The Clinical Congress Preliminary Program offers an overview of panel sessions, Postgraduate Courses, Named Lectures, Meet-the-Expert Luncheons, and other information related to the Clinical Congress, which takes place virtually October 23–27, 2021.

The New York Chapter is planning to organize an event and get together during the conference! Let us know if you'd like more information.

Governor Andrew M. Cuomo today announced that New York will end the state disaster emergency declared on March 7, 2020 to fight COVID-19. Given New York's dramatic progress against COVID-19, with the vaccination rates, and declining hospitalization and positivity statewide the state of emergency will expire after Thursday, June 24.

Federal CDC guidance will remain in effect, which includes masks for unvaccinated individuals, as well as all riders on public transit and in certain settings, such as health care, nursing homes, correctional facilities, and homeless shelters.

We will keep you abreast of any guidance coming out of the New York State Department of Health.

To see the governor’s complete release visit: https://www.governor.ny.gov/news/governor-cuomo-announces-new-york-ending-covid-19-state-disaster-emergency-june-24

On Tuesday, after 472 days, New York hit a vaccination milestone—70 percent of adult New Yorkers have received at least one dose of the COVID vaccine.

After reaching this goal, the state lifted most of the remaining COVID restrictions.

This means no more restrictions across commercial settings, including retail, food services, offices, gyms, entertainment, hair salons, barber shops, etc.—as well as no more social gathering limits.

Existing COVID health protocols are still in place for some settings such as public transportation, health facilities, and indoor Pre-K-12 schools. 

Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company and TDC Group

Artificial intelligence (AI) has proven of value in the COVID-19 pandemic and shows promise for mitigating future healthcare crises. During the pandemic’s first wave in New York, for example, Mount Sinai Health System used an algorithm to help identify patients ready for discharge.

Pandemic applications have demonstrated AI’s potential not only to lift administrative burdens, but also to give physicians back what Eric Topol, MD, founder and director of Scripps Research Translational Institute and author of Deep Medicine, calls “the gift of time.”[1]

Like any emerging technology, AI brings risk, but its promise of benefit should outweigh the probability of negative consequences—provided we remain aware of and mitigate the potential for AI-induced adverse events.

AI’s Pandemic Success Limited Due to Fragmented Data

Innovation is the key to success in any crisis, and many healthcare providers have shown their ability to innovate with AI during the pandemic. For example, AI has been used to distinguish COVID-19-specific symptoms: It was a computer sifting medical records that took anosmia, loss of the sense of smell, from an anecdotal connection to an officially recognized early symptom of the virus.[2] This information now helps physicians distinguish COVID-19 from influenza.

However, holding back more innovation is the fragmentation of healthcare data in the U.S. Most AI applications for medicine rely on machine learning; that is, they train on historical patient data to recognize patterns. Therefore, “Everything that we’re doing gets better with a lot more annotated datasets,” Dr. Topol says. Unfortunately, due to our disparate systems, we don’t have centralized data.[3] And even if our data were centralized, researchers lack enough reliable COVID-19 data to perfect algorithms in the short term.

AI Introduces New Questions around Liability

While AI may eventually be assigned legal personhood, it is not, in fact, a person: It is a tool wielded by individual clinicians, by teams, by health systems, even multiple systems collaborating. Our current liability laws are not ready for the era of digital medicine.

AI algorithms are not perfect. Because we know that diagnostic error is already a major allegation in malpractice claims, we must ask: What happens when a patient alleges that diagnostic error occurred because a physician or physicians leaned too heavily on AI?

AI in Healthcare Can Help Mitigate Bias—or Worsen It

Machine learning is only as good as the information provided to train the machine. Models trained on partial datasets can skew toward demographics that turned up more often in the data. Already during the pandemic’s first waves, multiple AI systems used to classify x-rays have been found to show racial, gender, and socioeconomic biases.

It’s critical that system builders are able to explain and qualify their training data and that those who best understand AI-related system risks are the ones who influence healthcare systems or alter applications to mitigate AI-related harms.

