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Compatibility is more than conformity

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Medical organizations are innovating in interoperability to improve patient outcomes and physician experience, and all healthcare organizations must prioritize interoperability to create a fully connected healthcare ecosystem.

While government initiatives such as the 21st Century Medicines Act and CMS interoperability advancing programs are moving the industry forward, the regulations only set a bare minimum, says athenahealth CEO Bob Segert, lead exhibitor at HIMSS23.

In the reviews from the top session on “Intuitive interaction and improved patient outcomesSegert will be joined by Clive Fields, VillageMD co-founder and chief medical officer, and Scott Middleton, founder of SC House Calls, to discuss new data applications to improve outcomes.

Doctors Want Improved Communication and Clarity

“We did a recent position opinion survey with 743 people and 94% of physicians said improved communication could improve patient outcomes, and 91% say it could improve physician experience,” Segert said. Medical IT News.

However, when patient data is transferred from another system, it ends up in these huge files, “and we litter the electronic health record,” he said.

The concept of “intuitive interoperability” is to make it easier to find the necessary patient data in the electronic medical record.

“It’s really about making sure that this information is accessible in a way that doctors can use it,” he explained.

Clinicians must quickly filter data to get the information they need as it moves from patient to patient, rather than trying to scroll through discharge records and other information.

“It’s like they can’t find what they need,” he said. “They don’t have 15 minutes to get ready for a patient appointment and sort it all out.”

Data analysis for ease of use

By curating patient data and giving doctors access to it so they can actually do their jobs more efficiently and effectively, they can deliver better care.

“We believe that interoperability is about much more than just flat file data,” Segert said. “We believe we can do better.”

At HIMSS23, Seget and his colleagues will share their opinion on what they think industry must do to move forward with the user experience and spend time answering questions from members to facilitate the exchange of ideas.

“How do we work together to identify the information that is really needed so that it can be put into an electronic health record, any health record?” He said.

Segert, Fields and Middleton will offer more perspectives in their panel discussion.”Intuitive interaction and improved patient outcomes”, moderated by Jessica Sweeney-Platt, vice president of research and editorial strategy athenahealth. It is scheduled for Tuesday, April 18 from 13:30 to 14:30 in the South Building, level 4, in room S100 B.

Andrea Fox is a senior editor at Healthcare IT News.
Email: afox@himss.org

Healthcare IT News is a publication of HIMSS Media.

Tracey Chu will go into more detail during her HIMSS23 session “Automation Boosts Productivity for Digital Education Applications”. It will take place on Wednesday, April 19, from 11:30 am to 12:30 pm PT in the South Building, floor 5, room S505.

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HEALTH

Income gap becomes physical activity gap

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Over the past two decades, tech companies and politicians have warned of a “digital divide” that could leave poor children behind their more affluent peers without equal access to technology. Today, with widespread internet access and smartphone ownership, the gap has narrowed dramatically.

But with less fanfare, another division has emerged: Across the country, poor children and teens are far less active in sports and fitness than more affluent youth. Call it a physical break.

Data from several sources show a significant gap in sports participation by income level. A study by the Centers for Disease Control and Prevention found that 70 percent of children from families with incomes above $105,000, four times the poverty line, were participating in sports in 2020. only 31 percent for families at or below the poverty line.

A 2021 research Seattle students from fifth grade through high school found that less well off youth were less likely to play sports than their more well off peers. The study also found that middle school students from wealthier families were three times more likely to follow exercise recommendations than students from less wealthy families.

A combination of factors is to blame. Reducing costs and changing priorities in some public schools have led to a reduction in physical education and sports activities. At the same time, privatized youth sports have become a multibillion-dollar enterprise offering new opportunities—at least for families who can afford hundreds to thousands of dollars each season in club fees, uniforms, equipment, travel to tournaments, and private coaching.

“As sports have been privatized, what has happened is that they have become haves and have-nots,” said John Solomon, editor-in-chief of the Aspen Institute’s Sports and Society program.

recently Aspen Institute Research found that among children from households with incomes of less than $25,000 a year, healthy activity participation fell to 26.6 percent in 2021 from 34.1 percent in 2013. For children from families with incomes between $25,000 and $50,000, participation dropped to 35.7 over that time. percent from 38.1 percent.

