By Dan Pichette, executive vice president, Output.
When we think of innovation in healthcare, what comes to mind? For many, it may be fancy diagnostic machines or breakthrough drug therapies. But sometimes, it can be as simple as a 3D-printed cover for an insulin pod. A product, or an improved process, that solves a need. While medical settings like hospitals and clinics are good at managing patient care, it can still be challenging to create and manage a culture of innovation.
According to Stanford University, innovation management is the process of taking imaginative concepts from inception to implementation, beginning with “the fostering of an environment where a new idea is encouraged.” In healthcare, stringent regulations and multilayered administration can often discourage this process. Staff in large medical environments often work within silos where close teamwork can incubate new ideas, but whose independence from each other can also isolate communication.
Embracing Innovation
Innovation is a key goal for the World Health Organization. Since 2017, the WHO Innovation Network, a digital and in-person network of global colleagues, has been engaged in learning and sharing events exploring “new ways of applying innovation in WHO’s work to accelerate health impact.” For its part, the American Medical Association has its seven-year-old Medical Education Innovation Challenge, enlisting small teams to propose a change to an aspect of medical education that better prepares students to meet future healthcare needs.
Nurses, the employees most on the front lines of medical care, are welcoming improvements. Nursing Management Journal exhorted that even though the healthcare industry is “innately risk-averse,” nurses must not only embrace new technologies such as AI, virtual reality and advances in genomic science, nurse leaders should proactively foster a culture of innovation, encouraging divergent thinking and promoting autonomy to instill confidence in employees.
Some institutions of higher learning have recognized the role that innovation increasingly plays in the medical sphere. Temple University’s Fox School of Business offers a 12-credit Graduate Certificate in Healthcare Innovation Management designed for current professionals looking toward the industry’s future. These credits can be applied to graduate degree programs such as Temple’s Master of Health Administration or its appropriately named Master of Science in Innovation Management and Entrepreneurship.
A Pandemic Catalyst
There is little doubt that the pandemic has shepherded unprecedented change. A May 2021 McKinsey survey, which polled over 100 industry leaders from medical providers to health payers to pharmaceutical and technology companies, found close to 90% of respondents agreed that the Covid pandemic “will fundamentally change the way they do business, requiring new products, services, processes, and business models.” Two main areas where they expected significant changes to endure: digital acceleration (from telehealth to digitally enabled clinical trials and customer-engagement models) and the workplace of the future (spanning remote patient care and virtual collaboration for professionals in the pharmaceutical and medtech industries).
The McKinsey Healthcare Innovation Through Crisis Survey concluded that adapting to these shifts, among others, will require many healthcare organizations to transform their operations and mindsets. During times of crisis, prioritizing innovation can “help unlock growth in the recovery, provided leaders approach it with commitment and establish key capabilities and processes.”
Medicare is a federal health insurance program in the United States that provides coverage to people 65 or older and some younger people with specific disabilities. The program is divided into several parts, covering different medical services and expenses. Medicare was first introduced in 1965 as Part of President Lyndon B. Johnson’s Great Society program and has since become an essential safety net for millions of Americans. However, navigating the different parts of Medicare and understanding its eligibility requirements and costs can be complex and daunting. This article will explore the meaning and coverage of Medicare Parts A, B, C, D, as well as eligibility, enrollment, and costs.
Medicare Part A
Medicare Part A or hospital insurance, covers inpatient hospital care, skilled nursing facilities, hospice care, and some home health care services. It is typically accessible to those who have paid Medicare taxes for at least ten years while working. Part A covers hospital stays of up to 90 days, with additional coverage for up to 60 “lifetime reserve days” beyond that. It also covers skilled nursing facilities for up to 100 days after a qualifying hospital stay. Hospice care is covered for those with a life span of six months or less, and some home health care services are covered for those who are homebound and need skilled nursing or therapy services. There are deductibles and coinsurance costs associated with Part A, depending on the length of the hospital stay.
By Ken Perez, marketing and strategy advisor to Vindeca Health and former vice president of healthcare policy and government affairs, Omnicell.
On Jan. 30, the Biden administration notified Congress that it plans to let the public health emergency (PHE) and the national emergency declarations related to the COVID-19 pandemic expire on May 11. The end of these declarations logically follows President Joe Biden’s “Sixty Minutes” interview that aired on Sept. 18, 2022 during which he stated, “The pandemic is over. We still have a problem with COVID. We’re still doing a lot of work on it, but the pandemic is over. If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape.”
