Shlomit Schaal, MD, PhD, MHCM

Great quote from Gary Haynes, MD, MS, PhD, FASA today in Becker's Healthcare ASC review: "The biggest investment this year is in recruiting and retaining anesthesiologists and CRNAs," Gary Haynes, MD, PhD, professor of anesthesiology at New Orleans-based Tulane University School of Medicine, told Becker's. "If we fail at that, we will have an even bigger expense in retaining locums anesthesiologists and CRNAs." It's the 2nd and 3rd order impact of decisions most organizations fail to think through; all anesthesia is expensive, but getting behind in coverage means paying significant premiums. https://lnkd.in/g-6W54er

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Single center EHR study of 5 064 pts w/ pre-diabetes compared those starting metformin (1154) vs 13 877 non-users w/ ~4 yrs F/U. Incidence of future gout was lower w/ metformin use (7.1 vs 9.5/1000PYs; HR 0.68); with no change in SUA or CRP https://buff.ly/3wDAERR

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A neat experience shared by Elizabeth Sprouse, MPH. I am interested in learning more about the goals of the Centers for Disease Control and Prevention's program and learning more about how data can intervene and mitigate experiences such as #covid. What do you think?

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We need to keep learning and improving in #healthcare. We need to share (and publish) creative care models that work well, and work #together across teams, historic silos, and locations to help our patients, communities, and each other. 📌 This is a fantastic overview of a virtual care connection model with specialists and local teams working together to care for patients. ➡️ “The clinical consultation took place in the local clinic facility, with the support of the on-site team.” ➡️ “Laboratory testing and imaging studies were coordinated through community settings, and tertiary site–based surgical, health psychology, and nutritional teams also followed up with this patient via virtual care clinic visits.” ➡️ “By providing these clinical services closer to the patient’s home through a clinical facility, numerous objectives were achieved: (1) patients received thorough clinical assessment and care plans; (2) patients were less likely to use the hospital or ED; (3) patients were more likely to remain in the workforce; and (4) community health care was off-loaded, reducing burnout and improving workforce retention.” ➡️ “This approach combines virtual care with a cooperative care delivery model, where the aim is not to shift patient care from one provider to another, but to expand access for patients and to create both new and clinically appropriate care for each care participant, with the aim that improved access will lead to enhanced care outcomes and more efficient care utilization.” #StrongerTogether #CrossTeamCollaboration #PatientCenteredCare

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Private equity has a role, but too often, it's exploiting healthcare. The WSJ highlights how these firms inflate costs, impacting patients and providers alike. In anesthesia, we witness this daily. We must champion investments that prioritize patient care over profit margins. It's time for leadership that demands ethical practices and safeguards our profession from those looking to make a quick buck. https://lnkd.in/e_akBuWV #Leadership #Anesthesia #Healthcare #PrivateEquity #EthicalInvesting

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From NEJM Group X: In an effort to reduce racial disparities in prenatal health, a Yale-based transdisciplinary research team, clinicians, and payers developed a program to deliver prenatal care in a group format. Read the full Perspective: https://lnkd.in/etKkZKx6 My take: We can address many maternal and infant disparities by implementing group prenatal care, training and hiring midwives, and giving patients access to doulas. Even better if we can train a diverse maternal health workforce. I’m glad we have even more evidence that group prenatal care works. #maternalhealth

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Great work by my colleague Ankur Sethi MBBS FACC, published in Structural Heart and featured in Cardiovascular Business, that highlights the need for timely #TAVR in order to improve patient outcomes and reduce costs. Key findings: - Delaying TAVR in severe #aorticstenosis (AS) patients increases healthcare costs by $10,000 per year.** - Delays due to incomplete evaluations, referral issues, and systemic barriers lead to higher costs and increased mortality risk. [Cardiovascular Business Article](https://lnkd.in/g8-Fw3bZ.) [Publication] (https://lnkd.in/gJkU96tj) Rutgers Robert Wood Johnson Medical School Robert Wood Johnson University Hospital #Cardiology #TAVR #HealthcareEconomics #HeartHealth #StructuralHeart #PatientOutcomes #HeartValveDisease #HealthPolicy #ClinicalResearch #Echocardiography #Medicare

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A drumbeat about the acute burnout faced by clinicians continues to plague the healthcare industry — and rightly so. Today, 49% of physicians say they are burned out. Further, one in five physicians indicate they are likely to leave their practice within two years. Burnout harms individuals and encompasses a variety of injuries including chronic stress, depression, exhaustion, and loss of joy in work as well as increased substance abuse and suicide. Clinician burnout clearly presents a wicked problem to address. However, the negative impacts of burnout in healthcare extend far beyond clinician well-being. As Dr. Thomas L. Schwenk said in a recent article in JAMA, physicians have effectively been the "proverbial 'canary in the coal mine.' While the canary may be sick, it is the mine that is toxic. Caring for the sick canary is compassionate, but likely futile until there is more fresh air in the mine." Therefore, it is imperative to usher fresh air into the mine by pulling up to understand and address burnout in a more holistic and comprehensive manner.” Burnout is a critical issue…to read more about the issues, please continue reading in the latest issue of Wharton Healthcare Quarterly.   Linda Roszak Burton and I are honored Z. Colette Edwards, MD MBA has once again invited us to be part of her amazing publication with this latest article “Executives Face a Moral and Business Imperative to Address Burnout”

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AI meets Rheumatology: ChatGPT and patient response optimization Large language models like ChatGPT, trained on vast text data, are revolutionizing healthcare by understanding and generating human-like language.

