Handshake-Free Zones Target Spread Of Germs In The Hospital

One hospital in California has created designated no-handshake zones in an effort to curtail the spread of germs.
Katherine Streeter for NPR

Dr. Mark Sklansky, a self-described germaphobe, can’t stop thinking about how quickly microbes can spread.

“If I am at a computer terminal or using a phone or opening a door, I know my hands are now contaminated, and I need to be careful and I need to wash my hands,” says Sklansky, a professor of pediatrics at the David Geffen School of Medicine at UCLA.

Not all health workers are so careful, despite strict handwashing policies in virtually all medical facilities. A 2010 study published in the journal Infection Control & Hospital Epidemiology shows that only about 40 percent of doctors and other health care providers comply with hand hygiene rules in hospitals.

Hospital-acquired infections are a serious and potentially life-threatening problem. On any given day, 1 in 25 hospital patients suffers from at least one infection acquired while they are in the hospital, according to the Centers for Disease Control and Prevention. And studies show the hands of health care workers are often to blame.

photo of Mark Sklansky, a pediatric cardiologist
Mark Sklansky, a pediatric cardiologist and self-described germaphobe, tested a new method for limiting the spread of germs: a handshake-free zone. He tested it in two UCLA neonatal intensive care units.

So Sklansky decided to test a new method for limiting the spread of germs and reducing the transmission of disease in the hospital: a handshake-free zone.

“We are trying to do everything to minimize hospital-acquired infection except for the most obvious and easiest thing to do, in my opinion, which is to stop shaking hands,” he says. Continue reading Handshake-Free Zones Target Spread Of Germs In The Hospital

Workers Blame Sedentary Jobs for Packed-On Pounds, Survey Finds

Danger Sitting signChicago, IL – Long periods of sitting, stress-related eating and workplace weariness are among the factors workers say have contributed to their personal weight gain, according to the results of a recent survey conducted by Harris Poll on behalf of job-search website CareerBuilder.

A sample of 3,420 full-time workers from various industries and company sizes were surveyed about what they believe contributes to weight gain at work. Forty-five percent of participants reported having gained weight in their current job. Of those, 51 percent cited “sitting at a desk most of the day” as a contributing factor, 45 percent identified being “too tired from work to exercise” as a cause and 38 percent believe stress-related eating played a role. Other findings:

  • 73 percent of respondents said they snack on office food during the workday.
  • 41 percent do not work out regularly.
  • 38 percent reported they do not have enough time to work out before or after work.
  • 24 percent eat out for lunch at least three times per week.
  • 19 percent skip meals because of time constraints.
  • 18 percent blame workplace celebrations.
  • 12 percent visit office vending machines at least once a week.

Of the 28 percent of respondents who said their employers provide gym passes, workout facilities or wellness benefits, 63 percent do not take advantage. However, 42 percent of the respondents whose employers do not offer wellness benefits believe they would use such benefits if provided.


Fresh Food By Prescription: This Health Care Firm Is Trimming Costs — And Waistlines

Heard on Morning Edition

But as a society, we’ve got a long way to go. About 1 out of every 2 deaths from heart disease, stroke and Type 2 diabetes in the U.S. is linked to a poor diet. That’s about 1,000 deaths a day.

There are lots of places to lay the blame. Calories are cheap, and indulgent foods full of salt, sugar and fat are usually within our reach 24/7.

So, how best to turn this around? Consider Tom Shicowich’s story. It begins with a toe. His left pinky toe.

“One day I looked down and it was a different color … kind of blue,” Shicowich says. And he began to feel sick. “I thought I was coming down with the flu.”

The next day he was on the operating table. A surgeon amputated his toe, and it took two weeks of intravenous antibiotics to fend off the infection.

Registered dietitian Anna Ziegler counsels Tom Shicowich, who has Type 2 diabetes. Since enrolling in the Fresh Food Pharmacy program, Shicowich has lost about 45 pounds. His hemoglobin A1C level has dropped significantly.

