jerusalem District Court despite the damning footage has delved repeatedly into the question of the former headmasters mental fitness.

On Wednesday, the Supreme Court is slated to hear an appeal against the Jerusalem District Court decision that found Leifer fit for the extradition hearing that took place last week. The district court wont hand down a decision on extradition until September 21, at which point Justice Minister Avi Nissenkorn will have to sign off on the move. While both a ruling in favor of extradition and a subsequent signature from Nissenkorn are likely, they too can be appealed to the Supreme Court, further extending the Sisyphean six-year process.

For the staunchly pro-Israel, Jewish community in Australia unaccustomed to openly criticizing Israeli authorities the 69 (going on 70) court dates have seen it dragged into largely uncharted waters.

The newly combative position taken by the Australian Jewish leadership as a result has had some onlookers concerned that the Jewish state might be souring a relationship with one of its closest friends in the Diaspora for good.

There are some donors who will halt their donations, Zionist Federation of Australia (ZFA) president Jeremy Leibler told The Times of Israel in late February.

Leibler was one of nearly a dozen prominent members of the Australian Jewish community who spoke to The Times of Israel regarding the broader impact of the Leifer trial. They compared the case to several other crises believed at the time to be equally ground-shaking and explained why the alleged abusers trial resonated with so many.

When Leibler first spoke to this reporter at the start of the year, President Reuven Rivlin was on his way back from a visit to Australia, during which he declined a request to meet with Leifers alleged victims. This refusal underlined the uneasy relationship between Canberra and Jerusalem over the case.

A private investigator tagged Malka Leifer as she did some shopping in Bnei Brak on December 14, 2017. (Screen capture/YouTube)

The apparent snub came weeks after Prime Minister Benjamin Netanyahu decided to reappoint Yaakov Litzman as health minister. Police in July 2019 recommended that Litzman, who represents the ultra-Orthodox United Torah Judaism party, be indicted for allegedly pressuring psychiatrists in his office to deem Leifer mentally incompetent. The bombshell development presented an explanation for the drawn-out proceedings, which included the Jerusalem chief district psychiatrist changing his diagnosis of Leifer three times.

The ZFAs Leibler had sent a letter to Netanyahu after the reappointment, calling it a slap in the face to the Australian Jewish Community, the Australian people, the community of Australian immigrants in Israel and most shockingly, the survivors of Malka Leifers alleged abuse.

Its really just an embarrassment because we want to go out and celebrate Israels successes, but this puts us in a very difficult position, Leibler said.

It was attitudes such as Leiblers that has led some familiar with the 120,000-strong Australian Jewish community to speculate that the Leifer case represented a fundamental shift in its relationship with Israel that would lead to a willingness among members to openly criticize the government over other issues as well.

Benjamin Netanyahu, right, listens to Yaakov Litzman at the start of the the weekly cabinet meeting at the prime ministers office in Jerusalem, January 6, 2019. (Gali Tibbon/Pool via AP)

That theoretical willingness to openly criticize Israel was put to the test several months later in the lead-up to July 1, which Netanyahu had vowed would mark the start of his governments plans to annex large parts of the West Bank. But despite what one Australian official described to The Times of Israel as near unanimous opposition to annexation in the countrys Jewish leadership, none of the umbrella groups issued statements warning against the move akin to the condemnations publicized by various self-described pro-Israel groups in the United States and Britain.

In a follow-up interview with ZFAs Leibler the day after Netanyahus annexation target date, with Leifers extradition now appearing to be set for approval, his tone has softened. He called the affair a chance for Israel and Australias Jews to find a way forward while agreeing to disagree on some matters.

Regarding annexation, Leibler said his organization largely refrains from commenting on the matter because the Israeli government had yet to announce what exactly it plans to annex and how.

The ZFA president also sounded less concerned regarding the long-term ramifications the Leifer case might have on his communitys relationship with Israel. In the four months that had passed since he first spoke with The Times of Israel, a judge had found Leifer fit for an extradition hearing (which took place last week), and Leibler described a feeling in Melbourne that this part of the proceedings against her was finally close to wrapping up.

Jeremy Leibler (Courtesy/Zionist Federation of Australia)

While Leibler stopped short of referring to the case as a watershed moment in the communitys relationship with Israel, he maintained that it had signaled new territory of strained relations.

There were many in the community who had an image of Israel as this perfect little country that defies reality. With Leifer, a little bit of that naivet was shattered, Leibler said. He added that he viewed the change in perspective as a positive development.

Australian Jews are quick to point out that their community is unlike many others.

