Population Health

An interview with Prof. Chyong-Huey Lai, Vice-superintendent of Chang Gung Memorial Hospital, Linkuo Branch.

In March, we asked our readers to share their stories of how the COVID-19 crisis is affecting them, both personally and professionally. Here is our fourth installment of collecting responses from our readers.   From the beginning of this global pandemic, the HIMSS Media information brands – Healthcare IT News, MobiHealthNews, and Healthcare Finance News – have been working to bring you important information and updates on the situation. But we felt that our readers, from healthcare providers to tech professionals, administrators, insurers, investors, entrepreneurs and others, could best tell us what they're seeing on the front lines and in their daily lives. We are updating responses weekly. Please send us your stories to yourstories@himss.org. We ask that you include your name, position, city and state/region, and country. Please let us know if you’d prefer your story to be shared without your name attached. If you do, we’ll honor that request. Comments may be edited for length and content. Our HIMSS Media publications want to share your stories, in your words. We’re living in a strange, often scary, new world. Let’s learn from each other and get through it together. ‘I had difficulty breathing and they told me I still had to wait’ April 3 Ricardo Quintana Hesperia, California I was recently hospitalized for COVID-19. I was at Victor Valley Global Medical Center, which took care of me well, I just couldn't eat. This was actually the second hospital I had to go to, the first [was] in Apple Valley, California, which sent me inside, asked me questions, did my vitals, then an X-ray. Then they stopped. They had me sitting and were further processing people that had gotten there after me. I finally mentioned to them of my difficulty in breathing and they told me I still had to wait, I had no choice than to leave right then and there. I could feel my health deteriorating. My wife had to drive me to the Victor Valley Hospital.  Update: April 17 I have recovered recently from COVID 19. I get very hot and sweat now and then, and my heart feels different now. The health department said they wouldn't retest me and said that I should be good after quarantine, I'm working again. I truck drive and I deliver hay for export to China, which for some reason never stopped, so I may have contracted the virus from that. Coronavirus is a crisis of health and financial stability April 4 Sandra Eichler Wilmington, Delaware Self-employed professional house- and pet-sitter Thanks and blessings to all sharing such impactful and heartfelt stories. We need to unite and help one another. I am excited to see unemployment expanding. I have been allowed to apply as a 1099 contractor and repeatedly updated my income only to be given $80 a week based on a seasonal job I held a year ago. Nothing about my full-time earnings based on three different corrections by me. Needless to say this will not pay my rent or car. Then I decided to be proactive and apply to a grocery store, to find out I was exposed to COVID-19 due to one of their HR employees having it. Now I sit and wait to see do I lose my entire life first or die from COVID-19? I continue to pray for us all. I have always been positive but I’m not able to see the good in this one. The exceptions are the extremely wealthy sector that thinks this is a vacation and wonderful time to utilize all their devices and have a staycation. I don’t begrudge them but fail to see where some of us are in this together. Update, April 17 Well I thankfully was with someone with COVID-19, but do not have it. Health and safety to you and all readers and family members. I am getting nowhere since I am a 1099 contractor and have not had a paycheck in a month. I can get nowhere online and all I keep hearing is the websites are updating in 3 to 6 weeks for 1099 and the self-employed. I fear it will be much too late. I was doing great but now have no clients and zero work.  The stimulus check is not working for 1099 or contractors as well. We desperately need it but since most of us end up owing federal taxes each year the checks will be mailed and I pray to the correct address. This is such a tragedy for all. I don’t know if I will die of lack of funds rather than COVID-19. Small business owner sees no hope of staying in business April 17 Joseph Bonavita Wilmington, Delaware Bonavita Cleaning Services I received your email from a very close friend of mine by the name of Sandra Eichler. I am a licensed and fully-insured business owner for over 20 years. I, like Sandra Eichler, receive a 1099 status for my business. I receive at least 10 1099’s for my services to offices. I cannot receive any unemployment benefits due to this status. My taxes for 2019 are completed and paid for. I expect the offices to reopen in the next three weeks, but I am paying bills with savings at this time. No hope in sight for any filing status to collect anything with the way my small business is set up. The labor board does not have any filing status in place as of today. Why not? A paper check will most likely be mailed to me for $1,200 dollars for the subsidy but that’s it. I will go under in three weeks for sure. I’m operating at about 20% of my true income because I am still servicing two open mandated businesses. COVID-19 treatment calls for specific ventilators April 2 Anonymous concerned physician working with COVID-19 patients Are the ventilators being talked about with such enthusiasm by POTUS actually going to be suitable for treating the lung injury seen in COVID-19? Will they interface with EHRS?  Be able to display flow-volume and pressure-volume curves?  Have alarms? I’m hoping someone knows the answer to my questions. Teledermatology will likely remain after COVID-19 crisis is over April 13 Dr. Nana Duffy Board Certified Dermatologist Rochester Regional Health, New York The amount of patients coming into the office has dramatically decreased. Aside from true dermatological emergencies requiring in-person care, we’re mainly communicating with patients through video visits, which present challenges unique to the specialty. In dermatology, the organ of interest is the skin. We need to see it really well, in all of its three-dimensional detail, as we’re trained to make diagnoses based on morphology. That means we need to see if something is flat or raised, if it’s smooth or scaled, if it has blisters or not. When we communicate with patients and we’re trying to make a diagnosis, we don’t just need an image, but a really good image. We need the camera to basically function as our eyes. In my experience over the past few weeks, I would say 50% of the images sent by patients have been usable and 50% have been completely unusable. Without a good image, I can’t make an accurate diagnosis. Last year we were thinking of telehealth as something we could potentially leverage, and now we have no choice. When video visits work well, it’s actually a great convenience for the patient. I anticipate that teledermatology will be something we offer more widely to patients in the future, even after the COVID-19 surge. Protecting seniors while maintaining connections is vital April 17 Moshe Pinto, CEO Wider Circle Redwood City, California   In California and across the U.S., seniors are in isolation to protect themselves against COVID-19. In these circumstances, it is more critical than ever for Americans to extend care to our most vulnerable family members, friends and neighbors. Whether through a simple phone call or by running an errand for an older individual, we must all take it upon ourselves to stay in touch with and help connect seniors to local resources they may need. Thanks to food banks, hyper-local organizations and large and small business donations, resources for vulnerable seniors are available; however, getting them distributed during the pandemic remains a problem. Fortunately, community-level peer-to-peer support groups, backed by community-outreach organizations and funded by payors, are stepping up to the challenge. Moving their in-person community meetings to a user-friendly online platform that anyone can access by smartphone or computer, these peer-to-peer support groups are making it easy for seniors to stay connected with one another, and voice any needs they have. These meetings are led by culturally competent, trained facilitators, who are then able to direct help to seniors through community-outreach organizations. Equally important, they provide a way for older adults to stay engaged in their communities, improving their emotional well-being and countering feelings of helplessness and anxiety.  Through these digital check-ins, seniors in your community are sharing their individual needs for social connection, telemedicine, food or medication. This, in turn, is opening up new lines of communication and social interaction by allowing them to virtually meet others in their community through buddy-check programs – giving members a sense of purpose and countering feelings of helplessness and anxiety. As U.S. states continue to experience COVID-19 surges, we must look to implement hyper-local resources to personally reach out to our seniors and get them the resources they desperately need. In doing so, our urban and rural senior communities alike can create meaningful connections and help to improve their emotional well-being.  We need each other now more than ever, and together we can all help create meaningful connections.

