Delivering care in the new virtual world…
But, Amazon Pulls Back From Telehealth For the Time Being – In the November 10th issue of The Wall Street Journal, the CEO of Amazon, Andy Jassy, announced the scaling back of several unprofitable businesses. And, the Amazon Care telehealth solution was one of the cuts!! According to the report, Amazon lost ($3B) in 2022 after posting $33B positive in 2021 and $21B positive in 2020. However, that does not mean Amazon is “out” of the health care business. In fact, Amazon continues to hold a $3.9B One Medical acquisition on the table. One Medical offers virtual as well as in-person primary care services. Keep an eye out on Amazon as I anticipate we have not seen the last of their efforts in the health care arena…
A Longer-Term Consideration – One of the side effects of the COVID-19 Pandemic has been the impact on the next generation. Specifically, the National Assessment of Educational Progress report – often referred to as the “Nation’s Report Card” was recently released and provides some ominous forewarnings on the education front. In virtually all of the states – and, I suspect worldwide as well – math and reading scores are down significantly. For 8th graders, only 26% of students showed proficiency which was down from 34% in 2019. The reading scores were equally ominous with only a third of students meeting proficiency standards in over half the states. There seems to be lots of finger pointing between Republicans and Democrats on the reasons for the decline. Rather than finger pointing; however, we should identify the core problem and create bipartisan, remedial solutions!!
Approaches To Alternative Care Delivery
Ideas and thoughts on how care delivery can be transformed…
The Ongoing Assessment of Telehealth and Telecare – Research on the effectiveness and efficiency of telehealth and telecare is clearly accelerating. In a new study published in the Journal of the American Medical Association (JAMA) the use of telehealth was found to be superior to in-person care for 11 of 16 quality performance measures related to primary care services. The American Academy of Family Physician’s Robert Graham Center in conjunction with Wellspan Health – a Pennsylvania-based health care system – collaborated in a study that included more than 500,000 patients who received primary care services across the Wellspan system over an 18 month period. The HEDIS (Healthcare Effectiveness Data and Information Set) measures were used as a point of reference for evaluating results in care delivery. In comparing the two approaches, in-person care was found to achieve better results in medication-based measures versus telehealth which scored higher in testing support services and counseling measures related to such care issues as vaccinations, chronic disease testing, cancer screening evaluations and depression screenings. Long story short – the data clearly showed the need for “integration” of the in-person and telehealth components of primary care delivery something I’ve been advocating for too long… The ongoing research will clearly help all of us as we move forward with telehealth and telecare initiatives in response to the ongoing march (however slight it may be seem to be) toward value-based care delivery models.
Delivering care in the new virtual world…
On Guns and Gun Violence – First, the topic of guns and gun violence is fraught with political peril – and, I realize it! Second, I grew up in North Dakota where owning a gun was a way of life. Third, the focus of our “way of life” was on hunting birds, deer, and such – not, on hunting humans. Fourth, I did my residency in The Bronx where the opposite was the way of life and hunting humans were far more common. So, as you can see from the outset, I’ve been conditioned with certain experiences that serve as a backdrop to my observations.
Also, as a person who was trained to use science, I’ve turned to the “what works?” with “good results?” approach to problem-solving. So, I thought it might be useful to look at some of the data points we should consider in any discussion related to guns and gun violence. I turned to two reputable organizations for their data on the topic. The American Public Health Association provides regular updates on the state of gun violence in the USA. This data was augmented by my review of the annual Pew Research Center updates on attitudes toward gun policy options. In addition to the Pew research, here are some data points to consider:
- Four-in-ten U.S. adults say they live in a household with a gun, including 30% who say they personally own one,according to a Pew Research Center survey conducted in June 2021.
- Based on the political affiliations of the respondents, there are clear differences in gun ownership rates with 44% of Republicans and Republican-leaning independents indicating they own a gun compared to 20% of Democrats and Democratic leaners. But, it’s not just political party affiliation. To be clear, gender, geography, and other factors are also at play related to gun ownership.
- Among the nearly two dozen countries we are often compared to including such places as Australia, France, Italy, Spain, and the United Kingdom, 82% of the deaths overall among adults and 91% of all children deaths (ages 0-14) were located in the USA.
- Each year, more than 39,000 people in the USA die from gun violence, and tens of thousands more suffer non-fatal gun injuries. By comparison, in 2021 there were just over 38,000 deaths from automobile accidents, but, we do insist on everyone wearing seat belts otherwise it would be much higher…
- Guns are the leading method of suicide in the USA, accounting for half of all suicide deaths. Furthermore, the use of firearms in suicide results in death 85% of the time, compared to just 3% for other methods such as drug overdose. Why is this important? Because almost 90% of people who attempt suicide once do not attempt suicide a second time.
- Finally, a recent poll revealed that 84% of gun owners and 74% of NRA members, AND 90% of non-gun owners support a requirement for universal background-check system for all gun sales. Hmmm – that means that bipartisan support for effective gun legislation should be very feasible. So, why is it not happening? Oh, that’s right – the NRA is opposed!
