Literature Review

The moral compass of medicine: Exploring ethical dilemmas Medscape, by Lambeth Hochwald; 4/23/24 While the ethical conflicts discussed in medical school once focused primarily on patient privacy, end-of-life issues, and conflicts of interest with pharmaceutical companies, today, the list of ethical dilemmas facing physicians has risen to include everything from gender care and vaccine issues to weight loss drug access and abortion regulations in some states. ... So, what happens when a physician’s expertise clashes with local, state, or national politics?

End-of-life care facility for people experiencing homelessness opens on Monona Drive [Wisconsin] Isthmus, Madison, WI, by Linda Falkenstein; 4/23/24It started as an idea from palliative care physician Dr. Ann Catlett. Catlett had experienced having to discharge terminally ill patients who had no housing onto the streets. And she had seen a model home where patients without a home could live out their days in peace, receive hospice services and other daily palliative care. ... Thus was born Solace Friends, a Madison-area nonprofit with the goal of opening a care facility for people with terminal illnesses who are unhoused or experiencing housing insecurity. ... The opening of the adult family home was celebrated Tuesday with a press conference and tour of the facility.

Operator hopes to expand residents’ digital literacy with unique tech concierge program McKnights Senior Living, by John O'Connor; 4/22/24Beginning in June, residents in some BHI Senior Living communities will be able to take advantage of a unique tech concierge program. For residents, the new service will feature on-demand tech support, alongside virtual assistance, in-home appointments and a curriculum of tailored enrichment classes and training sessions. For the operator, the program will deliver immediate tech support while also gathering and analyzing data that can be used to inform future technology investments and strategic moves.Editor's Note: How might you adapt this creative service for the persons you serve? What differences might it make in patient care? In hospice caregiver/family satisfaction? What tech support do you have for your staff, especially when they are making home or other in-the-field visits? Relating this to today's articles on the importance of "trust" and "nurses' negativity about AI," do your innovative technologies improve or impede the patient/family's needs and experiences with you?

[Maine] Attention Section 43 Hospice Services Providers: Electronic Visit Verification (EVV) implementation delayed until further noticeState of Maine Department of Health and Human Services; 4/22/24 As of March 15, 2023, MaineCare temporarily excluded hospice services from EVV requirements as a delayed enforcement of our approved State Plan requirements. On December 1, 2023, we announced our plan to implement EVV requirements for hospice services starting July 1, 2024. following enactment of P.L. 2023, ch. 576 (LD 2055), An Act to Prohibit the Department of Health and Human Services from Implementing Electronic Visit Verification for Hospice Providers Within the MaineCare Program Unless Mandated by the Federal Government, the Department is delaying the implementation of EVV requirements for hospice services until further notice.

AI-generated draft replies integrated into health records and physicians’ electronic communication JAMA Network; by Ming Tai-Seale, PhD, MPH; Sally L. Baxter, MD, MSc; Florin Vaida, PhD; et al; 4/15/24Objective: To investigate the association between GenAI-drafted replies for patient messages and physician time spent on answering messages and the length of replies.Conclusions and Relevance: In this QI study, GenAI-drafted replies were associated with significantly increased read time, no change in reply time, significantly increased reply length, and some perceived benefits. 

Increasing Hospice CAHPS scores through enhanced caregiver training Hospice News, by Jim Parker; 4/19/24 Improving education and training for family caregivers may give hospices’ quality scores a boost. Maryland-based Hospice of the Chesapeake has introduced a standardized caregiver training program designed to enhance the work they had previously done in this area. After a review of scientific literature, it became clear that nationally, caregiver training was spotty, and this affected families’ perceptions of the care their loved one received, Monica Ferebee, clinical manager of hospice at Hospice of the Chesapeake ... More than 70% of hospice patients are primarily cared for by untrained family caregivers with no medical background, Ferebee found. She led Chesapeake’s change project to address these concerns, and thereby improve performance on Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. 

Remote access technologies expose home care firms to cybersecurity vulnerabilities, experts sayMcKnights Home Care, by Adam Healy; 4/18/24 Some of the most commonly used technologies in home care are also among the easiest for criminals to exploit. ... Remote access systems include any technology that allows users to connect to and access a computer, server or network remotely. Within home care, this could be tools such as remote patient monitoring devices, secure messaging apps, telehealth platforms, cloud-based applications or systems that allow users to remotely access patient data, according to the Department of Health and Human Services. And while these technologies bring efficiency, they can also expose providers and their patients to risk.

