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Biden's COVID-19 plan: Masks, testing, more vaccine supplies
"Is issuing another flurry of executive orders aimed at finding the pandemic. The president announced plans to evoke the Defense production act to boost vaccine and testing supplies. He'll create a national testing board and require masks on Busses, trains and airplanes. President Biden also says the U. S. Will rejoin the World Health Organization,
Interview With Penny Powers
"Thank you very much penny for joining me and q. Barb in the rest of the special interest group for the invitation so we will have some general questions to begin with. How long have you been a therapist. I have practiced for forty five years. Wow that's quite a quite a career. At what point in your career did you become interested in assistive technology or in specialized wheelchair provisions after. I practiced a of years I received an invitation upon returning from china and adopting my second daughter Here at vanderbilt. I was offered the invitation to help out if you will in the wheelchair clinic and It afforded me the opportunity to move from a back in the day. They called it sub acute practice. So i was doing inpatient practice primarily with geriatrics medically complex patients in our sub acute unit. Which they've sort of gone away and gave me the opportunity to move to an outpatient setting so a single mom with two young children was attractive. But i have to tell you gave me great pause. I asked myself repeatedly. Could i learn a new area of practice and for me it. It really was a new area of practice and certainly I had to Get out my motivation. And i said yes for which there has been absolutely no looking back and although it's trite. I'm so glad. I jumped off that cliff great. So what is your current practice setting. Can you describe where you work. And what the setting is like sure I work at the within the vanderbilt bill wilkerson center which is Interesting are Hub for speech language and hearing sciences. And i work in the neuro rehab hub for the vanderbilt university medical center which is called the pie beta fai rehabilitation institute. And if it sounds like a sorority. It is because the pie fis gave the seed money to start this clinic and they are tremendous supporters of this clinic. The clinic did not start out just a little historical perspective. The clinic did not start out here. The clinic here at vanderbilt was part of rehabilitation services and started again. Hold onto your hat. In nineteen eighty five and so it really was on the forefront and so started in one thousand nine hundred eighty five but in two thousand five the department of rehab services which had Come under the umbrella of orthopedics divorced us and as part of the divorce agreement i brought the adult seating and mobility clinic And i say Pi beta phi. Me and jenny. Robertson took the pediatric component or division of the clinic to one hundred hoax. And of note. I think that really was a fait accompli. In that is everybody knows. A children's hospital wants everything pediatrics. So i think that part was a fait accompli. But i moved here to define two thousand five. We've been going pretty strong since then
How to Leverage Uncommon Thinking To Explode Your Healthcare Business with Tim Storey
"We're leading our clients but more importantly we leading ourselves. And i'd love to know in terms of working with all of those celebrities aloft often we when we looking watching. Tv was saying the e channel or whatever this the separation where they're on a pedestal. The from us talk to that a little bit. Because i think that sometimes we forget that we are all people and sometimes we can feel like a person just like that celebrity might but our client can view us on a pedestal like we re celebrities. I'd love to kind of get your feel on that. I think that you know when you think of double i think of. If you're gonna get double then you have to think beyond man. So i have looked up toward beyond in it means farther greater distance beyond regular reach beyond limits or boundaries which i think is such a cool thing so i think that whether you're in the space of any work that you do to to get double or to live life that's beyond that you have to really be uncommon so what i see with a lot of people that i work with. Which is the best of what they do is number one they. They think uncommon dots. They don't think regular thoughts on this. Secondly they make uncommon plans. I won't go through like certain list of celebrities. Because i think if you look up you'll see where i work with that. I've seen people before they made it. And then damn just explode. I mean become the biggest stars in the planet by uncommon thinking. I've sat there. Well make uncommon plans so uncommon thinking uncommon plans but then you have to have uncommon disciplined. And this is where i can. This is where i really cannot be. Beat i like that rap song everyday hustle and every day a muslim. And that's what i am. I am a hustler. But i'm fish int- because it's not how fast you move your feet. It's how big your strides and so the uncommon disciplined. The d. word is something that i see in many celebrities that i work with whether it be a singer or an actor who shows up on time memorizing their lines a dancer a professional athlete. You see that uncommon discipline the d. Word yeah. I think a lot of people have dreams. I don't think as many have belief and therefore plans for sure but discipline by fire. I feel like is the lowest on that that poll so to speak for most of us i. I'm not sure where that comes from. I feel like a lot of time. We we liked to go after something but that go sinc- of maine maintaining the if it beyond doing it. Not just for award. Where i think most people get stuck in and john achieve successful fulfilment that they could is because they going after it at the point where on getting something from it says that starts to be less and less reward for the effort they back up with that discipline if it whereas to get to. The knicks point at requires you to go beyond its like in terms of running marathons. You wanna be at the front of the pack or cycling because the gap between the two packs is too hot to cross. But once you're in it it's easy to maintain and stay in that pack but if you lose the pack they often never gain it back. And i think that's an example of that right. It's comfortable where i am is reward to get to the next level. I need to go beyond that. Push through consistently with no potential view of success in the future to get to that next place. I like what you're saying. And i think that what you're saying is so spot on about the discipline because the rewards don't always feel the same like i'm with people that do extremely well and i think that the house that they live in the just like enormous. It's amazing when i get it. But i notice after being around someone for a period of time then adjust becomes a place where they live and they have a lot of people running around. You know taking care of the house. But i think that for me. It's about being a good steward of my life and because of a teacher. I have notes so like a good steward of my health of my family. My mental hygiene my job my finances. So that's what i try to do like.
California warns against using a batch of Moderna COVID-19 vaccines after allergic reactions
"Official in California is warning against using one lot of the Madonna vaccine there. Mike Rossi has got this. California state epidemiologist says the state should halt the use of a lot of Corona virus vaccines after some people received medical treatment for possible severe allergic reactions. Doctor Erica Pan recommends Ah Hall to vaccinations using lot 41 L 20 a of the Madonna vaccine until an investigation of the possible allergic reactions is completed. More than 10. People who all received the vaccine at the same community site required medical attention over a 24 hour period.
