Consulo Indicium - 6/26/23

Information for your Consideration…

Alzheimer’s Disease Studies Need Patients! – A new report from the Alzheimer’s Association (AA) highlights the fact that there are presently 187 clinical trials – as of last count – for the neurodegenerative disease underway. The information was published by the association and derived from a review of the database. Big Pharma seems to be engaged  seems to be engaged on the issue and more trials are expected. In addition, there was a recent piece on National Public Radio on Huntington’s disease that will no doubt boost even more research on the Alzheimer’s front. It basically describes the current drug regimes used for the treatment of Alzheimer’s as cleaning up the forest fires that occur in the brain through the accumulation of beta-amyloid deposits. The new approach described in the NPR piece was on the focus of identifying the places in the brain where the fire starts before a forest fire occurs to prevent the formation of the beta-amyloid. It’s an intriguing finding from the work on Huntington’s disease. 

Calling Uber For Healthcare Support – It was only a matter of time before we would see the onset of Uber Health. And, it’s started!! The initial focus will be providing consumers with over-the-counter medication and grocery delivery. The company started moving in this direction in 2018 when they offered nonemergency medical transportation for patients. In April, Uber Health started offering same-day medication delivery to the home and will now provide the same service for over-the-counter medications as well as groceries. The focus is different; however, in that the service is directed specifically to the care delivery side (e.g. care coordinators, payors, providers). It’s clear that their service will be an important adjunct to the ongoing effort toward moving care to the home as part of the value-based care delivery movement. In fact, Caitlin Donovan – the Global Head of Uber Health stated as much in making the announcement about the extension of Uber Health. She noted: “Value-based care is the future of healthcare, but it’s complex and labor-intensive to deliver and scale. Uber Health addresses this challenge head-on…Our platform streamlines coordination across multiple benefits—nonemergency medical transportation (NEMT), prescription delivery, and food and over-the-counter medication delivery, empowering payers and providers to support patients beyond the four walls of a medical office.” So, I’m wondering – what’s next?

But, Uber Is Not The Only Interloper – Healthcare is moving beyond the local to the ubiquitous national!! With the likes of Amazon, CVS, Walmart and others from the retail world moving into the healthcare delivery space what should we expect in the future? Stacey Malakoff, Chief Financial Officer at NYC Hospital for Special Surgery, offered her insights on a recent HealthLeaders podcast 

The Critical Role AND Shortage Of Nurses – I’ve been working with nurses since I was a 16 year-old orderly in a nursing home and, I’ve developed a tremendous respect for their capabilities and talents. In fact, a short anecdote is in order to make the point. When I was a first-year intern at Montefiore Hospital in The Bronx in 1978, I will never forget my first night on call. It was shortly after midnight and I received a call to the Intensive Care Unit. I was asked to see and care for a patient who was in obvious respiratory distress. As the new intern – fresh from medical school – I dutifully answered my beeper, rushed to the ICU and started talking with the patient. I pulled out my stethoscope and bumbled about after a brief exam and looked at the nurse who was with me in that look of panic! The nurse calmly walked from the foot of the bed over to me, put her hand on my shoulder and quietly said, “Doctor, do you want me to save your ass?” I replied in the most humble way that I could with a quiet “Yes!”. So begat my learnings on the value of competent nurses as partners in care delivery. 

I share the story because the American Association of Colleges of Nursing recently released a very disturbing fact sheet outlining the fact over the period of 2020 to 2021 there was a drop of more than 100,000 registered nurses in the USA. Furthermore, the College projects more than 200,000 openings for RNs each year between now and 2031. Why? It’s largely because we Boomers and GenXers are moving toward retirement at a slower pace at best. Furthermore, as the USA moves from 52 million (2018) over the age of 65 to nearly 100 million (2060) the impact on care delivery will be even more dramatic. It seems clear that we will not solve the problem by simply attempting to increase numbers of nurses. While that needs to occur, it’s also clear that we need to rethink out entire approach to the care delivery process – and, I obviously believe that “augmenting” our care through the appropriate uses of technology is one avenue that will absolutely be required.

The Loneliness Epidemic – In a recent press conference, Vivek Murthy, MD – the USA Surgeon General – highlighted the “…epidemic of loneliness” as a major “…underappreciated public health crisis” in the nation. He also noted that while the COVID 19 pandemic was a major precipitating factor, there are other social dynamics at play contributing to the growth in loneliness and isolation across the nation. Why? A decline in trust of community and neighbors was a leading factor. Also, the rising tide of technology and its intrusion into our lives was another factor. Changes in family structure with the huge increase in single parent households was also cited. And, income disparities were another leading factor. The issue deserves our attention. Listen to the press conference for some insight into the growing problem that will no doubt affect the health of the populace in the years to come.

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