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  • 25 Sep 2023 11:42 AM | Deborah Hodges (Administrator)

    I’m an ER doctor: Here’s what AI startups get wrong about “ChatGPT for telehealth” The explosion of telehealth might seem like a huge opportunity for AI. But it is also a huge risk. [Fast Company]

    As a practicing ER doctor, I’m quite excited by the potential of LLMs like ChatGPT for health care. I already use it as a communication tool for some of my patients, and sometimes feed ChatGPT detailed prompts of patient symptoms to generate possible diagnoses I haven’t yet considered.

    As a part-time advisor to healthtech startups, however, I’m increasingly concerned that many in Silicon Valley are confusing the capabilities of LLMs as they relate to the practice of medicine. Especially telehealth.

    The omnibus bill President Biden signed last January extends telehealth flexibilities on patient appointments and insurance coverage through December 31, 2024. Assuming insurers continue following suit until then, we have about a year to deliver on the promise of telehealth.

    This might seem like a glowing opportunity for a program like ChatGPT. Thanks to the pandemic, virtual care/telehealth is now a standard procedure, with roughly 1 in 4 patient appointments conducted remotely. So why not integrate an LLM into the remote treatment process, acting as a virtual nurse practitioner which communicates to patients through text? Indeed, there are already a number of startups roughly based on that use case.

    After treating thousands of people remotely since the COVID era, I should explain in vivid detail how bad an idea this is. 



  • 22 Sep 2023 12:48 PM | Deborah Hodges (Administrator)

    A spokeswoman for the Department of Healthcare and Family Services confirmed Thursday that they are not pausing Medicaid disenrollments in Illinois. [Health News Illinois]

    That comes as the Biden administration ordered 30 states on Thursday to halt procedural disenrollments over concerns that a glitch in their eligibility systems caused children and other individuals to unintentionally lose coverage during the Medicaid redetermination process.

    While Illinois was one of the 30 states identified by the U.S. Department of Health and Human Services, HFS spokeswoman Jamie Munks noted an HHS press release said the federal agency required the pause unless states “could ensure all eligible people are not improperly disenrolled due to this issue.”

    “Starting this month, ex parte redeterminations are being conducted at the individual level, and HFS is working on reinstating the cases that were closed July 31 that would have been deemed eligible with this change,” Munks said. “As a result, Illinois has not paused Medicaid disenrollments.”

    Munks noted that if the ex parte process is not successful, the Medicaid members are then sent renewal materials.

    CMS sent a letter last month to all state Medicaid directors asking them to evaluate whether children in their states are being affected by Medicaid eligibility systems. For systems deemed faulty, the agency asked states to pause “procedural disenrollments” until the issue can be fixed.

    Munks said the agency has been “working for weeks on a solution to allow for ex parte redeterminations at the individual level before any additional disenrollments occurred.”

    HHS said Thursday that nearly 500,000 children and other individuals nationwide who were improperly disenrolled from Medicaid or the Children's Health Insurance Program will regain their coverage due to efforts to address the issue. The agency estimates that fewer than 10,000 Illinoisans were affected by the system glitch.


  • 21 Sep 2023 11:20 AM | Deborah Hodges (Administrator)

    Federal help is coming to the state of Illinois to combat mental illness. [Fox 32] See video here.

    There is now $130 million in grant money available across the U.S. for community-based mental health and substance abuse. 

    Illinois is set to receive $8 million of that money.  The funding is coming from the U.S. Department of Health and Human Services to expand certified community behavioral health clinics across the country. 

    The Biden-Harris Administration says it's an ongoing effort to tackle the country’s mental health crisis and beat the opioid epidemic.

    The federal announcement was made at the Chicago-based Thresholds Center for Mental Health and Well-Being.

    The organizations in Illinois will receive up to one million per year for four years.


  • 20 Sep 2023 9:33 AM | Deborah Hodges (Administrator)

    In the wake of growing alarm over the disproportionately high rates of maternal mortality in the U.S., maternal health experts have been pushing for changes — including expanding the midwife workforce. [STAT] Studies have shown that deliveries attended by midwives tend to have fewer complications and better outcomes, partially because midwife training relies less on medical intervention, leading to fewer C-sections.

    The number of credentialed midwives — including both certified nurse-midwives, who can attend births in hospital settings, and a minority of certified midwives, who don’t hold a nursing degree — in the U.S. more than doubled from 1991 and 2012 and has continued to grow steadily in the years since. Universities have also expanded their course offerings, with the number of new students enrolled in accredited midwifery programs growing from 1,006 students in 2014 to 1,214 in 2018, according to the latest data available.



  • 19 Sep 2023 2:57 PM | Deborah Hodges (Administrator)

    A photo of two women talking while sitting in a circle of chairs.Several months ago, I interviewed the late Sally Zinman, a heroine of our mental health movement of people with lived experience. I asked what changes she would like to see in the mental health system in the future. Without hesitation she said that the system should value and encourage self-determination and totally voluntary, noncoercive services. [MedPage]

    I will discuss here the dangers of involuntary commitment, and demonstrate the ways that I believe Emotional CPRopens in a new tab or window (eCPR), which I will define below, contributes to Zinman's vision.



  • 18 Sep 2023 11:20 AM | Deborah Hodges (Administrator)

    Since the end of the US Public Health Emergency on May 11, 2023, there has been a desire from elected officials and the public to put COVID-19 in the rearview mirror. However, the emergence of new variants and a summer wave of infections remind us that SARS-CoV-2 is here for the foreseeable future. This Viewpoint addresses the current state of COVID-19 in the US and summarizes key clinical information for health care professionals and patients. [JAMA Network]

    Current State of COVID-19 in the US

    With the end of the Public Health Emergency, COVID-19 surveillance in the US is no longer performed using case counts. Instead, wastewater surveillance and tracking of hospitalizations and deaths are the major indicators being used to understand trends. Since late June 2023, there has been a steady increase in the detection of SARS-CoV-2 in wastewater, a change that correlates with a bump in reported hospitalizations and deaths.