Understanding the Virus with Dr. Howard Fullman
"So i are host the quadruple board. Certified doctor of internal medicine. Pulmonary disease critical care in neuro critical. Care my very good friend. Dr steven day back. How are you steve doing. Okay deceive. oh we have one of our favorite experts returning to us today Howard j fomin. He is board certified in internal medicine and gastroenterology and howard served a multi decade tenure at kaiser permanent day as partner ford member president of the executive committee chief of staff and chair of the quality committee. He has supervised over forty three hundred staff and over five hundred doctors. Howard is now seen your operating advisor at atlantic street capital for their medically focused investments. Dr howard foreman nice to have you back thanks to be here high stated it good to see hey steve. What's it like in the icu. With the kobe patients has it gone. It's been very rough at my hospital. The surges hit us really hard. We actually we had a mini surge. Back in may when everybody else seemed to be really struggling at this time it has hit us really hard we have about one hundred and fifty plus cove patients in our hospital and i bought twenty percent of those are in the intensive care unit and those that intensive care unit. They are all on high flow oxygen or intimated. So they're all very very sick. And howard what. Are you hear about kaiser. How are they holding up in all this. I just very proud of everybody. Credible courage by the patients and their families what they're going through doctors nurses respiratory therapist all staff level of dedication i think of the healthcare professionals are just miraculous people. Tired in was there the other day doing data the procedures. And just in what. I do which is way less difficult than being in the icu. For twelve hour shifts just wearing in the ninety five masks in a shield and all the p p being more cautious than ever and trying to make sure that the patients can get in and out so that they're not in the medical center. One minute more than is necessary. Cetera et cetera. Just makes the practice of medicine which is already something that's very challenging even more challenging but my heart goes out to the patients and that that's just a culprit patients Anyone who needs services. The hospital is having more difficult time than usual inside easy being a patient thunder normal circumstances that along under these circumstances. i'm sure they're all kinds of treatments. That have changed since our last conversation. I mean the remdesivir steroids in a number of other treatments that you guys have raised a bad situation. What's working the best these days. Dr steve in actually the one medication that really has shown to decrease mortality everything that we have is decadent on an age old medication. A steroid that's used to decrease swelling decrease inflammation in the body thus far as the only medication that we're using that actually has been proven to diminish with a twenty eight day mortality. We do give them de severe because there has been shown that there's been some benefit in terms of shortening the course of the disease and so it's still part of our protocol and so everybody who's coming in is getting a coverage for we call community acquired pneumonia in case they have bacteria on top of covid. So they're getting the usual medications for that which is usually as for miocene in something called stuff triax zone but the standard therapy provided you have good kidney function that you're not to overwhelmingly sick is the decca drawn remdesivir but it is the decca drawn. That by far has been shown to be very effective. I do believe for those people who are not terribly ill that are just starting to show signs and symptoms of covid that have various co morbidity is considerably overweight have diabetes a monoclonal antibody that has given an infusion. I believe has also been a game changer. Although i've not seen formal data in that way but those are the big three medications that we give. I mean you've got to look at what's going on here in the us and it's gotta frustrate both of you. Knowing how many people are breaking the advice may be needle one column rules because somehow those of us in the us don't like those things called rules. Frankly i've seen a bunch of parties. Go on in my town. There have been a bunch of weekend weddings and dancing. And what have you and it's almost like. What are you supposed to do as a healthcare organization to get the message across. I can't imagine. What would happen. To dr steve here if there was a surge on top of this surge. That's an important point in all of us in healthcare professions of. I wanna start again by saying lots. Lots of people doing their level. Best imply vincent. I feel really badly for people who don't have a luxury to be at home. That essential workers people who were living in very congested areas. Tranquil did very best. They can difficult circumstances. So that's important to make sure we now. The hard work difficult circumstances lots of people living under now everybody's violating these guidelines but there are people who are either inadvertently or something some cases intentionally violence
WHO chief lambasts vaccine profits, demands elderly go first
"Organization chief is lamb basking Drugmakers profits vaccine inequalities at the opening of the W. H O Executive board meeting We hear more from correspondent Karen Shamas reporting, director General Tetra said Denham, Cipri ASIS Contempt, an imbalance in vaccine distribution globally, Not right that younger Healthier adults in rich countries are vaccinated before health workers and all their people in poorer countries had to escape. The example of Guinea is a poor country, his most vulnerable and nowhere near protected. The world is on the brink off catastrophic moral failure. United. The Wh Kovacs program has so far secure two billion doses. The program aims to get vaccines out to all countries ritual Paul based on need.
Personalized brain stimulation alleviates severe depression symptoms
"Two studies out today suggest ways to improve treatments for depression and obsessive compulsive behavior. Using brain stimulation. Thea Pro just delivers pulses of electric or magnetic energy to certain areas in the brain. Scientists report that stimulation is more effective when it is customized for each patient. MPR's Jon Hamilton has more Brain stimulation is usually reserved for people who haven't been helped by drugs or other treatments. People like this woman in her thirties who had severe unrelenting depression, the world was slow. And gray and flat. Everything kind of tasted the same. No actual sense of enjoyment or No ability to imagine NPR agreed not to use the woman's name to protect her medical privacy. After five years of searching for help, she got into a study run by Dr Katherine Scan. Gus of the University of California San Francisco. Scandals is part of a team trying to improve deep brain stimulation, which implants wires in the brain to deliver tiny pulses of electricity. Traditional deep brain stimulation has typically stimulated in one location. In every patient without really an understanding of how that effects each individual's depression symptoms. Scandals thought she might be able to relieve the woman's depression using a different approach. So she created a map of her patient's brain that showed which area was associated with each symptom. She had an iPad and she marked off her level of depression and anxiety. An energy level in response to each pulse of neuromodulation. Then scandals used that information to design a deep brain stimulation system that monitored these areas and delivered pulses on Lee when there were signs of trouble. Our goal is to develop a brain pacemaker. That can nudge these depressions circuits back into their healthy state and keep them there. And for this patient, it worked, she recalls. The first time doctors stimulated one particular area