Posts - Health Care Chief

Strike Canceled as Minnesota Hospitals and Nurses Agree on a Deal the Minnesota Nurses Association (MNA) has announced that a tentative deal has been reached with several Minnesota health systems, averting a planned strike by nurses that was due to begin. Approximately 15,000 nurses were due to walk out for about three weeks across 15 Twin Cities and Twin Ports hospitals, including those run by Allina Health and Children’s Minnesota. For most locations, the strike was supposed to end on December 31, while for others, open-ended strikes had been planned. If the strike had taken place as planned, it would have been the second in just a couple of months. In September, nurses went on a three-day strike, which the association hailed as the largest nurses' strike in the private sector in the country’s history. The agreement was reached after nine grueling months of negotiations and nearly half a year of work for nurses with no active contract. The outlined three-year agreement calls for unprecedented pay increases of 17% to 18% over the course of its duration and greater efforts to address understaffing in hospitals. Nurses in Twin Ports or Duluth areas would receive a 7% increase in the first year, with 6% and 4% jumps following in the next two years of the contract. The deal for nurses in the Minneapolis and St. Paul region is similar, with the only difference being a 5% increase in the third year. The collectively-agreed pay increases, according to MNA, are the biggest it has obtained in more than 20 years and include compensation going back to the expiration of the previous contract. The agreement also includes pay raises for nursing preceptors and charge nurses, who play key roles in the education and supervision of new nurses. These initiatives, according to the association, will assist health systems in retaining nurses at a time when many of them are walking out of their jobs at hospitals. The association also stated that the contract includes stipulations to ensure nurses aren’t penalized for raising concerns and expressing their opinions regarding different assignments. It also calls for reviews of staffing levels tied to patient and nurse well-being “This tentative agreement is a historic win for nurses and patients at the bedside,” Mary C. Turner, a registered nurse and president of the MNA, stated. “For years, hospital executives have been pushing nurses out of the profession by under-staffing our units and under-valuing our nurses. This tentative agreement will help to keep nurses at the bedside, where we will keep fighting to oppose the corporate healthcare policies which threaten our hospital systems and the care our patients deserve.” Nurses have now settled the contract dispute with 15 of the 16 hospitals involved. The truce between the nurses and Minnesota hospitals comes just a couple of weeks after a similar cease-fire between Kaiser Permanente and over 20,000 of its nurse staff - that deal included a 22.5% pay raise over four years.

Hospitals & Providers

Strike Canceled as Minnesota Hospitals and Nurses Agree on a Deal

Editorial Team

December 7, 2022
3 min read

Study Finds Google’s Kidney Disease AI to be Less Effective on Women in 2019, Google developed an artificial intelligence system that could predict severe kidney injury in patients up to two days in advance. Since kidney-related injuries are a common cause of death among hospitalized patients, the results were met with high hopes for the future. The Department of Veteran Affairs said it would immediately start work to bring the system to the market. However, a recently-published study has discovered that the AI system is not as effective when applied to females as compared to males. Another big problem is that simply modifying the system’s gender representation and sample size might not be enough to fix the algorithm. This possible problem in the initial study was acknowledged by the DeepMind and Veterans Affairs researchers. They noted that female patients made up less than 7% of the total patients in the study, and their model performance was very low compared to their male counterparts. However, it must be acknowledged that their findings only took into account patients suffering from early-stage kidney failure. These results were expanded upon in a more recent study of the deep learning AI led by a research team at the University of Michigan, which found that the model consistently misidentified female patients regardless of the severity of their acute kidney injury. The team also mentioned that when it added more women to the dataset, the performance discrepancies showed improvement among the general population. The problem persisted, however, when the AI was applied to a group consisting entirely of veterans, despite the enhanced controls for gender. This points to the fact that the problem isn’t solely the underrepresentation of women, according to the researchers; there are greater underlying issues at play. These might include practice patterns and the varying characteristics of female patients. About 1.7 million people per year lose their lives due to acute kidney injury, which is not easy to spot, and patients’ conditions often worsen before they receive potentially lifesaving treatment. A recent study found that 28% of those who develop the condition within the VA die within a year, with over 5% dying in the hospital. In the initial study of Google’s AI system, accurately predicted 90% of the patients in the VA whose kidney function eventually deteriorated to such an extent that they required dialysis. These sorts of results are typically considered breakthroughs in the medical AI space, but it’s often ignored how much more work lies ahead to ensure that the technology works well across different healthcare settings and on different kinds of patients. Jie Cao, the lead author of the study and a Ph.D. student at the University of Michigan, said, “We still have a long way to go in terms of using these models to change how health care works and to change a patient’s health.” She added that hasty adoption of Google's model might result in poor treatment choices by clinicians who might not be aware of its flaws. Google has announced new initiatives designed to speed up the company's AI research and development. The company’s researchers have released protocols and open-source code to implement whichever of its two models performs better. Furthermore, Google Cloud is providing a pilot-ready version of the model to healthcare systems worldwide that want to evaluate its potential benefits for their patients.

