Gun violence in America is a national emergency

Gun violence in America is a national emergency

As medical providers, we are gravely concerned about the impact gun violence has on our patients. Physicians are the last line of defense, witnessing gun violence in its numerous forms, including suicides, mass shootings, intimate partner violence, and accidental deaths. Almost as appalling as the recent tragedies in El Paso and Dayton, Ohio, is Texas lawmakers’ lack of leadership during the recent legislative session to address the critical factors contributing to gun violence. Instead, Gov. Greg Abbott signed ten bills heralded by the NRA as liberalizing access to guns in our communities and places of worship.

Every hour, four Americans die a firearm-related death, according to data from the Centers for Disease Control. Federal law requires background checks for firearms purchased through retailer sellers. However, millions of guns are sold or transferred annually through private dealers, online sales, or at gun shows without background checks. It is nonsensical for us to allow those with violent histories to purchase powerful weapons. We need background checks for all gun sales and, according to a Quinnipiac University Poll, 97 percent of gun owners agree.

Often times, shooters provide warning signs that they are considering harming themselves or others. This is when extreme risk protection orders, or red flag laws, can be very effective. They allow loved ones and law enforcement officers to ask a court to temporarily suspend a person’s access to guns when there are clear signs that the individual poses a threat to self or others. Research on suicides by scholars at Duke University shows that a red flag law in Connecticut saved one life for every 11 orders that were issued. Seventeen states have similar laws.

Finally, we need to harness the power of research to better understand the root causes of gun violence and to develop robust solutions that ensure safety and responsible gun ownership. Recently, the U.S. House allocated $50 million for gun violence prevention research, the first funding in 20 years. It’s time for the Senate to approve this provision during a special session this month.

Critics of these three legislative policies will argue that they violate the Second Amendment and will have limited benefit in reducing the incidence of gun violence.

However, no one policy can be the perfect solution to gun violence. Each of these policies helps safeguard our most sacred fundamental rights: life, liberty, and the pursuit of happiness. They have broad public support and collectively can protect the lives of our fellow Americans.

Hussain Lalani is an internal medicine resident. Justin Lowenthal is a board member, Doctors for America. This article originally appeared in the Dallas Morning News.

Source: Gun violence in America is a national emergency

Is chatbot-led communication sufficient for healthcare?

Is chatbot-led communication sufficient for healthcare?

Photo: anyaberkut, Getty Images

It’s easy to get caught up in all the excitement when new communication technology innovations in healthcare are revealed. We optimistically envision a better healthcare future and buy into the promises of a particular new entrant. But as an industry, we need to do a better job of remembering where we are today, the true purpose of communication technology innovation in our space and ultimately move the hype away from the technology itself and toward how it will enhance human-to-human relationships.

Let’s take Alexa’s move into healthcare as an example. The growth of Alexa’s capabilities to include the healthcare industry is positive. However, it just feels like so many people are letting their imaginations run wild and dreaming that care via Alexa will be simple and complete, as if all you have to do is ask Alexa one question and boom, you’ll get all the answers you need and get healthier immediately. Alexa is still just one, maturing mode of communication. The healthcare industry has some of the lowest Net Promoter Scores due to its complexity, lack of trust and poor end-to-end user experience. Is Alexa, a virtual assistant, really going to give consumers the trust and empathy they need to change the way they behave with their care teams and make smarter decisions about their health?

In my experience working outside of healthcare, in fintech and entertainment, I believe chatbot-led communication can be sufficient when human interactions are meant to be transactional. Healthcare is arguably the most difficult maze to navigate on a good day. When a person is under duress, such as experiencing flu-like symptoms that are worsening, trying to coordinate hip replacement surgery, or preparing to have their first child, a bot simply cannot be the first and primary interaction a person has throughout their care journey. Unlike other industries, where artificial intelligence has successfully replaced many human interactions, healthcare must remain human first, technology second. Chatbots can assist care teams, but they cannot replace them.

If implemented into healthcare properly, chat and bots have tremendous potential. After all, 5 billion people use chat to communicate on a daily active basis, according to a worldwide chat usage study by Statistic Brain. More than 40 percent of consumers prefer live chat support more than any other channels, according to a study by Kayako. Text-based conversations enable endless opportunities to improve operational efficiency and ensure clinical quality. So, what does this look like? Chat (as well as video and voice interactions) must mirror how people use communication tools with family and friends in their daily interactions. They should improve communication, collaboration, teamwork and information sharing to ultimately enhance the way people engage with their healthcare.

The key to a truly effective and efficient care journey is having human-to-human interaction at the core and then add whatever technology is necessary. For example, if a patient prefers chat as a communication method, then use it to instantly connect them to their human care team.