Israel is seen as a home away from home, and you dont criticize it because you might eventually need to go there, said Ittay Flescher, who taught English at Adass boys school and is now the Israel correspondent for Plus61J a progressive Australian Jewish news outlet.

Leibler described a community that was heavily influenced by a post-Holocaust wave of immigration, which expanded its size significantly and also led to a fundamental shift toward Zionism.

An Australian delegation meets with Prime Minister Benjamin Netanayhu (4th from L) at his office in Jerusalem on October 28, 2019. (Amos Ben Gershom/PMO)

Australian Jews saw their safety and well-being as tied to the success and survival of the Jewish state, even though they werent living there, he said.

That outlook has been passed on to the younger generation, 50 percent of whom are enrolled in Jewish day schools, according to Leibler.

Contrary to many other communities where Zionist sentiment is more strongly felt among older generations, a 2017 survey in Australia found that more Jews between the age of 18-29 identified as Zionists (75%) than any other age range.

Australian Jews saw their safety and well-being as tied to the success and survival of the Jewish state

ZFAs communications director Emily Gian acknowledged that todays Jewish youth are definitely more critical than their parents, but were probably a generation behind America in that sense.

J Street does not exist here, Leibler added, referring to the progressive pro-Israel lobby in the US that has not shied away from criticizing the Israeli government. There isnt an overwhelming amount of support among Jews for one [political] party in Australia. Its traditionally more conservative, but it has never been overwhelmingly so.

J Street U students march on the White House on February 25, 2017, the eve of J Streets annual conference. (J Street via JTA)

However, the ZFA president clarified that the strong connection to Israel does not mean the community has refrained from criticizing the Jewish state entirely. Among the issues denounced by his organization, he cited the Israeli governments reneging on an agreement that would have created an egalitarian prayer space near the Western Wall, the passage to the so-called Nation State Law and the treatment of African asylum seekers.

There has been an unwritten rule: everyone is free to express their views, but we dont criticize Israel on security issues, as were not living in Israel or serving in its army. But that does not extend to all other issues, Leibler said.

But others argued that even that criticism is rather limited.

Former Executive Council of Australian Jewry vice president Manny Waks recalled that in 2010, he had raised the idea of having a meeting to discuss the main umbrella bodys role in Israel advocacy while speaking with another member of the group. The other member quickly shot the idea down.

I was immediately told straight out not to make such a proposal, said Waks, who now lives in Israel and serves as the chairman of Kol VOz, an international group that supports victims of child sex abuse.

Things have changed since then, but only to a degree, he said. The general mainstream attitude is that the establishment [groups are] an additional mouthpiece and defender of the State of Israel and the government of the day.

Victims rights advocate Manny Waks (right) holds up a phone from which Malka Leifers alleged victims Dassi Erlich, Nicole Meyer and Elie Sapper speak to reporters at the Jerusalem District Court on May 26, 2020. (Jacob Magid/Times of Israel)

Many of those who spoke to The Times of Israel acknowledged that the Leifer case brought the community to voice a degree of criticism that until recently hadnt been heard.

They said that much of the fury had to do with the timing of the proceedings, which unfolded against the backdrop of the Australian governments Royal Commission into Institutional Responses to Child Sexual Abuse. The commission was established in 2013 and its findings were published in 2017.

The inquiry exposed massive failures in the Catholic Churchs handling of abuse, and Jewish institutions such as Melbournes Yeshiva Center and Sydneys Yeshiva Bondi were also revealed as having covered up decades of sex crimes perpetrated by faculty against their students.

Thanks to the Royal Commission, the issue of child sex abuse became front and center in Australia, said Waks, who testified before the inquiry.

Sexual abuse and institutional cover-ups have been the zeitgeist of the time, said Flescher. The Royal Commission made it acceptable to talk about the issue, which then made it okay to talk about the Leifer case, despite its rather intimate and gruesome details.

Australian Prime Minister Scott Morrison, center, delivers a formal apology to Australias victims of child sex abuse as a result of the findings of his governments Royal Commission, in the House of Representatives at Parliament House in Canberra on October 22, 2018. (Mick Tsikas/AAP Image via AP)

And yet, one of Leifers alleged victims, Dassi Erlich, recalled facing quite a bit of resistance from Jewish communal leadership when she launched the Bring Leifer Back campaign with her sisters Nicole Meyer and Elly Sapper in the beginning of 2017, calling for their former principals extradition.

At that point, her alleged abuser was a free woman living in the ultra-Orthodox settlement of Emmanuel, after a judge concluded that Leifer was too mentally unstable for extradition.

There were a lot of organizations that paid lip service to my cause, but werent really willing to do much beyond that, said Erlich, naming the ZFA (pre-Leibler ) among others.

