Literature Review

AI scribe saves doctors an hour at the keyboard every dayAMA, by Andis Robeznieks; 3/18/24 When a health system rolls out new technology that it insists will make physicians’ lives easier, the announcement is typically met with skepticism. But the use of augmented intelligence (AI)—often called artificial intelligence—has changed that. The Permanente Medical Group’s rollout of ambient AI scribes to reduce documentation burdens has been deemed a success, saving most of the physicians using it an average of one hour a day at the keyboard. ... Refinement of the tool, however, is ongoing. ... For example, one physician mentioned scheduling a patient’s prostate exam, but the AI scribe recorded that the exam had been performed. 

NH House passes medical aid in dying: Debate isn't over yet Portsmouth Herald, by Margie Cullen; 3/22/24 The End of Life Options Act, which would allow terminally ill people in New Hampshire to access medical aid in dying, narrowly passed in the House of Representatives Thursday. While versions of this bill have been brought to the legislature in past years, this is the first time it has passed the House. It comes after it gained its first victory in the House Judiciary Committee, where it was recommended to pass 13-7 for the first time. In the House Thursday, it passed 179-176.

New legislation proposes national expansion of integrated care modelsHealth Affairs, by Laura M. Keohane; 3/20, 24 This article is the latest in the Health Affairs Forefront major series, Medicare and Medicaid Integration. The series features analysis, proposals, and commentary that will inform policies on the state and federal levels to advance integrated care for those dually eligible for Medicare and Medicaid.  ... On March 14, a bipartisan group of senators—members of the Senate Duals Working Group—released legislation (The DUALS Act: Delivering Unified Access to Lifesaving Services Act of 2024) that commits to ambitious goals for aligning Medicare and Medicaid coverage ... Would the integration measures proposed in this bill be more successful [than previous programs] in achieving these goals? This Forefront article highlights the key components of the legislation and assesses its ability to advance better outcomes for dual-eligible beneficiaries.

March Madness is like a rollercoaster – even if your bracket is busted, the ride is still thrilling.

Racial/ethnic differences in care intensity at the end of life for patients with lung cancer The ASCO Post, by Matthew Stenger; 3/21/24 The study used data from the California Cancer Registry linked to patient discharge data abstracts. The primary outcome measure was intensity of care in the last 14 days before death, with greater intensity defined as any hospital admission or emergency department visit, intensive care unit (ICU) admission, intubation, cardiopulmonary resuscitation (CPR), hemodialysis, and death in an acute care setting. ... The authors concluded: “Compared with [non-Hispanic White] patients, [Asian/Pacific Islander], Black, and Hispanic patients who died with lung cancer experienced higher intensity of [end-of-life] care. Future studies should develop approaches to eliminate such racial and ethnic disparities in care delivery at the [end of life].”

36 rural hospitals have closed since 2020 Becker's Hospital CFO Report, by Alan Condon; 3/21/24 The closures highlight the heightened financial challenges that rural hospitals face amid persisting workforce shortages, rising costs and leveling reimbursement. In addition, only 45% of rural hospitals now offer labor and delivery services, and in 10 states, less than 33% do, according to the Center for Healthcare Quality and Payment Reform. [Listed in the article] are the 36 rural hospitals that closed since 2020, beginning with the most recent.

8 likely next in-demand nursing roles, per Tampa General's chief nurse Becker's Clinical Leadership, by Laura Dyrda; 3/15/24 ... "In the next two to three years, the nursing team may require new roles and skills to adapt to the changing healthcare landscape," said Wendi Goodson-Celerin, DNP, APRN, senior vice president and chief nursing executive at Tampa (Fla.) General Hospital. Dr. Goodson-Celerin outlined potential roles and skills that may be in demand over the next two to three years:

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

What are ageing and death from a biological point of view? Polytchnique insights, by Alexis Gautreau and Clemence Guillermain; 3/12/24 Linking philosophy and biology may seem strange. Yet there are many subjects where the two disciplines come into play and are, in turn, essential to understanding them. Death is a perfect example. This biological reality remains an abstract concept until we experience it in our own lives. But, however abstract it may be, death is based on a biological reality. 

The identity dilemma: Navigating rebranding decisions in home health M&A Home Health Care News, by Patrick Filbin; 3/14/24 ... While some companies swiftly integrate acquired businesses into their brand and splash their logo, marketing materials and likeness on the newly acquired assets, others opt to maintain the selling company’s identity. In home-based care, the decision to “rebrand or retain” takes into account a number of factors, sources told Home Health Care News. They include operational efficiency, patient/client retention, market positioning and more.

How the analytics of care can balance workforce capacity MedCity News, by Derek Streat; 3/19/24 U.S. healthcare is experiencing a supply and demand crisis as it races to keep pace with an aging population amidst a workforce shortage and mounting financial pressures. And the situation appears unlikely to improve anytime soon. In fact, recent projections anticipate a shortfall of 139,000 physicians in the next decade, according to the Association of American Medical Colleges. One limiting factor preventing the efficient management of workforce resources is a lack of data interoperability. ... 

Hospice group pushes for clarity in N.Y. state budget as some warm to for-profit care Spectrum News 1; by Susan Arbetter; 3/19/24 New York state has the lowest utilization of hospice in the country, which can be attributed to several factors, including low health literacy rates. But the state’s recent progress in support of end-of-life care may be threatened by something even more insidious: corporate greed. To investigate that issue nationally, a joint request for information was issued by the federal Department of Health and Human Services and the Federal Trade Commission into private equity-backed health care and its impact on quality. Yet despite dire warnings, New York state is slowly opening the door to for-profit, private equity-backed hospice care. 

CAHPS Hospice Survey - Quality Assurance Guidelines V10.0: Technical Corrections and Clarifications, March 2024 HospiceCahpsSurvey.org; 3/20/24Subsequent to the release of the CAHPS Hospice Survey Quality Assurance Guidelines V10.0 (QAG V10.0), it has been determined that there is a specific content item that requires correction, addition and/or further clarification. The protocol listed in this document replace the previous release of the content in the CAHPS Hospice Survey Quality Assurance Guidelines V10.0. The items are identified [in the pdf available at the title's link].