Literature Review

An AI chatbot outperformed physicians and physicians plus AI in a trial - What does that mean?JAMA; by Yulin Hswen, Rita Rubin; 12/27/24Jonathan Chen, MD, PhD, an assistant professor of medicine, and Ethan Goh, MBBS, MS, a postdoctoral scholar, both at Stanford University, have collaborated for 2 years on studying the integration of human and artificial intelligence to enhance clinical decision-making. They published a randomized clinical trial in JAMA Network Open on October 28 that found that the use of a large language model (LLM) did not significantly enhance physicians’ diagnostic reasoning beyond that of conventional resources. Surprisingly, though, the LLM alone performed better than the physicians did with either the LLM or the conventional resources... In our pilot study, we thought the doctors who had access to the chatbot were going to do way better than the doctors who only had access to the usual internet - UpToDate, PubMed, Google, whatever. Then when we actually did the randomized study, that didn’t turn out to be the case, which is really weird. The chatbot by itself did surprisingly better than all of the doctors, including the doctors that accessed the chatbot. That flew in the face of the fundamental theorem of informatics: human plus computer will deliver better results than either would alone. That sounds so good, right? I’ve been saying it as the last line in my talks for years. I don’t say it anymore because results like these challenge it.Publisher's note: An interesting interview with the authors of JAMA's Large Language Model Influence on Diagnostic Reasoning article, which we ran 11/16/24.

Time flies. It's up to you to be a navigator. ~ Robert Orben

St. Petersburg doctor coerced minors into producing child sex abuse material, feds sayTampa Bay Times; by Emily Wunderlich; 1/7/25 A St. Petersburg doctor who is the husband of the chief administrative officer of the Juvenile Welfare Board of Pinellas County is facing charges that he coerced minors into producing child sexual abuse material and even directed a girl to hang herself, federal prosecutors announced this week. ... Court records show Leedy was indicted on Oct. 24 and arrested Dec. 20. He is being held in federal custody in Atlanta. He is facing three counts of production of child sexual abuse material and two counts of coercing or enticing a minor to engage in sexual activity. If convicted on all counts, he faces up to life in federal prison.

Middle manager burnout, layoffs, and the search for solutions HR Query; 1/6/25Middle managers are facing unprecedented pressure. As organizations streamline communication, this critical layer is often caught in the crossfire, with layoffs impacting one-third of this group in 2023.A recent study revealed that 75% of middle managers report experiencing burnout, and 40% are actively seeking new opportunities. This alarming trend poses a significant risk to organizations, as middle managers play a vital role in driving revenue, fostering employee growth, and ensuring operational success. ... Dana Rogers, VP of People at O.C. Tanner, shares valuable insights on the critical role of middle managers in organizational success, strategies for HR teams to rebuild trust and support with middle managers, and leveraging employee appreciation tactics to reduce burnout and boost confidence. Her first tip? HR leaders should be loud with appreciation.

Patient sues California hospital network over ransomware attack Becker's Hospital Review; by Naomi Diaz; 1/6/24 PIH Health is facing a lawsuit over a ransomware attack that hit the health system on Dec. 1, Pasadena Star-News reported Jan. 5. Ferdinand Rivera has filed a lawsuit against PIH Health, accusing the health system of negligence, invasion of privacy and other violations following the ransomware attack. The cyberattack crippled information technology systems and phone lines across three hospitals — PIH Health Downey Hospital, PIH Health Whittier Hospital and PIH Health Good Samaritan Hospital in Los Angeles — as well as urgent care centers, physicians' offices, and home health and hospice services. Mr. Rivera's lawsuit, the first among more than a dozen filed in Los Angeles Superior Court, seeks unspecified damages, according to the Daily Journal.

Rural families have ‘critical’ need for more hospice, respite care Hospice News; by Holly Vossel; 1/6/25 Economic and financial headwinds have increasingly posed significant challenges for rural-based hospice providers, with some shuttering their programs in recent years. ... Hospices in rural regions have particularly been hard hit by these labor pressures amid rising demand for their services, with recent years bringing program closures across the country. ... Having a hospice offer services wherever a patient lives was the top priority cited by 400 rural-based caregiver respondents in a recent research study from the Alliance’s Diversity Advisory Council and Transcend Strategy Group. However, roughly 40% of the caregiver respondents were not able to name a nearby hospice provider. ... The lack of hospice availability has left gaps in supportive services that address terminally ill patients’ full range of physical, emotional and spiritual needs.This has also worsened disparities among rural family caregivers.Notable mention: Dr. Steve Landers, CEO of the National Alliance for Care at Home (the Alliance)

Escambia County Fire Rescue grants a hospice wish to a 17-year-old Cantonment resident Pensacola News Journal; by Tony Giberson; 1/6/25Escambia County Fire Rescue Deputy Chief Paul Williams and Lt. Darren Snipes visit with 17-year-old hospice patient Dalton Harvey and his family in the Cantonment area on Friday, Jan. 3, 2025. During the visit, the ECFR presented Dalton with gifts, including a real firefighter's helmet.