Accordingly, on February 9, the Department of Health and Human Services (HHS) cited these developments since the peak of the Omicron surge at the end of January 2022 to justify the end of the two emergency declarations:
Daily COVID-19 reported cases are down 92%
COVID-19 deaths have declined by over 80%; and
New COVID-19 hospitalizations are down nearly 80%
Background
On Jan. 31, 2020, then-HHS Secretary Alex Azar, under section 319 of the Public Health Service Act, declared a public health emergency because of the continued spread of COVID-19. As of that date, there had been an estimated 16 cases of COVID-19 in the U.S., nearly 10,000 people had been diagnosed with the virus globally, and more than 200 had died, all in China. The following day, the World Health Organization (WHO) declared a global health emergency.
According to a report by the World Health Organization, digital health technologies such as companion apps have the potential to transform healthcare delivery by improving health outcomes, reducing healthcare costs, and enhancing the patient’s experience. Meanwhile, as digital health technologies continue to advance, companion apps are poised to play an increasingly important role in preventive healthcare.
In this blog post, we will explore how companion apps can support individuals in staying on top of their preventive healthcare measures.
1. Scheduling Regular Check-ups and Screenings
Companion apps can assist people in making appointments with their healthcare professionals for routine check-ups and screenings. Numerous apps let users keep track of their medical history in one simple place and set reminders for upcoming appointments. With this, people can identify potential health issues early on and take proactive measures to treat them by getting frequent checkups and tests.
2. Staying Up-to-Date with Vaccinations
Companion apps can also help individuals stay up-to-date with their vaccinations. Some apps provide reminders for when vaccines are due, while others can even help users find vaccine clinics in their area. Staying up-to-date with vaccinations is important for protecting against infectious diseases and maintaining good overall health.
By Edward R. Gaines III, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners.
The limited and under-resourced infrastructure established by the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services to determine the disputes between physicians and hospitals versus the health plans known as independent dispute resolution (IDR), established under the No Surprises Act (NSA), has been overwhelmed. We also know that a federal judge in Texas has twice adjudicated HHS’ regulations in the past year to be contrary to the NSA statute.
The court ruled in favor of the Texas Medical Association (TMA) on February 6, 2023. It stated that HHS attempted once again to place its regulatory “thumb” on the scales of justice in favor of the health plans, which violated the express provisions of the NSA. The statute authorizes HHS, the U.S. Department of Labor, and the U.S. Department of the Treasury to issue implementation regulations.
Tens of thousands of backlogged IDR adjudications were made worse when CMS announced an immediate suspension of IDR decisions in light of the second TMA court decision. Also, the February 24, 2023, CMS announcement of the restart of certain pending IDRs with dates of service before October 25, 2022 — the effective date of the HHS final rule which was vacated in the TMA II case — will only partially address the tremendous backlog of IDR cases pending final determination by the IDR entity.
There are two additional lawsuits against the administration’s bungled implementation of the “batching rules” and qualifying payment amount calculations (TMA III). The qualifying payment amount is the median allowed amount by the health plan as of January 31, 2019, adjusted for inflation. Additionally, with the exorbitant, nonrefundable, still unaddressed fee increases (TMA IV), there remain many unknowns and issues regarding the resolution of the pending IDRs.
After grossly underestimating the number of IDRs that HHS expected and, in consequence, creating an under-resourced IDR system, the NSA has become extremely costly for the health care system. With millions of dollars tied up in the IDR process, it is particularly devastating for physician practices. Millions more have been awarded to hospitals and physicians; however, based on feedback from clients and industry associations, most insurance carriers, adjudicated as the loser in IDR, still haven’t paid what is owed.
Below is a summary of the many important questions and outstanding concerns that remain unanswered with severe consequences for healthcare physicians and organizations.
There is a huge debate on the topic is the internet, a great source of development and education for young people or is a boon that is responsible for killing all the privacy and security which are one of the most important parts of a service network. There were times when people used to log in to their accounts on other people’s phones and then without even logging them out they used to leave it just like anything.
The concept of cybercafes is one of the most dangerous parts as the person who is using a particular computer in the cyber Cafe is exposed to a lot of privacy and security threats in general known as cyber-attacks. Cyber attacks can be done in many forms and it is not just spam that you receive in your mail ID. As we know that cyber-attacks are at their peak nowadays, and there must be a lot of solutions in the market to prevent cyber-attacks to happen.
Penetration testing is one of the latest technologies for the prevention of cyber attacks.
Black Box Approach:
The main thing about the software which is to be tested and to prevent cyber attacks is that the information about the software must be there for the better prevention of cyber attacks but at the same time in Blackbox approach, the same does not happen. The internal knowledge of the products must be known at the same time while the cyber attack is spoofed. But when we talk about the black box approach, then the same thing is seen to be invalid as the internal knowledge is not present in the product. The behavior of the software and also the attributes of the software at the same time are important but in the Blackbox approach, they both are not known.
