UPMC Starts Curavi Health to help nursing-home patients via telemedicine
As a geriatrician who has cared for patients in nursing homes across western
Pennsylvania, Steven Handler, M.D., Ph.D., has seen first-hand how some are
transferred unnecessarily in the middle of the night to hospital emergency
rooms. Thatâs because nursing staff couldnât get the right medical advice at
the right time.
âTransfers to the emergency room, which frequently result in admission to
the hospital, are highly disruptive to older adults and sometimes harmful to
their health,â said Dr. Handler. âWhatâs more, these avoidable
hospitalizations are costing Medicare, private insurers and taxpayers
billions of dollars every year.â
Handlerâs experience prompted the creation of Curavi Health, a new UPMC
Enterprises-backed company that is bringing its comprehensive telemedicine
solution and physician care to the nursing home bedside, where patients and
staff need it most. âWeâve spent three years developing and refining the
equipment, software, training and support to help nursing homes
significantly reduce potentially avoidable hospitalizations. That means
better care and higher satisfaction for patients and staff,â said Dr.
Handler, now Curaviâs chief medical and innovation officer and associate
professor of geriatric medicine and director for geriatric telemedicine
programs at the University of Pittsburgh.
Although Curavi Health is new to the market, its deep expertise with nursing
homes and telemedicine stems from work done by Dr. Handler and his team over
the last several years, starting with 17 non-UPMC nursing homes under a
Centers for Medicare and Medicaid Services (CMS) Innovation Grant. Those
efforts to reduce potentially avoidable hospitalizations for conditions like
urinary tract infections and pneumonia were then expanded to include UPMCâs
owned skilled nursing facilities.
That combined experience resulted in training more than 1,000 nurses and
healthcare professionals in telemedicine, 212 real-time video consults and
avoidance of 108 unnecessary transfers of patients to hospitals over the
last two years.
According to recent data released by CMS, of the $14.3 billion spent by
Medicare in 2011 on inpatient admissions from nursing homes, an estimated $8
billion was spent unnecessarily. In Pennsylvania alone, those potentially
avoidable hospitalizations total 27,000 annually from about 700 nursing
homes, at a cost of $220 million.
Curaviâs telemedicine solution aims to change that by allowing nursing home
staff to access UPMC geriatricians at night and on weekends so that they can
identify acute changes in a patientâs condition and intervene in a timely
The CuraviCart equipment allows physicians to remotely interact with
patients and nursing home staff through a pan/tilt/zoom camera, Bluetooth
stethoscope, digital otoscope, document scanner and 12-lead EKG system. The
proprietary CuraviCare software, which facilitates interaction between the
remote physician and the patient, is designed for simple operation by
nursing home staff and tailored to their workflow.
Curavi expects to soon offer a âbring your own providerâ solution that will
allow nursing homes to use their own attending physicians and nurse
practitioners for on-demand telemedicine consults. That means Curavi can
expand quickly across the country without the need to license physicians
across state lines.
Visit UPMS for the story.
million Americans have âErin Brockovichâ carcinogen in their tap water
For more than a year, federal, state and local officials have struggled to
properly respond to the crisis in Flint, MI, where lead contamination of the
cityâs drinking water has threatened the health of 8,000 children and forced
residents to use bottled water to drink and bathe. Even now, Democrats and
Republicans on Capitol Hill are fighting over whether to include $100
million to assist that beleaguered community as part of a major year-end
Lead contamination of municipal water systems, sadly, is a relatively
widespread problem in this country and would require massive resources at
the federal and local level to adequately address the problem. CNBC reported
recently that data it obtained from the Environmental Protection Agency
(EPA) shows that 41 states have reported higher-than-acceptable levels of
lead in drinking water during the past three years.
Now comes a troubling report from the Environmental Working Group (EWG), an
activist research organization, that chromium-6, a carcinogenic chemical
compound, has contaminated water supplies for more than 200 million
Americans in all 50 states. The tests conducted by utilities across the
country and supervised by the EPA found chromium-6 in almost 90 percent of
the water systems sampled.