We’ve passed the tipping point with Alexa. She is going to further infuse into our healthcare world, which again is great. But when the next wave of Alexa headlines come…let’s all just remember that human interactions are still the real key to getting the care you need.

Source: Is chatbot-led communication sufficient for healthcare?

Flexible Transistors for Body-Worn and Implantable Medical Devices

Flexible Transistors for Body-Worn and Implantable Medical Devices

Recently, engineers in a variety of institutions have been making great progress in the field of flexible electronics. A variety of devices have been made, including completely flexible body-worn sensors. While a great deal of the components have indeed been created to be flexible, integrated circuits and the transistors that they’re made of have had to remain rigid.

Now, researchers at Tufts University have developed completely flexible transistors from linen thread. This will allow for completely flexible devices made of thread that can be integrated into clothing, worn directly on the skin, or even used in electronic medical implants, including ones that can attach to a beating heart.

Large numbers of the thread-based transistors (TBTs) can be made into logic circuits and integrated circuits that can perform common electronic functions. Pre-existing flexible sensors can be used alongside flexible circuits to provide completely flexible solutions.

The Tufts team has already combined thread-based sodium and ammonium ion sensors with an integrated circuit, allowing them to measure these biomarkers using a completely flexible device.

The flexible transistors can be manufactured without requiring a clean room and using a relatively inexpensive process. “In laboratory experiments, we were able to show how our device could monitor changes in sodium and ammonium concentrations at multiple locations,” said Rachel Owyeung, a graduate student at Tufts University School of Engineering and first author of the study. “Theoretically, we could scale up the integrated circuit we made from the TBTs to attach a large array of sensors tracking many biomarkers, at many different locations using one device.”

Study in journal ACS Applied Materials and Interfaces: Highly Flexible Transistor Threads for All-Thread Based Integrated Circuits and Multiplexed Diagnostics

Flashbacks: Fully Flexible and Wireless Body Monitoring Sensors; Flexible Body Monitor Measures ECG, Breathing, Heart Rate Continuously for Weeks; Wireless, Flexible Body Sensors for Monitoring Premature Babies; Flexible LED Sensor Monitors Blood-Oxygenation Levels Through Skin; Highly Flexible and Adhesive Electronic Body Monitoring Patch

Via: Tufts

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Source: Flexible Transistors for Body-Worn and Implantable Medical Devices

When patient and surgeon meet in Cancun for surgery

When patient and surgeon meet in Cancun for surgery

Image credit:
Donna Ferguson awoke in the resort city of Cancun before sunrise on a sweltering Saturday in July.

She wasn’t headed to the beach. Instead, she walked down a short hallway from her Sheraton hotel and into Galenia Hospital.

A little later that morning, a surgeon, Dr. Thomas Parisi, who had flown in from Wisconsin the day before, stood by Ferguson’s hospital bed and used a black marker to note which knee needed repair. “I’m ready,” Ferguson, 56, told him just before being taken to the operating room for her total knee replacement. For this surgery, she would not only receive free care but would receive a check when she got home.

The hospital costs of the American medical system are so high that it made financial sense for both a highly trained orthopedist from Milwaukee and a patient from Mississippi to leave the country and meet at an upscale private Mexican hospital for the surgery.

Ferguson gets her health coverage through her husband’s employer, Ashley Furniture Industries. The cost to Ashley was less than half of what a knee replacement in the United States would have been. That’s why its employees and dependents who use this option have no out-of-pocket copayments or deductibles for the procedure; in fact, they receive a $5,000 payment from the company, and all their travel costs are covered.

Parisi, who spent less than 24 hours in Cancun, was paid $2,700, or three times what he would get from Medicare, the largest single payer of hospital costs in the United States. Private health plans and hospitals often negotiate payment schedules using the Medicare reimbursement rate as a floor.

Ferguson is one of hundreds of thousands of Americans who seek lower-cost care outside the United States each year, with many going to Caribbean and Central American countries. A key consideration for them is whether the facility offers quality care.

In a new twist on medical tourism, North American Specialty Hospital, known as NASH and based in Denver, has organized treatment for a couple of dozen American patients at Galenia Hospital since 2017.

Parisi, a graduate of the Mayo Clinic, is one of about 40 orthopedic surgeons in the United States who have signed up with NASH to travel to Cancun on their days off to treat American patients. NASH is betting that having an American surgeon will alleviate concerns some people have about going outside the country, and persuade self-insured American employers to offer this option to their workers to save money and still provide high-quality care.

NASH, a for-profit company that charges a fixed amount for each case, is paid by the employer or an intermediary that arranged the treatment.

“It was a big selling point, having an American doctor,” Ferguson said.

