Category: Blog

Health care professionals are constantly developing and brainstorming innovative ways to increase access to healthcare in an affordable way. Is telemedicine the solution to the health care industry’s problems?

The American Telemedicine Association defines telemedicine as the “use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.” Although telemedicine is considered a recent trend, telemedicine has been utilized for over 40 years and continues to grow in popularity. Today, telemedicine is predicted by many healthcare professionals and public health analysts to drastically cut annual healthcare spending. One report claims that in the coming years, telemedicine will cut annual healthcare spending by $60 billion; $40 billion in eliminating roughly two-thirds of unneeded emergency room visits and $20 billion in by replacing one-third of physician visits. Analysts have also noted that an expansion in Medicare coverage for telemedicine services will further increase annual savings.

Some health care professionals, however, are not sold on telemedicines projected savings. Dr. Jha stated, “You do the telemedicine; it leads to more tests. It leads to more follow-up visits. And, over time, when you look at the data, it turns out that telemedicine overall is not necessarily a big cost saver.” Despite this, the overwhelming message from health care professionals and communication professionals alike is that telemedicine works and will account for unprecedented savings.

Currently, Medicare only covers telemedicine services for rural and medically underserved areas when video conferencing is used. As telemedicine continues to develop public health professionals will keep a watchful eye on the Centers for Medicare and Medicaid Services to see if reimbursement for telemedicine services expands.

Telemedicine seems to be the golden child in healthcare; it cuts costs, increases access to care, and spurs innovation. Despite this, advancements in telemedicine possess major privacy concerns. As telemedicine continues to evolve from its video conference/consultation base to more services are being offered via mobile apps and text messages, how is a patient’s information being managed and protected?

Telemedicine requires developers, consumers, and physicians alike to consider if information from a video consultations will be recorded, or how data collected from a mobile health app will be stored, and whether federal or state privacy law is violated with such practices. The Department of Health and Human Services (HHS) and the Office of the National Coordinator for Health Information Technology (ONC), recognizing the need for guidance in the telehealth arena, provide resources for providers, implementers and consumers to address the many privacy issues related to health and mobile devices. ONC harps on the importance of encryption and being an informed consumer to help decrease privacy violations. Even still, federal, state, and local governments will continue to develop laws and regulations that address the ever-changing privacy landscape in light of continued telehealth innovation.

In the United States District Court of Los Angeles a case is being brought against the Compton Unified School District for failure to not adequately provide appropriate education and assistance for those students who have suffered from a “complex trauma.” The Plaintiffs assert that too often the school district turns to punishment for students who are attempting to cope with the struggles they face in their lives.

To better understand the type of trauma these students are experiencing it is important to understand the environment these children have grown up in throughout their lives. Compton is a city located south of Los Angeles and has an extremely violent reputation; last year alone the murder rate in Compton was five times the national average. These students face problems of addicted parents, homelessness, and a constant fear of violence in their everyday lives. One of the Plaintiffs said that he witnessed his first murder at the young age of eight, took a bullet to the knee, and in 2014 alone witnessed twenty shootings; another Plaintiff was mistakenly arrested at gunpoint by police at school. One plaintiff was sexually assaulted on the bus, on her way home from school. Gangs are a normal part of life and fear is something that students have to accept as a part of their lives. According to Susan Ko of the National Center for Child Traumatic Stress, exposure to violence can have a profound impact on one’s ability to learn.

The suit being brought argues that “complex trauma” should be considered a disability under the Rehabilitation Act and Americans with Disability Act. The complaint states that individuals who experience chronic or repeat trauma demonstrate physiological impairment in performing normal daily activities such as thinking, learning, reading, and concentrating. Something as simple as social interaction can cause bodily distress due to former trauma. Memories of fear can be created on multiple levels in the brain’s system because trauma triggers multiple functions of the brain. Research by Victor Carrion and Shane S. Wong of Stanford University shows that the hippocampus plays an important role in learning new information. Those who have experienced “complex trauma” have a smaller hippocampus, which makes learning more difficult. By classifying “complex trauma” as a disability the complaint asserts that these children will be able to receive the help they need to process their trauma and move forward.