AI Can Help Spot the Next Outbreak

More than a week before the World Health Organization (WHO) released its first warning about a novel coronavirus, the AI platform BlueDot, created in Toronto, Canada, spotted an unusual cluster of pneumonia cases in Wuhan, China. Meanwhile, at Boston Children’s Hospital, the AI application Healthmap was scanning social media and news sites for signs of disease cluster, and it, too, flagged the first signs of what would become the COVID-19 outbreak—days before the WHO’s first formal alert.

These innovative applications of AI in healthcare demonstrate real promise in detecting future outbreaks of new viruses early. This will allow healthcare providers and public health officials get information out sooner, reducing the load on health systems, and ultimately, saving lives.

[1] Topol E. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. New York, NY: Hachette Book Group; 2019:285.

[2] Cha, AE. Artificial intelligence and covid-19: Can the machines save us? Washington Post. Published November 1, 2020. Accessed November 9, 2020. https://www.washingtonpost.com/health/covid-19-artificial-intelligence/2020/10/30/7486db84-1485-11eb-bc10-40b25382f1be_story.html

[3] Reuter E. Hundreds of AI solutions proposed for pandemic, but few are proven. MedCity News. Published May 28, 2020. Accessed October 19, 2020. https://medcitynews.com/2020/05/hundreds-of-ai-solutions-proposed-for-pandemic-but-few-are-proven/

by Cherisse Berry, MD, FACS, Governor, American College of Surgeons, Manhattan Council, Board of Governors Diversity Pillar

Intersectionality: the intersection and interconnectedness of identities such as race, gender, ethnicity, sexuality and disability. It is a term coined in 1989 by Kimberlé Crenshaw, JD, a University of California, Los Angeles, law professor who published, "Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics" in the University of Chicago Legal Forum. Discussing three legal cases involving the co-existing issues of racial discrimination and sex discrimination, Dr. Crenshaw introduced the concept of intersectionality: a problematic consequence of the tendency to treat race and gender as mutually exclusive categories of experience and analysis. For example, Black women are both Black and female and thus subject to discrimination on the basis of race, gender and possibly a combination of the two.

Read the complete article

The American College of Surgeons (ACS) has issued a call for abstracts to be presented at the 2021 ACS Quality and Safety Conference, July 12–16. The submission deadline is April 30.

Individuals at participating sites are encouraged to submit a 250-word abstract for poster presentation. The abstract should relate to surgical quality improvement initiatives including the development, implementation, or validation of best practices. We are also interested in operational best practices relating to workflows around collecting data and reporting. Abstracts should utilize data from one or more of the following ACS Quality Programs.

Please note: Abstracts that have been submitted or recently presented at other meetings are eligible for presentation at the ACS Quality and Safety Conference. In the view of the ACS, previous presentation of a paper does not prohibit the presentation or publication of the material at the Quality and Safety Conference.

Submissions from the following categories will be welcomed:

·         Bariatric

·         Cancer

·         Collaboratives

·         Education

·         Efficiency and Value

·         Geriatrics

·         Pediatrics

·         PROs/Patient Centeredness

·         Trauma/Acute Care

·         Surgical Potpourri

·         Healthcare Informatics for Quality

·         Health Equity/Access

 Submit an abstract

For questions, contact us at acsqsconference@facs.org or 312-202-5319.

NYS Department of Health Commissioner Dr. Howard Zucker released
the following statement regarding the Johnson & Johnson vaccine:

"Today the CDC and FDA issued a statement recommending a pause in the use of the Johnson & Johnson vaccine out of an abundance of caution. New York State will follow the CDC and FDA recommendation and pause the use of the Johnson & Johnson vaccine statewide immediately today while these health and safety agencies evaluate next steps. All appointments for Johnson & Johnson vaccines today at New York State mass vaccination sites will be honored with the Pfizer vaccine.

"As the CDC and FDA have said, any adverse events related to the Johnson & Johnson vaccine 'appear to be extremely rare' and, 'People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.'