The American surgeons work closely with a Mexican counterpart and local nurses. NASH buys additional malpractice coverage for the American physicians, who could be sued in the United States by patients unhappy with their results.

“In the past, medical tourism has been mostly a blind leap to a country far away, to unknown hospitals and unknown doctors with unknown supplies, to a place without U.S. medical malpractice insurance,” said James Polsfut, the chief executive of NASH. “We are making the experience completely different and removing as much uncertainty as we can.”

Medical tourism has been around for decades but has become more common in the past 20 years as more countries and hospitals around the world market themselves to foreigners.

There are, of course, risks to going outside the country, including the headache of travel and the possibility that the standards of care may be lower than at home. If something goes wrong, patients will be far from family and friends who can help — and it might be more difficult to sue providers in other countries.

Chasing lower costs

The high prices charged at American hospitals make it relatively easy to offer surgical bargains in Mexico: In the United States, knee replacement surgery costs an average of about $30,000 — sometimes double or triple that — but at Galenia, it is only $12,000, said Dr. Gabriela Flores Teón, medical director of the facility.

The standard charge for a night in the hospital is $300 at Galenia, Flores said, compared with $2,000 on average at hospitals in the United States.

The other big savings is the cost of the medical device — made by a subsidiary of the New Jersey-based Johnson & Johnson — used in Ferguson’s knee replacement surgery. The very same implant she would have received at home costs $3,500 at Galenia, compared with nearly $8,000 in the United States, Flores said.

Galenia is accredited by the international affiliation of the Joint Commission, which sets hospital standards in the U.S. But to help doctors and patients feel comfortable with surgery here, NASH and Galenia worked to go beyond those standards.

That included adding an extra autoclave to sterilize instruments more quickly, using spacesuit-like gowns for doctors to reduce infection risk and having patients start physical therapy just hours after knee- or hip-replacement surgery.

I. Glenn Cohen, a law professor at Harvard and an expert on medical tourism, called the model used by NASH and a few other similar operations a “clever strategy” to attack some of the perceived risks about medical tourism.

“It doesn’t answer all concerns, but I will say it’s a big step forward,” he said. “It’s a very good marketing strategy.”

Still, he added, patients should be concerned with whether the hospital is equipped for all contingencies, the skills of other surgical team members and how their care is handed off when they return home.

Officials at Ashley Furniture, where Ferguson’s husband, Terry, is a longtime employee, said they had been impressed so far. The company offers the option of overseas surgery through NASH at no cost — and with an incentive.

“We’ve had an overwhelming positive reaction from employees who have gone,” said Marcus Gagnon, manager of global benefits and health at Ashley, a Wisconsin-based company with 17,000 employees. Ferguson was the company’s 10th insured person to go to Cancun.

Ashley also has sent about 140 employees or dependents for treatments at a hospital in Costa Rica, and together the foreign medical facilities have saved the firm $3.2 million in health costs since 2016, he said.

“Ever after the incentive payments and travel expenses, we still save about half the cost of paying for care in the United States,” Gagnon said. “It’s been a nice option — not a magic bullet — but a nice option.”

NASH’s strategy has its skeptics.

“Building a familiar culture in a foreign destination may be appealing to some American consumers, but I do not see it as a sustainable business,” said Irving Stackpole, a health consultant in Rhode Island. “It’s not unusual for people thinking about this to have doctors, family, and friends who will see this as a high-risk undertaking.”

Stackpole said only a limited number of Americans were willing — even with a financial incentive — to travel abroad because most perceive the care won’t be as good.

“You are nuts for doing this”

Ferguson’s knee started causing her trouble two years ago, and last fall a doctor recommended replacing it. She is on her feet most of the day assembling furniture toolkits at her job at American Furniture Manufacturing in Ecru, Miss. Terry Ferguson mentioned the Cancun option he had heard about at work. The couple pay $300 a month in premiums for family health coverage.

“I had a friend say, ‘You are nuts for doing this,’ but Dr. Parisi trained at Mayo, and you can’t do any better than that,” Ferguson said before the surgery. Also, having an American doctor meant that if something went wrong, she could file a malpractice suit in the United States, she added.

IndusHealth, Ashley’s medical travel plan administrator, arranged for her to get a physical exam, knee X-rays, and heart tests near her home to make sure she was a good candidate for surgery. It even had her see a dentist to make sure she didn’t have an infection that could complicate her recovery. Parisi reviewed some of those records before Ferguson headed to Cancun.

The company also coordinated her medical care and made travel arrangements, including obtaining passports, airline tickets, hotel, and meals for the couple.

In Mexico, the day before surgery, Ferguson had more X-rays and had her blood drawn. After lunch, the couple met with Noemi Osorio, a nurse, who reviewed Ferguson’s schedule and showed her the physical therapy facilities. Later, they met Parisi and the rest of the medical team.