Technology & AI

Study Finds Google’s Kidney Disease AI to be Less Effective on Women

Editorial Team

December 7, 2022
3 min read

Elon Musk has revised the timeline for Neuralink’s brain implant, three years after introducing it and promising to start human trials by the end of 2020, a target that was covertly missed and forgone in favor of continuing animal studies. He predicted that by the middle of 2023, the business may finally begin implanting people, a year after its competitor Synchron. Musk stated, "We've been working hard to be prepared for our first person. I believe we’ve filed most of our documentation to the FDA, and we believe that in about six months we should be able to have our first Neuralink in person. We want to be very careful and confident that it will operate properly before putting our device in a human.” The CEO himself could be among the first to use the technology. He states that the device is discreet enough that people will not know if he has had it placed or not. To stimulate both mental and physical activity, the Neuralink implant is made to replace a removed portion of the skull by matching its size and thickness. Musk said it was similar to inserting an Apple Watch or Fitbit in a portion of the skull. According to the CEO, the company will prioritize the implant’s first two applications once it has the FDA's approval to start conducting human studies. The first application is focused on restoring vision to those who are visually impaired. Musk claims that the implant will be able to correct blindness in even those who were born blind. The second will be designed for those who are paralyzed and the aim is to restore movement. Plans for Neuralink include deploying numerous Neuralink implants in the brain and spinal cord to assist paraplegic individuals in regaining their ability to move and walk. Beyond its medical applications, Musk stated that the implant may assist all people to move closer to becoming half-human, half-robot hybrids, ideally with sufficient superintelligence to topple any potentially harmful artificial intelligence that may emerge to endanger mankind. Several claims had risen regarding the mistreatment of animals in testing. Musk reassured the audience that animal testing started only after the device had passed multiple testing phases on a sample artificial human brain, to which it was confirmed as a usable product. Neuralink’s brain implant has not shown success in animal trials as of yet and the claims made by the CEO are hypothetical at this point.