Holistic and seamless: How health systems advocate, Mass General Brigham are advancing at-home care Home Health Care News; by Joyce Famakinwa; 1/6/25 A big part of the evolution of health systems has been more meaningful engagement with the home as an extension of brick-and-mortar operations. In recent years, organizations like Advocate Health and Mass General Brigham have exemplified this shift. These major health systems are reevaluating their home-based care capabilities and partnerships, and leveraging technology and innovative care models–including hospital-at-home–to enable more integrated and cost-efficient services. ... In August, the organization was awarded $4.6 million from the Massachusetts Executive Office of Health and Human Services to study short-term rehab at home. The study is a randomized controlled trial that examines the impact of delivering short-term rehab care at home compared to a traditional post-acute care setting.

Masonicare completes merger with UMH, facility acquisition McKnights Senior Living; by Kathleen Steele Gaivin; 1/6/25 Wallingford, CT-based Masonicare has completed its planned merger with United Methodist Homes, the companies said Thursday in a joint statement. Masonicare Corp. is Connecticut’s largest not-for-profit senior living and care organization, offering independent living, assisted living, memory care and skilled nursing as well as short-term rehabilitation, respite care and hospice care. UMH, a 150-year-old organization, has five locations in the Nutmeg State. The communities provide independent living, assisted living, memory care, skilled nursing and short-term rehab. The merger moves UMH under the Masonicare brand and extends to UMH access to Masonicare’s comprehensive continuum of care, the companies said.  Also on Jan. 2, Masonicare announced the acquisition of Atria Greenridge Place in Rocky Hill, CT, rebranding the assisted living and memory community to Masonicare at Greenridge Place.

Managing clinical care after M&AHealthleaders; by Christopher Cheney; 1/6/25Coping with the challenges of mergers and acquisitions has become an essential responsibility for CMOs.

The Jimmy Carter White House Connection to Hospice & Palliative Care TodayCohen-Fyfe Communications; by Mark Cohen; 1/3/25Jimmy Carter’s impact on the hospice movement goes further than his very public decision to be admitted to hospice in February 2023 ... and even further than his administration’s decision in 1980 to launch the Hospice Demonstration Project that directly led to congressional passage of the Medicare Hospice Benefit, with strong bipartisan support, in 1981 during the first year of the Reagan Administration. How much further? You might not be reading this daily newsletter if were not for the Carter White House. If you were a fan of Hospice News Today, which I published from 2012 to 2023, and/or if you’re a fan of Hospice & Palliative Care Today, then you should know that Jimmy Carter(and his long-time senior aides Jody Powell and Hamilton Jordan) deserve some of the credit for these two unique daily environmental scans that have served the hospice movement now for more than a dozen years. ... [Fascinating story and with this spoiler alert:] So, Inauguration Day in 1977 found me walking into the Old Executive Ofice Building as the youngest person on the 369-person staf of The Office of the President. My job? One of six stafers who produced the daily News Summary for the President and nearly 200 senior oficials throughout the White House and the Cabinet and executive agencies. [Click on the title's link to read more.]Editor's note: As President Carter's body is taken to the Capitol today, we celebrate the simple moments that can change the course of another's life. Did you read Jimmy Carter's questions to the young Mark Cohen? At Hospice & Palliative Care Today, we are grateful for Mark's journey and long-lasting impact. What interest are you taking in the lives of those who serve in your organization? May we pause. Learn. And live.

National Alliance for Care at Home, Transcend Strategy Group release hospice report HomeCare, Alexandria, VA and Washington, DC; HomeCare; 1/3/25 The National Alliance for Care at Home (The Alliance) and Transcend Strategy Group, a marketing agency for homecare companies, published the results of their Rural American Hospice Insights report, a new study that explored perceptions of hospice care among rural and small-town communities. The Alliance said the survey, which included 400 participants, aims to provide health equity and break down barriers to accessing hospice and homecare through knowledge sharing, data collection and collaborative discussion.  “Ensuring access to high-quality hospice and homecare in rural communities is critical,” said Steve Landers, CEO of The National Alliance for Care at Home. “These communities deserve care that is tailored to their unique needs, and in an America where more and more health care desserts are arising due to provider closures from inadequate reimbursement, maintaining quality care and continuing to build trust in the care provided is of the utmost importance."