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New York City Council Passed Legislation To Address Algorithm Discrimination

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The New York City Council yesterday passed legislation seeking to address problems with Algorithms which can determine which school a child can attend, whether a person will be offered credit from a bank, what products are advertised to consumer, and whether someone will receive an interview for a job. Government officials also use them to predict where crimes will take place, who is likely to commit a crime and whether someone should be allowed out of jail on bail. The algorithms used in facial recognition technology, for example, have been shown to be less accurate on Black people, women, and juveniles.

The new bill seeking the signature of Mayor Bill de Blasio. States:

This bill would require the creation of a task force that provides recommendations on how information on agency automated decision systems may be shared with the public and how agencies may address instances where people are harmed by agency automated decision systems.

The task force would need to be formed within three months of the bill’s signing, and importantly it must include “persons with expertise in the areas of fairness, accountability and transparency relating to automated decision systems and persons affiliated with charitable corporations that represent persons in the city affected by agency automated decision systems.”

The New York division of the ACLU has argued in favor of it.

See The bill Here,

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Those Sinking Medicare Margins

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Payment shifts and regulatory mandates are putting hospital Medicare margins on a downhill slope. Hospital executives say the chasm between the two has widened in recent years due to a number of factors: federal mandates to deploy expensive health information technology systems under the meaningful use program, a 2% across-the-board cut to provider Medicare payments under the Budget Control Act of 2011, reductions in Medicare disproportionate-share hospital payments and the move to alternative-payment models. Layoffs and reductions in services have been common coping mechanisms to avoid the income drop

While expanded coverage is a net positive, hospital leaders still complain that the government payment programs do not cover costs. For Medicare, hospitals received 88 cents for every dollar spent caring for beneficiaries in 2015 and 90 cents for Medicaid patients, according to the American Hospital Association. Combined underpayments from the government programs were $57.8 billion in 2015. This includes a shortfall of $41.6 billion for Medicare and $16.2 billion for Medicaid, the association reported.

Attempts to move Medicare from a fee-for-service system to a value-based model pose perhaps the most serious challenge to hospitals and health systems struggling with low Medicare margins.

In 2015, the Obama administration announced it wanted 30% of payments for traditional Medicare benefits to be tied to alternative-payment models such as accountable care organizations by the end of last year and 50% by the end of 2018.

The first goal was met, but since the Trump administration took over in January, CMS officials have been coy about their own goals for the shift beyond noting they want the move to be voluntary.

Overall, hospital leaders believe they are getting mixed messages from the Trump administration over whether it still supports the move away from fee-for service Medicare, given that it has canceled or scaled back several new pay models created under the Obama administration.

medicare margins take a dive

There are things Congress can do to stabilize and lessen the financial pressures hospitals now face. The Medicare recovery audit contractor program could be overhauled. Under the program, private companies audit the medical records of hospitals and doctors to find instances of improper billing or erroneous payment from the government.

Hospital executives argue that claims are often mistakenly flagged as being improper in some way. Of the claims that have completed the appeals process, 62% were overturned in favor of the provider, according to the AHA. The association found that 43% of all hospitals reported spending more than $10,000 managing the RAC process during the third quarter of 2016, 24% spent more than $25,000 and 4% spent over $100,000.

Despite those concerns, the program has scored big for the federal government. RACs have recouped $8 billion in improper payments since its inception in 2009, according to the CMS.

The other recurring request from hospitals is that Congress preserve the individual mandate in the Affordable Care Act. A proposal to repeal the mandate is included in the Senate version of tax reform legislation.

 

 

Internet of Things & Insurance

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Health is an area where Internet of Things devices are already being used to lower insurance premiums for those who agree to wear the devices and to share data with insurance companies.  wearables like FitBit have been tied to several insurance premiums.

 Other areas of consumer related lifestyle data include the use of vehicle telematics devices (devices that enhance navigation, safety and communication features). Those who agree to have these devices integrated with their vehicles can see lower car insurance costs.
Networked smoke detectors for informal settlements, in the townships of South Africa have been developed by the company Lumkani. Lumkani is described as “the world’s first networked heat-detector designed specifically for a slum environment.
Lumkani devices are networked to each other using radio frequency. When a fire is detected, the alarm sounds in all homes within a 40 meter radius. A variable sound is used signal to users when a fire is in a separate dwelling.

Radio-frequency identification (RFID) chips are tracking livestock for insurance, such as the IFFCO-Tokio system. IFFCO-Tokio is piloting a cattle insurance project targeting more than 25,000 poor farmers and their families in the Indian states of Gujarat, Punjab, Maharashtra, Rajasthan and Orissa.

Madagascar Is Fighting a Deadly Plague

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The World Health Organization has delivered more than a million doses of antibiotics to Madagascar amid a raging epidemic of plague in which at least 33 people have died and 230 others have been infected, the BBC reported.

