|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
1. Biden Administration says that all hospitals must provide abortion care in emergencies. This week, federal health officials sent hospitals clarification that the federal Emergency Medical Treatment and Labor Act (EMTALA) protects the provision of abortion care during medical emergencies, regardless of state laws. The guidance also offers EMTALA as a possible legal defense for providers against state enforcement of antiabortion laws. Texas Attorney General Ken Paxton has already sued the Department of Health and Human Services (HHS) to set aside the guidance, claiming the agency is exceeding its authority.
The Gist: This latest federal action follows President Biden’s recent executive order directing federal agencies to protect access to reproductive care, and HHS’s warning that pharmacists refusing to dispense medications used to induce abortions could be violating federal civil rights laws. The Federal Trade Commission and Justice Department have also announced that they will enforce data privacy rules and pursue legal action against states that look to restrict patients from traveling to obtain abortion care. These quick federal actions, while limited, are an attempt provide clarity for providers trying to deliver lifesaving care in a timely manner, without running afoul of state laws. Some Democrats, however, argue that they don’t go far enough, and are pushing for the President to declare a public health emergency on abortion, though it’s not clear that would provide much patient benefit. Meanwhile, reports from Texas and other states with restrictive abortion laws reveal physicians are already delaying care for ectopic pregnancies and other life-threatening conditions, setting up all-but-certain legal action when patients experience adverse outcomes.
2. Expanded national mental health crisis hotline launches July 16. Individuals in crisis can dial 988 to speak with mental health professionals, receive immediate medical assistance, or be directed to treatment. Established by a 2020 law, the hotline is an expanded version of the previous National Suicide Prevention Lifeline, intended to provide Americans with a single mental health emergency access point, akin to 911.
The Gist: While 988 has the potential to help more Americans, as well as reduce some burden on overstressed first responders and hospital emergency rooms, media outlets are reporting concerns from national, state, and local partners that they lack adequate staffing and funding to handle the expected level of demand. The nation is long overdue for creating accessible, coordinated mental health crisis care, and this is a step in the right direction. But with one in six calls to the current hotline system now going unanswered, the rollout needs to be coupled with funding for local infrastructure needs.
3. “Superbug” infections and deaths rose in 2020. While the world’s attention was focused on fighting COVID-19, antibiotic-resistant infections were spreading. A Centers for Disease Control and Prevention (CDC) report finds that hospital-acquired infections and deaths from antimicrobial-resistant pathogens increased 15 percent in 2020, compared to 2019. COVID overwhelmed healthcare settings, shifting the focus of infection control resources, resulting in sicker patients with longer catheter and ventilator use, which increased infection risks. Plus, clinicians initially unsure of how to treat the new disease prescribed COVID patients antibiotics at unusually high rates, setting the stage for growing drug resistance.
The Gist: This uptick reverses years of progress made on reducing the number of superbug infections in hospitals. Prior to the pandemic, hospitals were becoming markedly safer places, with fewer hospital-acquired infections, adverse drug reactions, and poor procedural outcomes. As health systems exit COVID crisis mode, hospitals must renew their focus on these longstanding goals of the infection control agenda.
Plus—what we’ve been reading.
4. Acknowledging the losses that come with a new strategy. Embarking on a new strategy requires myriad organizational changes—which will inevitably come with losses. Some parts of the business, people, roles, processes, and traditions will inevitably be deemphasized, or even eliminated from the organization. A recent article in the Harvard Business Review identifies how leaders launching new strategies typically spend a significant amount of time trying to plan for the unpredictable future, while overlooking one of the most predictable parts of any change in strategy: what will be lost when something else is gained.
The Gist: It is critical to identify, acknowledge, and plan for these losses in adopting any new strategy, as the unexpressed fear of loss is a key driver of organizational inertia and resistance to change. With health systems deep in strategy development for the post-COVID market, leaders must take into account the wide range of challenges their organizations will face when it comes to reconfiguring investment, growth, competencies, and people, in addition to focusing on new areas of opportunity revealed by the pandemic. Failing to confront these tradeoffs head-on may sacrifice any strategic gains resulting from new initiatives.