All told, he spent a month in the hospital and a rehab facility.
“Oh, I tell you, it was a bad year,” Shicowich recalls.

But this wasn’t just bad luck. His toe emergency was somewhat predictable. Foot infections are a common complication of Type 2 diabetes — often due to nerve damage and poor blood flow, especially when the disease isn’t well-controlled.


Even Small Quantities of Opioids Prescribed for Minor Injuries Increase Risk of Long-Term Use

Source: Perelman School of Medicine at the University of Pennsylvania
May 17, 2017

short term opioid use rish graphOverprescribing of opioid medications for pain has contributed to a record-high number of drug-related deaths in the United States in recent years. A significant part of the issue, experts say, is the vast amount of variation in opioid prescribing habits for minor injuries such as ankle sprains — which don’t require treatment with such risky drugs in the first place.

For example, patients who received their first opioid prescription for an ankle sprain treated in U.S. emergency departments (EDs) commonly received prescriptions for anywhere from 15 to 40 pills, according to new research from the Perelman School of Medicine at the University of Pennsylvania.

Those who received 30 or more pills compared to less than 15 pills were twice as likely to fill an additional opioid prescription within three to six months. The authors say the results point to the urgent need for policies and guidelines to address when opioid medications are indicated for minor injuries and to reduce the number of pills supplied for opioid prescriptions. The study will be presented today during the plenary sessions at the Society for Academic Emergency Medicine annual meeting in Orlando, FL.

“The substantial variation in prescribing patterns of such extremely addictive medications for minor injuries results in many thousands of pills entering the community, and places patients at an increased risk of continued use and potentially addiction,” said lead author M. Kit Delgado, MD, MS, an assistant professor of Emergency Medicine and Epidemiology at Penn. “It’s vital that we identify and understand the root causes of this growing issue.”


5 Reasons Your Employee WANTS to Return to Work

May 11, 2017 by Leave a Comment

Back to Work road signThere can often be a negative connotation for those that are injured at work.  After dealing with thousands of claims adjusters can get jaded that claimants are up to no good and are only looking for a free paycheck.

A handful of bad apples can ruin it for everyone, but for the most part people just want to get back to their normal routine.  When injured, workers are usually in pain, receiving less money than they are used to, and traveling back and forth to doctor offices for examinations and therapy.

A revolving statistic may state that up to 10% of claims filed are not necessarily legitimate.  That leaves 90% just looking to heal and get back to pre-injury status.  Some injured workers even heal or return to work quicker than expected.  But why?  It seems obvious, but let’s explore some of the reasons in more detail:

  1. Loss of income

The biggest factor for an injured worker wanting to go back to regular duty is the income they receive.  There aren’t many people out there than can get rich off of receiving work comp pay.  Typically they receive a percentage of the income they are used to receiving, ranging from 60% to 80% of their net income.

Even in dual income families, this loss of income can be substantial, especially those that are living from paycheck to paycheck.  Do not be surprised when your injured worker is in a rush to get back to normal.

As long as a qualified doctor releases them to work with no medical restrictions, then you should be all set.  Of course this will vary on the injury.  I have handled cases when the claimant is adamant about making the doctor return them to work, and the physician will indicate in the notes that they are just retuning the patient back to full duty because that is what the patient requests.  You have to be very careful in this situation to avoid further injury, so if this should happen review it on a case by case basis.


Workers’ Comp Should Embrace Wearable Technology with Caution

May 9, 2017 by

photo of arm wearing multiple fitness and heatlth monitoring devicesThey come in all types of gadgets. Wristbands. Watches. Eye glasses. They can be woven into your clothes. Or embedded in your jewelry. Or implanted in personal protective equipment.

These ‘wearables’ are small, electronic wireless devices capable of communicating with other devices and people. They allow for data collection and analysis in real time, and are increasingly being used to prevent injuries, aid recovery and expedite claim processing.

