Monday Roundup

David Ermer–COVID-19, Telehealth, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington DC,

  • The Department of Health and Human Services “announced two awards totaling $2 million under “the Leading Edge Acceleration Projects in Health Information Technology (LEAP in Health IT) funding opportunity. LEAP in Health IT awardees seek to create methods and tools to improve care delivery, advance research capabilities, and address emerging challenges related to interoperable health IT.”

From the public health front,

  • Medscape takes a look at the current state of Covid.
    • Cautious optimism and a call to remain vigilant seem like the consensus at the moment. While the numbers remain low so far, and the uptick in new cases and hospitalizations are relatively small compared to past scenarios, “It makes sense to boost our anti-Omicron antibody levels with immunizations before fall and winter,” Anne Liu, MD, an allergy, immunology, and infectious disease specialist at Stanford University, said.
    • “It’s just advisable for everyone — especially those who are at higher risk for hospitalization or death — to be aware,” Bernard Camins, MD, an infectious disease specialist at Mount Sinai Hospital in New York City, said, “so they can form their own decisions to participate in activities that may put them at risk for contracting COVID-19.”
  • MedPage Today says,
    • “Reassuringly, a history of oral contraceptive use had no deleterious effects on cardiovascular disease (CVD) and survival over long-term follow-up, a U.K. Biobank study showed. * * *
    • “These findings provide significant public health insights and may facilitate a shift in public perception because OC [oral contraceptive] use is common in women of reproductive age, and previously negative publicity exists about the safety of OC use,” Huijie Zhang, MD, Ph.D, of Nanfang Hospital, Southern Medical University, in Guangdong, China, and colleagues wrote in the Journal of the American Heart Association.”
  • Fierce Healthcare says,
    • “CareFirst BlueCross BlueShield is joining forces with Ryse Health, a company that specializes in providing in-person and virtual care for patients with uncontrolled Type 2 diabetes, in hopes of driving better long-term outcomes.”
    • “CareFirst officials said they believe the effort will help improve care by better pinpointing what they need most.”
    • “This partnership with Ryse is unique from our perspective because it’s one of the first ways in which we’ve been able to create a longitudinal value-based program that is complementing the broader value-based program efforts that the organization has,” Nathan Coffey, CareFirst’s manager of payment transformation, told Fierce Healthcare.
    • “But there’s been a gap, not just with us, but across the industry where you have a lot of discrete care programs for specialists, but having that longitudinal tie that amplifies the impact of those larger population health programs—that’s harder to create,” Coffey said.”

From the telehealth front —

  • mHealth Intelligence reports
    • “Despite the boom in telehealth use during the COVID-19 pandemic, Americans and healthcare workers largely agree that in-person care is higher quality, more efficient, and more affordable than virtual care, a new survey shows.
    • “Conducted by Morning Consult, the survey polled 1,006 healthcare workers from May 5 to May 18 and 2,202 United States adults from July 21 to July 23.
    • “But patient perceptions regarding telehealth may be changing. The survey shows that only 6 percent of US adults prefer virtual care versus 53 percent who prefer in-person care.
    • “This preference for in-person care was evident across all age groups. Generation Z displayed the highest preference for virtual care, with 9 percent of survey respondents in this group saying they preferred virtual care. However, 49 percent of Gen Z patients preferred in-person care. Similarly, while only 8 percent of Millennials said they preferred virtual care, 43 percent preferred in-person care. * * *
    • “On the other hand, hybrid care proved relatively popular across age groups. About 30 percent of Gen Z patients, 40 percent of Millennials, 37 percent of Gen X patients, and 31 percent of Baby Boomers said they preferred a hybrid healthcare model that includes both in-person and virtual care.”

From the U.S healthcare business front,

  • Healthcare Dive informs us,
    • Religiously affiliated hospital giant AdventHealth is suing cost management firm MultiPlan, alleging the company works with health insurers to systematically underpay for out-of-network medical claims.
    • AdventHealth alleges providers have lost at least $19 billion per year as a direct result of MultiPlan’s anticompetitive agreements with major payers, including UnitedHealth, Aetna, Elevance, Centene, Cigna, Humana and a number of Blue Cross Blue Shield insurers.
    • MultiPlan called the lawsuit, which was filed last week in the U.S. District Court for the Southern District of New York, meritless in a statement.
  • From what the FEHBlog knows about Multiplan arrangements, he agrees with Multiplan’s take.

Following up on yesterday’s lede article, the FEHBlog tracked down the American Society of Anesthesiologist’s warning about the relationship between the use of GLP-1 drugs and aspiration while under anesthesia.

“ASA’s Task Force on Preoperative Fasting suggests the following for patients taking GLP-1 agonists for type 2 diabetes or weight loss who are having elective procedures. It is also calling for further research to be done regarding GLP-1 agonist medications and anesthesia.

“Day or week prior to the procedure:

  • Hold GLP-1 agonists on the day of the procedure/surgery for patients who take the medication daily.
  • Hold GLP-1 agonists a week prior to the procedure/surgery for patients who take the medication weekly.
  • Consider consulting with an endocrinologist for guidance in patients who are taking GLP-1 agonists for diabetes management to help control their condition and prevent hyperglycemia (high blood sugar).

“Day of the procedure:

  • Consider delaying the procedure if the patient is experiencing GI symptoms such as severe nausea/vomiting/retching, abdominal bloating or abdominal pain and discuss the concerns of potential risk of regurgitation and aspiration with the proceduralist or surgeon and the patient.
  • Continue with the procedure if the patient has no GI symptoms and the GLP-1 agonist medications have been held as advised. 
  • If the patient has no GI symptoms, but the GLP-1 agonist medications were not held, use precautions based on the assumption the patient has a “full stomach” or consider using ultrasound to evaluate the stomach contents. If the stomach is empty, proceed as usual. If the stomach is full or if the gastric ultrasound is inconclusive or not possible, consider delaying the procedure or proceed using full stomach precautions. Discuss the potential risk of regurgitation and aspiration of gastric contents with the proceduralist or surgeon and the patient.

“Full stomach precautions also should be used in patients who need urgent or emergency surgery.”

https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/patients-taking-popular-medications-for-diabetes-and-weight-loss-should-stop-before-elective-surgery