of her brain. I wasn't really expecting anything to happen, and then suddenly It was this kind of wash off the sense of pleasurable happiness and glee, and I literally think I giggled. She says The implanted stimulator she went home with is still doing its job. Months later. The world is Is back. I'm back. I feel like myself again. A personalized approach to brain stimulation also seemed to help people with obsessive compulsive behaviors. Trade. Grover, a graduate student at Boston University, was part of a team that studied people who had thoughts that wouldn't go away or behaviors that they felt compelled to repeat, checking whether we've switched the stove off or not. Have you washed her hands enough in, particularly in times like ours today in the pandemic, Such behaviors can be exacerbated. The team knew that these kinds of behaviors are linked to problems in the brain's reward network. So they studied the activity in this network for about 60 patients. Then they devised a unique stimulation treatment for each person. Grover says The treatment sends pulses of alternating current through electrodes placed on the scalp. It allows us to stimulate the brain. And mimic the kinds off Ray to make activity patterns that are typically associated with healthy behavior, He says. People who got the treatment instead of a placebo got better. By the fifth day of stimulation, obsessive compulsive behaviors had significantly reduced. On average. There was a 28% reduction, and Grover says the treatment works best on people with the most severe symptoms. Both studies appear in the journal Nature Medicine. Jon Hamilton NPR news
US cancer deaths hit ‘single-year record drop,’ American Cancer Society says
"More strides in the fight against cancer. Researchers say from two thousand seventeen to twenty eighteen. The cancer death rate in the us fell by two point. Four percent which eclipses the record set the year before the american cancer society says longhand accounts for almost half of the overall decline in deaths over the past. Five years. part of the reason is that fewer people are smoking. there's also been medical. Advances like newer drugs and better screening. Cancer remains the second leading cause of death in the us after heart. Disease
COVID-19 cases in children continue to rise
"Discussed discussed the the most most at at risk risk groups groups for for the the coronavirus. coronavirus. It's It's often often those those over over the the age age of of 65 65 people people who who live live in in long long term term care care facilities facilities in in frontline frontline medical medical workers. workers. This This case, case, CBS CBS is is Jeffrey Jeffrey Shall Shall reports there are now growing concerns about Children younger than the age of 17. According to data from California medical health leaders. There have been more than 300,000 coronavirus cases involving Children younger than age 17, including six deaths. Grace Lee is professor of pediatrics at Stanford University School of Medicine. She says she hopes trials underway by vaccine provider Moderna of Children ages 17 and younger will show they should be included among those vaccinated and especially as we're thinking about returning to schools. In addition, Tonto using vaccines of the really effective tool to protect Our educational work for us, for example, and hopefully we'll have vaccines for teens as well. As you may know, it's been really challenging to open up high schools a lot easier to open up elementary schools for the younger age group from a multitude of reasons, but we also need to be able to get our high schoolers back in return is stage three vaccine trials for Children aged 12 to 17 or currently underway. Results could be available by spring.
Reduce No-shows, Fill the Schedule, and Improve Patient Experience with Michele Perry
"Back to the outcomes rockets. All marquez here. Today i have the privilege of having michelle. Perry on the podcast. She is. The ceo of relations has sast based patient centered. Engagement company that utilizes a modern and mobile first approach to improve patient and provider communication. Michelle perry has almost thirty years of experience in software and health technology an undergraduate degree from the wharton school at the university of pennsylvania and her nda from harvard business school. Just the the important topic around how we communicate patients effectively. And how do we do that at scale. It's going to be a great talk and michelle super excited to have you join us today. Thanks for having me excited to be here absolutely and and so before we dive into the awesome way. You guys engage patients at relations. Talk to us a little bit more about you. Michelle wu spires your work and healthcare the patient. You know really. This truly has to be about the patience to have been easier way to access healthcare This pandemic has shed light on. The fact that truth helped get a truly is about the patients. And that's why you know. I joined a company named relation relating to the patient and focusing on the patient. How do we make it easier for the patient because anything related to health care is high and so why don't we make it easy. Yeah and i think the nature of kind of how healthcare works and fortunately that it's complex And the need for that expertise of simplifying and getting a message to the right person at the right time is critical so michelle talked to us about how relations is adding value to the healthcare ecosystem. Exactly what you just said you still my words saw. It's all about getting the right Right message to the right person at the right time. And you know the industry's been a little too focused on patient portals and just dumping information they're figuring out the patient would find the information and it's just not working you know we need to make it easier both for the practices and health systems to make it easy for their patients to access healthcare. And we need to do it in a way. That patients are use to communicate. Say and we all carry this phone You know there are a few people in the country maybe not for the most part people have a phone kind. You know in their pants pocket or in the hand of something all day. So how can we make it very easy using that mobile device to get them just that right information and not a data dump just the right information at the right time. Yeah and so there's a flow you know. There's there's a step by step process that kind of we go through when we get care. There's a scheduling. There's there's actually going to see the clinician where you wait. I guess there's a lot of waiting and cars now with with the pandemic reminders etc. So there's a lot of touch points that potentially league we could miss and so talked a little bit about what you feel makes relations special and different than what's there today. Yeah so you know. Unfortunately healthcare has so many rules and regulations Starting with that introducing some of this technology to be patient facing can be really non thing and then you add all all the communications laws which tcp a of the can spam and. This really seems way too. Risky move forward and health care. So that's where many practice of just put it in puerto new best enough but the adoption and usage of portals. It's just really low. So what we focused on is making it just easy to get the critical information at that point in time. Whether it's about an appointment to make sure that you know it and confirm it and we have best practices where we combine own email and chat messages over the course of five three one day to get the best response rate and to get people if they can't make it you know to cancel reschedule and get them back on the calendar that you can get waitlist filled spots that they laughed and moving all of that so really combining all these with one platform that can make this really productive for the practice which would make it productive for the practice can make it easy for their patients totally.
