Literature Review

Making AI actionable in healthcare – a high-level guide Becker's Hospital Review; by Calum Yacoubian, MD, Director Healthcare AI Strategy, IQVIA; 5/14/24 Never has there been more interest and excitement around the potential of Artificial Intelligence (AI) in healthcare. The advent of Generative AI and LLMs, popularized by OpenAI with ChatGPT, has opened many people’s eyes to what might be possible. Yet, the translation of this promise to patient impact is only in its infancy, and while it is a path with huge potential, as healthcare professionals, we must tread carefully and responsibly. In this article, we discuss the importance of the ecosystem in which healthcare AI must exist, to be successful. That ecosystem is made up of people, process, and technology.

NAHC advocacy scores wins in CongressNAHC Newsroom; Press Release; 5/10/24Tireless advocacy by the National Association for Home Care & Hospice (NAHC) and our partners at the National Hospice and Palliative Care Organization, has resulted in the approval of the Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261) through the Ways & Means Committee of the U.S. House of Representatives. While the committee advanced the legislation, it will still need to be passed by the full House of Representatives and the Senate as well. This first step was crucial to get the bill on the pathway to its ultimate enactment into law. This legislation provides:

Hospice remains underserved by Medicare Advantage, data showsBioMedWire; 5/13/24 While the Medicare Advantage space grows bigger, it is difficult for regulators and the medical industry to decide how best to integrate hospice into MA programs. This is a major concern because hospice care is the only segment of the healthcare sector that isn’t catered for in Medicare Advantage (MA). ... Almost 50% of all individuals (1.7 million) on MA programs that succumbed to their terminal illnesses in 2022 were recipients of hospice services. ... 

Potential progress at Optum Tri-State complicated by corporate care crisis: It's bonuses for bodies' The Examiner News; by Adam Stone; 5/13/24 'It's Bonuses for Bodies' This is the 16th installment in an investigative series, launched in December 2022, about CareMount/Optum/UnitedHealth and broader concerns about corporate medical care. ... I know this piece is a long ride to the larger point but buckle up and pretend you’re reading a few book chapters instead of a newspaper column, because all of the context matters, and interconnects. ... 

California to redirect more than $7B in healthcare funding Becker's Hospital CFO Report; by Mackenzie Bean; 5/13/24 California is seeking to divert more than $7 billion in funding from the healthcare sector to address a major funding deficit, according to a revised budget proposal released May 10. Gov. Gavin Newsom has proposed reallocating $6.7 billion from Medi-Cal provider rate increases planned for Jan. 1, 2025, to balance the state budget. This funding was generated by the managed care organization tax created last year. ... The proposed budget would also cut funding for healthcare workforce initiatives by $854.6 million through 2028. Funding for public health and various behavioral health programs would also be reduced. 

“Mental wellbeing is as important as physical wellbeing – both are interconnected” Marie Curie Hospice; by Anne Finucane, Marie Curie Senior Research Fellow, and David Gillanders, Senior Lecturer, Clinical Psychology, The University of Edinburgh, United Kingdom; 5/13/24 At least one in every four people living with a terminal diagnosis will experience depression, anxiety, adjustment disorder or low mood. Many more will experience distress because of deteriorating health and related uncertainty. Feelings of hopelessness, discouragement and even a desire for hastened death can occur. People have reported that psychological support helps them develop better coping strategies, helps them be more open to their situation and improves communication with their families and those involved in their care.Editor's Note: Executive leaders, what value do you give to your interdisciplinary team members and their contributions to patients' mental/emotional care? What advocacy, support and recognition do you have for your social workers, chaplains, counselors? What mental wellbeing measures do your employees experiences throughout your organization--and more directly--from your leadership with them? Perhaps it's time to "take the pulse" of your culture's mental wellbeing.

Nurse practitioners improve skilled nursing's dementia care outcomes, but regulatory barriers remain: studyMcKnights Long-Term Care News; by Josh Henreckson; 5/13/24[Nurse pracitioners'] NPs’ involvement can significantly improve end-of-life care outcomes for residents with Alzheimer’s disease and related dementias (ADRD), according to the results of a new study in JAMA Health Forum. ... Those benefits, however, were shrunk by state regulations on the scope of care NPs are allowed to provide. ...  Elizabeth White, PhD, assistant professor of health services, policy and practice at Brown University [describes,] “For example, when a state restricts NPs from signing Do Not Resuscitate orders, that can serve as a barrier to advance care planning and could contribute to unnecessary hospitalizations at the end of life.” Editor's Note: We posted this JAMA Health Forum article on : Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia. 

