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EPtalk by Dr. Jayne 2/18/21

February 18, 2021 Dr. Jayne 6 Comments

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I had a moment of excitement in my pre-HIMSS planning when a friend clued me in to reasonable rates at The Palazzo. I’m happy to be rebooked somewhere that is attached to the meeting facility so I don’t have to melt in the August heat on the way to the show. The HIMSS room reservation system shows that the resort fees are optional this year,  which is great for those of us who never get to experience the “resort” component since we’re frantically trying to see everything possible then write it up before collapsing every night. I also had a thrill when I came across this ad featuring a vintage booth babe. I’m a sucker for opera length gloves and a dramatic up-do, so it certainly got my attention.

People always ask what kinds of things I’m interested in looking at when I attend HIMSS. Smart glasses are back on my radar. It’s been years since Google Glass came and went, but I’ve seen two articles in the past week that featured some variation on smart glasses. Specific use cases include helping a remote clinician better visualize a patient during a telehealth consultation or using the glasses to deliver diagnostic information from AI-powered clinical support systems.

One of the articles noted the potential for patient-side wearables to capture clinical information for later review by the care team. There’s always a lot of talk about wearables, but I haven’t seen a tremendous body of evidence that they can significantly drive clinical outcomes. We’ll have to see what companies bring to the table come August.

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The American Medical Informatics Association issues a call for proposals for the AMIA 2021 Annual Symposium, to be held October 30-November 3 in San Diego. A quick scan of the website showed they are currently planning for a live event “with a limited component of live streaming.” It goes on to note that the AMIA board will make a decision in June if this needs to change. For those interested in presenting, submissions are due March 10.

Although I read a number of journals regularly, I enjoy JAMIA because of its focus on informatics issues. One recent submission looks at gender representation in US biomedical informatics leadership and recognition within the biomedical informatics community. The authors assessed data on AMIA members, academic program directors, clinical informatics fellowships, AMIA leaders, and AMIA awardees. Not surprisingly, men were more often in leadership positions, including 75% of academic informatics programs, 83% of clinical informatics fellowships, and 57% of AMIA leadership roles. Men also received 64% of awards.

I’ve worked with a number of informatics organizations and have seen significant differences in how they approach the creation of a diverse workforce. While some hope it will happen by chance, others work quite intentionally to provide opportunities for groups that are traditionally underrepresented in technical fields. I recently met with a group of women informatics leaders and learned about their strategies for recruiting diverse teams. We certainly can benefit from broader perspectives.I look forward to seeing what those numbers look like in five or 10 years.

JAMIA publishes a study that examines the impact of after-work EHR use and clerical work on burnout among clinical faculty. Specifically, they looked at faculty across Mount Sinai Health System, with 43% of eligible faculty members participating. They concluded that spending more than 90 minutes on EHR work outside the workday and performing more than one hour of clerical work per day are associated with burnout. The findings were independent of demographic characteristics and clinical work hours.

I’ve spent a good chunk of my career trying to help organizations improve their workflows and am always gratified to see an organization that cares about how technology is impacting workers. Unfortunately, many groups don’t see this as a priority or are happy to watch their clinicians absorb increasing amounts of non-clinical work.

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Challenges with personal protective equipment are once again in the news, as healthcare organizations have been saddled with millions of counterfeit N95 respirators. Impacted organizations include Cleveland Clinic, the Washington State Hospital Association, Jersey Shore University Medical Center, and Hennepin County Medical Center in Minneapolis.

I was discussing this article on a local physician forum and ended up talking with a local academic faculty member who couldn’t believe that community hospitals and private organizations are still struggling to provide adequate PPE. My clinical employer provides a limited number of N95 respirators to our team and makes their use inconvenient by only stocking them at a single location, requiring people to travel on their days off to pick up a new supply and to rotate that supply over an extended number of days. Some of us are providing our own respirators to avoid reuse, but the counterfeit issue is still a concern. Co-workers who don’t go through the steps are still being diagnosed with COVID-19 despite vaccination.

I have friends who are nurses at community hospitals that sometimes receive N95s only once a week since they’re not on dedicated COVID units. Others have to beg supervisors to replace their PPE when straps break, or they become wet from wear. It’s a tragedy that we are still dealing with this a year into the pandemic. I can’t help but think that if the Centers for Disease Control made N95s mandatory for patient care encounters that we would stop seeing healthcare workers being infected. Employers would be forced to raise their game and to support those employees who want the highest level of protection. But as long as they say that surgical masks are an OK alternative, we’ll continue to see cases.

Fortunately, I have enough masks to make it through the end of my current clinical situation, since I’ve officially tendered my resignation. The fact that I made the right choice was confirmed a few days later when the organization announced some fundamental changes that will significantly alter how the business operates. It will be interesting to see how many people jump ship. I was asked not to reveal my resignation to staff until a couple of weeks before I actually leave, so for all I know, there could be others in the same position. It should make for an interesting couple of months. In the mean time, I’m looking forward to having a break from work-related COVID while I figure out my next move.

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The Washington Post reports that Europe’s oldest person, a 117-year-old French nun, has survived COVID-19. Lucile Randon, who took the name of Sister Andre in 1944, was diagnosed on January 16. She was born on February 11, 1904, which means she also lived through the 1918 pandemic. Her birthday celebration was slated to include foie gras, capon with mushrooms, and red wine. Best wishes to Sister Andre for an uneventful 2021.

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Reader Comments

  • PM Consultant: Insightful piece Dr. Jayne. I read this WaPo piece as well. I took my company to 100% remote 7 years ago. We are loca...
  • IANAL: I don’t claim any special insight but it does feel like there is a lot of combined insurer-health tech-healthcare prov...
  • Smartfood99: Zoom meetings have their place but I'm pretty confident over time people and organizations are going to almost completel...
  • Mr. HIStalk: Thanks. Maybe I should research which of the startup-type insurers are touting their technology along with (or instead o...
  • IANAL: I think traditional healthcare not paying attention to the insurance health tech industry is a bit short sighted. Those ...

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