Interview with Kristin Musselman about Reactive Balance
"Welcome to discuss. Discussions and spinal cord injury sci where we bring you interviews with researchers and clinical leaders in spinal cord injury rehabilitation. I'm rachel tappin. today. I'll be speaking with dr kristen muscleman who is last author on a recent paper in the journal spinal cord along with co co-authors. Catherine chan jaywalking less journal. Unger angela you and k musani the papers titled reactive stepping after a forward fall in people living with incomplete spinal cord injury or disease. Dr muscleman is a physical therapist and scientists with the neural engineering and therapeutics team at the cato institute which is the research arm of the toronto rehabilitation institute. She's assistant professor in the department of physical therapy and rehabilitation sciences institute at university of toronto. She's active in the canadian physiotherapy association and now of course and the american physical therapy association with this very podcast. And she's academic lead of the walking measures group and the canadian community of practice for the practice spinal cord institute so welcome. Kristen muscleman. thanks rachel so much for having me. It's a pleasure to be here. I'm so happy to have you so. Let's start by talking about balance after spinal cord injury and i wanna talk about reactive balance in particular where the person needs to recover from a loss of balance. Can you just describe for us in general. What do we know. Or i guess. More specifically what did we know prior to this to this study in this area. Sure well react to balance. It's a key part of our posture control system. And as you kind of mentioned it really is our last line of defense against a fall so to try to recover balance that's been lost and so refers to our ability to reduce control of The movement of our center of mass where or to pull our center of mass back within our basis support and we we can do this through movement at the ankles hips. You know which we've Often called the ankle hit strategies or you can do it by taking Rapid reactive steps to try to increase our base of support. And it's this Rapid reactor stepping that. We've focused on in our research and you know surprisingly we actually don't know that much about reactive balance control after spinal cord injury We do know that. In other neurological populations like individuals living with the effects of stroke. The inability to take a reactive step is associated with the occurrence of falls And as many of those listening are aware people cred injury. Do you have a lot of falls as well. So a recent meta analysis found that seventy eight percent of the ambulance chasers with spinal cord. Injury will fall each year so it's definitely reasonable to expect that reactive balance control is impaired after injury but specifically what aspects are impaired wasn't known for example are there deficits related to the timing of the movements and muscle activation or insider their spatial deficits. So you know for example. Maybe they can't take a big enough react to step to appropriately reposition their center of mass. So those are some of the questions that we had. I'm going into doing this research. Great boy and i can certainly point to as a clinician. You're supporting things that i felt like. I knew already as i would experience that in the clinic of people having lots of difficulty with reactive balance after spinal cord injury and looking to the research literature and really having a hard time understanding how to proceed so for reinforcing or validating. The experience that i've had at least you study your your group did the study. And so what did you do. And what were the results. Yes what we wanted to do was to characterize reactive stepping in and people who are living with incomplete spinal cord injury so as a first step We compared their to stepping ability to out of age and sex matched individuals who have a spinal cord injury and what we decided to do in this for study is focus on two aspects of reactor stepping so i is is a behavioral response which just simply looks at. How are the participants recovering their balance after appreciation. So can they take a single step like most people who haven't neurological damage do or do they need to take several steps to reposition that center of mass in their basis support or are they unable to recover their balanced. So that's the behavioral piece that we looked at And then the second piece we looked at were these temporal parameters of reactive stepping so this includes things like the onset of muscle activity and legs And also the reaction time so you know. How quickly can they respond for that. We look at the length of time. Between the onset of the nation and then the actual movement That's elicited so in this case you know lifting off the switch a reactive step but what we needed to figure out how to look at this behavior in a standardized way and so we use a lot based assessment That's called the released test And this has been used with the stroke population it's also been used previously in older adults And basically what it does it simulates a forward fall of course in a safe way so if you just try to picture yourself standing and you're in a safety harness that's gonna prevent us from from hitting the ground if you were to lose your balance That saves you harnesses around your trunk. And then what we do. Is we attach a horizontal cable to the back of the safety harness right around the level of your lower back and then not cable which is about a meter long. It's attached to the wall behind you and you get asked to lean forward from your ankles as best as you can until about. Ten percent of your body weight is supported by that cable.
Health and tech leaders including Microsoft and Mayo Clinic are developing digital COVID-19 vaccination passports
"Oracle and healthcare company. Cigna and mayoclinic are part of a coalition pushing for digital records of those who get vaccinated. It's called the vaccination credential initiative and the idea is to let people get encrypted digital copies of their immunization records stored in a digital wallet of their choice. No smartphone you'd get a paper. Qr
US appeals court: Supervised injection site defies drug law
"Against supervised injection sites in a case out of Pennsylvania. The third Court of Appeals found that starting such a sight would violate federal drug laws, saying that while organizes the program, they have noble intentions. Federal statute makes such sights illegal. It's unclear how the really will affect efforts to open a similar site here in King County.
General info about BI SIG with MaryBeth Osborne
"Everybody to the brain injury sig podcast. This is our first podcasts. And we are so excited to have mary beth born as our person that we are interviewing for this podcast so as our inaugural version here. We figured we'd do is talk about the sig in some influent in some Can up-to-date versions of what's going on with the sig. So mary beth is a physical therapist who initially got her degree from the university of north carolina at chapel hill in nineteen eighty nine and then went back a few years later to get her. Dpt in two thousand nine as she has clinical specialization in neurologic. Physical therapy which She was board certified in two thousand fourteen. She has professional experience in a lot of different settings. I'm a large portion of her time in brain injury community based re entry and then supported living program. She was adjunct faculty at unc chapel hill for five years and then has been at university health for five years in their outpatient narrow clinic in serves as the co director of the neuro residency program. She has expertise in the hippo. Therapy and aquatic therapy so. Welcome mary beth. Good to have you thank you. I'm delighted to be the first gassed on your podcast. And help promote the sake right so i guess i should mention the reason why you're here as our guest for the big is that you have quite a lot of experience helping out with the brain injury sig in general in the a n. P. t. on so could you maybe just tell us a little bit about your role in the brain injury sake. Sure i'm the immediate past chair of the brain injury special interest group and served two terms And it was an extra year is well because it was We transitioned from chair. Lacked position which i served that year so i believe it was seven years as the brain injury. Sick share I started as the chair so A lot of people know came back or karen mccullough she nominated nominated me from the floor at a csm meeting and That's when i started being involved with the big. Wow awesome and we thank you for all your work that you've done for the many changes in the accomplishments that you had over the years with it so for people who don't really know the structure of organization of maybe kind of umbrellas. Ap ta in a n. p. t. could you just kinda give a brief Overview of kind of how the brain injury falls into place where really falls amongst the structure of the aneka ti. Of course that abt a has a number of academies sections and so the academy with under which the brain injury special interest group falls is the academy of neurologic physical therapy or a. n. p. t. and so under a. n. p. t. There are eight special interest groups or six and so the brain injury special interest group is one of those eight special interest groups and the intent is just to break down the content area or Interest area of clinicians and their pets Into common interest areas so that the special interest groups kind of interface directly with the membership on a smaller level. Right right thanks. That's really helpful. I think to kind of know where everyone falls in alignment and kind of how they all work together. So the brain injury sig than is part of the a. N. p. t. Does the brain injury saying have its own particular goals or kind of missions or things that it's doing to can help on conditions who are had interested in helping individuals with brain injury. Yeah so the jury's special interest group mission aligns with the economy of neurologic. Pt's mission and is basically. And i'm paraphrasing. But it's basically just a forum to promote health wellness Optimal function and quality of life for individuals with acquired brain injury That's kind of the overall arching thing is to gather people who are interested in providing care and assisting individuals with acquired brain injury From the physical therapy perspective.