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🏥 Extending Hospital at Home: A Bipartisan Initiative 🏥 Senators Tom Carper (D-Del.) and Tim Scott (R-S.C.) have introduced the Hospital Inpatient Services Modernization Act of 2024. This pivotal legislation aims to extend the CMS Acute Hospital Care at Home waiver program for five additional years. Here's what this means: - **Continued Success**: The program has shown to reduce healthcare costs, improve patient outcomes, and alleviate hospital burdens. - **National Reach**: Currently active in 37 states, including Delaware and South Carolina, with the program set to expire on December 31, 2024. - **Home Care Benefits**: Enables Medicare beneficiaries to receive hospital-level care in the comfort of their own homes. - **Bipartisan Support**: This extension builds on prior successes and bipartisan efforts to innovate healthcare delivery. - **Healthcare Evolution**: ChristianaCare has successfully admitted over 1,000 patients, showcasing the effectiveness and patient satisfaction with home-based care. 🗨️ "Our efforts aim to revolutionize healthcare by allowing vulnerable Americans to receive high-quality care at home, reducing traditional hospital risks," said Senator Scott. Take a look a the bill here: https://lnkd.in/ge4CMpx8 #HospitalAtHome #HealthcareInnovation #BipartisanHealthcare #Medicare #HomeCare #PatientCare #HealthPolicy #ModernMedicine #SeniorCare #CMS 👩‍⚕️🏡 Let's support the future of healthcare, where home is where the healing happens!

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Duke AI Health, and Duke University Health System hosts HHS to talk about trustworthy AI! A great discussion by the panel today on the challenges and opportunities of the near future in this space.

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The Sequence for the week of 4/8-4/14 discusses the different types of assessments for breast cancer risk, and what could happen if you combine all three for population screening. What impact would be expected from a three-part population risk assessment for breast cancer susceptibility that included family history risk assessment, genetic testing, and polygenic risk score testing on everyone? #genetics, #publicpolicy, #geneticcounseling, #precisionmedicine, #translationalmedicine, #genetictesting, #geneticresearch, #breastcancer, #breastcancerawareness, #familyhistory, #breastcancerprevention, #polygenicriskscores

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Well worth tuning in to this important talk!

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I’m thankful that I could share my thoughts at that very hearing. There is so much misinformation about 340B. For me, it comes down to two main points: 1- if hospitals need that money as a subsidy to fund everyday activities, they should just ask for a subsidy. Let’s open up the books of these institutions, which already get a huge subsidy with their non-profit status, and see why they are running in the red. Are they really losing money on Medicaid patients or are they just bloated and inefficient? 2- let the subsidy follow the patient. This is a drug benefit program. Why does the funding go to an institution? Imagine if we did that with SNAP, giving a bunch of money to large restaurant chains in exchange for their promise to use the revenue to provide food for poor people (with no oversight to ensure that’s done). We don’t do that; instead we give the benefit to the person who needs it. Let’s change 340B to match that model. Adam J. Bruggeman, MD, MHA, FAAOS, FAOA Daniel Choi Colin Yokanovich John Strom Peter Stein Adam Fein Deborah Williams Lisa Grabert Maya Babu, MD, MBA Katie Orrico Larry Bucshon, M.D. Ann M. Richardson, MBA

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Health care organizations face an inflection point. With operating margins hovering at historically low levels, organizations urgently require funds not only to invest in core needs like physical plants, technology and clinical programs but also to fuel growth, to drive care transformation and to address expanding priorities around social drivers of health, access, equity and well-being. This makes it critical for all of the health care organization’s financial resources to be deployed to their most effective and best use; yet many organizations still diminish the potential impact of philanthropy by using charitable dollars for initiatives outside their strategy. Given how philanthropy deployment can significantly influence a health care organization’s ability to invest in future opportunities and outcomes, organizations should pursue alignment between strategy and philanthropy. Read more in the lastest issue of Trustee Insights from American Hospital Association in the attached or here: https://lnkd.in/dE5E8fCu This article is shared with the permission of the American Hospital Association. Thank you so much to the exceptional executive leaders who graciously shared their time and perspectives for this article. #Healthcare #Leadership #Philanthropy

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Interesting perspective piece on physician unionization in the face of consolidation by Kevin Schulman & Barak Richman (https://lnkd.in/e63EY7aJ.) Physicians are increasingly finding themselves in the position nurses and others have been in for decades: replaceable and interchangeable production units, a cost to be minimized. While the roles and specifics are different, the poor management, organizational failures, limited voice in decisionmaking, restricted autonomy, tyrannical EHRs demanding constant attention, untenable workloads, and eroded work-life balance have become a shared experience of work. Our work at the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing shows as much. https://lnkd.in/eF7J8Kca Not only bad for clinicians, but bad for patients. An important moment in time for interdisciplinary unity and collaboration to reshape our professional lives. American Nurses Association

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Hospital financial performance continues to present significant challenges.  While median operating margins are up, 40 percent of organizations are still losing money.  That means it’s critical to continue to lean in around harnessing the power of philanthropy as an alternative revenue source.  For more on the current financial state of health care, read here: https://lnkd.in/eTUK2cqj

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In a landscape defined by rapid change and complex challenges, most leaders are at the forefront of shaping a resilient future. 🚑 The evolving business landscape calls for an agile approach without compromising innovation. 💼 With labor costs on the rise, the pressure is on to optimize operational efficiency without compromising the quality of service. 🌐 The emergence of virtual support, be it a chatbot or virtual nurses, is a testament to how technology can help scale business, yet there are questions about the future of the labour market. 🛠️ Embracing the meta-leadership approach; it is time to engage all stakeholders, fostering unity, and leading with empathy amidst change. 🗣️ Investing in negotiation, conflict resolution skills, and leadership development at all levels is not just an option but a necessity. The article focuses particularly on healthcare leaders and their ability to drive innovation and operational efficiency without compromising empathetic, patient-centric care - however, the core principles in my opinion apply to us all! #leadership #transformation #healthcare

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