CMS extends Medicaid waivers to 2025 Becker's Payer Issues; by Rylee Wilson; 5/13/24 CMS will extend flexibilities designed to help states keep more eligible individuals enrolled in Medicaid through June 2025. The waivers, previously set to expire at the end of 2024, will be extended for six more months, Daniel Tsai, deputy CMS administrator and director of the Center for Medicaid and CHIP services, wrote in a May 9 memo to states. Nearly all states were expected to complete the unwinding process by June 2024, Mr. Tsai wrote, but because several states took extension waivers from CMS, several states will continue renewals past June. 

6 ways to cut EHR burdens for physicians AMA - American Medical Association; by Sara Berg, MS; 5/7/24 When Jane F. Fogg, MD, MPH, first became a doctor, patient charts were on paper. She looked forward to the rise of the EHR, believing electronic charting could help modernize the care she provided while also empowering herself and her patients. Funny how things turn out. “EHRs are a source of burnout—we have lots and lots of great evidence that has helped us understand the low usability and the high work burden that it adds to physicians,” Dr. Fogg, senior physician adviser at the AMA. ... Here are just a few ways that health systems and organizations can improve EHR workflows to reduce physician burden.

Beyond medicine: 'Being Mortal' challenges healthcare's approach to death and dying SwiftTelecast; by Shawn Butlere; 5/11/24 This video from the “Frontline” series, titled “Being Mortal,” follows Dr. Atul Gawande as he explores the complex relationships between doctors, patients, and end-of-life decisions. Based on his best-selling book “Being Mortal,” Gawande discusses how medical training often falls short in preparing doctors for the realities of death and dying. The documentary highlights personal stories, including Gawande’s own experiences with his father’s illness and death, to illustrate the challenges in balancing hope with realistic outcomes and the importance of quality life in the face of terminal illness. 

A Philadelphia pharmacy’s closure after 26 years highlights the industry’s growing challenges Times Daily; by Lizzy McClellan Ravitch, The Philadelphia Inquirerer; 5/11/24Last Monday, Friendly Pharmacy filled 318 prescriptions. For about 100 of them, insurance companies paid the pharmacy less than $3. In 22 instances that day, the reimbursement was less than the cost of the medication. ... [Managing pharmacist Brad] Tabaac plans to close his doors on May 31 after 26 years in business. ... Independent pharmacies like Friendly, as well as some chains, have been pinched by pricing and fees set by pharmacy benefit managers — the companies that handle prescription drug plans for health insurance. The three biggest pharmacy benefit managers are CVS Health, Optum Rx and Express Scripts. They control nearly 90% of the market, according to the National Community Pharmacists Association (NCPA), and some of their parent companies also own pharmacies.

Design and death: palliative care needs more creativity AAP - Australian Associated Press; by Cassandra Morgan; 5/10/24 At the Caritas Christi palliative care unit, "homeliness" is sprawling crayon lines and scribbled messages of "get well soon", drawn by children in its arts room. It's the sense of quiet, the soft carpet underfoot, and the ability for patients to simply open a window, or walk outside their rooms and touch a tree or feel the soil. Architectural expert Rebecca McLaughlan says homeliness is more about what a space allows people to do than how it looks. ... "In subtle ways, these facilities do affect the quality of time and the quantity of time that people spend with their loved ones." ... The researcher is among experts advocating for greater design innovation in the palliative care sector - a concept often dismissed as incongruous with the reality of evolving health and safety regulations.

Two documentaries could bring attention, not all of it wantedMcKnights Senior Living - Editors' Columns; by Lois A. Bowers; 5/13/24 The past couple of weeks have brought news of two upcoming documentaries that promise to shine a spotlight on senior living, warts and all. One, “Caregiving,” will focus on professional and family caregivers “as the United States’ long-term care system threatens to tip into crisis,” according to public media station WETA. The two-hour film will debut on PBS in spring 2025. No doubt the project will draw attention because one of the executive producers is Bradley Cooper, who was a caregiver to his late father when he had lung cancer. "That was a wake-up call for me, ..." he said ... Another project premieres sooner — [today 5/14], in fact — on Paramount+. Whereas “Caregiving” includes someone famous, “Pillowcase Murders” centers on someone infamous, at least to the readers of McKnight’s Senior Living. The three-part docuseries is about the actions of convicted killer Billy Chemirmir, who was sentenced for two murders and suspected in the deaths of more than two dozen older adults in Texas, most of whom were women residents of senior living communities.