The Role of Consumer Payments Products in Healthcare with Greg Boulton
"Welcome back to the outcomes. Rocket saul marquez's here. And today i have the privilege of hosting greg. Bolton he's a corporate development executive with experience in the financial technology industry who has spent the last ten years focused on payments and payments products in the healthcare space. We are going to be discussing the impact that the financial industry technology and products can have on improving healthcare delivery knowing all the challenges that exist in how we pay for healthcare. I think today's discussion with greg is going to be a really interesting one. And so with that I wanna i wanna give you a warm. Welcome to the podcast greg. Thanks so much for joining today Absolutely so you have been focused on basically how we pay for things in healthcare. Greg what has been your inspiration to spend the time that you have in the sector. sure So i came to the healthcare space from financial services industry specifically looking at payments products so credit cards data cards prepaid cards and in a lot of respects. The industries have a lot cinemax celebrities. They're obviously very critical industries and services they deliver a critical the lives of our members our customers and inherently complicated products plex but in many ways we sort of felt like the defense industry had maybe made faster inroads into bringing automation and customization to our products in the national services industries coming into healthcare really looking for opportunities to streamline and make participating in engaging in healthcare easier for the members so And that sort of dovetail with the health care industry really getting more deeply into consumer directed health care and focusing on the members decision making and the rule that plays in healthcare and so we really saw those industries coming being well aligned a lot of the financial products in the healthcare space. Not really been around that long. Very first tax advantaged accounts around healthcare. We're in the very late nineties. Really got going early two thousand so one of the things that we did early on was to try and attach a card to assam these tax advantaged products. And make it easier for administrators to move the money and also for the members understand what they're spending and make it reduced amount of paperwork in manual actions required for them to take advantage those tax advantaged accounts. It's interesting in your right there so much that has happened in finance that just sped past healthcare and in i had a. I had an interview several months ago with the chief medical our chief information officer at phillips and he came from citibank all the innovations that they were taking advantage at citibank. Now they're getting leveraged by phillips in that company and so there's a ton that we can learn from the financial industry and so talk to us a little bit about some of those things greg and And maybe how this particular approach can add value to what we're doing in healthcare. Well i think some of the things that we've been engaging with a lot of course as i mentioned automation and debts really almost entirely contingent on standardization through a lot of advantages services. Industry has had compared to health care. There's much higher level of standardization and the bodies that would create maintain both system rules as well as as the legal constructs behind all that allowed enforcement of rules. Were so much stronger in the financial services area than they've been in healthcare so in the initial services we've had visa and mastercard had nachon had a very prescriptive. A central planning operates nash services and that's allowed all of the companies to code robustly to bill very robust infrastructure around a data said and mediation standards. That didn't have a lot of variation in the healthcare space of course do have standards. But they're far looser and there's a lot more variation variation in healthcare plans and there's a lot more variation kind of diversity of approaches across the healthcare space. That makes it all much more difficult to approach but overall approach very much has been as we're going to try and create a consumer product built on a on a mountain of technology at complexity but trying shield that and make it seem as easy to consumers possible. Make that decision point. Essentially you know in the the member of the consumer is at at a point of sale. We want them to go to the wall. No which which carving out trying to keep it as simple as that and healthcare space
2020s MedTech Innovation Winner with Paul Grand of MedTech Innovator
"Hey welcome back. Outcomes rocket listeners and viewers glad you have tune in again today. I have the privilege of having to guests one. He's a repeat offender here on the podcast. A good friend of mine paul grand. He's the founder and ceo medic innovator. They're the premier nonprofit accelerator in the metric industry that really seeks to improve the lives of patients by advancing companies poised to transform the healthcare system and also on the podcast. We have annalisa samarra. She's the c o rayo's who will actually the winner of midtech challenge and we're gonna dive into how that happened. And what that means but misnomer brings over twenty years experience working with startups in different capacities including biomedical research. Venture capital technology transfer operations and more in. Her interest is leaning startups. It really stems from ortho. Cell technologies a medical device company. She co founded in two thousand five obviously is passionate about making healthcare. Better hydrocephalus is what she's tackling with radios and you'll learn a little bit more about what they're doing at that company through annalisa so i wanna just start off by thanking both of you for being with us today. Thank you for having a saw It's great to be back on the outcomes rocket and it gets some time with you as always so. Let's check guys. It was a long run. We were together in february. In fact paul annalisa like we were in the same room. We recorded some interviews. It was fun. The energy was high and here. We are in october. And you know it's eight months later. The contest is over. Why don't you give us a summary of what happened paul. And some highlights and then we could lead into annalisa and and some of her insights sure yet. Thanks saw i mean. It's hard to believe that was eight months ago in some ways it seems like two months ago in some ways it seems like three years ago all the events the pandemic and everything. It's been happening since then. We are fortunate to be there in chicago or in person right before things got bad with covid and we had to go fully virtual on rested at road tour. So yeah what's happened to between we went through the process of evaluating over a thousand companies meeting with a couple of hundred person. We then move onto an incredibly fruitful. But you know challenging in many ways program where we do what we do every year arena. We find all this incredible companies. We partner them up with some of the leading strategic and providers and other people in our industry as mentors and advisors and we run this program that we typically do. We've been doing now for six years as a virtual accelerator but we depend on a lot of big in person events as well so that one february is one of the last ones that we got to do this year in person and we had to do everything else virtually but when incredibly well we selected fifty companies in our main program who were part of the primary toward and then we had another twelve companies on top of that that were just part of pediatric. Track for fifteen companies total that were part of the pediatric program and we had another twenty companies in asia pacific so Running a lot of stuff A lot of programs. And it's literally nonstop. Since i you in bed worry. Having taken a break there's the notifications has been no arrest. I haven't been reorganized and finally get vacation though. I mean it's over right or well. No i Was the first weekend actually kind of rest. A little bit still running that asia-pacific program that runs for another month until it's finals and we saw value competition coming up value word during midtech strategist conference in november. So we had a lot more to do still an. We're opening up applications for mid second beater. But i guess the last thing. I'll say when and we can dig into some more details that we've managed to pull it all off we slough some radical companies. Who just blew us away this year. Not only as they always do with their technology in their teams more passion and the way in which they're coming things being able to do that during a pandemic was kind of clean boggling. At how well these dumpings are executing you know no one is like hanging up their shingle and saying well and to go Go to start a farm or something. During the pandemic everybody is just executing and finding creative ways to do that and some have been accelerated as a result. So it's been tremendous were thrilled. I wish i could say it was time for vacation but i'll get one eventually. That's awesome man. I mean to work through the pandemic and in february i mean none of this pandemic was even in sight. I mean at least for me. I was like we were running. We were having a great time over there. Shaking hands and hugging. It wasn't until right. It was only a couple of weeks later that it's right like looking getting a little wider. What we're staying here and starting to look at each other going to keep doing this stuff you know in person. I remember the very beginning of march. We had another event at ucla and And people were that event. We're gonna look around going like. Is this totally separate. One of our partners didn't come to that event because they said that their corporate headquarters at stop travel and we thought that was really strange. Where like you can't fly from san jose to l. a. This is crazy by a week later. Like i was doing so the big one was when hams cancelled. Yeah oh wow. That was the real.
