EPtalk by Dr. Jayne 8/5/21

A federal judge denies Elizabeth Holmes’ request to suppress patient complaints and Theranos testing results as evidence during her trial. Attorneys argued that the failure to preserve the laboratory information system database should allow the exclusion. Theranos is accused of decommissioning the database and giving investigators an invalid copy. Jury selection begins August 31 for what is sure to be an entertaining trial.

I see a lot of error messages, but this was one of my favorites. Not even a cookie, just a crumb.

The US Department of Health and Human Services announces the availability of $103 million in funding from the American Rescue Plan to reduce burnout and improve mental health among healthcare workers. The funding will be available over a three-year period and is targeted to consider the needs of rural and medically underserved communities. It plans to “help health care organizations establish a culture of wellness among the health and public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers.”

I take issue with the whole idea of needing to “build resilience” among healthcare workers. We are plenty resilient to begin with, but the systems that surround us have failed patients and have failed us. Telling us we need to be more resilient is not the answer – that’s a “blame the victim” strategy implying we’re somehow not “enough” for the situations we are in. Let’s fund efforts to reduce abuses in healthcare, improve caregiver-to-patient ratios, reduce or eliminate nonsense regulations and requirements that make it harder to do our jobs, and adequately fund public health and health literacy efforts in the US. Those types of transformation will really put a smile on our resilient little faces.

Feel-good story of the week: A WWII vet celebrates her 100th birthday with a helicopter tour around a ship named after her late husband. Ima Black was part of the Women Accepted for Volunteer Emergency Service (WAVES) program during World War II and for 50 years was married to Delbert D. Black, who after surviving Pearl Harbor went on to become the highest-ranking enlisted sailor in the Navy. The Navy named a destroyer after him and a Florida helicopter crew flew her not only around the ship, but showed her downtown Jacksonville to boot.

Less than feel-good story of the week: The Journal of the American Medical Association publishes an op ed piece regarding “The Increasing Role of Physician Practices as Bill Collectors: Destined for Failure.” Shifting of costs from insurance companies to “patient responsible” balances has led physicians to manage a growing share of the payment portfolio. Patients are responsible for deductibles, co-pays, and co-insurance, all of which can be confusing, not only from a healthcare literacy perspective, but from a financial literacy perspective as well. Physicians struggle with collecting these amounts due, which drives a spiral where they request higher reimbursements, which increases charges, and the cycle starts again.

I made the difficult decision this week to cancel my trip to HIMSS21. Clark County, NV is being hit hard, with 89% of ICU beds in use. Although I’m vaccinated and at low risk for complications of COVID, my analysis had the risks outweighing the benefits. I’ve been seeing a significant number of breakthrough COVID cases in fully vaccinated (and otherwise healthy) individuals, and it’s not clear whether it’s the remoteness of the vaccine versus the properties of the now-prevalent delta variant that is responsible. One of my favorite people was just diagnosed today and I hope he recovers quickly. It doesn’t seem prudent as a healthcare provider to potentially take myself offline for patient care by attending a large event regardless of the mitigation strategies. Not to mention that masking in airports and on planes is far less than universal.

The county’s hospitalization numbers mean that the Las Vegas area is not equipped to respond to any kind of mass casualty event like it has unfortunately seen in the past. I would be pretty angry if a convention rolled into my similarly sized metropolitan area right now regardless of the economic benefit. My own personal ROI was also a factor – my client meetings have been canceled and I suspect even those exhibitors that are still attending will send skeleton crews, so it wouldn’t be productive from a business standpoint. At this point I can reuse my airfare (thanks Southwest!) while attending digitally and am only out my first nights’ hotel charge. I guess I’m also out of pocket for the sassy shoes I purchased for the Mothers in Medicine Fund reception that was wisely canceled due to public health concerns. I’ll wear them around the house Tuesday night and think about the hard-working healthcare moms the Fund is trying to assist.

I went ahead and tried to queue up my HIMSS Digital account, which requires that you submit your name and email address to receive a validation code by text and email. I never got the text and the code in the email didn’t work, so I had to go through the process again. Second time was a charm, although I was annoyed by the process and moved on to other things. I’ll have to spend some quality time with the agenda tomorrow, deciding on my sessions and dropping the Patrick Dempsey keynote onto my schedule. It still won’t be the same as seeing everyone at HIMSS, so I’m looking forward to hopefully a more “normal” HIMSS22.

On the positive side, since I won’t be out of town, I will be here for our local school board meeting where I plan to go toe-to-toe with anti-vaccination and anti-masking advocates. Our hospital admissions rates look just like they did last October so I’m supportive of anything we can do to try to crush this surge. The hospital teams are completely burned out and there are no travel nurses or reinforcements on the horizon. It’s going to be a bumpy end to the summer, for sure.

For those of you attending HIMSS21 in person, I wish you a safe and uneventful conference. Hopefully everything will be low key and you’ll be able to accomplish what you set out to do by attending. Please feel free to keep us apprised of any cute shoes you see, wild booth promotions, or general HIMSS shenanigans. We’re counting on you!

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