Hospitals in Appalachia, the Upper Midwest, Mountain West and Southwest and are dealing with record numbers of COVID-19 cases, and a Utah plan details the possibility of prioritizing younger patients over older ones when determining who gets admission to the ICU. "The data is just going up on hospitalizations, and we are going to run into trouble -- it looks like almost inevitably," said Ross McKinney of the Association of American Medical Colleges.

Measuring "excess days in acute care" intead of 30-day readmissions could lead to changes in Hospital Readmissions Reduction Program penalty status for about 25% of hospitals, researchers reported in the Annals of Internal Medicine. The study found about half of hospitals in the highest-performing group would drop to a lower-performing group, and a similar number in the low-performing group would be classified in a higher group.

Geisinger Medical Center in Danville, Pa., used a standard form to collect structured data on every diagnostic error case for a registry to help clinicians learn and improve quality, and some results were published in the Joint Commission Journal on Quality and Patient Safety. The form captures objective and descriptive details, lessons learned, and details on feedback and how dissemination were handled, and degree of harm is rated on a 3-point scale for each incident.

The US is seeing a surge in novel coronavirus cases this autumn, but unlike earlier in the pandemic, hospital systems are waiting longer before stopping non-urgent, revenue-producing procedures to ensure they have bed space for COVID-19 patients. Tenet Healthcare CEO Ron Rittenmeyer told analysts the system assumes that COVID-19 spikes will be part of the health care landscape until a vaccine is widely distributed, and while there is no perfect solution, he believes lessons learned from each surge improve responsiveness, planning and effectiveness.

About an hour of a primary care physician's day is spent managing EHR inbox messages on average, and a significant proportion of that time is usually outside of scheduled work hours, according to a study in the Journal of the American Medical Informatics Association that included EHR inbox usage for more than 1,200 physicians. Researchers analyzed time spent on various inbox tasks and found that redesigning EHR interfaces to reduce the need for switching between windows could improve efficiency.

The CMS this week plans to announce that Medicare and Medicaid will cover out-of-pocket costs for any COVID-19 vaccines that obtain emergency use authorization from the FDA, according to sources with knowledge of the plan. The policy will also address other pandemic-related issues such as expanding flexibility for Medicaid beneficiaries seeking COVID-19 care, sources said.

Cybersecurity experts say hospitals could see a wave of cyberattacks during a fall COVID-19 surge after attacks earlier this year significantly disrupted patient services. Government agencies and industry groups have formed to help prevent attacks and defend health care organizations.

A study in the Journal of the American College of Cardiology linked both sugar-sweetened and artificially sweetened beverages to higher cardiovascular risks, when comparing consumers to non-consumers. People who consumed the beverages less frequently still had higher CV risks, compared with non-consumers.

Researchers examined transthoracic echocardiographic and electrocardiographic scans from 305 adults with confirmed COVID-19 and found that 62.6% had myocardial injury, and those with MI had increased electrocardiographic abnormalities, elevated inflammatory biomarkers and greater TTE abnormality prevalence, compared with those who didn't. The findings, published in the Journal of the American College of Cardiology, indicate that "an echocardiogram performed with appropriate personal protection considerations is a useful and important tool in early identification of patients at greater risk for COVID-19 related cardiac injury, who may benefit from a more aggressive therapeutic approach earlier in their hospitalization," said researcher Dr. Martin Goldman.

The ACC on Oct. 21 released the 2020 ACC Expert Consensus Decision Pathway on Management of Conduction Disturbances in Patients Undergoing TAVR in the Journal of the American College of Cardiology. Led by Writing Committee Chair Scott M. Lilly, MD, PhD, FACC, the document reviews existing data and experiences regarding the management of conduction disturbances after TAVR and proposes an evidence-based expert consensus decision pathway for management. Read more. Along with the document, the ACC launched the Decision Guide for Managing Conduction Disturbances After TAVR, which supports clinicians in identifying, monitoring and managing patients at increased risk for developing a post-TAVR conduction disturbance.

Cardiovascular disease is the leading cause of death among American Indians and Alaska Natives, which is not surprising given that it is also the leading cause of death in the U.S. However, the cardiovascular disease that takes the lives of American Indian or Alaska Native populations is somewhat nuanced and requires a tailored focus. As we observed Indigenous Peoples' Day and look to observe National Native American Heritage Month in November, Cardiology spoke with clinician experts on American Indian and Alaska Native cardiovascular health and health care in an effort to better understand the challenges facing these unique patient populations. Read more.