Paperwork Isn't Sexy (But Its Important)
"With me. Today is roz jones. She is the owner of a home health company. And we're going to discuss documents. You need when you're taking care of a loved one. And that's any loved one not to somebody living with alzheimer's but she is going to touch tiny bit on the extra ones we need for those. Thanks for joining me. Roz you are so welcome. You're welcome and thank you for the opportunity to speak before your community. You're welcome. This is not a topic. It's like paperwork is not. My thing is not sexy. Anything about caregiving is true is not sexy but it has to be done. It has to be particularly now in. A cobra has really shifted everything for caregivers. You have alzheimer's dementia. Whatever the case may be it has taken me shoe ship. Beautiful have documentation. If you really don't have it now. A lot of things are gonna happen that you didn't want to happen and believe that i just i know my dad had all his stuff together when he was in and out of the hospital right at the end of his life. He had mom's pretty much put together because she was in a care home. Like we'd go to the doctor. This was always frustrating. They'd say oh what medications are selling you tell me. You're the one described them. So i always had to make a mental note to get the list from the med tech at the carol. She was in so that. I can tell the doctor who prescribed like oh people. I don't need to know about the medication. Because the doctor tells the care home in the care home orders them. And that's all that's set it all up so i didn't have to worry about it so that's kind of how i handled paperwork. My husband is paperwork. guy is a real estate broker. So paperwork is his thing. So where do we start with documents. And how how should we have them. We have them scan into our phones as well as paper. Copies let look letter e all the above the more people that have copies the better and the reason why i say that is because even with the pandemic we still have hurricanes floods tornadoes fires earthquakes fires. Okay and and my client is in california's well so anything could happen. Anything can happen to where you get back to that paper copy or you can get to the computer or to debate the save wherever you keep those documents. Tell people now we have copies with you but to a relative that. That's you know or friend. That's not in the same area as you so if something does happen. Hey can you send me a copy. Email it and now in some speights facilities that's according to our ideal bracelet. What all your documentation in there which is good particularly for people who have alzheimer's which something happens in the middle of the night and you can't get in contact with the loved ones and all the information is on a bracelet so you know there's things out there now that That consist you remember when the id bracelets came out longtime ago to let people know that your insulin and it's the same thing it's the same thing so you know The paper i in electric hire. You can get it done. Get her done.
Gov. DeSantis to hospitals: Use the COVID-19 vaccine shots or lose them
"Dissatisfied has issued a warning to Florida hospitals use it or lose it. He's talking about hospitals that have received the Corona virus vaccine but are not administering it to seniors. Not one vaccine. Just be idle. In some hospital system to Santa says any hospitals found to be hoarding. The vaccine will lose their allotment and the vaccines will be distributed to other health care facilities.
South Africa's COVID-19 Variant: What is the risk?
"Let's go to South Africa Festival, the variant of covert there is causing concern among scientists because it has more mutations. But there's no evidence it is deadlier, maybe faster spreading. Let's sir talk to the BBC's Andrew Harding. He's in Johannesburg. Welcome, Andrew. So tell us about this South African variant. We've been talking about it for a while. Here on news day. What is the latest information We have? Good morning. Yes, It's certainly very transmissible as transmissible is the one that's currently spreading so fast across Britain. Likewise here the mutation, one of the key mutations seems to allow the virus to spread to be caught more easily. There's no evidence as you say. Yet, although tests are still being performed here, no evidence that this new mutation makes the virus more deadly. That's the same in Britain and elsewhere. But the concern that people focusing on at the moment is a third mutation. And this is the mutation that Piss to affect the viruses. Ability to connect with other cells on gets that part of the virus that the vaccines are hoping to target on the confirm, which again is now being tested with great speed and urgency here in South Africa. The concern is that there is a theoretical risk that that particular mutation which we haven't seen in Britain or elsewhere. That particular mutation might just might make these new vaccines that are coming onto the market that being jabbed into people's arms already in parts of the world might make those vaccines less effective than might be. Some reservists calls from this new mutation. But scientists here are being very cautious and saying, Look, we will have an answer to that within two or three weeks are Scientists are very busy and are ahead of the curve if you like. They've been studying this aggressively for some time, and they're in a good position to find this out soon, but there is a theoretical risk of some level of resistance. And we know it's one thing we do know through this whole pandemic is that, you know, days matter. Never mind a couple of weeks. So what is the government they're doing whilst this crucial information Has found out about the whether this third variant is resistant to the vaccine. What's the government doing to Stop the spread. Well, I mean, there are two issues there. If you want. One is the vaccine is to South Africa is struggling on the vaccine front is struggling to secure supplies. The concern is that here and in other parts of Africa, it's going to be many months before vaccine start, arriving in sort of numbers needed to create herd immunity in the immediate term in terms of transmission and keeping this second wave under control, a new big, hard lock down Is in place here across South Africa on officials who I think will really caught by surprise By the speed and aggression of this new This new variant are doing what they can The tackle it and contain it. They're saying that look, it's not just the mutations that are driving the spread of this second Wait. It's also human behavior. People getting relaxed or tired people gathering in large groups and the government as well. Failing At least a month or two ago, failing to prevent mass gatherings. And you say there's problems with the vaccine getting through to South Africa, which one have they Ordered or have they ordered several well, they're working on the comebacks scheme that many poorer countries middle income countries are hoping will get them access. But the concerns you says there are multiple Different types of vaccine, and most of those have been pre ordered by wealthier countries on a lot of countries like South Africa of really been reluctant to throw money at vaccines that might not bear fruit, so they've been hedging their bets, and that's costing them in terms of finding that sells at the back of the queue now when it comes to trying to access the most effective Vaccines in the ones that are most
