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Northwell Health’s Forest Hills Long Island Jewish (LIJ) Hospital is pioneering the integration of telehealth in the management of burn injuries, implementing a service known as teleburn. This telemedicine initiative allows emergency doctors at the LIJ Forest Hills to consult with burn specialists at Staten Island University Hospital’s Regional Burn Center without geographical limitations. Teleburn aims to enhance the speed of care decisions and patient outcomes by providing immediate expert consultations.
Teleburn: A Leap in Remote Consultation and Assessment
The fundamental component of teleburn is its cutting-edge video teleconferencing technology. It allows physicians at remote emergency departments to interact virtually with burn specialists. “With this technology, we can have a quick evaluation by a physician who is miles away and who can help us make decisions about care and whether we need to transfer a patient to that site,” said Christopher Calandrella, DO, chair of emergency medicine at LIJ Forest Hills. This innovative tool permits remote burn specialists to access real-time patient data and maneuver the teleburn camera to closely assess the burn injury. It offers a detailed insight into the burn’s size, depth, and other crucial details necessary for immediate treatment decisions. As stated by Dr. Michael Cooper, director of the burn center, this technology aids in determining the different depths of burns, their extent, and appropriate treatments swiftly and efficiently.
Implementation and Future Expansion
LIJ Forest Hills is the trailblazer in the Northwell system, being the first to implement teleburn. Plans are underway to extend the service to Long Island Jewish Valley Stream and Long Island Medical Center in the following weeks. The integration of teleburn into these facilities will enhance their capacity to assess whether burn patients can be managed onsite or necessitate transportation to the Regional Burn Center.
The decision for patient transport depends on multiple factors including the size and depth of the burn, the presence of smoke inhalation injury, and the available resources at the initial treating hospital. Northwell’s system can facilitate the transfer of burn patients requiring specialized care via ambulance or helicopter, providing a lifeline to those in the New York City metropolitan area and beyond.
Northwell Health’s teleburn system has the potential to be more than a technological breakthrough, and could act as a lifesaving tool that tranforms the trajectory of burn patient care. This remote service provides an immediate lifeline to patients who might be miles away from a specialized burn unit, ensuring that they have access to comprehensive, high-quality care at a critical time. It’s a significant advancement that directly addresses the challenges of time and geographical limitations that often complicate emergency medical care. This real-time, remote evaluation and decision-making tool increases the efficiency of care delivery, which can be pivotal in a burn emergency where every second counts. The commitment shown by Northwell Health in integrating such a system signals an evolving approach to healthcare, one that leverages technology to break down barriers and deliver the best possible patient outcomes.
Epic, a leading provider of electronic health records (EHR), has partnered with Nuance Communications, a Microsoft company, to introduce advanced ambient clinical documentation integration. This collaboration combines Nuance’s Dragon Ambient eXperience Express (DAX Express) tool, which utilizes conversational and ambient AI, with OpenAI’s state-of-the-art model, ChatGPT-4, hosted on the Microsoft Azure OpenAI Service. By integrating DAX Express with Epic’s platform, healthcare professionals can automatically generate EHR notes during patient encounters, whether in-person or via telehealth, for immediate review and completion. This strategic alliance aims to enhance healthcare efficiency and improve the overall provider- patient experience.
Transforming Healthcare Delivery with DAX Express for Epic
DAX Express for Epic is poised to revolutionize healthcare practices by leveraging ambient AI technology. The DAX ambient solution developed by Nuance has already showcased its potential in transforming the provider-patient experience. With the added integration of generative AI through Epic’s platform, healthcare providers gain more options to utilize technology effectively, resulting in improved outcomes for both providers and patients. Josh Wilda, the chief digital and information officer at the University of Michigan Health-West, expressed enthusiasm for the collaboration, emphasizing the significant advancements it will bring to healthcare delivery. Enhancing Productivity and Work-Life Balance for Clinicians Clinicians who have incorporated DAX into their workflows have reported numerous benefits, including improved work-life balance and reduced burnout. The introduction of DAX Express for Epic further enhances these advantages. Healthcare providers can now save valuable time by leveraging the capabilities of this integrated solution. Clinicians have reported saving an average of seven minutes per patient encounter, allowing them to accommodate an additional five appointments per clinic day on average. The seamless integration of DAX Express with Epic’s EHR system expedites the generation of clinical notes, eliminating the labor-intensive task of manual
documentation. This time-saving feature enables clinicians to redirect their focus toward providing high-quality care and treatment to their patients. Hal Baker, MD, chief digital and information officer at WellSpan Health, praised DAX Express for its ability to streamline the documentation process and allow physicians to prioritize patient care without unnecessary delays.
