Literature Review

Perspectives on artificial intelligence–generated responses to patient messagesJAMA Network Open; Jiyeong Kim, PhD, MPH; Michael L. Chen, BA; Shawheen J. Rezaei, MPhil; April S. Liang, MD; Susan M. Seav, MD; Sonia Onyeka, MD; Julie J. Lee, MD, MPH; Shivam C. Vedak, MD, MBA; David Mui, MD, MBA; Rayhan A. Lal, MD; Michael A. Pfeffer, MD; Christopher Sharp, MD; Natalie M. Pageler, MD, MEd; Steven M. Asch, MD, MPH; Eleni Linos, MD, DrPH; 10/24Generative artificial intelligence (AI) has the potential to assist clinicians in responding to patients’ messages. Satisfaction was consistently higher with AI-generated responses than with clinicians overall and by specialty. However, satisfaction was not necessarily concordant with the clinician-determined information quality and empathy. For example, satisfaction was highest with AI responses to cardiology questions while information quality and empathy were highest in endocrinology questions. Interestingly, clinicians’ response length was associated with satisfaction while AI’s response length was not. The findings suggest that the extreme brevity of responses could be a factor that lowers satisfaction in patient-clinician communication in EHR.

Patterns of migration following dementia diagnosisJAMA Network Open; Momotazur Rahman, PhD; Bishnu Bahadur Thapa, PhD; Christopher Santostefano, MPH, RN; Pedro Gozalo, PhD; Ulrike Muench, RN, PhD; Cyrus M. Kosar, PhD; Hyesung Oh, PhD; Elizabeth White, APRN, PhD; Vincent Mor, PhD; 10/24In this cohort study of more than 1 million Medicare fee-for-service beneficiaries, individuals with a diagnosis of dementia were almost twice as likely to migrate to another county or state compared with those with diagnoses of myocardial infarction, chronic obstructive pulmonary disease, or colon cancer. Of the excess migrations resulting from dementia diagnosis, 55% occurred in community settings, and 45% occurred in institutional settings. The marked increase in migration among patients following a dementia diagnosis highlights a distinctive need for policy and support interventions tailored to their unique migration patterns and care requirements.

Advance Directives: How to make sure your end-of-life decisions are followed Bottom Line Inc; by Mathew D. Pauley, JD; 10/24/24 Nearly 40% of older Americans have some form of advance directives, such as a living will to communicate wishes about life-saving treatment…or a medical power of attorney appointing a loved one as proxy if they’re incapacitated.  Problem: Your wishes may not always be followed in real-world situations. Examples: Emergency paramedics typically provide CPR to restart a patient’s heart even if that patient’s living will says otherwise. And complex medical circumstances at the end of life often arise that force your loved ones to make judgment calls about what you really want. Bottom Line Personal spoke to clinical ethicist Mathew Pauley about how to make sure hospitals, medical providers and family members follow your medical wishes.

New FTC regulations could create obstacles for hospice M&A Hospice News; by Jim Parker; 10/24/24 Changes to federal rules governing mergers and acquisitions could have sweeping effects on hospice and other health care transactions. The Federal Trade Commission (FTC) recently finalized a rule that will implement changes to required pre-merger notification forms. Pursuant to the Hart-Scott-Rodino Act, parties to certain transactions must submit these documents to the FTC and other regulatory agencies to help identify and address potential antitrust concerns. The law requires that transactions exceeding $120 million must submit the form, which agencies will use to conduct a 30-day premerger assessment, according to Luke Smith, member at the law firm Bass, Berry and Sims. The final rule will likely complicate the closing of some hospice acquisitions.

Saint Francis Hospital’s Healthy Village creates national social-services healthcare model DelawareLive, Wilmington, DE; by Jarek Rutz; 10/23/24 Saint Francis Hospital hopes a new, unique initiative will be a national model for healthcare. As it celebrates 100 years of service, the hospital is expanding its community outreach to the Wilmington community by launching the Healthy Village at Saint Francis Hospital, which aims to deliver essential social services to those in need. Located in economically challenged neighborhoods, Healthy Villages are designed to enhance the traditional safety net hospital model. “The goal is to create the ultimate one-stop care setting that promotes synergy, diversity, and equity,” said Lillian Schonewolf, executive director of the Healthy Village at Saint Francis, in a YouTube video. Editor's note: See the article we posted yesterday about the importance of community, "Who gets access to a good death?"

Hurricane Helene: NC recovery update after one monthHospice & Palliative Care Today; Chris Comeaux with Cordt Kassner; 10/29/24This is an ongoing series of interviews with Chris Comeaux, President / CEO of Teleios Collaborative Network, who lives and works in Western North Carolina – the area most impacted by Hurricane Helene. Chris framed today’s discussion as the good, the bad, and the ugly:

National Care at Home Month 2024: Celebrating Care at Home in November National Alliance for Care at Home (formerly NAHC and NHPCO); 10/31/24 National Care at Home Month celebrates and supports paid and unpaid caregivers and builds on the existing work of National Family Caregivers Month. Customizable templates are available now. ... The National Alliance for Care at Home brings together two legacy organizations – the National Association for Home Care & Hospice and the National Hospice and Palliative Care Organization – representing, advocating for, educating, and connecting providers of care in the home for millions of disabled, elderly, and dying Americans who depend on that care. ... To represent this strength in unity, the Alliance is introducing National Care at Home Month, an annual observance recognized each November to inspire outreach to communities, media, and policymakers, recognize the valuable contributions of provider staff and volunteers, and continue building awareness of the home care continuum. To this end, we are paying special attention to different types of care at different points throughout November.