  • 15 Sep 2023 10:33 AM | Deborah Hodges (Administrator)

    Chicago Mayor Brandon Johnson and city council members unveiled an ordinance Thursday that would pave the way for implementing his plan to expand mental health clinical services and non-police responses for those experiencing behavioral and mental health crises. [Health News Illinois]

    The ordinance would establish a working group to develop a suggested framework for how to implement the Johnson administration’s plan. Members would look at budgetary needs, sources of revenue, staffing recruitment, retention strategies, capital and facility needs, and metrics to evaluate success.

    The group would include Chicago Department of Public Health staff as well as stakeholders from other city organizations.

    "Together, we will work to implement more holistic, collaborative solutions for the mental health crisis we face and ensure all Chicagoans have access to necessary resources and care,” Johnson said.

    The working group would be tasked with submitting its recommendations to city leaders by the end of May.

    Johnson’s mental health plan consists of several components, including the reopening of city-run mental health clinics that were closed under former Mayor Rahm Emanuel and the hiring of community health workers.


  • 14 Sep 2023 1:16 PM | Deborah Hodges (Administrator)

    Some Chicago-area residents will be able to test the water quality in their homes as part of a Northwestern study that will begin providing free test kits later this year. [Chicago Tribune]

    Awarded a $3 million federal grant, researchers plan to phase in testing over several years in 350 households, where residents will be able to begin testing immediately for lead. In subsequent years, they will also be able to test for other contaminants such as PFAS, or perfluoroalkyl and polyfluoroalkyl substances.

    “The end goal is to empower people with knowledge: the knowledge of whether or not lead is in their water,” said Sara Young, who is leading the project with her husband, Julius Lucks, in a statement from Northwestern. “These tests do this by offering the same certainty and simplicity found in at-home COVID-19 and pregnancy tests.”


  • 13 Sep 2023 6:05 PM | Deborah Hodges (Administrator)

    A “critical problem” related to receiving additional Medicaid matching dollars led to the recent decision to suspend copays in the program that provides Medicaid-like coverage to undocumented individuals, an official from the Department of Healthcare and Family Services said Tuesday. [Health News Illinois] 

    Omar Shaker, an attorney for the department, told members of the Joint Committee on Administrative Rules that the existing system did not allow them to receive matching federal dollars when a non-citizen requires an emergency room visit.

    He said the department chose to suspend the copay rule until it can “draw in as much federal matching as possible in these situations.”

    HFS sent a notice last week to providers saying they should not charge cost-sharing for the population “until further notice.” Any cost-sharing that providers may have already collected must be returned.

    Shaker told lawmakers he could not pinpoint when it was decided to suspend the rule, but added conversations began about two weeks ago on whether the department could implement the match into their system without the need for a suspension.

    He added there is no timeline for when copays may be reinstated, nor is there an estimate for how much could be recouped through the federal match.

     The rules, unveiled earlier this summer, include a pause on new enrollees between 42 and 64 and copays for hospital services not eligible for a federal match. Seniors can still join the program until their enrollment reaches 16,500, a threshold that officials recently said has yet to be reached.


  • 12 Sep 2023 6:29 PM | Deborah Hodges (Administrator)

    Over the past several years, many health care organizations — especially in response to the Black Lives Matter movement and the murders of George Floyd, Breonna Taylor, and others — made strong public declarations of their commitment to advance equity and racial justice. [ Beckers]

    This attention was long overdue. Some have described this as the largest groundswell of energy focused on racial justice in decades.

    This racial reckoning touched every industry, and health care systems were no exception. Yet, while many companies rushed to hire chief diversity officers, chief equity officers, and similar positions several years ago, the Wall Street Journal recently reported that many organizations are now shedding these positions or rolling back their initial commitments. In too many cases, positions created to advance equity were neither adequately resourced nor given clear and specific objectives. As a result, the top-tier talent who filled these roles were not set up to achieve the results that people have hoped for, leading to much frustration.

    This is a troubling development and should be seen as a call to recommit ourselves to advancing equity, diversity, and inclusion. Some organizations may simply be recalibrating or rethinking how they want to do this work. But others may be abandoning these equity leadership roles and initiatives because the effort is more difficult, more complex, and takes longer than they expected. Instead of pulling back, individual organizations should consider how taking part in coordinated and collective action could strengthen their anti-racism and equity efforts.

    Don’t Go It Alone

    The Institute for Healthcare Improvement (IHI), the organization that I lead, has joined with the American Medical Association (AMA), in collaboration with Race Forward and a growing list of organizations, to create the Rise to Health Coalition. The Coalition brings together individuals and organizations committed to equity and justice within the health ecosystem to build, lead, and advance shared solutions and collective actions to transform and strengthen health care. We have invited a coalition of individual practitioners, health care organizations, professional societies, payers, and pharmaceutical, research, and biotechnology organizations to deliver more equitable care outcomes to patients, families, and entire communities. 

    The theory behind the Rise to Health Coalition is that no individual or single organization can advance equity and justice alone, and three years into our equity commitments, many organizations are now at an inflection point. This is neither the first nor the last time we will face such a moment. But, as we have in the past, we must now commit ourselves anew to taking action with colleagues and communities to build a future where health and care are better, fairer, and more equitable. 



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