Unlocking the Potential of Ambient Clinical Documentation
DAX Express for Epic is an inclusive offering available to users of DAX, ensuring a seamless transition for clinicians already utilizing the DAX ambient solution. Dragon Medical One customers can also benefit from DAX Express by purchasing it as an add-on, thereby harnessing the advantages of this cutting-edge technology. In line with strict privacy and security standards, Nuance has developed DAX Express as a HIPAA-compliant solution. Both Epic and Nuance prioritize the integration of trustworthy and secure AI products into healthcare systems, ensuring the utmost protection of patient data. The partnership between Epic and Nuance to enhance EHR integration with advanced ambient clinical documentation marks a significant milestone in the healthcare industry. By harnessing the power of conversational and generative AI technologies, healthcare providers utilizing Epic’s platform will experience a remarkable transformation in their daily workflows. DAX Express for Epic empowers clinicians to automatically generate EHR notes during patient encounters, significantly reducing the burden of manual documentation. This technology not only improves work-life balance and reduces burnout for healthcare professionals but also enables them to deliver enhanced care to their patients. As the healthcare landscape continues to evolve, collaborations like this drive innovation and pave the way for a more efficient and patient- centric future.
The American Hospital Association’s Response to New Regulatory Landscape
The American Hospital Association (AHA) recently offered their viewpoints on the proposed rules affecting Medicaid and Children’s Health Insurance Program (CHIP) managed care, as well as the fee-for-service (FFS) delivery systems. They asserted to the Centers for Medicare & Medicaid Services (CMS) that these new regulations would have a significant impact on the current regulatory environment for Medicaid and CHIP programs.
Despite appreciating the overall direction of these proposals, the AHA expressed apprehension over the possible risk to states’ access to essential financial resources. They cited the CMS’s plan to further tighten state sources of Medicaid funding and impose additional attestation requirements on hospitals as potential hazards. The AHA urged CMS to consider using the average commercial rate as the upper payment for state-directed payments to hospitals, opposing any more restrictive upper payment options.
The AHA also highlighted the need for states to analyze and disclose the comparison between rates for certain crucial services and Medicare FFS rates. However, they advised against assuming the adequacy of Medicare FFS rates. They pointed out that Medicare underpayments to providers exceeded $75 billion in 2020, stressing that this analysis should be seen as a part of a larger review on the impact of provider payment on beneficiaries’ access to care.
Welcoming Proposals, Addressing Challenges
In recent communications, the AHA has been particularly supportive of certain specific proposals. They welcomed plans for states to regularly publish fee-for-service rates transparently, breaking down the rates by geography, population, and provider type. They also agreed with proposals for states to conduct a “threshold access analysis” that should approximate 80% of Medicare rates, and to improve oversight of home- and community-based services.
While supporting CMS’s direction with these propositions, the AHA also recognized that states are currently under considerable strain. As they embark on the largest eligibility redeterminations in the program’s history, it is imperative to maintain a balance between reform and state capacity.
Balancing Eligibility Redetermination with Access Improvement
The AHA encouraged CMS to remain considerate of eligibility redetermination efforts. They suggested that further information, such as comparisons with Medicare fee-for-service rates, is needed to understand provider payment rates better. As new proposals and rules reshape the Medicaid and CHIP landscape, a balanced approach that addresses access, finance, and quality is crucial to ensuring healthcare access for all beneficiaries.
Benefits of comprehensive comparisons with Medicare fee-for-service rates:
More Informed Policymaking: These comparisons can provide policymakers with the data they need to make informed decisions about future regulations and improvements.
Enhanced Rate Transparency: This practice promotes transparency, which can lead to improved trust and understanding between service providers, beneficiaries, and regulators.
Assessment of Financial Adequacy: By evaluating the payment rates against those of Medicare, the adequacy of payments for services can be assessed, ensuring fair compensation and financial sustainability for service providers.
Improved Access to Care: If payment rates are adequate and sustainable, providers are more likely to continue offering essential services, enhancing beneficiary access to care.
Potential to Adjust Underpayment Issues: By identifying instances where underpayment may be occurring, corrective measures can be taken to adjust these issues, ensuring that providers receive adequate compensation for their services.
Better Insight into Market Trends: Comparing provider payment rates with Medicare fee-for-service rates can reveal market trends and disparities that need to be addressed.
Epic, a leader in healthcare software, has extended its partnership with Nuance Communications, a Microsoft subsidiary specializing in AI and cloud-based services. This expansion includes the integration of Nuance’s Dragon Ambient eXperience Express (DAX Express) into Epic’s electronic health record (EHR) system.
DAX Express: Combining AI Technology and Clinical Documentation
DAX Express is a unique application that merges Nuance’s proven conversational and ambient AI with OpenAI’s advanced GPT-4 model, delivered via the Microsoft Azure OpenAI Service. The integration of DAX Express into Epic will serve as a co-pilot for Dragon Medical users, helping to manage administrative tasks and thereby reduce burnout. By enabling automatic drafting of EHR notes from the exam room or through telehealth encounters, DAX Express promises to revolutionize clinical documentation, freeing up time for clinicians to focus on patient care.