Finding that Relaxation Mode with Dr. V
"I'm so excited to be here with you into share some personal thoughts about my second healing journey and essential number four. Heal the emotional wounds now. When i was going through my second healing i recognized that there was the need to really take a deep dive. Into all of these central's the today. I'm going to talk specifically about essential number four because i feel that healing emotional wounds is often the most challenging part of healing. We are multitaskers. We are really good at taking care of people but we often tend to neglect ourselves. And we put ourselves last on the to-do list. And so i want to really encourage you to listen closely and if any of the things that i talk about really resonate with you i encourage you to ride them in your journal are riding on a post it note. But go back to this after you've listened to the podcast because these are the things that can truly be transformational. Remember that a breast cancer. Healing journey is not just about getting rid of the the lump or the cancer. But it's about a complete transformation of your life because what brought you to the point of developing breast cancer in the first place is what you need to change. So it's about transformation is like that cocoon the caterpillar cocoon to the butterfly. Its transformation now personally. My biggest takeaways from my healing journey as far as my emotions are concerned. Were two things number one. I recognized for the first time in my life what it was like to live in the relaxation response. All my life. I had my nose to the grindstone and i was a personality. Push push push. Even when i didn't physically feel like pushing. I would push my body to the point of a new my detriment now. Getting into the relaxation response is something that is so key because if we have our foot on the accelerator and we are activating the sympathetic nervous system. The fighter flight mode there studies that have shown us that that can literally trigger cancer genes to turn on and it increases the risk for metastasis. So that alone should be a motivation for you to look at essential number four and to learn to get into the relaxation response. I have trained my body and my mind that when i feel stress in my body i stop and i pulled back and i am. I really make the effort to go into that relaxation mode the second big takeaway for me on my second healing journey was that i now take the time to nurture that little girl. That little girl inside of me was very wounded. Little girl for decades not until late forties early fifties. Did i realize that. I was living the life of an adult but with the wounded child making those decisions for me and so now i take the time to do more things that bring me joy in that little girl joy and do more things that that bring pleasure because that's something that i neglected most of my life so when we talk about healing our emotions are several things we we want to look at first of all. If you're a good stuffer do you find that. You're always fine. Know people ask you how you doing on fine. That's what we call a good stuffer right. We we have feelings. We have thoughts. We have energy but we just keep swallowing swallowing swallowing. Because we don't wanna take the time to really take a look at what's what's happening. What's bothering us. There's a quote from dr lisa. Rankin that. I really like. When i read her book a mind over medicine and she says if you don't grow you grow a tumor. And that's so true because not internal conflicts that we have causes a stress response. You may not recognize it as a stress response. Perhaps you're used to living that way that tension that you have
N.J. front line workers get second dose of COVID-19 vaccine
"New Jersey's first health care workers are beginning to get their second doses of the covert vaccine and SK Y W. Who's Mike DiNardo reports. The state says online appointments for the next vaccination group could be rolled out soon. New Jersey Health Commissioner Judy Pers Achilles said a state website may be ready in a couple of weeks to register vaccination appointments for the so called one B group. Likely essential workers and people over 75. She said. Vaccine supply is an issue as well as having enough qualified people to administer it per securely said the state had received 400,000 doses of the vaccine so far, and while 101,000 doses have been given, she said, the number is likely higher due to delays in reporting, especially at psychiatric hospitals. As for any lack of public confidence in the vaccine, the medical director for the state health Departments Communicable Diseases Service, Dr Ed Lifshitz, put it this way. In New Jersey. We've had about half a million cases of covert, with almost 20,000 deaths in the United States. We've given almost 10 times that number doses or over four million doses, with zero deaths from the vaccine. I certainly would take my odds with the vaccine over the virus any day of the week. Mike
Pharmacist arrested, accused of intentionally allowing COVID-19 vaccines to spoil
"Are coming out about a pharmacist near Milwaukee who deliberately spoiled dozens of vials of the Corona virus vaccine. From reporter Steve Futterman. According to prosecutors. The pharmacist Stephen Brandenburg, has admitted he intentionally tried to ruin hundreds of doses of the vaccine because he felt the shots were not safe. Brandenburg was arrested last week. According to investigators, he deliberately removed 57 vials of the most during a vaccine from refrigeration. Those vials contained enough doses to inoculate 500 people. The FBI and Food and Drug Administration are also involved in the investigation.