The first confirmed death from the epidemic began on August 28th in the town of Moramanga,.“Plague is curable if detected in time. Plague first arrived in Madagascar from Indian steamboats in 1898 before spreading through other harbors and then into the mainland along railroad construction lines. 

 

More Medical Schools Going Bookless

AILEEN MCCRILLIS
NYU health sciences library

The Association of American Medical Colleges predicted that by 2030, the United States would have a shortage of up to 104,900 physicians. To try to curb this impending crisis, a wave of new medical schools have opened in the last decade. Eleven schools have been accredited by the Liaison Committee on Medical Education in the last five years, and eight more are currently under consideration.

As a condition of accreditation, these new schools must provide access to “well-maintained library resources sufficient in breadth of holdings and technology” to support the school’s educational mission, however, many medical schools are deciding that large print collections are no longer a vital component of those resources.

Paperless Libraries

Charles Stewart, associate dean and chief librarian of City College of New York, of the City University of New York system, said that his institution chose to go a paperless route for the newly opened CUNY School of Medicine on the City College campus for much the same reason — 24-7 access. “Stewart says they chose the all-electronic option since their medical school clearly wanted instant e-access to all their resources.

 

The Frank H. Netter School of Medicine at Quinnipiac University, which accepted its first students in 2013, is designed as a paperless institution. The school has a library space where students can read and study, but the vast majority of the library’s resources are online. Bruce Koeppen, dean of the school, said that by making most of the library’s holdings electronic, it ensured that students and faculty could access information “anywhere and anytime, even when the library is closed.”

Hybrid Approach

The Virginia Tech Carilion School of Medicine, opened in 2010, with just 50 books on its shelves, however, the students quickly pushed to expand this collection to 4,000 books, saying that they preferred to use physical materials for studying. The school noted, however, that it did not want to increase its print collection beyond the current level.

Fay Towell, director of libraries at the Greenville Hospital System, said that it was interesting that students at the University of South Carolina School of Medicine Greenville, which opened in 2012, frequently requested access to both print and electronic resources. Given the small size of the library, and the prohibitive cost of providing both print and online versions of texts, Towell said the library had to be selective. She noted that often journals might cost more electronically than in print — “if a journal cost is $4,000 electronically and $400 in print, then the library makes space for print,” she said.

Roger Schonfeld, director of the Library and Scholarly Communication Program for Ithaka S+R, pointed out that when medical libraries thin their print collections, it does not necessarily mean that the campus loses access to those physical materials. “Whether the collections are moved to an off-site facility, or the library participates in a shared print program, it is almost always still possible to provide access to a print version on those occasions when it is necessary to do so.” The trend for thinning print collections is not unique to medical libraries, said Schonfeld — many science and engineering libraries have done the same.

Hackensack Meridian Health Invests $25M in Tech Incubator

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New Jersey-based Hackensack Meridian Health has teamed up with the New Jersey Innovation Institute (NJIT) to open a health incubator with a design similar to the reality show ”Shark Tank,” in which companies pitch healthcare innovation ideas to a panel of experts. The incubator, Agile Strategies Lab, is the first of its kind for healthcare advances in New Jersey, according to officials. The lab, located on the New Jersey Institute of Technology (NJIT) campus in Newark, is designed to help create and launch the next wave of problem-solving in healthcare through better devices, improved technology and more efficient services to provide a higher quality of care, lower costs, and an enhanced patient experience, officials said in an announcement.

Hackensack Meridian Health has committed $25 million, a new revenue stream to help companies develop trailblazing products and services. This seed money will help launch ideas to the point where they can become viable and receive financing through venture capitalists. And the organization’s vast network—13 hospitals in seven counties, and more than 100 outpatient centers and 6,000 physicians—will look to serve as a vehicle to test some of the innovations once they are advanced enough as determined by a panel of experts from multiple disciplines.

The new Thing In Mental Healthcare

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Dr Jeffrey Lieberman from Columbia University says” the new technologic innovation that is emerging and which does seem likely to impact psychiatry and mental health care in a time that is commensurate with the other specialties of medicine, is the technology that informs how we use Internet-based smartphone mobile app devices. The rudimentary ways in which this has already begun to permeate medicine and mental health care include electronic health records and telemedicine, which is ideally suited to psychiatry in terms of being able to provide consultation at a distance.“The initial idea is to have smartphone-based applications that can perform several functions. One is a monitoring function: having apps that can passively monitor the activities or biologic signals of an individual—whether it is movement, heart rate, respiratory rate, or level of activity—and have an ongoing record that can be catalogued, observed, and interpreted by clinicians. A second function is as a means of communication. Doctors already have begun to employ FaceTime, Skype, and texting to maintain contact with patients remotely in a variety of situations. Another area would be to develop apps that could provide some kind of actual therapeutic assistance, including cognitive-behavioral therapy, motivational interviewing, and supportive types of techniques or protocols when needed. All of these have great potential and can expand the reach of healthcare providers, psychiatrists, and mental health care clinicians, and provide help to a larger proportion of people when they need it.”

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