At one point, Erlich was asked to address an event organized by a pro-Israel group she requested not to identify, whose organizers repeatedly reminded her beforehand to stress to the audience that she does not pass judgment on the entire State of Israel, despite the repeated delays in the Leifer case.

(From L-R) Dassi Erlich, Ellie Sapper and Nicole Meyer pose for a photo in Jerusalem on November 29, 2018. (Jacob Magid/Time of Israel)

It felt like they, in a way, were using me to raise money, she said.

Erlich described a general hesitancy from various groups, which didnt want to be seen as publicly criticizing the Jewish state, to honestly address the issue and Israels role in it.

I was very naive when I started the campaign and could not understand why I was encountering so much resistance, she said. Growing up in the [ultra-Orthodox] Adass community, which is strongly anti-Zionist, I had no idea of the extent to which the wider Jewish community was in a completely different place.

Erlich said some advised her to join forces with the Boycott, Divestment and Sanctions movement, as such activists would be able to amplify her message regarding ongoing injustice taking place in Israel.

But that wasnt what the campaign was about, Erlich said, explaining her decision to resist such advice. Combating sexual abuse is its own issue and we didnt need another platform to hang ours on.

Australian sisters Nicole Meyer (L) and Dassi Erlich (R) take part in a demonstration on March 13, 2019, outside the Jerusalem District Court after an extradition hearings for Malka Leifer, a former girls school principal wanted for sexual abuse in Australia. (Yonatan Sindel/Flash90)

Erlich recalled meeting with former Australian politician Ted Baillieu, who recommended starting her outreach at the national level and leaving the Jewish community aside for the time being.

As he predicted, the Jewish communitys support eventually followed, she said, citing a late 2017 meeting held by community elder Mark Leibler (Jeremys father) with then Israeli justice minister Ayelet Shaked. Leibler stressed the importance of bringing Leifer back to Australia, which Erlich said effectively gave permission for others in the community to make the same demand.

As for Erlich herself, she admitted that she hasnt been able to make that separation between the case and the state in which it is currently unfolding.

My sisters buried in Israel, so thats the only reason I would go back there after this, she said. The place just holds too much trauma for me right now, and I cant ever imagine feeling like Id ever want to go back there.

Its easy to look at the Leifer case in a vacuum, but in conversation with The Times of Israel a number of the elder statespeople in Australian Jewry were quick to point out that the communitys relationship with Israel has faced other crises that many believed would be no less damaging.

Former ZFA president Ron Weiser asserted that nothing has affected the Australian Jewish community vis-a-vis Israel more negatively and deeply than the deadly bridge collapse that took place at the 1997 Maccabiah Games during his tenure.

Israeli rescue workers evacuate members of the Australian Jewish athletic team from a bridge at the Yarkon River in Tel Aviv on July 14, 1997. (AP/Jeremy Feldman)

Four Australian athletes were killed and roughly 70 others were injured when the makeshift overpass above the Yarkon River gave way as they were making their way to the Ramat Gan stadium during the opening ceremony of the Jewish Olympics.

Subsequent investigations in Israel found that the Maccabiah organizers had taken negligent shortcuts in constructing the bridge, leading to the eventual conviction of five. The Maccabiahs president and chairmen were forced to resign and a Haifa court ordered the insurance company for the event, along with the Israeli government, to pay $20 million in damages to over 50 victims.

The fallout took seven years to subside. Fundraisers for Israel were feeling the effect, Weiser said. People who had sent their kids to Israel on programs during wars either were reconsidering sending them or indeed did not send them.

During that time, Australia boycotted the Maccabiah games. This step, Weiser stated, is something we havent seen during the Leifer process.

Israeli rescue workers evacuate members of the Australian Jewish athletic team from a bridge at the Yarkon River in Tel Aviv on July 14, 1997. (AP/Jeremy Feldman)

The Leifer case is terrible, but you have to take into account that the bridge collapse resulted in death, and thats just not comparable, Weiser said. Anyone over the age of 45 or 50 would tell you the same thing.

He also added that Israel could not be solely blamed for all the missteps in the Leifer case, as the Adass Israel school employing her was responsible for booking the red-eye flight that whisked her out of the country in the first place.

But others did not see the bridge collapse as having as deep an impact.

The community was mature enough to understand that in the bridge collapse, it wasnt the government that was in charge of the games, said one of Weisers successors at the ZFA, Philip Chester.

Likewise, the era in which it occurred made for a different response. It happened during the pre-social media era when we were getting our Jewish news once a week on Thursdays, as opposed to now when everything is instantaneous, said Leibler.

