EPtalk by Dr. Jayne 3/16/23

I’ve been carefully following the Silicon Valley Bank implosion, especially the stories about the electronic transactions that contributed to its death spiral. The most striking data point: customers were attempting to withdraw more than $42 billion within a 24-hour period, which works out to approximately $500,000 per second.

I admit that I’m one of those people who has grown used to being able to transfer money on a timeline of minutes to seconds, but the idea of that much money moving around is nearly unfathomable. The bank failure, along with concerns about other lenders, has led to the flow of more than $15 billion to Bank of America. Other large banks, such as Wells Fargo and Citigroup, have yet to comment on the amount of new money flowing in.

People frequently compare what we’re doing in healthcare IT to the digital revolutions that have occurred in other industries. I enjoyed this article about accounting firm PwC and its plans to use an AI chatbot to help its legal team boost efficiency. More than 4,000 workers will have access to an AI-enabled chatbot provided by Harvey with the expectations that it can assist with tasks such as due diligence and contract analysis. Harvey works with large language models in the legal space and uses OpenAI and ChatGPT technology.

Even though we’re several days past the Daylight Saving Time transition, several people I know are still struggling with sleep/wake cycles, especially where children and pets are involved. There’s plenty of push for making Daylight Saving Time permanent, but the medical establishment isn’t convinced. A recent article in JAMA notes that medical societies such as the American Academy of Sleep Medicine “overwhelmingly” support the continuation of Standard Time if we’re going to stop jumping back and forth. They note that during Daylight Saving Time, “the body’s internal circadian clock, which synchronizes to solar time, is out of step with the social clock, or local time.” This results in higher numbers of motor vehicle crashes, depression, and stroke, not only during the transition period, but throughout the summer. There’s not a ton of research on time changes, though, with the authors noting that only 159 articles have been published since 1962.

The reality is that there’s a finite amount of sunlight each day, and choosing one time paradigm over the other determines whether that extra light is in the morning to help us get going or whether it’s later in the day for after-work and after-school activities.

Interestingly, some of the most prominent research in the field stems from Russia, which instituted permanent Daylight Saving Time from 2011 to 2014 before moving to permanent standard time. In a retrospective study of adolescents and young adults, researchers found that ongoing Daylight Saving Time created a dissociation between social and biological clocks which “potentially exerts a negative influence on adolescents’ sleep habits, mood, and behavior.” People also forget that the US tried year-round DST in January of 1974, resulting in an extended period of dark mornings during the winter when children are headed to school. Standard time was restored by October of that year. There’s plenty of other great information in the article, so if you’re looking for a deep dive, I’d give it a read.

I was interested to learn about proposed legislation that would prevent companies from using health data for advertising and marketing purposes. US Senators Amy Klobuchar, Elizabeth Warren, and Mazie Hirono introduced the Upholding Protections for Health and Online Location Data (UPHOLD) Privacy Act, which would curtail the profits companies generate by using personally identifiable health data for advertising. Where HIPAA focuses on covered entities, this bill takes protections to the next level, allowing patients even more control over their health data when it resides with apps, tech companies, and other organizations. The bill would impact the numerous companies that harvest health information but aren’t regulated by HIPAA and would also ban the sale of location data.

From Igloo Fan: “Re: organ donation. Did you see this article about the donated liver that got stuck due to road closures for a marathon?” I hadn’t seen it, so I appreciate the share. Apparently the liver was stranded by the Philadelphia Half Marathon with 30,000 participants hitting the streets. Dr. Adam Bodzin ran into the field, traveling half a mile to where the van carrying the organ had reached a literal road block. Fortunately, police were able to transport him back to the hospital with his precious cargo. I had the privilege of working on my hospital’s transplant team during training and it was an unbelievable experience, if often surreal. Our team treated each organ procurement surgery with the reverence and awe it deserved and as a surgical subintern I was honored to be left behind to help return the donors to the best appearance possible for their families. Once those cases were complete, we caught up with the team performing the actual transplant procedures, and the sense of awe continued. There’s nothing like watching a donor organ start functioning. If you’re an organ donor, make sure your family knows your wishes. If you aren’t, please consider making it possible to give the gift of life should something unforeseen happen.

I love it when readers send me funny emails, even though I don’t always have time to reply to them. I’ve had some long-term back and forth correspondence with some readers to the point where I feel like I really know them. One of those readers and I have had an ongoing dialogue about virtual workplaces where you’re constantly expected to be on camera. It was the best laugh of the day when I opened a message to read this: “I’m on a Zoom and this woman is casually sipping a bottle of magnesium citrate.” I’m just hoping his co-worker was knowingly drinking a laxative and didn’t have it confused for some other beverage in the refrigerator. March is Colorectal Cancer Awareness Month, so perhaps she was getting ready for a recommended screening test.

What’s the wildest thing you’ve seen on a conference call? Leave a comment or email me.

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