A recent article said that a program implemented in the Los Angeles School District of 10 counseling sessions was effective in helping the students recover and improve their performance in school. By providing programs such as this one in low income areas teachers will receive the training necessary to: recognize trauma and seek mental health support to assist the students in coping with their trauma. These programs will allow school’s from a punishment structured system of handling student outbursts as a result of their trauma to promoting reconciliation and mediation before jumping to a suspension or expulsion.

The school district is extremely sympathetic to these children, but has to acknowledge the large costs that would have to be allocated to these programs and that there are other school districts with these same issues that do not have lawsuits pending.

While the cost may be high,is it possible that now is the time to spend more in cities and neighborhoods such as Compton to promote students getting the help they need for the trauma they have experienced throughout their lives? As a nation we should prioritize investing in children’s futures. It is important to recognize that every child deserves a chance to have a positive learning experience and feel safe in the school environment. While this occurs in places outside of Compton, maybe it is time for all states to take a look at their lower-income neighborhoods to see what they can do to help kids who are suffering from “complex trauma.” These kids deserve a chance to learn and create better lives for themselves and future generations. This transition may not be an overnight transformation, but by classifying “complex trauma” as a disability more students will be able to get the help they need.

 

Health Law & Policy Brief 2015-2016 Applications

The Health Law & Policy Brief (HLPB) is accepting applications for new members! We encourage 1Ls, 2Ls, 3Ls, and LLMs to apply.

The Health Law & Policy Brief covers a broad range of topics including: health care, food & drug, disability law, administrative law, and business law; both domestic and internationally. HLPB is entirely online. We publish long academic articles by students, professors, and practitioners. We plan to have two issues in the coming year – a Fall 2015 issue and a Spring 2016 issue. HLPB also has a blog component, which features short pieces on new and developing topics. The blog​ ​is located at​ ​https://www.healthlawpolicy.org/ ​and​ ​is updated every month.

We are primarily seeking multiple staff members to “spade” (edit) our academic articles. If selected as a staff member, you will receive training and advance notice before getting a spading assignment. You will be supervised by a more experienced Articles Editor. You will not receive more than one spading assignment per semester.​ ​We are also seeking one Marketing Director​.​

To apply, please email the HLPB Editor-in-Chief, Mohammad Mesbahi, at mohammadh.mesbahi@gmail.com with the​ ​​​subject line “LAST NAME – HLPB Application.”​ ​​Please briefly explain your interest in joining the HLPB, and if applicable, any interest or prior experience in health law, food and drug law, or disability law. Please also attach a current resume (GPA not required).
​​
Application deadline: Friday, October 2, 2015 at 11:59am (noon). ​​ We look forward to receiving your application!

​​Applicants who are selected ​to become members of HLPB ​should try to attend the HLPB Spading and Blogging Training on Saturday, October 3, 2015 from 1:00 PM – 4:00 PM in WCL Room 526.​ ​Those who cannot attend would be expected to notify the HLPB Editor-in-Chief and will be allowed to meet at a later time with the HLPB Editor-in-Chief.​ ​ Those attending this meeting should bring a laptop and their Bluebook.

In July 2015, the FDA proposed a rule that would update the Nutrition facts label on most food packages to include more information about how much added sugar is in a food product and what the appropriate consumption levels are. Added sugars are sugars and syrups that are added to food or beverages when they are processed or prepared.  Major sources of added sugar include soft drinks, sugars, candy, cakes, cookies, pies and fruit drinks; dairy desserts and milk products (ice cream, sweetened yogurt and sweetened milk); and other grains.

The proposed rule will require declaration of the “percent daily value” for added sugars. Presently, it is recommended that daily calories from added sugars not exceed 10 percent of a 2000-calorie diet. In a 2000-calorie-a-day diet, that works out to a daily maximum of about 200 calories a day or 12 teaspoons of added sugar. Currently, added sugar is presented in grams on nutrition fact labels. One gram of sugar contains about 4 calories. http://www.npr.org/sections/thesalt/2015/07/24/425908798/no-more-hidden-sugar-fda-proposes-new-label-rule

Food companies throughout the United States add sweeteners to their products, which increases calories but provides no nutritional value. Also, consuming too much added sugar leads to weight gain, obesity, Type 2 diabetes, and reduced heart health, and heart disease. Most Americans consume way more sugar than they realize. Sugar is one of the few major food components that doesn’t have a recommended consumption level on U.S. food labels, primarily because FDA hasn’t issued recommended consumption levels. This action by FDA will promote consumer awareness and allow Americans to make informed decisions relating to their sugar intake.

