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Past lessons shape health care’s future

SmartBrief readers last month focused on stories offering optimism and a way forward on several challenging issues for the sector.

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SmartBrief readers in October dug deeper into stories that indicate hope for health care’s future. They wanted to read about opportunities for growth and change, including what health systems can do to head off cyberbreaches, what the struggles of the retail health clinic movement can teach us, how physicians can better serve patients by improving their own wellness, and what emerging weight loss drugs can do for patient longevity.

Cybersecurity breach provides key lessons

What happened: The massive ransomware attack suffered by UnitedHealth Group’s Change Healthcare subsidiary this year ranks as one of the largest in history, affecting the personal health information of an estimated 100 million people – nearly one-third of the US population. The breach was enabled by a lack of multifactor authentication on a legacy server at the company.

The stolen data included names, birthdates, addresses, Social Security numbers, and key health information like diagnoses and treatment plans. Hundreds of thousands of medical practices, hospitals and pharmacies were prevented from receiving payments and submitting claims, and many had to revert to manual processing methods, compromising their ability to deliver care. The company has been notifying affected patients on a rolling basis due to the size and complexity of the breach. 

What’s next: Legislators have been discussing how to improve health care cybersecurity standards and deter future attacks, with proposals including higher financial penalties for HIPAA violations and greater accountability for executives in charge of cybersecurity practices. A JAMA Health Forum letter from USC researchers outlines lessons gleaned from the attack and its aftermath.

Struggling retail clinics offer takeaways

What happened: Just a year ago, retail-based primary care clinics like those operated by Walmart, Walgreens and CVS Health were a hot topic in health care, and by early 2024, there were about 1,800 of them across the US. The picture has changed considerably since that time. Some companies have closed clinics and reassessed their presence in the market in recent months – ostensibly over obstacles like poor financial performance and misplaced assumptions about the clinics’ popular appeal. 

What’s next: Professor Timothy Hoff of Northeastern University outlined in the Harvard Business Review several considerations for companies still interested in offering retail primary care. For it to work well, Hoff suggests approaching primary care as a core business, extending it into suburban and rural areas, offering higher-margin care like chronic disease management, and teaming up with other providers for support. 

Despite challenges, CVS Health recently announced plans to widen primary care access through its MinuteClinics in some markets. “This is all about changing the patients’ perceptions from cough, cold, flu and immunizations to a longitudinal relationship-based model,” noted CVS retail health president Dr. Creagh Milford in an interview.

Doctors must help themselves to help others

What happened: Urologist Dr. Neil Baum of Tulane University has seen the public’s perception of physicians decline over the years, and he offers advice on recapturing the joy they should be able to expect from their work. 

“We had an opportunity to regain our esteemed status after COVID-19 when doctors and other health care workers worked tirelessly and risked our own lives to care for acutely ill patients,” Baum observes. “However, as the pandemic progressed, public opinion became more divided.” Feelings of lack of control, emotional exhaustion and administrative pressure still weigh heavily on physicians and erode their compassion and commitment, Baum notes. 

What’s next: Baum offers physicians advice on finding purpose, maintaining supportive relationships, handling finances and practicing healthful habits to help them recoup their motivation to serve. He points out that although a medical career is never without stress, it also provides many opportunities for fulfillment. “The truth is that we have a lot more to be happy about, and we should focus on being happy to be doctors,” Baum says.

Weight loss drugs may save lives

What happened: A study published by the National Academies of Science found that weight loss and diabetes drugs such as Zepbound and Ozempic could prevent more than 42,000 deaths per year in the US if every eligible patient had access to them. That includes the lives of about 11,800 patients with type 2 diabetes, researchers said. 

The drugs can help control insulin and blood sugar levels, decrease appetite and slow down the digestion of food, contributing to weight loss. Research suggests that helping patients lose weight could reduce their risk for obesity-linked conditions such as heart disease, type 2 diabetes and cancer. “Expanding access to these medications is not just a matter of improving treatment options but also a crucial public health intervention,” noted researcher Alison Galvani of the Yale School of Public Health.

What’s next: After more than two years, the FDA has removed Ozempic, Mounjaro, Wegovy and Zepbound from its “currently in shortage” list, though some patients still encounter obstacles in accessing them. The agency has said its “intentional approach to gradually increase supply into the US market” is having a positive impact. 

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