While wearables hold great promise for the workers’ compensation industry, they are also largely unproven, unregulated and possibly, unsafe. Employers can reap tremendous benefits from this emerging technology — if they understand the risks and how to mitigate them.

What They Are

Wearables are not new. There was the calculator watch of the 1980s, and before that, the hearing aid was a form of wearable technology. Things changed in the early 2000s with the introduction of the HugShirt. With its Bluetooth connectivity that allows you to send hugs via smart devices, Time Magazine named it one of 2006’s Best Inventions of the Year.

Since then, wearables have spread to many other applications. Consumers use wearable wristbands to monitor everything from their caloric intake and steps per day, to their sleeping patterns. The medical profession has embraced the technology to monitor patients by tracking their heart rates, physical activity, and blood glucose levels.

In our industry wearables are used to detect concussions in workers wearing hard hats, and monitor fatigue among employees wearing special wristbands. They are also used post injury to track the injured worker’s recovery and improve a catastrophically injured worker’s quality of life, such as the Exoskeleton that allows paraplegics to walk.

The data produced by wearables can help better coordinate and manage medical care and, ultimately help the worker and employer. However, much of the data being transferred is private and/or sensitive. Companies need to consider the unintended consequences involved.


Life Expectancy Can Vary By 20 Years Depending On Where You Live

There’s more grim news about inequality in America.

New research documents significant disparities in the lifespans of Americans depending on where they live. And those gaps appear to be widening, according to the research.

Longevity age gap


You can see an interactive version of this map here.

“It’s dramatic,” says Christopher Murray, who heads the Institute for Health Metrics and Evaluation at the University of Washington. He helped conduct the analysis, published Tuesday in JAMA Internal Medicine.

Health experts have long known that Americans living in different parts of the country tend to have different lifespans. But Murray’s team decided to take a closer look, analyzing records from every U.S. county between 1980 and 2014.

“What we found is that the gap is enormous,” Murray says. In 2014, there was a spread of 20.1 years between the counties with the longest and shortest typical lifespans based on life expectancy at birth.

In counties with the longest lifespans, people tended to live about 87 years, while people in places with the shortest lifespans typically made it to only about 67, the researchers found.

The discrepancy is equivalent to the difference between the low-income parts of the developing world and countries with high incomes, Murray notes.

For example, it’s about the same gap as the difference between people living in Japan, which is among countries with the longest lifespans, and India, which has one of the shortest, Murray says.

The U.S. counties with the longest life expectancy are places like Marin County, Calif., and Summit County, Colo. — communities that are well-off and more highly educated.

Continue reading Life Expectancy Can Vary By 20 Years Depending On Where You Live

Apple Watch Engineers Working On Way To Read Glucose Levels,

But Let’s Be Realistic.

Dr. Iltifat Husain’s physician take is at the end of this article

The Apple Watch could soon be used as a tool for glucose monitoring that could change the lives of millions who are managing diabetes, according to CNBC. The news organization reported that Apple engineers have been developing a way to read glucose levels continuously without puncturing the skin by using lights and sensors on the Apple Watch.

SCREENSHOT: continuous glucose monitoring appLast year, Apple hired Dr. Rajiv Kumar, a leading pediatric endocrinologist from Stanford, which caused a lot of excitement in the medical community, including iMedicalApps.com, and maybe offered a clue to the company’s long game.

Whether or not Dr. Kumar’s hire was a hint, for the past five years, 30 researchers have allegedly been secretly exploring the noninvasive technology in a “remote location.” While that intriguing detail might seem to be out of a biotech spy story, it has every reason to be. If true, this would be a groundbreaking next step for mobile health and telemedicine.

There are already diabetes management apps on the market, including “smart” socks and continuous glucose monitoring apps. A nonintrusive continuously monitoring device seems to be the holy grail in Silicon Valley. Google has prototyped a contact lens, and Dexcom is working with Verily to create smaller glucose-monitoring devices.