But among households with incomes above $100,000, participation rose from 43.9% to 46% over that period, the Aspen Institute found.

“Especially for low-income children, if they don’t have access to sports in a school environment, where will they be physically active?” Mr Solomon said. “The answer is nowhere.”

Schools do not always fill the gap. recent report from the Physical Activity Alliance, a non-profit organization, has given schools across the country a D– for physical fitness. This is a downgrade from C- in 2014, with the new score reflecting even less access to regular PE lessons, gym time and equipment in schools.

Ann Polls-Neal, a longtime physical education teacher and track and field coach in Albuquerque, has watched this trend develop. For almost 20 years, until 2017, she taught at the John Baker Elementary School, which was attended primarily by students from middle- and high-income families (less than one third the right to a free lunch or lunch at a reduced price). There, “all of my students played at least one sport after school,” she said. “Club football or almost anything club.”

She then transferred to Wherry Elementary where 100 percent students eligible for a free or reduced price lunch. The students played in the playground, she said, “but we only had three kids who played any sport outside of school.”

She suggested reasons. She suggested that families can’t afford private sports, or don’t have cars or time to take their kids to workouts, and clubs are unthinkable “unless those venues or clubs do workouts on the bus line.”

In 2019, Ms. Polls-Neal became Chair of the Department of Health and Physical Education at Highland High School, where 100 percent students are entitled to a free lunch. Here, she says, she saw the impact of “this club-school split.”

Children from more affluent families are often well-prepared for sports — “a little ahead,” said Ms. Polls-Neal, who is also the executive director of the Society of Health and Physical Education Educators in New Mexico, or SHAPE America. “And it’s more convenient for them to move to places where students from low-income areas do not live.”

A similar pattern is seen in Detachment District 1.5 in McLean County, Illinois. Faced with a budget shortfall, Board of Education voted this year make a number of cuts, including to sports. All youth sports will disappear next year: boys’ and girls’ basketball, cross-country running, track and field, boys’ wrestling and baseball, and girls’ softball and volleyball.

The cuts also include freshman sports at the district’s two high schools; The proposed cuts for the 2024-25 school year include junior high school sports. In November, county voters rejected a proposal to raise taxes to fund these programs.

“It’s devastating for kids,” said Kristen Weikl, the county’s superintendent. She said that school sports contribute to good grades and improve the physical and emotional health of the students who participate in them.

She added that private sports are available to some low-income families, but not to all: “It’s not just the cost of participation,” Ms Weikle said. “This is the cost of traveling to competitions. It’s time to take the kid to the club and then buy the equipment.”

To improve fairness, Valentine Walker, the district’s boys’ and girls’ high school football coach, founded a free football club in 2008. At the time, his 8-year-old son was playing baseball and football clubs that cost hundreds of dollars a season. Mr Walker noticed “an influx of Jamaican, African and Hispanic children whose families couldn’t afford to play for money.”

Raised poor in Jamaica, Mr. Walker saved money by borrowing school equipment and a 13-seat tour van from a friend, and by accommodating six or seven players in a hotel room. “I had to stick my nose under the door to get some fresh air,” Mr. Walker said with a laugh.

Mr. Walker is now fielding the second generation of this team, which costs about $400 a season; families who cannot afford it do not pay, and wealthier families and sponsors subsidize the experience.

He acknowledged that his private team usually took more gifted players or those with special potential. But he doesn’t make cuts on his public school teams because many less affluent students who don’t have club experience wouldn’t be able to play otherwise. During the summer, he hosts open soccer practice from 6:30 am to 8:30 am, followed by strength training at the gym.

“It’s not politics — it’s just me,” he said. “It’s because of my desire to reduce inequality.”

While public schools struggle with the economics of physical activity, a private youth sports industry has flourished. According to private data firm WinterGreen Research, annual market revenue from team registration, travel, apparel, equipment and other expenses rose to $28 billion in 2021 from $3.5 billion in 2010.

“It all started with software that allowed teams to organize and raise money,” says Susan Eustis, president of WinterGreen. And then, according to her, “schools began to refuse funding for their sports.”

At first, she added, “the two things didn’t have much to do with each other.” But increasingly, entrepreneurs and private coaches have used technology to market, organize and host tournaments, and to serve a growing number of parents who want a deeper experience for their children and whose schools are ditching sports and fitness programs.

