October 24, 2022

How can you protect yourself from a cyberattack?

MercyOne in the Des Moines metro is part of the CommonSpirit health care system. For the past three weeks, facilities and providers in 21 states have been directly impacted by a crippling ransomware attack on their electronic health information (EHI). Now the dust is settling and EHI is coming back online (hopefully, with minimal damage to patients' medical records).

Let's take a few moments to better understand the cyber threats swirling about us and, as importantly, to appreciate the steps we can take as health care consumers and advocates to minimize harm and continue to achieve best health outcomes--in spite of a cyberattack.  My op-ed in the Des Moines Register says it all:

DES MOINES REGISTER - OCTOBER 23

October 15, 2022

This attack is much too close to home

Of course, I know there are cyber security risks swirling about 24/7, but it's all too vivid when it hits a health care provider in my own backyard. Last week, MercyOne, a part of the CommonSpirit Health family, was hit by ransomware. For many Iowans, it has meant delayed diagnostic tests, cancelled surgeries and potential harm from the lack of accessible electronic health information.

We have come to take for granted the wonder of having our glucose monitored remotely, doctors who can review our last test results with the click of a key and online appointment scheduling. Poof, and they were gone.

There are some simple action steps that can make your journey as a health care consumer or advocate safer and more likely to result in best health outcomes, even in the event of a techno catastrophe. Please take time to learn and practice those strategies for self-preservation.

September 25, 2022

No one to answer 911 calls? Fuggedaboudit.

In response to the Des Moines Register's two-part story on the shortage of emergency response workers throughout Iowa, I wrote this Letter to the Editor, published September 25, 2022. Not that anyone's listening . . .  


EMS troubles highlight deeper problems

Re: "When you call 911, will an ambulance come in time?" (Sept. 18): For those who claim Iowa’s lack of emergency services is just another crisis that needs some money thrown at it, chew on these facts (not opinions):

At the same time Iowa’s EMS demands grow because of the demographics of aging and chronic illness, the number of Iowans aged 18 to 64 is shrinking.

A convoluted and expensive process to declare EMS “essential” is moot for the nearly 1,000 Iowa towns that don't even have the funds to train willing volunteers, which are 75% of the EMS workforce.

The conscious denial of Iowa’s crisis of health care access by those who are paid to know better is not only deplorable, it is downright life-threatening. 

- Jo Kline, West Des Moines

September 13, 2022

On the small chance a politician is listening

Earth to fearless leaders: Eight of every ten American adults are somewhat concerned they can't access quality and timely health care. Half are extremely concerned about that. And yet, we have candidates who no longer consider "health care" an issue that even merits a place on their agenda. Deja vu all over again. 

"Americans give health care system failing marks"

August 8, 2022

What are they waiting for?

The Inflation Reduction Act cap on Medicare drug costs doesn't take effect until 2025.

That makes sense. Not.

July 14, 2022

We need more beach umbrellas!

It's like watching a tsunami on the horizon while Iowa's policy makers call for more beach umbrellas. The Iowa leadership and legislature continue to deny Iowa is facing a devastating health care worker shortage in the near--and distant--future. A good example is the new program to fund 12 psychiatric residencies at the University of Iowa:

Jo's 7-14-2022 Letter to the Editor 

We're going to spend $1,200,000 annually on these psychiatric residencies, when we know (or at least some of us know) that two thirds of our graduating residents leave Iowa to practice medicine. As for our fellow states, are we generous, or what?

It would be super cool if this crisis of access would take care of itself without policy makers stepping up to address a life-limiting threat to Iowans' health. It won't. 

July 6, 2022

One step forward, two steps back

The dust has settled on the 2021-2022 Iowa legislative session and we can now see how the cause of health care access for Iowans was furthered. One bill I watched closely called for funding more psychiatric residencies, intended to address the mental health needs of Iowans.

So the good news is that there will be an additional 12 psychiatric residencies at the University of Iowa Hospitals. Preference will be given to Iowa residents who got their undergraduate or medical degree at an Iowa school. All good, right? 

Not so much. Less than one fourth of Iowa's medical school graduates stay in Iowa, and only one third of those who complete a medical residency in Iowa end up practicing here. (FYI, data is from the Association of American Medical Schools, because Iowa's medical schools don't even track this.) This new law contains no incentives or mandatory requirements to stick around after the residency. $1,200,000 per year will be spent on these scarce residency slots. 

I cannot understand why policy makers refuse to acknowledge the brain drain of Iowa's medical professionals that further threatens Iowans' access to care. It eludes me.

June 15, 2022

It's not just about leaving a sponge behind

They're called "never events," the medical errors we hope never occur, like operating on the wrong patient or leaving a sponge behind after surgery. Nevertheless, they do happen about 4,000 times a year. But they're not really what you should be worrying about.