Another tragedy that tested the communitys relationship with the Jewish state was the so-called Prisoner X affair, in which Israel was found to have secretly held Australian-Israeli Ben Zygier before he reportedly killed himself in 2010.

Zygier was allegedly a Mossad agent said to have inadvertently leaked names of other agents in the Middle East resulting in their arrest, imprisonment, or death. He was held under a strict media blackout and became known as Prisoner X.

Ben Zygier. (Screenshot ABC TV via Youtube)

Chester, who was serving as ZFA president at the time, said it caused major uproar in the community he represented. However, because details coming out of Israel were so scarce, the address of blame was never clear. Was it the prisoner authorities? Was it the Shin Bet? Was it the Mossad? We didnt really know.

Waks argued that as opposed to the Leifer affair, Prisoner X was seen as a security-related matter. As a result, many in the Australian Jewish community were more willing to give Israel the benefit of the doubt that it hadnt acted inappropriately, he said.

As for the Leifer case, Australian Jewish leaders are now confident that they will be able to weather the damage significant as it might be to the communitys relationship with Israel. That is, of course, dependent upon the July 29 Supreme Court hearing, and the September district court decision.

At the end of the day they still wrote that check because Israel as a whole is far bigger than one issue

I think there are many in the Australian Jewish community who certainly feel that Israel has and continues to take their support for granted, and for them, this has been a very sobering experience, Waks reflected.

Leibler expressed a more optimistic outlook and argued that the crises proved just how sustainable his communitys relationship to Israel has become.

People who picked up the phone called to say how mad they were about this, but at the end of the day they still wrote that check because Israel as a whole is far bigger than one issue, Leibler said.

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Australian Jews' Israel ties sorely tested by saga of alleged sex abuser Leifer - The Times of Israel

Army Medical Command Sees 70% Boost in Virtual Health Care Amid COVID-19 – GovernmentCIO Media

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The Army has adopted the technology, especially in mental health care, as DHA has advanced telemedical capabilities

U.S. Army photo by Jason W. Edwards

U.S. Army Medical Command has seen a 70 percent increase in virtual health amid COVID-19, especially in providing its beneficiaries greater access to mental health treatment, Army Surgeon General Lt. Gen. R Scott Dingle said Wednesday.

Virtual health, telemedicine has blown up as the restrictions of COVID hit our country to ensure that were not exposing beneficiaries, patients, by coming into a facility or to a location Dingle said in an Association of the U.S. Army webinar. We have increased our virtual health 70 percent. It has been a phenomenal occurrence of increase in virtual health and the virtual machine platforms.

Dingle credited the Defense Health Agency for largely leading the rapid scale up and success of telemedical capabilities across the military health system and treatment facilities, noting that the Army has been nested within the DHAs work of expanding virtual health. Even with DHAs leadership, the Army has taken its own role in supporting virtual care amid COVID-19, providing its own funding to bolster the technology and to provide virtual mental health care.

The Army has a big role, in which weve not only nested under [DHA], but us coming out and out of our own pockets to support and reinforce and expand virtual health across the Army medical treatment facilities to include behavioral telehealth, Dingle said. It has been an amazing increase in our quality of life task force as the United States Army talks about mental health and access to mental health.

To support telemedicine and virtual behavioral health, the Army has leveraged telemedicine advancements within the civilian sector, implementing those preexisting technologies across the Army medicine enterprise to scale up quickly in recent months.

The increase of telemedicine care for mental health services especially has helped remove the stigma around mental health careand create more accessibility for beneficiaries seeking it, Dingle added.

One soldier said it best, Dingle said. This particularly soldier said, I understand that weve removed the stigma with going to seek mental health. But he said, One of the greatest things that encouraged me to seek health was that it was behavioral telehealth, virtual health, and he had the option to access and leverage the platform. And he said it was the best thing in the world and allowed him and many others [to seek care], because then he spread the word for more leaders to access and use the virtual platform.

Dingle not only emphasized mental health care for Army medicine beneficiaries, but also for military healthcare providers who face potential challenges with mental health as they confront the stress of tackling COVID-19 at the front lines on a daily basis. Army Medical Command has done this by implementing behavioral health systems of care that provide mental health relief and provide education on mental health self care.

Even with the internal support that Army Medical Command is providing to its personnel and beneficiaries, it is also continuing to support the greater COVID-19 national response. Dingle said that it has actively recruited retired medical professionals to help at the front lines, both in military treatment facilities and to aid in civilian care, and is aiding the COVID-19 Task Force and executive office in research and development resources and personnel as well

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

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

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

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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

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

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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

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

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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 | 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

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

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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

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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

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

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(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

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

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

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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

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

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

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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.

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