Consulo Indicium - 2/6/24

Information for your Consideration… 

The Good From AI/ML – Researchers at Microsoft have made a very significant discovery that will greatly help the extension of AI/ML capabilities. Specifically, one of the current concerns in the use of these new technologies is the dependence upon lithium ion batteries. The Microsoft researchers have created a new battery that is 70% LESS reliant upon lithium for moving the electrical charges through the battery. They were assisted by AI/ML capabilities where they examined 23.6 million candidate materials as potential replacements for the electrolytes and lithium atoms used in making such batteries. The work of the research team is moving ahead and there is hope that a viable commercial product will be available sometime in the not-too-distant future (i.e. not tomorrow, not next week, or even next year but beyond that “sometime”).

It’s Not Pontificating But Protelyzing – In 1982 (I think that’s correct), I had an “event” that brought me to my knees at the ripe old age of 31. I was traveling in rural Montana for work on “rural health” near Cody, Wyoming when I developed chest pains and a very rapid heart rate. Being the physician that I was and inclined toward treating myself, I went to the hotel ice machine, got a bucket of ice, went back to my room, put the ice in the sink, ran some water into and stuck my face into it. Yes, my heart did slow down, but…too much. I ended up going to the hospital and being admitted with the missive that I should “cut down on my smoking.” I got home and was with one of my closest friends in life when I was smoking on a street corner and the same symptoms appeared. I vowed to quit…and, I did. You see – I was smoking four (yes, “4”) packs per day (NOTE: What a stupid doctor). So, I quit and have never regretted it but I’ve always been an evangelist for those who need to (i.e. must) stop smoking. I’ll support anything that prevents the onset of disease through passive means – like smoking.

Which takes me to my issue. Here are some myths that we need to dispose of ASAP for the good of society that relate to the use of cannabis and other similar products that offer people “other places to go” with their thoughts from smoking. Check out what the Family Physicians are sharing with patients. It’s right on the mark. The myths including the following:

• Myth #1: E-cigs are a safer alternative to smoking cigarettes.

Fact: Makers claim that e-cigarettes don’t contain the harmful chemicals that cigarettes do. Of course, this is not true. Most devices contain nicotine. Plus, e-cigarettes may also contain ultrafine particles that can be inhaled and cause lung inflammation.

• Myth#2: E-cigs aren’t addictive.

Fact: While there are some cartridges that don’t contain nicotine, most do. Any time a smoker inhales nicotine, they are inhaling an addictive and harmful chemical.

• Myth #3: You can use e-cigs indoors.

Fact:  At first, makers of e-cigarettes said that e-cigarettes were appealing because they could be smoked in places that didn’t allow traditional cigarette smoking. This is no longer true. Most states have created laws that prohibit vaping in the same areas where traditional smoking is not allowed.

• Myth #4: E-cigs are a way to quit smoking.

Fact: Marketers claim it is easier to quit smoking if you switch to vaping first. But e-cigarettes contain nicotine and may even lead to a user becoming a traditional cigarette smoker.

Now…Go out there and share the news. The harm we are causing across society is incredible. We can stop it now, if we just speak up. Now is the time. Now is the moment. Now requires action! And, it all happens at the state level. Speak up now or you may lose someone you love…

Listen Carefully – Perhaps it’s because my ears are attuned to the latest information on health care happenings but the number of ads and other forms of information flowing out to the public seems to be increasing at a dramatic rate. Of course, it could be that I’m listening carefully for “stuff” I may need as part of the aging process. But, putting that aside, there are any number of adverts that caught my eye this week. First, I was watching the National Geographic News – a politically neutral news source that often shares information you don’t hear on other channels. However, in the space of a couple of minutes there were ads for “Kardia Mobile” – a remote EKG to for individuals to check for tachycardia, afib, bradycardia, NSR or normal sinus rhythm. And, their web site had an interesting name = www.BuyBeActivePlus.com.  Then came the ad that was looking for nursing staff to provide care for individuals residing at home on www.BrightStarCar.com. These were followed by an array of other ads on various aspects of “care.” While I’m a big fan of self-care – the ads seemed to overstep the line and gave assurances for better health that did not relate to the underlying problems. Hmmm – how to deal with digital, channel and virtual information that speaks “to” the problem but does not “deal with” the problem… 