Provider and Patient Benefits
According to Josh Wilda, Chief Digital and Information Officer at the University of Michigan Health-West, the use of DAX Express will provide a transformative shift in healthcare delivery. DAX’s ambient AI capabilities have already demonstrated significant improvements in provider-patient interactions, and the introduction of generative AI is expected to yield even better outcomes.
The use of DAX has proven to be beneficial for healthcare providers, with reported improvements in work-life balance and reductions in feelings of burnout. Clinicians have also reported time savings of about seven minutes per encounter, enabling them to schedule additional appointments.
Game-Changing Impression
The impressions of DAX among clinicians have been overwhelmingly positive, with many describing it as a game-changer. Hal Baker, Chief Digital and Information Officer at WellSpan Health, anticipates that the integration of DAX Express for Epic will enhance this sentiment. The ability to generate notes within seconds, as opposed to hours, could significantly improve operational efficiency and allow clinicians to devote more attention to patient care.
Compliance and Availability
DAX Express is developed with a strong focus on data security and privacy, and it is considered HIPAA compliant. The application will be available to existing users of DAX and as an add-on for Dragon Medical One customers. It is set for private preview in the Summer through Fall, reflecting Nuance’s commitment to producing trustworthy and safe AI products.
Promoting Mental Wellness for Cancer Patients through Innovative Collaboration
Calm Health, the renowned meditation app, has joined forces with the prestigious Mayo Clinic to develop digital mental health programs specifically tailored to help cancer patients cope with anxiety, depression, and overall mental well-being. Launched last year, Calm Health aims to address mental health concerns for employees, payers, and healthcare providers, offering a seamlessly integrated digital solution to monitor and manage patients’ mental well-being.
Through partnering with Mayo Clinic, Calm Health intends to create a comprehensive clinical mental health program for adult cancer patients. Leading the initiative is Dr. Andrea Wahner Hendrickson, an esteemed oncologist and researcher at Mayo Clinic, alongside Dr. Jennifer Kilkus, a psycho-oncology specialist and assistant clinical professor at Yale School of Medicine.
Recognizing the critical importance of prioritizing mental healthcare on par with physical care, Rhett Woods, the General Manager at Calm Health, emphasizes the need for transformational and effective mental health and mindfulness tools. These tools are aimed at supporting patients through the challenging emotional and physical journey of chronic conditions such as cancer.
Research from the past decade, highlighted by Calm Health, underscores the urgent necessity for mental health support among cancer patients. Studies estimate that up to one-third of patients receiving cancer treatment in hospitals experience common mental health conditions. Additionally, rates of major depressive disorder in individuals with cancer can be up to three times higher compared to the general population.
Calm Health’s existing offerings include programs designed in collaboration with its parent company, Calm, known for its engaging content. These programs, coupled with screening tools to guide users towards appropriate mental healthcare levels, comply with federal privacy standards. Moving forward, Calm Health intends to expand its mental health programs beyond cancer to encompass various diseases like diabetes, hypertension, and obesity.
The upcoming mental health program, expected to be completed in the third quarter of 2023, will be available to Calm Health customers and designed to cater to all adults with cancer. The company plans to roll out the program by the end of the year. Although Calm Health officially launched in October, it was formally established in early 2022 when Calm acquired Ripple Health Group, a health app maker, bringing Ripple CEO David Ko on board as co-CEO of the mental health unicorn.
The collaboration between Calm Health and Mayo Clinic comes at a crucial time when the demand for behavioral health services is surpassing the available supply of providers. The digital mental health market is poised to meet this demand, particularly in the wake of the stressors brought on by the COVID-19 pandemic. Recent developments in the field include a $71 million funding round and $2.5 billion valuation for digital mental health benefits company Spring Health, as well as Apple’s increased support for mental health tracking within its Health app.
Meditation’s Positive Impact on Mental Health: A Study Reference
In a study conducted by Goyal et al. (2014), the researchers examined the effects of meditation on mental health outcomes. The meta-analysis included 47 trials involving a total of 3,515 participants. The results demonstrated that meditation programs had moderate evidence of improving anxiety symptoms, depression, and overall psychological well-being. Moreover, the study indicated that the benefits of meditation were particularly prominent in individuals with elevated levels of stress. This evidence highlights the potential of meditation as a valuable tool in promoting mental health and well-being, which aligns with the goals of Calm Health’s collaboration with Mayo Clinic.
Please note that the above study is provided as an example and may not directly relate to the specific mental health program being developed by Calm Health and Mayo Clinic.