HHS has just released a study verifying that one fourth of Medicare patients are harmed while being hospitalized. Those medical errors are called "hospital acquired conditions" and almost half are preventable. Falls, infections, misdiagnoses, faulty medicating. All result in patients who now have a medical ailment they didn't have when they were admitted. Many do not survive to be discharged or are permanently impaired. 

Please consider how you can be a more engaged--and safe--patient. Then start making self-advocacy a priority in your own health care journey. 

June 10, 2022

The part of Obamacare that got left behind

It's been 12 years since the passage of The Affordable Care Act (Obamacare). It's  important to note that a crucial element of that key legislation was the creation of The National Healthcare Workforce Commission, mandated to provide for a sufficient number of health care workers in the future. The statutory intent is to collect data on our present workforce, project needs based on our aging and chronically ill population and make effective preparations so that health care is accessible to all Americans, now and in the coming decades.

Over a decade later, as we face a crisis of worker shortages in health care, the National Healthcare Workforce Commission has yet to hold its first meeting. Why? Because Congress has repeatedly passed on the opportunity--and its obligation--to appropriate a meager $3 million for the Commission to do its work. Pathetic.

May 15, 2022

The health care worker shortage: The first wave of a perfect storm

As we hear stories and experience the health care worker shortages first-hand, it begs the question, "Why now?"

If you listen to Jo's interview with Jeff Angelo of WHO Radio's "Need to Know," you'll learn how this crisis of access is just a hint of what's to come:

April 30, 2022

Well, we've certainly identified the problem . . .

 Another story featuring Iowa's failure to effectively protect its most vulnerable, the youngest and oldest among us. 

Des Moines Register: Nurse fired for reporting resident abuse

But not to worry. The State Long-Term Care Ombudsman office (those in charge of making sure there are "eyes on the ground" at Iowa's care facilities) assure us they have recruited 52 volunteers to oversee 55,751 beds. 

We are beginning to see what our policy makers' and stakeholders' "failure to plan" really looks like. It's not good.

April 14, 2022

Children, patients and the elderly. Who speaks for them?

There's an interesting op-ed in today's Des Moines Register. Substitute the word "patient" or "elderly person" for every "child" and you will find the message equally relevant. 

Des Moines Register op-ed by E. J. Wallace

Gosh. Convening another "task force" wasn't the solution to a systemic problem? Almost hard to believe. As for passing legislative "solutions" that fly in the face of common sense and the will of constituents, nothing new to see here.

Child care, elder care and health care access are all in crisis mode. That's largely due to the demographic realities of a shifting dependency ratio and our leaders' unwillingness to acknowledge and prepare for what was entirely predictable.

As the Iowans most directly affected--parents, patients and advocates--we must be the change. Leaders' epic failures to act in a timely and competent manner leaves us little choice. The time to pursue innovative and cooperative answers for these life-altering dilemmas is now.

March 10, 2022

Name calling is not a planning strategy

We all see them. There are Now HIring! signs at every type of business: service, retail, education, law enforcement, yada, yada, yada. It would be wrong headed to expect the health care industry to be an exception. It is not.

Job openings in the "Health Care and Social Assistance" sector have grown 810,000 since the pre-pandemic standard of February 2020. They now total 1,944,000. Nurses and direct care workers find themselves in the unusual position (for them) of being in a sellers' market. The reaction of policy makers and stakeholders? To label them and the staffing agencies they are turning to as "greedy" and this predictable supply/demand phenomenon as "price gouging." 

That will not address the issues of health care access now stemming from mass retirements and burnout. It just will not.

March 3, 2022

COVID-19 is receding. Why isn't the health care worker shortage?

"They" keep saying we have delayed surgeries, long waits for care and no hospital beds because of COVID-19. But infection and hospitalization rates are way down, so why are hospitals still paying $220 an hour to contract nurse agencies? Post hoc, ergo propter hoc. "Since event Y followed event X, event X must have caused event Y". Maybe sometimes, but not in this case.

Health care worker shortages were destined to occur, ever since the 1960s. Demography is destiny and health care utilization has risen dramatically due to our aging population and America's epidemic of chronic illness--not to mention all the Baby Boomer health care professionals now retiring.

Are people starting to see the light? Wall Street Journal - March 3, 2022

February 22, 2022

What IS the next step?

A Facebook friend asked what we can do to address the problem of health care worker shortages and Iowa's "brain drain." I wish I had a smart and credible answer for her. Instead, I admitted that I am very frustrated with the refusal of Iowa's leaders to listen to the facts and acknowledge reality. Their proposals for "solutions" are not only poorly thought out, they will most likely serve to exacerbate existing obstacles to health care access for Iowans.

I am struggling with how to proceed, but I have a feeling I will be going straight to the people with the most at stake and most willing to forge ahead: the health care consumers and those they advocate for.

Stay tuned. I will be back soon with a plan. Wish me luck.