White Box Approach:
As discussed before the main thing about the software which is to be tested and to prevent cyber attacks is the information about the software which was not present in the black box approach. But when we talk about the white box approach then it is present and it is a major advantage for this type of approach. When we talk about testing practices, then we must make sure that it is done in the right way and under the system supervision of the developer as he is the source of the software. In the white box approach, the testing practices are done from the perspective of a developer. It is also known as structural testing.
Grey Box Testing:
Grey box testing as the name suggest must be a combination of white and black which in itself when mixed produces grey color. When the white and black colors are mixed, then a grey color is formed and this type of testing method also indicates the same. All the positives of the black box approach or mix with the best positives of the white box approach to give a result as a grey box testing method.
It is no secret that the U.S. has been struggling with a nursing workforce crisis for years, with healthcare organizations recruiting foreign nurses as a quick fix to fill swelling vacancies. During the pandemic, the influx of international nurses from the Philippines, Jamaica, India, Canada, and Africa increased significantly, up 44% from 2021 and 109% from 2018, according to the O’Grady Peyton International Inc. 2021 survey of International Nurses. Expected to continue in 2023, this trend may help to stem our national shortage in the short term but it also adds to nursing shortages felt abroad.
One country where we have seen a large number of nurses coming to the US to practice from is the Philippines. However, this has left the Philippines with a shortage of over 350,000 nurses, many who come to the U.S. for better wages and working conditions, explained Maria Rosario Vergiere, officer in charge for the Ministry of Health. These nurses who are looking to make an important change in their career raise a fundamental question: Is it ethical to take nurses from one country to fill the nursing shortage in another?
The migration of nurses from one country to another also exposes a larger issue: today’s nursing shortage is global, not just domestic. Countries and global nursing organizations need to work together to solve the nursing workforce crisis globally. The International Council of Nurses and the World Health Organization are recognized leaders in addressing the global nursing shortage; however, they need equitable support from all nations to ensure the shortage is addressed from a global perspective.
International nursing challenges
While recruiting internationally trained nurses may seem like a quick fix, it brings with it a host of challenges along with it that are not always immediately clear. One example is that international nurses must pass the NCLEX exam; and they must adjust to cultural and scope of practice differences. CGFNS International, an immigration-neutral, nonprofit organization, assists internationally educated healthcare professionals wanting to live and work in a desired country. They assess and validate their academic and professional credentials, educating them on language, culture, and practice differences (CGFNS, 2023). The work of this organization has been instrumental over the years in helping acute, long-term care, and other healthcare organizations fill vacant nursing positions with foreign candidates.
International nurses have traditionally struggled to pass the NCLEX exam compared to U.S. nursing graduates due to some of the roadblocks they encounter in their move. In 2021, the first-time pass rate for the NCLEX-RN exam was 82.48% for U.S.-trained nurses and 46.48% for internationally trained nurses (CGFNS, 2022). As nurses attempt to pass the exam again, health systems could experience a strain in their onboarding process for them. However, the bar raises in April when the National State Boards of Nursing releases the Next Generation NCLEX exam for RNs and LPNs. The new NCLEX exam, which assesses clinical judgment and readiness to practice for graduating nurses, could adversely impact the already tenuous flow of internationally trained nurses eligible to work in America.
Will nurses trained in foreign countries be able to pass the Next Generation NCLEX examination? Will their scores be better or worse than the results on the current NCLEX exam? Only time will tell what impact the test changes will have on the international nurse pipeline.
Investigational medicines are drugs or treatments not approved by the U.S. Food and Drug Administration (FDA) for use in the general population. For many patients, especially those with serious illnesses or conditions, these investigational medicines can offer hope when other treatments have failed or are unavailable. However, navigating the process of requesting an investigational medicine can be complicated and intimidating, but it doesn’t have to be. Here is a step-by-step guide to help you understand what you need to know before submitting an application for an investigational medicine.
Understand Your Rights as a Patient
According to the FDA, every patient has the right to access experimental treatments if they meet certain criteria and their doctor agrees it is appropriate for them. It is important to note that while your doctor may agree that an investigational medicine may benefit you, they may not be able to get it approved by the FDA or insurance company due to medical necessity criteria or budget constraints. As such, you need to understand your options before deciding whether or not to pursue investigational medicines.
Research Clinical Trials and Compassionate Use Programs
The most important step is to research clinical trials and compassionate use programs that might be available to you. Many websites, such as ClinicalTrials.gov or Drugs@FDA, provide information on current and upcoming clinical trials related to your condition. If you qualify for a clinical trial, contact the study coordinator on the website to inquire further.
Suppose there are no suitable clinical trials available. In that case, you should explore compassionate use programs offered by pharmaceutical companies or doctors approved by the FDA to give expanded access to drugs outside of clinical trials. Contacting these entities directly is often necessary to gain access if no other options are available.