Healthcare still underprepared for scope of cyber threats, says Kroll reportHealthcare IT News, by Andrea Fox; 4/17/24Healthcare is the industry that's most likely to self-assess as having "very mature security," according to a new cyber readiness report from Kroll. But it's also one of the most-breached sectors – topping the list in 2022 and coming in second this past year. That discrepancy can be traced to many factors – not least the fact that healthcare organizations have long been among the top targets of cybercriminals and bad actors.

Help Serenity Hospice workers win their unionSEIU503; 4/18/24Workers at Serenity Hospice have been organizing for pay equity, adequate raises, affordable health care, regular hours, PTO, and the ability to manage trauma and compassion fatigue. The workers unanimously decided to form a union, and asked management to voluntarily recognize them. Serenity’s parent company (Addus Healthcare) already has SEIU-represented employees at its home health agency in Eugene. Instead, Addus hired one of the most expensive union-busing law firms in the country, and has been paying them hundreds of dollars per hour to spread anti-union propaganda. Workers are sticking together and staying strong, and plan to vote YES in their union election next week. Editor's Note: Hospice & Palliative Care Today's posting of this article denotes neither support nor opposition to this action. Rather, we are reporting it for hospice and palliative care leadership awareness. Unions and strikes among healthcare professionals--for these same cited reasons--continue to be a growing trend, nationwide.

Summaries: FFY 2025 Hospice, Inpatient Rehabilitation Facility, Skilled-Nursing Facility Medicare Payment Rules California Hospital Association, 4/17/24 What’s happening: Summaries of the hospice wage index, inpatient rehabilitation facility (IRF) prospective payment system (PPS), and skilled-nursing facility (SNF) PPS proposed rules are now available.What else to know: Comments on the proposed rules are due by May 28. The members-only summaries, from Health Policy Alternatives, Inc., describe proposals for the post-acute care Medicare prospective payment systems for federal fiscal year 2025: 

'Speak Up & Speak Out,' LeadingAge members head to the Hill on Lobby Day 2024 HomeCare; 4/18/24 Senator Mike Braun (R-IN) joined Katie Smith Sloan, president and CEO of LeadingAge, and hundreds of the association’s nonprofit and mission-driven members for the kick-off of annual Lobby Day activities. More than 225 LeadingAge members, who serve older adults and families nationwide in a range of care settings and community types, ... headed to Capitol Hill on Wednesday, April 17 ...  [Leading Age members] visited their elected officials in the House and Senate to discuss critical aging services issues to ensure older adults and families can access the care and services they need to age with dignity, including [but not limited to]: 

CT Hospice says it can’t provide home care under bill to protect healthcare workersCT News Junkie, by John Ferraro; 4/16/24Connecticut Hospice has warned lawmakers it will be unable to care for gravely ill patients in their homes under a proposed law aimed at protecting home healthcare workers. At issue is Senate Bill 1, which would require organizations that care for people in their homes to conduct background checks on the clients and anyone in the location where care is being given. ... Barbara Pearce, the chief executive officer of Connecticut Hospice, urged lawmakers to remove Connecticut Hospice from entities that would be required to conduct those background checks, noting that the organization which provides end-of-life care is typically called into homes when a patient has days left to live. “Our national hospice organization could find no similar bill in any other state,” Pearce wrote in testimony to the Public Health Committee. “This bill is too broad, too unclear as to requirements, not guaranteed to achieve its aims, duplicative of other procedures required in hospice care, and contradictory to certain regulations of Medicare.” ...Editor's Note: See the previous article in our newsletter today, After death of nurses, CT lawmakers look for solutions: 'We just cannot ignore that risk'.

NHPCO's CaringInfo program launches new consumer blog, insights NHPCO Press Release; 4/15/24 CaringInfo, a program of the National Hospice and Palliative Care Organization (NHPCO), has launched a new consumer blog, Insights, offering timely and practical content on serious-illness care and services from a variety of perspectives in both English and Spanish. ... CaringInfo also offers more information about advance directives and free advance directives and instructions for all 50 states plus Puerto Rico and Washington DC in both English and Spanish, downloadable as PDF files.