Proponents want Medicaid and private insurers to extend coverage for one year postpartum.

"We see an enormous opportunity to enhance disease tracking for improved population health during the COVID-19 pandemic," said Scripps Research Translational Institute's Dr. Eric Topol.

The technology by Deputy offers a “touchless clock-in” for staff which enables them to register for work without touching a screen.  

Earlier this week, the Department of Health (DOH) of the Philippines launched its new COVID-19 Tracker. The revamped tracker features additional information on the epidemiology of COVID-19 in the country, COVID-19 testing, health facilities, and availability of personal protective equipment (PPEs). The public can now view data on the laboratory testing capacities of the DOH accredited laboratories including the total number of tests and unique individuals tested.  The public can now also have a snapshot of the country’s health system's capacity in responding to the pandemic based on data collected from the DOH DataCollect application. The DataCollect app gathers daily data from hospitals and stakeholders such as essential resources and supplies, availability of hospital beds, isolation rooms, ICU beds and mechanical ventilators, and human resource needs. The application will also be able to accurately calculate the projected need of PPEs, and link to our logistics offices for delivery of supplies. This will facilitate easier and faster tracking of reports between DOH offices. Under the “Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act" or RA 11332, all of DOH’s partner hospitals are mandated to implement this system of data collection. DOH worked with epidemiologist Mr. Nel Jason Haw and data science consulting firm Thinking Machines in the creation of its new COVID-19 tracker. THE LARGER TREND Having a data platform or dashboard to monitor and track the development of COVID-19 cases can help public health authorities plan and intervene according to the needs of the health system(s). In the UK, the NHS is working with US tech companies Palantir, Microsoft and Amazon to develop a data platform to inform the COVID-19 response, according to a report by Healthcare IT News.  ON THE RECORD “The new COVID-19 tracker is not perfect and we hope to add more information in the succeeding days, but it is our fervent hope that this responds to the information needs and the call for transparency from our citizens,” Health Secretary Francisco Duque III said. “Right now, health facility data is only limited to around 550 reporting hospitals and infirmaries so we call on our hospitals to submit information through our DataCollect App to help us protect our healthcare workers in beating COVID-19,” the Secretary added.

Just days after the application period opened, some $3.23 million has already been approved to help hard-hit health systems deploy telemedicine technology, connected devices and remote patient-monitoring tools.

In a HIMSS20 Digital session, the Honolulu-based health system explains how it "put the IT in capitation," and earned a first-in-the nation distinction for its technology-enabled improvements.

The health system is implementing new technologies to help it pinpoint frequent readmissions and identify underlying social determinants of health.

COVID-19's long-term impact on acute and post-acute care is more detailed documentation and a greater emphasis on event notification services to track care progression, says Nick Knowlton, vice president of business development at Brightree.