The study found that levels of chromium-6 are at or exceed 0.03 parts per
billion in three-quarters of the samples that were tested between 2013 and
2015. Roughly seven million people received or consumed tap water with
levels of the compound higher than the 10-parts-per-billion legal limit set
by California - the only state that currently imposes a maximum contaminant
Arizona, California and Oklahoma had the highest average statewide levels,
according to the report. Phoenix by far had the highest average level among
major cities while Houston and St. Louis also registered comparatively high
levels. Hexavalent chromium or chromium-6 is a chemical compound commonly
used in industry for a number of purposes, including electroplating and
manufacturing stainless steel and textiles.
Chromium-6 is also used as a coolant in power plant towers and is found in
the ash of coal burned by utilities. While scientists may differ on the
degree of public health risks that it poses, research has shown that
exposure to small quantities of chromium-6 in drinking water can produce
cancer in humans and animals.
The National Institute for Occupational Safety and Health (NIOSH) considers
all chromium compounds to be âoccupational carcinogensâ that are closely
connected with lung, nasal and sinus cancer, according to a government
The chemical industry has long opposed tough regulation of chromium-6,
arguing that additional research was needed. The EPA has never set a
specific limit on chromium-6 in drinking water, although the environmental
agency has established a drinking water standard of 100 parts per billion
for all forms of chromium, which is a natural occurring element.
Environmental activists say a national standard for chromium-6 in drinking
water is long overdue.
Visit the Fiscal Times for the article.
Disease-related malnutrition costs U.S. $15.5 billion annually
The United States could save at least $15.5 billion in annual healthcare
spending if malnutrition caused by chronic diseases is better addressed,
according to a study.
The study, conducted by Abbott Laboratories' nutrition division and the
University of Illinois, noted one in three patients who arrive at a
U.S.-hospital suffer from malnutrition. A further one-third become
malnourished during their stay.
Disease-associated malnutrition (DAM), which is linked with longer hospital
stays, higher rates of readmission and increased mortality, is considered an
invisible affliction as it occurs in both obese and underweight individuals.
It disproportionately affects the elderly, who have vulnerable immune
systems and are commonly afflicted with chronic diseases. While individuals
over 65 represent only 14 percent of the American population, they accounted
for nearly a third, or $4.3 billion, of DAM costs, according to the study.
An aging population and rising medical costs are expected to lift healthcare
spending by an average 5.8 percent annually over the next decade, the U.S.
federal government estimated in July.
Malnourished patients cost 20 percent more to treat on average, said lead
author Dr Scott Goates, a health economist at Abbott's nutrition division,
which accounted for about 34 percent of the company's $20.41 billion in 2015
The study used publicly available data to calculate the increase in
expenditure due to malnourishment associated with eight common chronic
diseases, including stroke, depression, dementia and colorectal cancer.
It did not factor in patients' socio-economic status. Companies, including
Abbott, Nestle SA and Danone SA, sell products that help in recovery
following illness, injury or surgery. These products are particularly useful
for patients having trouble swallowing or digesting.
Visit Reuters for the report.
Possible new treatment for Alzheimer's disease
Despite the promise of immune therapy for Alzheimer-type dementias, several
approaches have failed. Now, industry-funded investigators report results on
a newly developed, experimental monoclonal antibody, aducanumab.
In animal studies, aducanumab passed through the bloodâbrain barrier,
attached to both soluble and insoluble amyloid, and decreased brain amyloid
accumulations. In a human phase-1b double-blind, placebo-controlled, safety
study, 165 participants with prodromal or mild Alzheimer disease
intravenously received various aducanumab doses (1, 3, 6, or 10 mg/kg-1) or
placebo, administered monthly for o1 year.
Dropouts occurred in 25% of the placebo group and 23% to 38% of the
aducanumab subgroups (dropout rates increased at higher doses). On positron
emission tomography (PET), most aducanumab doses were associated with
decreasing amyloid in a dose- and time-dependent fashion.