“For the past decade, consumers have been advised to reduce their intake of added sugars, and the proposed percent daily value for added sugars on the Nutrition Facts label is intended to help consumers follow that advice,” wrote Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, in an agency news release.

Currently, the FDA is taking comment on the new proposal for 75 days. Many health activists and consumer advocate groups have applauded the FDA’s efforts to inform consumers about how much added sugar they are actually consuming when they consumer processed foods and beverages. The agency will probably also hear from food companies. The Sugar Association has already weighed in, probing whether the move to constrain added sugars to no more than 10 percent of daily calories is backed by sufficient scientific evidence and studies. Moreover, food companies argue that nutrition fact labels do not influence most consumers and it will be expensive for companies to implement into their products.

This proposed rule is a part of a major overhaul by the Obama administration to modernize nutrition fact labels and inform consumers so they may lead healthier lives.

 

Written by Karina Velez–Fellow Health Law and Policy Brief Junior Blogger

There is a new wave of medicine that has been sweeping across the healthcare world. Telemedicine (also known as “remote healthcare”) is the new modern wave of healthcare. Telemedicine is the use of medical information exchanged from a single site to another via electronic communications to improve a patient’s clinical health status. The original purpose of telemedicine was to extend healthcare’s reach to rural areas to allow patients from these areas to be provided access to healthcare benefits. The technology that has become available after forty years of development now extends to services using two-way video calling, smart phones, and other wireless tools to provide services to the rural population in the United States. Since telemedicine creation the original purpose has expanded to include a variety of resources to both rural and urban patients in addition to the medical community. First, telemedicine provides primary care for those individuals in rural areas that may otherwise not have access to healthcare. Second there is the ability for doctor’s to monitor those patients who live remotely and need to have blood pressure or glucose levels checked on a regular basis. Third, the telemedicine field allows consumers to obtain specialized medical information, have access to discussion groups on health diagnoses, and provides peer support groups in times of need. Finally, telehealth is giving the medical field a makeover in how it shares information because doctors are now able to access more techniques and services through these devices to grow his or her technique in a particular field of study.

There are significant benefits from the expansion of telemedicine; healthcare can now be provided to a wider range of individuals, telemedicine is more cost efficient, improved the quality that as a nation we provide, and lastly there is more patient’s want to use telemedicine because it reduces the stress and time a person has to dedicate to ensuring his or her body is in good health.

As a result of the increase in patients and doctors alike wanting to use telemedicine, Congress would like to restructure how Medicare pays for telehealth. The representatives in support of this idea have proposed the Medicare Telehealth Parity Act of 2015. The act consists of three phases that are to be implemented over a four year period expanding the coverage of telemedicine not only to the members of the rural community but also to urban areas. Phase 1 consists of expanding the rural health centers and adding centers to metropolitan areas with a population less than a 50,000; this phase also includes the expansion of specialists such as diabetes educators and speech therapists. Phase 2 encompasses expanding telehealth sites to include metropolitan areas with populations of 50,000 to 100,000 people. The third and final phase of Congress’ plan is to then extend the telemedicine services to all geographic locations regardless of population size.

Bipartisan members of Congress that support the expansion of telecommunication have tried to introduce legislation that reimburses those companies that support telehealth endeavors. Unfortunately, in both 2013 and 2014 the bills did not leave the House Energy and Commerce Subcommittee on health despite the support the bill received from the Telecommunications Industry Association and American Telemedicine Association. The representatives are now hoping that the bill will get the chance to leave the Committee and that members of the healthcare community will sponsor this bill in order to have healthcare be available to every individual that needs it. This bill is legislation that would allow medicine to be provided to a larger demographic and ultimately benefit society by having healthcare be provided a little closer to home.