Dr. Iltifat Husain’s take

While having the Apple Watch monitor glucose levels would be fascinating, we need to be realistic as well. There are massive regulatory and also clinical situations that would need to be taken into consideration before the Apple Watch could try to read glucose levels in a noninvasive manner. A project like this would require clinical trials to test efficacy, along with a slew of discussions and testing by the FDA. Frankly, this isn’t realistic for a company like Apple.  Apple in the past has done everything possible to make sure they don’t fall under FDA scrutiny — so I don’t think this is something they would come to market with first. I compare this to Apple trying to create a self driving car — it sounds cool, and they might create a “concept car” in 5 years or so, but we all know they aren’t going to be selling cars anytime soon.


7 Ways to Proactively Reduce Comorbidity Costs

photo of fat guy to illustrate comorbidityAs if managing workers’ compensation claims isn’t challenging enough, we’re increasingly seeing comorbid conditions among injured workers. We know that these health issues can increase the likelihood of workplace injuries and illnesses, and then add to the complexity and costs of managing a claim. The aging workforce means we’ll probably see more multiple comorbidities per claim in the years ahead.

Some jurisdiction, such as California, require employers to pay for treatment of a comorbidity if it hampers recovery. Even in states that don’t have that requirement, it still benefits payers to identify and address comorbid conditions that are present or, ideally, try to prevent them in the first place.

The Stats

The rate of claims with comorbid conditions per claim nearly tripled between 2000 and 2009.  These claims are more likely to include lost time and have about two times higher medical costs than comparable claims.

Obesity, addiction, mental health and hypertension are those with the greatest impacts on negative outcomes. Obese workers, for example, file two times as many claims as non-obese workers, have medical costs that are seven times higher, and incur an average 13 times more days away from work.

Diabetes has one of the lowest impacts on claims among comorbidities; and yet it is associated with increased recovery times, delayed healing, an increase in the likelihood of infections and other complications, and results in increased reserves.

When more than one comorbidity is present the increases are staggering.

  • 76 percent increase in claims duration.
  • 341 percent increase in total incurred costs.
  • 285 percent increase in temporary total disability days.
  • 147 percent increase in litigation rates
  • 123 percent increase in surgery rates


To Bring Down Stubbornly High Blood Pressure, It Helps To Have A Team

5/4/2017     Science : NPR     Wendy Rigby

Patient getting team approach to high blood pressure treatment
Ann Mazuca has diabetes and glaucoma that can be aggravated by high blood pressure. The support shown by clinic staff at the University Family Health Center Southeast, in San Antonio, helps her do what’s needed to reduce hypertension, she says. “The fact that they care makes me care.”
Wendy Rigby/TPR

You’ve probably heard the phrase “it takes a village” to get things done. Many clinics across the U.S. are finding that’s true for effectively controlling their patients’ high blood pressure.

“It’s not just medications that are required to treat hypertension,” explains Kirk Evoy, a clinical assistant professor at the University of Texas Health Science Center in San Antonio and pharmacist at University Family Health Center Southeast. “It’s also things like lifestyle changes,” he says. “What do you eat? Do you exercise? Do you smoke?”

A quick prescription and an annual lecture from a doctor aren’t always enough to get ahead of this quiet killer, specialists say. Some patients need extra coaching — and from different kinds of coaches.

Take Ann Mazuca, for example. She’s 63, has diabetes, is developing glaucoma and really struggles to keep her blood pressure down.

“I know that I have to try to help myself,” Mazuca says, but weekly check-ins with the staff at University Family Health Center Southeast help keep her on track in juggling her various conditions. “The fact that they care makes me care,” Mazuca says. “People want me to live. And that gives me a lot of hope.”

Continue reading To Bring Down Stubbornly High Blood Pressure, It Helps To Have A Team