Confirmation – For a whole bunch of decades I’ve been arguing that patients having a primary care physician as the first line of defense in the care delivery process is a priority for several reasons, including the management of cost! In fact (and, I’m not overstating here), the literature is replete with articles over that period of a “whole bunch of decades” that access to primary care enhances care delivery, results in better outcomes and reduces costs. So, why am I engaging in echolalia? The NEJM Journal Watch, Vol.44 No.3 in the February 1, 2024 issue posted an article, “Another Benefit of a Primary Care Continuity Relationship” by Thomas Schwenk, MD, Associate Editor. The article outlined the results of a Canadian study of 5 million Ontario residents over the period 2021-22. Rather than put it in my own words, let me quote directly from Dr. Schwenk’s report: “After controlling for sociodemographic variables, diagnoses, and timing of virtual visits, likelihood of an ED visit was 66% higher for patients who saw physicians who were not identified FPs than for patients who were seen by their own physicians. This difference corresponds to 1 additional ED visit for every 77 virtual visits. This difference was accentuated about fivefold when virtual visits were with direct-to-consumer telemedicine clinics.” This report is yet another strong statement of support for all individuals having access to a primary care provider – and, at the same time – we’ve got a massive, looming shortage of primary care providers on the immediate horizon (i.e., within the next five years). While it’s nice to have confirmation, we also need to recognize that: “Houston, we have a problem!” Need I say more?

When Is Enough, Enough? There was a recent report on NPR.org, the media station noted a report from Oxfam outlining the fact that the five richest men in the world doubled their combined income over the period of 2020 – 2023 from $405B to $869B. During that same period almost 5 million people grew poorer across the world. I don’t know about you but an extra $464B in the pocket seems like a bit of excess retention by five (yes, “5”) individuals. I would think – but, then I’m sometimes considered pie-in-the-sky – that these five gents could do with just a bit (perhaps more than a bit) less than the mega–billions they hold in their pockets.

Value-Based Care Getting More Attention – The USA Centers for Medicare and Medicaid are continuing their march forward with an emphasis on value-based care delivery. Innovation is the key and it is getting support. Furthermore, it would appear that the managed care companies are also beginning to move toward fiscal consideration for support and reimbursement of value-based care delivery models. This is a trend that deserves the attention of all leaders in the healthcare community.

The Focus of the C-Suite – A new report was recently released by Sage Growth Partners, a healthcare advisory firm with extensive expertise in market research, strategy, and communications. The report consisted of a survey of 108 healthcare leaders from across the USA and is available at this site: The New Healthcare C-Suite Agenda: 2024-2025. The top two issues on the minds of the C-suite are: 1) investments in human resources, including technology integration of workforce needs and support. At the top of the list of workforce issues are recruitment, retention and workforce resilience of health care workers with the latter point garnering 61% of the C-suite recognizing the issues as a “top challenge”. The second issue that is highlighted in the report is the recognition of health IT investments as a way of protecting against unfavorable economic headwinds. The C-suite plans for 43% of the participants noted an increase in capital investments during 2024 which included: 20% for a new EMR, 15% for AI investments, and 13% related to virtual monitoring capacity. Of note was the fact that nearly 50% of the C-suite view AI integrations as supporting improvements in data quality and accessibility. Conversely 35% indicated that their organization had not realized any real benefit from AI investments at this point.

Vaping Declines Among High School Students – In November, the US Centers for Disease Control and Prevention (CDC) issued a report on the extent of vaping among high school students in 2023. It revealed that the use of vaping as a technique had declined from 14% in 2022 to 10% by late Spring 2023. That’s the good news. The not-so-good news was that vaping among middle school students over the same period increased from 3.3% to 4.6%. At the same time, use of tobacco products remained low at less than 2%. So, my take is that “education” matters and can have an impact since many schools have taken on the issue of educating their students on the trials and tribulations of vaping. It’s also an issue that many state legislatures are taking up in various forms by preventing access to flavored products – especially near schools.