DCMedical News: Wednesday, July 22, 2020
DCMedical News-DCMN
Washington, D.C.
Wednesday, July 22, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below). .
THE BIG STORY IN HEALTH CARE
Tracking by Johns Hopkins shows on 7-21 at 8:00 p.m. EST worldwide 14,835,470 confirmed COVID-19 cases; 613,710 deaths worldwide; 141,883 U.S. deaths (23%). A report from CDC in JAMA Internal Medicine (here) indicates that, by serology, the number of Coronavirus infections may be ten times that reported through COVID-19 active infection testing. The New York Times reports (here) more than 1,000 COVID-19 deaths in one day for the first time in July.
HHS Unveils Data Gathering Website
The Department of Health and Human Services unveiled its hospital data collection website, here. The first data set, on available and occupied ICU beds, in Excel, is here. Modern Healthcare reports that “The move comes one week after HHS directed hospitals and states to submit daily data reports to a new central database called HHS Protect and managed by the department, rather than the Centers for Disease Control and Prevention's long-standing National Healthcare Safety Network.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Radiologists Urge Slow Roll for AI
Radiology Business reports that “The two most prominent radiological societies in the U.S. are urging the federal government to proceed cautiously in its pursuit of artificial intelligence models that operate autonomously. RSNA and the American College of Radiology spelled out their concerns in a letter [here] sent to the Food and Drug Administration . . . they believe it’s unlikely the FDA can provide assurances of such technology’s safety in imaging care, absent further testing, surveillance and other methods of oversight . . . If the goal of autonomous AI is to remove the physician from the image interpretation, then the public must be assured that the algorithm will be as safe and effective as the physicians it replaces, which includes the ability to incorporate available context and identify secondary findings that would typically be identified during physician interpretation.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospitals Sinking Financially
The American Hospital Association released a KaufmannHall report (here) which says “Prior to COVID-19, in 2019, a number of hospitals already had a negative margin—an indicator of the economically fragile state of the industry. In the second quarter of 2020, when we experienced COVID-19’s initial impact, we saw almost half of America’s hospitals with negative margins—a figure that was far worse prior to distribution of CARES Act funds. However, even as COVID-19 recedes, our analysis shows half of America’s hospitals will remain with negative margins without any further support.” A negative 7% margin (median operating loss) is predicted.
Magnet Hospitals for Nurses
Nearly forty years have passed since inauguration of the “Magnet Hospital” movement begun after a study by the American Academy of Nursing. A review of studies in the American Journal of Nursing (here) reports that “Lower rates of nursing shortages, burnout, job dissatisfaction and turnover were observed at Magnet hospitals compared with non-Magnet hospitals. The rates of patient mortality, falls, hospital-acquired infections, and pressure ulcers were also lower.” List of Magnet Hospitals in Excel here.
Hospitals and Enhanced Interrogation Techniques
An opinion piece in the Annals of Internal Medicine (here) compares the hospital environment and hospital practices to those of “enhanced interrogation.”
DRUGS & DEVICES
Proposed Medicaid Rules Draw Comment from the Pharmaceutical Research and Manufacturing Association
PhRMA puts forward (here) a letter with 49 pages of discussion, support and opposition to proposed rules “Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Rebate and Third Party Liability (TPL) Requirements.” AHA letter here.
Private Equity-Funded Institutional Review Boards Draw Scrutiny
An essay in the Annals of Internal Medicine (here) notes that “A group of U.S. senators recently raised questions about the increasing use of for-profit IRBs to review research proposals (as opposed to boards typically housed at academic medical centers and health care institutions) and, more specifically, about the growing trend of private equity ownership and consolidation of for-profit IRBs.”
Hospitals Retain More Revenue Than Manufacturers for Physician-Administered Drugs in Outpatient Setting
A report from RevCycle Intelligence (here) says that “Hospitals collected 91 percent of the gross profit margin while serving just 53 percent of patients receiving physician administered medications. In contrast, physician offices treated 47 percent of patients in the commercial market and retained just nine percent of the gross margin. The analysis also showed that hospitals retain more than biopharmaceutical manufacturers for medicines administered in the outpatient setting. For every $100 spent on physician-administered drugs in the hospital outpatient setting, the hospital retained $58, while the manufacturer received less than $42.”
READINGS & REFERENCES
Coronavirus Public Health Resources and References (alphabetical):
Association of American Medical Colleges Clinical Guidance Repository, here.
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information here.
CDC information page for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
Council of State Governments, here.
JAMA Network’s COVID-19 resource center here.
Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports.
NIH information page here.
National Library of Medicine Coronavirus page here,
New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here.
The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here.
The New York Times Coronavirus coverage, here.
Reproduction rate (rt), website https://rt.live/ tracks the highest and lowest COVID-19 reproduction.
State actions, Kaiser Family Foundation, here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
The White House open research dataset (CORD-19) here.
World Health Organization COVID-19 page here.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
July 23, 24, 27, 28, 29, 30, 31
August, none
September 8, 9, 10, 11, 14, 15, 16, 17, 22, 23, 24, 25, 30
October 1, 2
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.