MRCS Weekly Recap 4 (2.20.22-2.26.22)

1. COVID

A "heartbreaking" pandemic has left more than 5.2 million children orphans grieving the loss of parents or caregivers. Just 1 out of 1 million vaccinated adolescents have developed rare COVID syndromes. These eye-opening statistics show us why receiving the vaccine is as vital as ever. Our World in Data estimates that roughly 77% of the US population has received at least one dose, 65% are fully vaccinated, and 39% have received the booster shot. The trends show that these numbers are only going to increase. Moderna is betting on the increasing demand for booster shots and is advancing their new "bivalent" COVID-19 shot. This shot targets both the original strain and the omicron variant. They are starting with testing on individuals who have already received the booster shot. Moderna expects the sales of existing vaccines to rise in the coming months as COVID-19 becomes endemic. A CDC report shows that some people receiving the Pfizer or Moderna vaccines should wait up to 8 weeks between their first and second doses rather than the previously recommended 3-4 weeks. Meanwhile, a global trial in Australia, Indonesia, and Magnolia will test fractional dosing of vaccines to spread scarce supply in low-income countries. Reduced boosters could prolong protection for vaccinated people while easing the strain on supplies of first doses.

Several state legislators are mobilizing to roll back covid-19 public health measures. This includes changing target measures for vaccine and mask requirements. Florida Governor and Surgeon General Ron DeSantis and Joseph Ladapo updated the state's COVID-19 guidance by shortening isolation periods. This advises against masks in community settings and grants healthcare practitioners flexibility to treat patients with emerging and off-label drugs for the virus. While predicting the pandemic's next act is complex, several potential scenarios have emerged in recent months. Physicians, epidemiologists, and global health officials outlined four possible paths the pandemic could take in the future.

2. Practice Management

Paul Farmer, a co-founder of Partners in Health, championed the idea that "people from all backgrounds living in all regions of the world deserve high-quality health care." This brought the notion that we need to treat the systems (the ecosystem) and the person. A common trend in the health service industry is focusing on patient experience. RehabPulse is one of the companies making strides by focusing on the consumer. RehabPulse shortens the timeline to get patients at-home medical equipment through an online marketplace platform. The company handles patients' insurance reimbursement, so they don't have to. RehabPulse started with the idea to grant disabled patients access to equipment from the convenience of their homes. RehabPulse, like many other healthcare providers, is learning and adapting to the "patient empowerment" era.

Through evaluating patient research data, healthcare organizations can personalize their experiences to improve health care delivery and health equity.

I. Data- Activate your existing data and unlock hidden insights.

II. Interoperability- think of the patient experience holistically.

III. Collaboration- work to understand "the why behind the what" to focus time and resources. Providers need to communicate and stay agile with real-time data to evaluate changes.

The pandemic has been extremely tough to predict. There has not been a clear understanding of what will happen next, from the virus to immunity to human adaptation. The one thing we do know is that US hospitals are not ready for the post-pandemic world. With staffing shortages, lower morale, and less institutional memory, health care workers are "done" with having their sense of duty and commitment to patient care taken for granted. A pause on non-covid care at some hospitals may become the new regular, causing hospitals and health systems to specialize. About 35 percent of healthcare establishments increased wages and salaries, paid wage premiums, or provided bonuses because of the COVID-19 pandemic.

A trend to look for moving forward is remote work. If we learned anything through the pandemic, it is that people can and want to work from home. A fall 2020 survey showed that 69 percent of Gen Z wants to work remotely at least half the time. Many Gen Z members, born after 1997 and graduated college during the pandemic, seem to like working remotely.

3. Staffing Shortages

A recent McKinsey survey shows that around a third of registered nurses are considering leaving their current role, up 10% from this point last year. Insufficient staffing levels are the top reason nurses are leaving their jobs. The second reason is seeking higher pay elsewhere (ex, traveling nurses). USA Today and Ipsos Research reported that more than half of healthcare workers say they are being burned out, and over ¼ are considering quitting their jobs. 40% of healthcare workers believe that "the American healthcare system is on the verge of collapse."

Medical partner, AvaSure, is bringing 24-7 virtual monitoring solutions to hospital rooms across the country, improving current telehealth and clinical transformation strategies. Even before the pandemic, research suggested that the staffing crisis would only get worse. A study in the American Journal of Medical Quality predicts a shortage of over 510,000 nurses by 2030. The idea behind AvaSure is to "free nurses to practice at the top of their license, providing clinical care instead of constantly worrying about fall-risk patients or responding to routine patient requests."

4. IT Updates

Even with the digital transformation in healthcare and implementation of EHRs, providers are still writing down notes on paper, and some critical communication never happens between clinicians, resulting in medical errors. The Joint Commission claims that over 70% of medical errors occur due to communication failures. Another common trend in the past few years with health IT has been the threat of ransomware attacks. A joint security advisory has been issued by cybersecurity agencies in the United States, United Kingdom, and Australia, warning about the increased globalized threat of ransomware attacks and the elevated risk of targeted attacks on critical infrastructure entities.

A new study showed that black patients were more likely to be labeled "nonadherent" or "noncompliant." Other biased words such as "angry" or "agitated" often describe Black patients. Some patients' files list "exam inconsistent with patient-reported pain," while a white patient in the same experience might have a file that reads "patient struggles or battles with chronic pain." Even in today's digital world, racism is impacting medical health records.

5. Policy Updates

After receiving stakeholder feedback, CMS changed the Global and Professional Direct Contracting model to improve health equity. Lawmakers drafting the bill have split on whether they think the Biden administration interpreted the law correctly. Senate health committee Chair Patty Murray (D-Wash.) and House Energy & Commerce Chair Frank Pallone (D-N.J.) said they think the Biden administration's interpretation is correct. Still, Ways & Means Chair Richard Neal (D-Mass.), Rep. Kevin Brady (R-Texas), and a bipartisan group of 152 lawmakers who prefer the more doctor- and hospital-friendly approach argued that lawmakers intended for all factors to have the same weight. On a similar note, new bilateral legislation has been introduced to identify and close the current privacy gaps associated with emerging technologies to ensure health data is better protected, including data that HIPAA does not currently protect.

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