She cited cost as a barrier to the participation of underprivileged children in private sports. The Aspen Institute found that families spend on average $1,188 a year per child for football, $1,002 for basketball, $714 for baseball, and $581 for football.

Ms. Eustice is heavily supportive of private youth sports, which she says provide “elite” training, reduce bullying from professional coaches, and start as early as 3 years old. Then there’s the option to travel with the family as a group activity – “dynamic new travel teams that host nights and weekends for families,” she wrote in her 2022 report. “The very best and brightest want their children to receive first-class sports training.”

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Minnesota nuclear power plant shut down due to leak; residents are worried

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MONTICELLO, Minnesota. — The Minnesota public utility began shutting down a nuclear power plant near Minneapolis on Friday after it found water with low levels of radioactive material leaking from a pipe for the second time. While utility and health officials say it’s not dangerous, the issue has caused concern among nearby residents and raised questions about the aging pipelines.

In November, Xcel Energy discovered a leak of about 400,000 gallons (1.5 million liters) of water containing tritium. The utility made a temporary fix, but this week it became aware of hundreds more gallons of tritium-laced water leaking, leading to a shutdown decision.

After the plant cools down over the next few days, workers will cut off the leaking pipe, which is more than 50 years old, according to Chris Clark, president of Xcel Energy. The utility will then analyze the pipe in hopes of preventing future leaks, he said.

“We could just keep operating the station safely and repairing the catchment area, but then of course there is always the risk that it will spill again and more tritium will enter the groundwater,” Clarke told reporters near the Monticello nuclear power plant. Plant, about 35 miles (56 kilometers) northwest of Minneapolis. “We didn’t want to take the risk, so we’ll shut down the plant.”

Edwin Lyman, director of nuclear safety for the Union of Concerned Scientists, said the fact of the second tritium leak “shines light on the problem of maintaining aging pipelines” underground at old nuclear power plants.

The temporary closure could be due to being overly cautious, “or it could be a sign that they don’t know how serious the problem is and they need to dive deep to figure out what’s going on,” he said.

Clarke said the tritium poses no risk to drinking water in Monticello or the nearby city of Becker, saying the cities draw water from various areas of the Mississippi River. Even if tritium were to enter the river, which Clark had assured him would not, he said, it would dissipate within a few yards.

Clarke said the spill did not leave the utility site.

The utility reported the initial leak to state and federal authorities in late November, but was not made public until last week, raising questions about transparency and public health concerns. Government officials said they would like to wait for more details before publicizing the information widely. Criticism over the delay played a role in Xcel’s decision to hold a public information session on Friday.

Tritium is a radioactive isotope of hydrogen that occurs naturally and is a common by-product of nuclear power plants. According to the Nuclear Regulatory Commission, it emits a weak form of beta radiation that does not travel far and cannot penetrate human skin.

Becker’s Cindy Remick attended an information session on Friday and said she still had concerns that nearby residents, especially those using well water, would be safe. Remick also worries about whether the radioactive material could harm wildlife.

“We have a very large population of eagles here and I would like to make sure they are not affected,” Remick said. “Minnesota is known for its wildlife, and if this (tritium) slips out of their Mississippi plant, it could be very devastating.”

Tyler Abayare, who has been fishing on the Mississippi River near the plant, said he has come to the river every day for five years and usually sees 15 to 20 other fishermen.

“Usually at this time of year, many families go out and fish with their children,” he said. “Now, after the media reported what happened, not a soul was left in sight, and it just ruins the holiday.” and passion for fishing.

Abayare said he did not believe the Mississippi River was safe. He does not eat the fish he has caught and no longer ties the line with his teeth so as not to get sick.

Nuclear Regulatory Commission inspectors are monitoring the shutdown and repairs, agency spokeswoman Victoria Mitling said. In a statement, she said the leak “poses no safety hazard to the public, drinking water sources, the plant, or the environment.” The leak also did not go beyond any agency restrictions.

Clarke said Xcel Energy had already planned to close the plant on April 15 for nearly a month to refuel, and it’s not clear if it will reopen immediately once the leak is fixed.

Clarke said the leaking pipe is part of the original plant, opened in 1971. Xcel has applied to extend its operating license at Monticello until 2050.

“We want to inventory the age of everything in the plant and make sure we are dealing with something that we need to upgrade,” he said.