These decreases were similar for prodromal and mild disease and for those
with or without the APOE4 risk allele. In exploratory cognitive testing,
disease progression slowed at some aducanumab doses. Cerebral vasogenic
edema, seen on PET, occurred in 3% to 41% of aducanumab recipients (highest
at upper doses) and resolved within 4 to 12 weeks.
Visit NEJM for the study.
Some Zika 'firsts' as disease spreads across Caribbean
The World Health Organization's (WHO's) weekly Zika update included a series
of Zika "firsts" in several countries, including the first Zika-related
birth defects reported in Guatemala. Also, the CDC released new Zika numbers
for the United States, while human trials of a vaccine are set to begin in
According to the WHO's weekly Zika situation report, the two-island nation
of St. Kitts and Nevis is now experiencing Zika transmission, bringing the
number of countries or territories with Zika virus to 73.
The number of cases of Zika-related microcephaly also increased this week,
as Guatemala reported 17 suspected cases of congenital birth disorders.
These are the first such cases reported in the Central American country.
Brazil reported 23 more cases of microcephaly, bringing that country's total
More cases of microcephaly were also reported in Martinique and the United
States, bringing the total number of Zika-related microcephaly cases to
2,047 in 21 countries. Microcephaly, a severe congenital malformation of the
brain, is one of the most serious outcomes of Zika infection.
Ecuador reported its first cases of suspected Zika-related Guillain-Barre
syndrome (GBS), bringing the number of countries with reported GBS to 19.
The WHO noted that "neurological complications have been linked only to
post-2007 strains of the 'Asian' lineage" Zika virus, but it warned that as
new information about different strains of the virus emerges, there could be
cases linked to the African strain of the virus, or to strains in Southeast
The Centers for Disease Control and Prevention (CDC) also released its
updated Zika numbers which includes all cases in the United States and its
territories. The CDC reported two more babies born with Zika-related birth
defects, bringing that number to 20. The number of pregnancy losses stayed
at 5. There are 749 reported cases of Zika in pregnant women in the US
states (18 more than last week), and 1,348 in US territories (192 more than
last week) as of Sep 15.
The number of travel-related Zika infections in the Unites States is now at
3,314, with 182 more cases reported. In US territories, the number of local
infections increased by 2,077 to 17,629, most in Puerto Rico.
Two Zika DNA-based vaccines developed by the National Institutes of Health (NIH)
proved to be effective in protecting monkeys from the disease after two
doses, the NIH said today in a press release. The vaccine uses circular DNA
to replicate the shape of the Zika virus.
One of the vaccines is already being testing by human volunteers in three
study centers in the United States. If the phase 1 trials are successful, a
phase 2 trial in Zika-endemic countries will begin in early 2017.
Visit CIDRAP for the report.
Leading cause of injury, death in older Americans is on the rise
Older Americans need to go for regular eye exams, get rid of their throw
rugs, and retire their high heels. These are just some of the pieces of
advice experts on aging and government health officials are doling out in
tandem with a new report that shows falls are the number one cause of fatal
and nonfatal injuries among adults over 65.
In 2014, older Americans fell 29 million times, leading to seven million
injuries, according to the report out today in the U.S. Centers for Disease
Control and Preventionâs Morbidity and Mortality Weekly Report.
About 2.8 million cases were treated in emergency departments, and
approximately 800,000 seniors went on to be hospitalized for fall-related
More than 27,000 falls led to death.
And the problem is growing as more Americans age into the 65-and-over
The CDC said individuals, families and healthcare providers can take steps
to defy the trend.
Dr. Gisele Wolf-Klein, M.D., director of geriatric education at Northwell
Health in Great Neck, New NY, told CBS News one concern is that seniors who
have experienced a fall alone at home donât tell anyone. When that happens,
prevention efforts donât begin and theyâre at risk for additional â and
possibly more serious â tumbles that lead to broken bones and brain
When someone does fall and hurt themselves, especially if theyâre put in the
hospital or have to have surgery, theyâre often never the same, Wolf-Klein
Falls also lead to higher healthcare costs, CDC experts said in the report.
