Violent patients put into comas to protect staff, emergency doctor says

From The Age:

Hospitals are putting violent patients into comas as a last resort to protect staff who are being sprayed with blood, held hostage, and bashed on the job, a leading doctor says.

Simon Judkins, a spokesman for the Australasian College for Emergency Medicine, said more funding was needed to protect health workers from a growing number of dangerous patients, including some who are lashing out due to long waits for care.

Ohio residency program using virtual reality to train emergency medicine residents

From iMedicalApps:

As part of Ohio University’s Immersive Media Initiative to increase VR use in realistic situations, this program drops residents right into the middle of a virtual trauma bay. The users can walk around a virtual ER, and view various medical scenarios in stereoscopic 3D. Each environment is created through the use of multiple 360 degree cameras with additional audio recordings, recorded with consent of patients during real-life encounters. These are then stitched together to create a full VR environment, viewable through the Vive. They currently have 3 scenarios, and plan for creating a full library of VR environments to better equip residents for critical care situations. While users can roam the virtual emergency rooms, the experiences are otherwise non-interactive, and similar to 360 videos.

Self-funded team led by an ER doctor wins ‘Star Trek’-inspired competition

From the Washington Post:

A seven-member, self-funded team including four siblings won the international X Prize tricorder consumer medical competition — yes, inspired by the “Star Trek” gizmo — besting 312 entrants from 38 countries, many with corporate and government backing.

Final Frontier Medical Devices, led by Basil Harris, a suburban Philadelphia emergency room doctor, won the $2.6 million top prize. The open competition, launched in 2012, challenged applicants to produce a lightweight, affordable health kit that diagnoses and interprets 13 health conditions and continuously monitors five health vitals. The team’s kit, equipped with noninvasive sensors, collects information that is synthesized on a diagnostic device — an iPad was used in the competition, but it could ultimately work on a smartphone.

Harris’s only invention before this competition was a cotton-candy machine he made with his brothers in grade school.

How Telehealth Platforms Will Reshape U.S. Healthcare Delivery

From the Huffington Post:

Telehealth is far more than a new means of visiting the doctor. It’s the gateway to a new system of coordinated care platforms: Services that leverage the expertise of people with advances in technology. As these platforms become ever more sophisticated, while delivering better health outcomes at lower costs, they will fundamentally reshape the delivery of U.S. healthcare.

Out-of-Network Bill Threatens Safety Net of Emergency Care in Nevada

Press Release:

WASHINGTON, April 13, 2017 /PRNewswire-USNewswire/ — The American College of Emergency Physicians (ACEP) today joined Nevada ACEP to oppose a proposed bill before the Nevada Assembly (AB 382) that would require physicians who practice in emergency departments to accept certain payments decided by insurance companies as “payments in full,” giving  the upper hand to the health insurance industry and resulting in a mass exodus of emergency and on-call providers in the state, which already has physician shortages.

“Patients are caught in the middle of a conflict that only a few people understand,” said Bret Frey, MD, FACEP, Legislative Liaison for the Nevada Chapter of ACEP. “Too often, people receive bills and they don’t understand what their insurance won’t cover due to high deductibles, and what portions of the bills are because of out-of-network services.”

Dr. Frey added that there is a transparency problem in the health insurance industry that has led to gross misperceptions regarding out-of-network billing.  If a patient purchases an insurance plan with a narrow network, they generally will end up out-of-network in an emergency , through no fault of their own, because they have a condition that by its nature demands a very specialized level of care, such as a stroke, heart attack, and trauma.

Emergency physician in Nevada have supported solutions to the “surprise billing” problem by endorsing Nevada Senate Bill 289 that would require certain policies of health insurance to cover services provide by out-of-network physicians.

“SB 289 brings us closer to a balanced and transparent solution that is patient-centered than ever before, said Dr. Frey.  “It will unburden our patients from uncertainty, and provides transparent protections that keep patients from being placed between a rock and a hard place.”

Emergency physicians are calling for transparency by insurance companies and use of independent databases, such as Fair Health.  Payments for emergency visits should be based on usual and customary charges, rather than arbitrary rates set by the insurance industry that don’t even cover the costs of care and sack patients with unfair bills.  The insurance companies are exploiting federal law (EMTALA) that mandates that hospital emergency departments see all patients, regardless of their ability to pay.

“What’s potentially happening in Nevada threatens patients in other states as well,” said Rebecca Parker, MD, FACEP, president of ACEP.  “Health insurance companies have a long history of denying care for emergency patients.  They are misleading patients by selling so-called ‘affordable’ policies that cover very little, then blaming medical providers for charges’ State and federal policymakers need to ensure that health insurance plans provide adequate rosters of physicians and fair payment for emergency services.”

Dr. Parker said that health insurance companies used to deny emergency claims based on final diagnoses, instead of symptoms. In other words, if chest pain brought a patient to the emergency department, and the patient turned out to have indigestion, the insurance company refused to cover the visit. Emergency physicians successfully fought back against these policies. Now, insurance companies are exploiting a federal law [EMTALA] mandating that hospital emergency departments see all patients, regardless of their ability to pay, and insurance companies are shifting more and more costs onto patients and medical providers.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

Detroit emergency room doctor charged with child genital mutilation

From WXYZ:

Henry Ford Hospital emergency room doctor has been arrested and charged in connection to performing female genital mutilation on young girls.

Jumana Nagarwala, 44, of Northville Michigan is accused of performing female genital mutilation on underage girls.

According to a criminal complaint, Nagarwala performed the procedure on girls ages six to eight years old at a medical clinic in Livonia.

Some of the children were brought from out of state for the illegal procedure. Female Genital Mutilation (FGM) is considered the complete removal or partial removal of the clitoris, known as a clitoridectomy. FGM is internationally recognized as a violation of the human rights of women and girls.

Healthcare’s new rural frontier

From Politico:

Rural hospitals are facing one of the great slow-moving crises in American health care. Across the U.S., they’ve been closing at a rate of about one per month since 2010. About 14 percent of the U.S. population lives in rural counties, a proportion that has dropped as the number of urban dwellers grows. Declining populations mean a smaller base of patients and less revenue. And the hospitals are caught in a squeeze: Because many patients in the countryside are older and sicker, they require more intensive and often expensive care.

Faced with these dramatic economic and demographic pressures, however, some hospitals are surviving — even thriving — by taking advantage of some of the most cutting-edge trends in health care. They are experimenting with telemedicine, using remote monitors to track patients and buying high-tech equipment to perform scans and other types of exams. And because many face physician shortages, they are partnering with universities and increasingly relying on nurse practitioners, paramedics and others to deliver care. In parts of rural Oregon and Washington, veterans can get counseling through a tele-mental health program. Physicians in Iowa and North Dakota have access to virtual emergency room support.