“My job is pretty easy,” Parisi told her. “How you do over the next five or 10 years depends on how well you work with the physical therapy.”

The surgery began at 8:20 the next morning. Dr. Daniel Rios, an orthopedic surgeon who practices full time in Cancun, worked with Parisi. Rios, who had done a fellowship at Brigham and Women’s Hospital in Boston, checked on Ferguson for several days after the operation.

By 9:30 a.m., the operation was over, and at 11 a.m. she left the recovery area. Parisi checked on her there. “Everything went great,” he told her before heading to the airport for his 2:30 flight home.

Parisi said that the lack of English proficiency among some surgical staff members created “momentary delays” but that the bilingual surgical assistant helped.

A little more than three hours after the surgery, Ferguson was in her hospital room, and a physical therapist came and helped her out of bed. Using a walker, she gingerly took some steps to test out her new knee. By the next morning, she was on crutches walking the hallway and was discharged before noon. She stayed at her hotel ten additional days while having physical therapy twice a day at the hospital.

“It’s been a great experience,” she said two days after the surgery. “Even if I had to pay, I would come back here because it’s just a different level of care — they treat you like family.”

Phil Galewitz is a senior correspondent, Kaiser Health News.

Source: When patient and surgeon meet in Cancun for surgery

Healthcare Virtual Assistant Market to Reach $1.76B by 2025

Healthcare Virtual Assistant Market to Reach $1.76B by 2025

The global healthcare virtual assistant market is expected to grow at a CAGR of 24.7% from 2018 to reach $1.76 billion by 2025, according to market research published by Meticulous Research.

The emergence of Healthcare Virtual Assistant Market

Virtual assistants are AI and rule-based systems that interact with humans to perform various tasks. These assistants use cognitive technologies such as machine learning, natural language processing, and neural networks to enable interactive communications with the end-users. Virtual assistant technology in the healthcare industry can assist in transforming various health processes and improve healthcare delivery, worldwide. It helps in improving healthcare quality, patient care, and patient outcome at lower costs.

Key Market Drivers

Currently, there is an increasing demand for various types of virtual assistant solutions, globally, which is primarily attributed to the increasing focus on patient-centric care delivery, growing adoption of IoT, growing internet connectivity and smartphone devices, and increasing focus on patient engagement. In addition, the shortage of healthcare professionals, increasing burden of lifestyle diseases, and need of reducing healthcare costs are also expected to contribute to the growth of the healthcare virtual assistants market. However, lack of awareness among healthcare professionals, data privacy and security awareness may dampen the growth of this market during the forecast period of 2018 to 2025.

Benefits of Healthcare Virtual Assistants

Increasing need and demand of the healthcare professionals to spend more time with patients and better communication through incorporation of technological tools in healthcare practices are driving the focus on various patient engagement technologies. Virtual assistants can easily automate the task of patient engagement by automating patient interactions through the use of chatbots or smart speakers. The chatbots product segment is estimated to command the largest share of the overall healthcare chatbots market in 2019, mainly due to increasing advancements in natural language processing & machine learning models.

Healthcare Virtual Assistants Market by Product

The global healthcare virtual assistants’ market is primarily segmented by product

[if !supportLists]1. chatbots and smart speakers)

[if !supportLists]2. Technology (speech recognition)

[if !supportLists]3. Text-to-speech, and text based)

[if !supportLists]4. End user (providers, payers, and other end users)

Largest Market Share Segment: Speech Recognition-based Virtual Assistants

In the healthcare industry, speech recognition-based virtual assistants form one of the most promising technologies currently being explored by various technology providers for a variety of applications. Currently, applications of speech recognition-based virtual assistants for the healthcare industry is focused on aiding the administrative tasks for physicians by automating the operational processes, such as medical transcription, scheduling, chart search, and medical information search. This technology commanded the largest share of the overall healthcare virtual assistants market; however, error in the transcription, high cost, challenges of adoption among healthcare professionals, and variation in the quality and security issues are the major factors that may hamper the growth to a certain extent.

North America Dominates Healthcare Virtual Assistant Market

Geographically, North America has been at the forefront of the technological advancements in the healthcare industry and has evidenced a sequential change in adoption of various patient engagement technologies, including healthcare virtual assistants over the past few years. Majority of the growth in this market is driven by high technology adoption among healthcare providers in the region, high awareness among healthcare payers and providers for new technologies available in the market, increasing need to reduce healthcare cost and rising demand of the technologically advanced solutions to maximize efficiency of healthcare systems.

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Source: Healthcare Virtual Assistant Market to Reach $1.76B by 2025