Tim Judson, executive director of the Nuclear Information and Resources Service, a group that opposes nuclear power, said the second leak was “obviously worrying” and that public fears about possible health risks were exacerbated by the recent toxic train derailment in Ohio, where residents across remain concerned about possible health effects, despite government promises of air and water safety.

“People see what happened in Ohio and they’re concerned about the government’s response,” Judson said.

___

Daley reports from Washington. Associated Press writer Scott McPhetridge of Des Moines, Iowa contributed to the story.

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HEALTH

Why does a California bill want to ban skittles?

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WITHCalifornia legislators are considering check this could potentially ban the sale of Skittles and some other popular snacks because studies show some of the chemicals in them are toxic.

The bill would force companies to change recipes for some of their favorite sweets, including M&Ms and Nerds, or take drastic action to remove their products from the California market. It’s unclear if the bill will gain momentum, but if passed, California would become the first state to ban certain additives in food.

The ban will apply to five chemicals – Red No. 1.3, titanium dioxide, potassium bromate, brominated vegetable oil and propylparaben – which are commonly used as preservatives, colorants and texture enhancers. The chemicals are approved for consumption in the US by the Food and Drug Administration (FDA), but they are all banned in Europe for safety reasons.

Some supporters of the bill believe that federal regulations overlook scientific studies linking chemicals to diseases, including cancer, neurological problems another behavioral problems in children.

Here’s what you need to know.

What are the intentions behind the bill?

The Assemblyman behind the bill, Jesse Gabriel, admits that he loves candy, especially Skittles, and that he would definitely not support a bill to ban Skittles. That’s not the intention of the bill, he told TIME. “This bill is intended to force companies to change their recipes,” says Gabriel. “Still sell Skittles in Europe. They just removed titanium dioxide, which is a very dangerous ingredient.”

As a father of three young children, Gabriel is worried about supplements like these chemicals, citing health risks. child development, reproductive problems and concerns about carcinogens and damage the immune system.

“One of the reasons we chose [these five] because for each of them there is a more secure alternative readily available,” says Gabriel.

Opposition to the bill was strongest from trade associations, including the American Chemical Industry, the American Bakers’ Association, and the California Chamber of Commerce. In a letter to the California Assembly’s health committee, 11 groups wrote, “This measure usurps the comprehensive food safety and approval system for these five supplements and prejudges current ratings.”

What are the potential risks of these chemicals?

Many studies on these chemicals have shown potential animal health risks that scientists believe could apply to humans as well. In 1990, the FDA banned the use no red dye. 3 in cosmetics, but continues to allow it into thousands of foods. potassium bromate was banned in the UK, India, Brazil, Canada, and across Europe due to concerns that it might be carcinogenic. While all of the chemicals proposed in the bill are FDA-approved, some, such as propylparaben and titanium dioxide, are limited to 1% or less of a food product’s composition.

“A number of things on this list have been shown to have potentially harmful effects,” Carolyn Slupsky, professor of nutrition at UC Davis, told TIME, adding that while we weren’t aware of the many risks when the chemicals first hit the market, now additional information is available.

“The government needs to be ready to help fund research into these chemicals that people want to add to food or that are already in food, and start looking at them more closely,” Slupsky says.

The FDA classifies many chemical additives as GRAS, or “generally recognized as safe,” allowing their use. Gabriel is critical of the FDA’s review process, arguing that most chemicals have never been independently reviewed or were last reviewed decades ago. V FDA process to review nutritional supplements entails collecting data directly from manufacturers and rejecting or approving supplements for specific uses, but some researchers feel that decades-old data on certain supplements should be verified. overrated.

“These companies will have to put some of their money into finding alternative ways to preserve their products,” Slupsky says. “A lot of this is just for [food] color[ing]”.

Recent studies have also raised concerns that ultra-processed foods increase the risk of various health problems, including obesity, high blood pressure, diabetes and dementia. “It’s not just that everyone is sitting on their asses eating chips,” Slupsky says. “I think we need to start being more mindful of the types of food we eat.”

Gabriel hopes that as companies become aware of their social responsibilities to consumers, trade associations will also face the need to promote new alternatives. “If it passes, it will certainly have an impact outside of California,” he says. “No one is going to leave the California market; It’s too big.”

The bill will be presented at a committee hearing next month, starting April 11.

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