Technology & AI

Elon Musk believes Neuralink is six months away from human testing

Editorial Team

December 6, 2022
3 min read

Texas Medical Association files third suit against No Surprise Act, claiming arbitration process is unfair to providers the No Surprise Act 2021 is a federal law that aims to assist consumers when they are stuck with hefty medical bills and are in dispute with their provider over payer pricing. The law establishes a process under which payers and providers seek third-party arbitration to settle pricing disputes, both parties submit a price they think is appropriate for the service in question to the arbitrator who then picks the price they think is most appropriate. In this process, patients are removed from the dispute. The Act has been facing legal challenges since 2020. The first lawsuit that the Texas Medical Association (TMA) filed against the Act and won had to do with its implementation. The victory forced regulators to make changes to the language in the final rule. Previously, arbitrators were instructed to begin with the assumption that the qualifying payment amount (QPA), that is the median in-network rate for a specific service in a specific region, was an appropriate amount. Providers fought against this stipulation arguing that this set a ceiling on prices and in a February ruling, a federal judge agreed to strike down this language. The Associate, however, was still not satisfied with how the judge drafted the final rule and claimed that the ruling still unfairly benefited insurers. This was because arbitrators were still putting undue weight on the QPA and so, a second suit was filed in September. In the latest lawsuit that the TMA has filed, they allege that certain aspects of how the QPA is calculated automatically deflate prices. In the final ruling, arbitrators were instructed to consider QPA when picking between a provider’s and payer's proposed amounts, the TMA argues that there are several ways in which the QPA can be calculated by payers that deflate the value of the QPA, meaning that inevitably payers will have to pay a low amount. For example, insurers can include “ghost rates” when calculating their QPA which essentially are rates that are the contracted amounts with the providers for the services that are not subject to arbitration. Insurers are able to include the rates of healthcare providers that are not necessarily in the same specialty as the provider in the payment dispute. “TMA is concerned that these provisions unfairly disadvantage physicians in payment disputes with health insurers and will ultimately rob patients of access to physicians’ care,” said TMA President Gary Floyd. Floyd further explained how all these factors rig the arbitration process in favor of insurance companies to the detriment t of providers and patients. Another objection against the ruling is that the ruling goes against Congress’s intent of the law as the body could not have intended to introduce a benchmark average rate for the arbitration process.

Insurance Providers

Texas Medical Association files third suit against No Surprise Act, claiming arbitration process is unfair to providers

Editorial Team

December 6, 2022
3 min read

Japanese company Eisai has not rejected the possibility that its Alzheimer’s drug had a hand in the brain bleeds of two patients. The patients died during the trials but the company insists that the drug was not the cause of the deaths. According to Eisai, the deaths could not possibly be directly credited to lecanemab, which is a drug used to decelerate cognitive decline in patients with early-stage Alzheimer’s by 27%. Lecanemab is being developed in collaboration with Biogen. Both the patients who passed had taken blood-thinning medication and were elderly, one in his 80s and the other in her 60s. Knowing this Eisai told doctors to hold the risk-benefit dialogue with the caregivers before a prescription for patients taking anticoagulation medication. Eisai stood by its monoclonal antibody therapy’s safety, which is the very first to reduce the rate of the condition’s progression in a big trial. It has raised expectations of a new treatment for the disease which is affecting over 50M people globally. Ivan Cheung, the CEO of Eisai US said, “Our assessment is that these deaths cannot be attributed to lecanemab. Of course, we cannot rule out the possibility that lecanemab might have increased the susceptibility of bleeding risk in the brain.” The results of the trial showed that 13 out of about 1,800 participants (Below 1%) died in the first year and a half of the trial. However, none of the fatalities were credited to lecanemab. 7 of the 13 deaths were of people in the placebo group. Two deaths that were alarming for the investors took place during an extension period after the first 18 months. During this period lecanemab was administered in placebo group patients as well. Doctors have long been worried about the chance of swelling and bleeding in the brain due to monoclonal antibodies. According to Eisai, one of the deaths was due to a brain hemorrhage, while the other cause of death was concluded as cardiopulmonary after autopsy. Vice-President of clinical research at Eisai, Michael Irizarry said that there were complicating aspects in both cases and lecanemab does not seem to be directly responsible for the deaths. However, he said that the possibility of its involvement cannot be ruled out. Michael Irizarry also mentioned the need of discussing the benefit-risk concerning lecanemab use for people who are consuming or intend to start consuming anticoagulative medicine. Hostile events befell 14% of the participants in the active drug group while 11.3% of the placebo group participants faced similar problems. Nearly one in six participants (16.7%) who were given the drug went through micro-bleeds in the brain compared to below one in ten (

Alzheimer’s drug did not lead to trial patients’ deaths according to Eisai

Editorial Team

December 6, 2022
3 min read