Search

Objective: To examine patient-user symptom reporting to an AI-based online virtual triage (VT) and care-referral engine to assess patterns of mental health symptoms (MHS) reporting prior to and during the COVID-19 pandemic. Methods: The frequencies of 11 MHS reported through VT were analyzed over three time intervals: one year prior to the WHO declaring a global COVID-19 emergency; from pandemic declaration to a mid-point in US vaccine distribution/uptake; and one year thereafter. Results: A total of 4,346,987 VT encounters/interviews presenting somatic and MHS occurred, increasing over time and peaking in the COVID-19 post-vaccine interval with 2,257,553 encounters (51.9%). In 866,218 encounters (19.9%), at least one MHS was reported. MHS reporting declined across subsequent time intervals, was lowest in the COVID-19 post-vaccine period (19.1%), and slightly higher in the pre-pandemic and COVID-19 pre-vaccine intervals (p = 0.05). The most frequently reported symptoms were anxiety, sleep disorder, general anxiety, irritability, and nervousness. Women reported anxiety less often and nervousness and irritability more often. Individuals aged 60+ years reported anxiety and nervousness less frequently, insomnia and sleep disorder more often than individuals 18–39 and 40–59 years old, and sleep disorder more often than those aged 40–59 years in all periods (all p = 0.05). Conclusions: Overall VT usage for somatic and mental health symptom reporting and care referral increased dramatically during the pandemic. VT effectively screened and provided care referral for patient-users presenting with MHS. Virtual triage offers a valuable additional vehicle to detect mental health symptoms and potentially accelerate care referral for patients needing care. [ABSTRACT FROM AUTHOR]

Objective: Gather insights into healthcare organization (HCO) preparedness for new 21st Century Cures Act information blocking disincentives and challenges in achieving greater accuracy/interoperability of patient identity/data. Methods: Survey of 197 U.S. healthcare executives (54.7% response rate), included 46 health systems (23.4%), 141 hospitals (71.6%), and 10 payer organizations (5.1%), evaluated organizational gaps in patient identity data management/interoperability and preparation for information deblocking. Results: Healthcare organizations are unprepared to meet information deblocking requirements and manage increased data influx/exchange. Although 61% have invested in meeting requirements, only 36% have capabilities in place. Majorities reported inability to comply with information blocking rules (59%), communicate electronic patient activity notifications to other organizations (56%), or share/receive patient-level information with patients and other HCOs (57%). Across 12 critical functionalities, 57% lacked key capabilities; 97% reported inadequate patient data/identity management/interoperability as data volume expands, adversely affecting care quality/safety and outcomes; and 57% envision patient data-matching errors precipitating a healthcare crisis in 5-10 years. Conclusions: Many HCOs are unprepared to meet new Cures Act information blocking requirements and resultant increase of internal/external patient data volumes. Next generation master data management, enterprise master patient index, and referential matching technologies can improve HCO patient identity and data management, and information interoperability. [ABSTRACT FROM AUTHOR]

A total of 637 cases of unattended or questionable deaths of children 12 years or younger in Orange County (California) were reviewed by a multiagency team investigating possible cases of fatal child abuse. Analysis revealed that, when compared with unreviewed deaths, differences were found in age distribution, gender, ethnicity, and cause of death. (DB)

An interim set of human immunodeficiency virus (HIV) testing guidelines for victims of pediatric sexual abuse (PSA) is proposed. Guidelines are based on responses of 63 practitioners of PSA assessment to 7 hypothetical clinical profiles with 12 testing criteria. (Author/DB)