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How Sharing Clinical Notes Affects the Patient-Physician Relationship

“…On April 5, a new federal rule turned OpenNotes’ goal into the law of the land.

Now, virtually every US medical practice and health system must make all information in electronic health records—with a few exceptions—easily accessible to patients at no charge. The mandate, part of the 20th Century Cures Act enacted in 2016, originally was supposed to go into effect November 2, but the US Department of Health and Human Services (HHS) at the last minute extended the compliance deadline due to the COVID-19 pandemic….

The US Core Data for Interoperability lists 8 types of clinical information that must be shared: consultation, discharge summary, procedure, and progress notes; imaging, laboratory report, and pathology report narratives; and history and physical. The rule doesn’t apply to psychotherapy notes kept separate from the patient’s health record or notes compiled in reasonable anticipation of use in a civil or criminal court case or an administrative proceeding. In addition, the mandate permits withholding information if doing so “will substantially reduce the risk of harm” to a patient or another individual, such as in a domestic abuse situation.”

(J. Harris: Many years ago, a doctor asked me a question, and I declined to answer “because the information was personal and might never go away if recorded on his chart.” Now, the records are computerized, and the patients’ answers to questions ARE permanently imprinted  in the Cloud as is virtually all of the pertinent medical information.)

Michigan surge strategy: Biden sends federal resources, isn’t boosting vaccine supply

“…The Biden administration is sending Michigan federal resources to support vaccinations, testing and therapeutics…will help Michigan better administer the doses allocated to the state, as well as surge testing capacity and drugs for virus treatment,…President Biden told Ms. Whitmer that his administration is ready to send 160 Federal Emergency Management Agency and CDC personnel to Michigan to aid the vaccination effort, in addition to the 230 federal personnel already deployed to the state…

“On Feb. 1, Michigan eased some restrictions, allowing indoor residential gatherings of up to 15 people from no more than three households, and indoor gatherings outside the home of up to 25 people. Masks and social distancing are required at all residential gatherings. ”

Dire consequences’: Iraq issues COVID warning after record cases

Iraq recorded 8,331 new coronavirus cases in 24 hours on Wednesday, the highest figure since the ministry began keeping records at the onset of the pandemic last year. (J. Harris: Of course, The US still has some troops in Iraq.)

Neutralization of SARS-CoV-2 Variants B.1.429 and B.1.351

 These results, and the high efficacy shown by these vaccines, suggest that vaccine-elicited neutralizing antibodies are likely to remain effective against the B.1.429 variant [Californis]. The magnitude of resistance seen with the B.1.351 [S. African strain] variant is of greater concern with respect to current vaccines.

(J. Harris: The variants demand that vaccinated people continue to exercise caution for the foreseeable future, in my opinion.)

Walgreens, churches to vaccinate 5K Houstonians this weekend, with free rides, walk-up slots

India’s Outbreak

“…India has become the epicenter of the coronavirus outbreak, reporting a record of 131,968 new cases in the last 24 hours as the virus spins out of control. Deaths are rising, hospitals are quickly filling up and the country’s vaccination campaign is perilously behind schedule…The surge in India is a troubling development for the broader pandemic. The sheer number of new infections creates a breeding ground for possible new variants that could be resistant to vaccines, or better able to reinfect people who have already had the virus…Experts say complacency and government missteps are to blame for the recent surge…After cases dropped in December, many Indians shed masks and resumed normal life. Leaders also began acting as if the problem were solved, allowing large Hindu religious festivals and political rallies.”

(J. Harris: The Covid Pandemic is not over now and won’t be over soon in most of the world. For my small efforts, I will continue focusing on LOCAL COVID. I don’t think Covid-19 will be controlled world wide in my lifetime. Dammit.)



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Reparations for the nation’s history of slavery

Reparations for the nation’s history of slavery.

Yea or nay?

With a history of being editor and publisher of newspapers where racial disharmony was a constant stain on the communities I served, where cultures conflicted as a part of everyday life, and having a black son-in-law and biracial grandchildren, you can guess where I stand.

Or maybe not.

Attempting to erase the nation’s nefarious and horrid treatment of people of color — Black, Asian, Native American or “other” — by handing out wads of I’m-sorry! cash is not a plausible solution.

History is what it is, and the white contingent’s treatment overall of citizens and residents of different cultures, religions and colors is reprehensible and indefensible.

But trying to solve our collective consciences with bucket loads of lucre is not the answer.

Who would we pay? How much? For how long? For what specific act or collection of acts?

The answer to the past disputable behaviors lies in visible change, in the switching of attitude, creation of laws and additional opportunities with an aim of an equalization of cultures. These goals must include the education of all citizens on the importance of the fundamental right of equality.

This is the United States of America, once described as  “A City upon a Hill”, a phrase derived from the teaching in Jesus’s Sermon on the Mount. In a modern context, it has been used in United States politics to refer to America acting as a “beacon of hope” for the world, a “shining city.”

From a global perspective — and also from a domestic viewpoint — the democratic luster  is gone from our nation. Where once the United States was held aloft as a symbol of freedom and hope, our political, racial, cultural and religious differences have caused us to be pitied and scorned.m by nations which once held us as a positive example of freedom and democracy.

Now, right now, is the time to summon  our better angels, to pray for uplifting support and guidance and make a determined effort to work in unity to recreate the America of promise and hope. Our goal should be to create, finally, a kinder, gentler America, a nation that values all citizens equally and welcomes all who share our vision, our hopes and our dreams.

We can do better. We must do better. We must change. Our children and grandchildren demand action from us.

We must not, cannot let them down.


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