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EPtalk by Dr. Jayne 2/2/23

February 2, 2023 Dr. Jayne 3 Comments

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I don’t change the clock on my laptop when I travel because it’s just easier for me to continue to operate in my home time zone. I also display multiple time zones on my Outlook calendar even when I’m at home, so it’s not difficult for me to sort out the local time from my usual time.

In the past, I have found the Microsoft Viva employee engagement platform to be mildly annoying, but last week it decided to tell me to stop burning the midnight oil based on what it thought was late night laptop usage. For those of you who haven’t experienced Viva, it also tells you things you already knew, like how busy your calendar is and that there isn’t any time between meetings for you to get work done.

According to the website, Microsoft charges extra for these insights. I wonder how many employees actually think they are beneficial. Employers should take note of these add-ons and make sure they are providing benefit. I know a lot of employees that would rather receive a Starbucks gift card every couple of months for the same price as “engagement” communications that make us feel busier than we already feel.

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I have always found public health informatics to be fascinating, but I haven’t had the opportunity work in the field beyond the population health management that is done by CMIOs. I was excited to see this write-up about reorganization at the Centers for Disease Control and Prevention (CDC). Director Rochelle Walensky, MD, MPH has announced the creation of new offices, including an Office of Health Equity and an Office of Public Health Data, Surveillance, and Technology. The latter will be charged with creating the infrastructure needed to solve the mess of federal, state, and local public health data management.

Walensky stated that the 75-year-old organization “did not reliably meet expectations” during the COVID pandemic, necessitating the reorganization. Those of us that worked the front lines at the beginning of the pandemic still feel acutely the fear and disillusionment we felt when the CDC told us we could wear bandanas as masks if our employers couldn’t provide appropriate personal protective equipment. Many providers have lost faith in the CDC and it will take years for it to attempt to recover to the chaos and confusion of the pandemic and the role the agency played in all of it.

Organizations are having to get creative to deal with ongoing nursing shortages, and I was interested to see that Trinity Health will be piloting the use of virtual nurses to care for hospitalized patients. The creation of the virtual roles provides an opportunity for nurses to continue practicing when they are unable or unwilling to continue in demanding bedside care roles. The so-called Virtual Connected Care Program was piloted at Trinity Health Oakland Hospital in Pontiac, MI during January 2022, with an update in June 2022.

Trinity is creating nursing teams with three nurses: one direct care nurse, one virtual nurse, and one licensed practical nurse. Virtual nurses will be used to make sure patients and families understand the daily care plan and manage patient concerns that might otherwise be reported through a call light or call bell system. Virtual nurses may also provide discharge teaching and help coordinate care with other professionals.

Speaking of virtual care, the Centers for Medicare & Medicaid Services (CMS) plans to add a telehealth indicator to clinician profile pages on its Medicare Care Compare and Provider Data Catalog sites. The Telehealth Indicator is designed to help patients and their caregivers identify providers who deliver telehealth services, as indicated by a low-key graphic near the physician’s name in their listing. The indicator will appear for clinicians billing telehealth visits using Point of Service codes 02 and 10 or using modifier -95 on claims. They intend to use a six-month lookback period and refresh the indicator bi-monthly, along with other provider director information. The code will appear only on individual clinician profile pages, not pages for groups.

This announcement comes at the same time as one about a new federal telehealth program designed to treat COVID-19 patients at home. The new Home Test to Treat program from the National Institutes of Health will allow patients in select communities to receive home rapid test kits, telehealth consultations, and antiviral treatments, all from the comfort of their homes. The program will launch in Berks County, PA, which has up to 8,000 eligible residents. Telehealth services will be provided by EMed and UMass Chan Medical School will work with the provider organization to analyze data to determine what kind of impact the program has on patient outcomes.

I’ve been party to several discussions around the virtual water cooler about hospitals and healthcare delivery organizations contacting patients to recruit them to the donor ranks of associated healthcare foundations and endowments. In some reports, physicians have even been asked to approach patients while they are still hospitalized, laying the groundwork for future donations. I haven’t run across this personally (although I did care for a number of patients in my hospital’s VIP wing during medical school) until I started getting solicited after a series of visits at the local academic medical center. The messaging isn’t even remotely subtle. It makes clear suggestions that patients can “express their gratitude” and “inspire a healthier future” by making donations in the name of care team members who participated in their treatments.

The most recent mailing provided tips on how to solicit donations through an obituary, along with instructions for employer matching and estate planning. These were part of an ultra-glossy magazine that I’m sure wasn’t cheap to produce or distribute.

As a physician, I don’t like the idea of someone trying to coerce my patients into making donations in my honor, and I definitely dislike the concept of approaching people when they are vulnerable. Not to mention that these mailings might be arriving at homes where recent treatments weren’t successful, and I’m sure not all family members would appreciate such a delivery. The hospital in question is sitting on billions of dollars that could certainly be released to the community more generously than is currently happening, so they won’t be getting any of my donation dollars right now.

What do you think of hospitals and health systems soliciting patients and families for donations? Leave a comment or email me.

Email Dr. Jayne.



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Currently there are "3 comments" on this Article:

  1. The ongoing prevalance of “Grateful Patients” programs twists my head around.
    One one hand, it is wrought with ethical concerns (like you mention), opportunities for perverse incentives (such as at Jefferson: https://www.inquirer.com/health/thomas-jefferson-university-grateful-patient-fundraising-bonuses-doctors-20210219.html), and uncomfortable pressure put on clinicians.
    On the other hand, there is some evidence that an opportunity to express gratitude, even in the cases where the treatment was not successful, can improve well-being of patients, or patient families. (Collins, et al., 2018 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211779/)

    Personally, it’s too slimy for me and I find the focus on it to be misguided.

  2. Good description of the problems with Microsoft Viva. I usually just say it’s not helpful, obnoxious, and angering. Your description is more helpful.

  3. Mass General is doing patient based fund raising. And it’s been years since we used their system. It never made it past the recycling bin in the garage. No thanks.







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