Creating death box eases stress, brings 'peace of mind' to those left behind BradfordToday.ca, Canada; by Andrew Philips; 10/26/24 Creating a death box might sound like sort of a morbid thing to do, but it’s vitally important. That’s according to Tammy Vaters, supportive care coordinator at Hospice Huronia-Tomkins House, ... who leads upcoming workshops on creating a death box or a “legacy box or final wishes box” for those uncomfortable with the more succinct terminology ["death box"]. ... Besides end-of-life wishes, Vaters says the box can include photos that someone would like displayed at a celebration of life or similar offering along with personalized letters to family and friends and personal mementos that have special meaning. “It gives you more opportunities of expressing how you feel about somebody,” she says, noting the boxes should also contain usernames and passwords that may aid one's loved ones after death. “They can be more thoughtful and personal.” Vaters, who is a specialist in thanatology (the study of death, dying and bereavement), says people will often use another term for death. 

A priceless business leadership lesson from The Grateful Dead Forbes; by Eli Amdur; 10/26/24 Phil Lesh, the Grateful Dead’s singularly iconic and beloved bassist, died last week at age 84. ... And the lessons we learned from him – and the boys – are more applicable to business than ever before. The timeliest of all comes from Phil ... The essence of the Grateful Dead, he explained, is “the infinite mutability of our music.” ... And if anything signals a business survival mandate in today’s dizzyingly changing world, that’s still it: infinite mutability. ... Every time they stepped on stage, they were a living, breathing experiment in creativity, fearless about treading new ground, easily drifting into their 20-minute jams (or more) on “Dark Star” or “Goin’ Down the Road” or “Morning Dew” or just about anything else … [They] stayed fresh, new, fearless, and constantly innovative. ... And who pointed us to this lesson? Phil, that quiet, unassuming bassist who usually could be seen stage right, away from the glare of the spotlight, while Jerry and Bobby took vocal and instrumental leads and Mickey and Billy wove together an integrated drum partnership ... All the while. There was Phil – the most innovative bassist I ever saw – laying down a foundation to support the Dead’s infinite mutability ...

[In case you missed it] The HOPE Assessment Tool: What you need to know [free webinar by CHAP]Community Health Accreditation Partner (CHAP); 10/21/24 On October 16, 2024, we hosted a webinar on the upcoming implementation of the HOPE Assessment Tool, which will catalyze hospice care starting in 2025. The webinar provided valuable insights into the tool’s implementation, content highlights, and its anticipated impact on hospice program operations. During the session, participants asked numerous important questions, many of which we’ve compiled into this FAQ for further clarification. Access the recorded session and handouts if you missed it or would like to review the presentation.

Why home health providers want employees working at top of license Home Health Care News; by Audrie Martin; 10/17/24 As home health organizations fight for a margin in tough labor and payment environments, they are increasingly seeking ways to help employees practice at the top of their licenses. By applying top-of-license assignments in organizations, less complex work is handed off to the level below. This allows organizations to see more patients, bill for more services, reduce burnout and provide better care. The process helps employees feel more satisfied, and also could help with recruitment. “What we’ve got to do is improve our margins,” Pinnacle Home Care CEO Shane Donaldson recently said at Home Health Care News’ FUTURE conference. “That means we’ve got to get evaluating clinicians to do as many evaluations and assessments as possible, and we’ve got to get the non-evaluating clinicians doing the majority of straight visits.” 

Eight important financial questions to ask your aging parents LifeHacker; by Emily Long; 10/23/24Money conversations can be uncomfortable, but they are also essential. ... When you start asking financial questions of your parents, remember that you don't need specifics, such as dollar amounts or who is inheriting what. The purpose of these discussions is to ensure your parents' wishes are backed by a plan and to understand whether (and how) they want or need your support as they age. Their plan may also affect you directly if you have power of attorney, help with paying bills, or are expected to be a caregiver in the future.

SSM Health at Home joins Wisconsin Hospice & Palliative Care Collaborative Hospice News; by Jim Parker; 10/22/24 The home health and hospice provider SSM Health at Home has joined the Wisconsin Hospice & Palliative Care Collaborative (WHPCC). SSM Health at Home is part of the SSM Health System. Headquartered in Missouri, the system also services patients in Illinois, Wisconsin and Oklahoma. WHPCC was incorporated as a 501c3 organization in 2021. The collaborative includes members Agrace, Rainbow Hospice Care, Unity Hospice, Adoray Home Health & Hospice, Hospice Alliance and Sharon S. Richardson Community Hospice. Their combined geographic footprint covers 80% of the state.