Fall injuries in 2014 amounted to an estimated $31 billion in annual
A CDC initiative called STEADI â Stopping Elderly Accidents, Deaths, and
Injuries â is aimed at reducing the risk of falls and offers guidance
for doctors, patients and families. It includes information on how to screen
a personâs fall risk, online resources to help train healthcare providers to
deal with the issue, and informational brochures for patients and
Part of the challenge is overcoming the stigma associated with the problem.
Visit CBS News for the story.
Vocera Integration with prescriptive analytics reduces patient falls
Vocera Communications, Inc. announced that long-time customer MedStar
Montgomery Medical Center has improved patient care with the launch of a
fall prevention program. The new initiative combines prescriptive analytics
using the hospitalâs clinical data with the Vocera Communication System.
The software platform enables real-time alerts and notifications, secure
texting, hands-free communication, and integration with more than 75
clinical systems including electronic health records, nurse call and bed
management solutions. The program is supported by analytics MDâs
prescriptive analytics solution.âš
With a continuous focus on patient safety and satisfaction, MedStar
implemented analytics MDâs prescriptive analytics solution in 2016, gaining
real-time, actionable insight into its patient population. The analytics MD
platform looks at both historical and transactional data to proactively
notify MedStar team members about fall risks.
Now MedStar has a real-time fall alert system that notifies care teams about
high-risk patients. These alerts are sent directly to assigned nurses via
their Vocera Communication Badge. Because the badges are wearable, staff
membersâ hands are free to quickly help patients at the bedside while also
calling for co-workersâ assistance if needed.
Visit Vocera for the release.
Clorox Healthcare introduces the next generation of bleach
Bleach has played an important role in public health for more than a
century. Announced at the Association for the Healthcare Environment (AHE)
EXCHANGE 2016 annual conference, Clorox Healthcare is proud to release itâs
healthcare disinfection with the introduction of Clorox Healthcare Fuzion
Fuzion is the next generation of bleach and the first product of its kind to
combine trusted bleach efficacy against tough-to-kill pathogens with the
aesthetics required for broad use throughout healthcare facilities. Fuzion
is Environmental Protection Agency (EPA) registered to kill Clostridium
difficile (C. difficile) spores in two minutes, the fastest kill
time available, and 35 other pathogens in one minute.
Clorox Healthcare Fuzion Cleaner Disinfectantâs innovative features include:
Efficacy: The formula is EPA-registered to kill drug-resistant threats such
as C. difficile, methicillin-resistant Staphylococcus aureus (MRSA),
vancomycin-resistant Enterococcus faecalis (VRE) and carbapenem-resistant Klebsiella
pneumoniae (CR-KP) as well as other bacteria, viruses and fungi in two
minutes or less.
Excellent Aesthetics and Surface Compatibility: Fuzion is a pH-neutral,
highly-efficacious form of bleach that wonât cause damage to common
surfaces. It can be safely used on stainless steel, chrome, countertops,
sinks, mattress covers, glazed tiles â even finished wood, clear plastics
and glass. The low residue formula leaves surfaces looking clean, not
cloudy, and has a low odor profile with any mild bleach odor dissipating in
for Enhanced User Experience: Fuzion was designed with environmental
services professionals (EVS) in mind. The product features an ergonomic
bottle shape and innovative trigger spray designed to deliver the
appropriate concentration of active ingredient every time the trigger is
This approach makes Fuzion tough on pathogens, yet easy on surfaces and
practical for everyday use across a wide variety of healthcare surfaces and
settings. These features, combined with the ease of use of a one-step
cleaner and disinfectant represent the next generation of disinfectants and
an entirely new user experience designed for efficacy and satisfaction.
Visit Clorox for more information.