Riverside County Hospitals Running Out Of Beds, Staff As Coronavirus Surges
"I see you capacity for the 11 County region remains it 0%. The same goes for the San Joaquin Valley region. Dr. Mark Alley, the state's health and human services secretary, says that does not mean there are no beds available. It's the hospital's air, surging to deal with high numbers of patients and ICUs have so many covert patients that they're ill prepared to care for people with non covert emergencies. We are essentially are projecting that the ICU capacity is Improving in Southern California and family Keene Valley, and the demand will continue to exceed capacity, Galli says. If the projections for adjusted ICU capacity of rise above 15% at any time, the stay at home order will be lifted. When I say it's remains in Southern California, the order remains in San Working Valley. It is not to say that it is there again for at least another three weeks. It could be shorter than that, given the huge numbers of new cases being reported. In L. A county hospitalizations are expected to keep rising and they've been setting a new record daily for weeks now. Claudia Plastic Utah, KNX 10 70 NewsRadio, Los
Mark Campbell, Vice President of Clinical Services for RxBenefits
"There to provide that expert advice to help people get those savings that they're looking for us really control area of healthcare. So such a privilege to have you here with us. Mark can't thank you enough for making the time. Well thank you very much for having me. I'm looking forward to it likewise so before we dive into our x. benefits and all the things that you guys do to make healthcare better for us. Tell us a little bit about you. Mark can and what inspired your really just a long career in healthcare. Wh- lights the fire for you. Thank you very much. i Got into managed care in the late nineties. And i began working with self funded employer groups and the prescription benefit. Industry can be a bit daunting. I can become flex at times. And there's a lot of drugs out there so it's very difficult for the average human resources person to really spend the time and focus In a way that's going to help them maximize the quality and the cost of care so I found a role for myself and and helping to give them an education. Advise them giving them some direction so that they could feel good that what they were doing was really the best thing for their members clinically but also helping them to balance the cost associated with with prescription benefit. Back then it was. You know six percent a total healthcare dollar today for many as well over twenty percent so it's been a very satisfying career because we've been able to couple of people along the way bridge that gap and and manage their cost until good about what they're doing. Yeah that's i mean. Your purpose is so clear mark. And you know i'm a i'm a firm believer of follow one course until successful and you've been doing it for so long in the same area. I'm sure you have seen a lot. And yeah you know you call out from six percent to twenty percent. it's agree gis What what's happening right now. In in healthcare for a lot of employers and individuals talk to us exactly about what are benefits is doing to help in the a healthcare ecosystem. Sure so as i mentioned the prescription benefit industry can be relatively complex. And so there's all these new drugs some of them very very expensive ca- tens of thousands of dollars some far less expensive so for an employer who has five hundred thousand or more people that are responsible for those people on average are using ten prescriptions. A year in many of them are generic very good value very helpful to staying a much better outcome to lower incidence of heart disease and strokes before them. Many of the newer drugs are a bit of a question. Mark So a lot of the drugs that treat rheumatoid arthritis and chronic conditions for gastrointestinal issues or some of the new cancer therapies. These are drugs that can cost anywhere between fifty thousand and a million dollars a year until they find themselves in a very different situation out really trying to understand the cost because he associated with us for such a small number of their members so our ability to come and help give them some guidance some reassurance and and help them navigate. The process can be particularly useful. Not just from an economic standpoint but just to make sure that they feel like they're doing the right thing for their numbers most every employer i've ever met wants to make sure that they give full access to their members who things they need but at the same time they're trying to balance the cost of this new world we're on against the realities that they have to live in today's economic environment. Yeah now while sad and you know. I've even heard of you. You mentioned it right complexity complexity complexity complexity. And there's so much that that we don't know and that we could learn from a company like errors. I heard from folks that oftentimes for one therapy there could be six solutions. You know that the form is different. It's in the tablets powder to a syringe. There's a lot there that we don't know and so talk to us a little bit about that and what you believe makes what are benefits provides different and better than what's available there sure and it's a great question. I think i have a pretty good example for you to illustrate there. There are a lot of parties that are involved in the healthcare delivery model until you have patients who are inherently Very good people trying to do the right thing. Has doctors again. Inherently good people really trying to do the right thing. Manufacturers who develop new therapies and bringing them tomorrow which can be very good for us in general pm's that helped to connect the pharmacies and the manufacturers and all these parties together and so all of those entities and individuals are inherently trying to do the right thing but there are gaps that can occur as those parties. Try to come together and we'll give you an example. Impatient may go to see a physician And the doctor prescribed a medication. Some medications are what's called parody priced. So you can have the same price regardless of the strength of the medication while that may not sound like very much In case of certain medication that could be the difference between paying two hundred forty thousand dollars a year for a patient who taking a medication for particular type of cancer and paying nine hundred and sixty thousand dollars a year because one milligram tablet. Four milligram tablet costs the same two. Four one milligram tablet to cost four times as much as one milligram tablet so my goodness in an offense which you really need somebody who understands these. Complexities is watching. Offer these things who can step in and we've done that many cases where we reach out to the doctor who's not particularly aware that this exist and effected change. which has a substantial impact for the employer financially There's no negative impact to the number. No negative impact to the provider. So it's really just a way of trying to find those opportunities where things can be done. That are drive. Better clinical and economic outcomes. And that's
Advocating for Yourself with FNP Shemeka Davis
"My old friend. Welcome to the wool med. I'm so excited. thank for so it should weaken. I used to work in the nikki together. And let's start there. What made you decide on nick you so i've always had a passion for finding babies. I thought i want to be on labor and delivery nurse but out. I thought there for the laboring mother. I just love though And i know you get this game problem with the babies there year before we'll stay longer so Yeah i probably just up. Always look they power to make you younger brother. He's down sticky. Nick babies though that i knew that. Yeah kinda open up my eyes to the world like a bowel obstruction. He was boris though he has to have a perjury like they are was born though he was one of our surgery cases. Way back when and are up. That's wild so you never worked anywhere else. You just came straight to nick you. Oh no i worked at a on. Folio apollo rectal surgery for we took care. Yeah but their patients went off the me and patients that have had any part of our restrictions or if they had beer after surgery though. That's where i started. I got my hand like really dirty work. No that would allow coupe and asked me Austin is the true art. He thinks more. Nick austin me. Oh yes the ask austin. Is there like actively foreing out while you're trying to change back stopping so we have really really fast to get it ready. The i did a lot of that. I don't know i i would. I would think in nikki one would be harder even like the nicky wu ilyasova. Me's 'cause you know baby hands are going everywhere you're right always there's a lot either keeps dumb. You know you. Yeah yeah sometimes prolapsed and you know they can be dating trying to get the thing on friday. So i had a lot of fine. That's kind of how i know in the yes stumbles on that floor yet. Right go back. So don't you know a lot of people ask how in the world that you leave and make the best job and you know. I'm like no heart. You know my heart was says a alerts though but i'll stop School on your on the regular schedule. Monday through friday so i knew a clinic setting i you know i knew that i was going have to say by for the vegas eventually so i ended up down boards pool without became a family nurse practitioner. Kinda into where. I'm at now. Which is oncology oncology I am into a position of power daily adult the Studying typically work with patients. They have cancer. Though you know when viagra all the way from the stock is all the way down. the rectum. So i getting a lot of patients in. It wasn't what i thought. I guess this is what i thought what i started. I thought that i was going to be more cases where it decuir people's cancers but i realized that a lot of my patients but i was pumping contact with you. Know their cancer was and so. I had to deal with the reality of learning how to deal with by now a little different from dick you these people