"I am in constant contact with the federal government and we will update New Yorkers as more information becomes available."

https://www.thedoctors.com/articles/telehealth-from-the-field-case-study-involving-remote-monitoring-problems/

Even before the COVID-19 pandemic, the use of remote patient monitoring was expanding. The technologies offer many benefits, but they may also create potential malpractice risks. Consider the following case example and strategies that can help mitigate risks.

Case Example
During an annual physical, the physician recommended ambulatory electrocardiography for a patient with a history of prior cardiac arrhythmia. The physician told the patient he would receive the ambulatory monitor by mail and that the package would contain everything he needed.

About a week later, the monitoring package arrived. opened it, read the instructions, and applied the device. After a few hours, the device fell off. He reapplied it multiple times, but the device continued to fall off. After several calls with the device manufacturer, the patient gave up, tucked the device in the box, and mailed it back to the manufacturer.

A week later, the patient received a letter from the physician, stating that his monitoring results were normal. The patient—who was surprised to receive these results—followed up. During the discussion, the physician told him that the device manufacturer downloaded and evaluated the results and provided a report that the physician then shared with the patient. The physician
was surprised to learn that the patient had not completed the monitoring period and the device had not performed as expected, but the results were still reported as normal. The patient lost confidence in both the physician and remote monitoring technology and did not return to the
practice.

Patient Safety Strategies
Whether you have already implemented remote patient monitoring or are thinking about it, consider the following strategies:

• Use a deliberate process to evaluate and select remote patient monitoring devices.
• Determine how the data will be collected, transmitted, stored and reported. In the case example, the manufacturer reported the study as normal even thought the full monitoring period was not completed.
• Ensure the patient is ready to participate. Advise patients to call the office about any device problems or concerns. In the case scenario, the device did not adhere properly to the patient’s skin.

Plan and Prepare
This case study highlights the importance of careful planning and preparation when incorporating remote technologies into the patient care services offered by a medical practice. Providers who recommend products and services to their patients have a responsibility to apply due diligence in confirming that the device manufacturer is reputable, the device is safe, and
the information it produces is accurate and reliable. Once a decision is made to use remote technology, the next steps should be to develop appropriate use guidelines that include preparing patients, managing device concerns/troubleshooting, tracking results, and following
up with patients.

Federally funded research from the perspective of public health has contributed to reductions in motor vehicle crashes, smoking, and Sudden Infant Death Syndrome. The ACS believes this same approach should be applied to firearm related injuries and gun safety.

Under the Consolidated Appropriations Act of 2021 (H.R. 133), signed into law by President Trump on December 27, 2020, the Centers for Disease Control and Prevention and the National Institutes of Health each received $12.5 million to study firearms research funding. The continued allocation marks only the second year that federal funding has been specifically designated to firearms research in more than 20 years.

This year, the College again joined more than 100 medical, public health and research organizations asking Congress to appropriate $50 million in funding for firearm morbidity and mortality prevention research. The College will continue its support for firearm injury prevention research as the federal funding appropriations process continues this year.

Read the ACS letters of support for the funding to the House and the Senate. For more information on trauma advocacy, contact Kristin McDonald, ACS Manager of Legislative and Political Affairs, at kmcdonald@facs.org.

Last week, the ACS joined a letter of support for the Ensuring Lasting Smiles (ELSA) Act (S. 754/H.R. 1916). Introduced by Sens. Tammy Baldwin (D-WI) and Joni Ernst (R-IA) and Reps. Anna Eshoo (D-CA) and Drew Ferguson (R-GA), the bipartisan and bicameral legislation would address issues that prevent access to necessary diagnosis and treatment for patients with congenial craniofacial anomalies such as such as cleft lip and palate, skeletal and maxillofacial abnormalities, facial paralysis, microtia, hypodontia and craniosynostosis. ELSA would require all private group and individual health plans to cover medically necessary services that repair or restore a patient's anomaly.  For further information contact Kristin McDonald, ACS Manager of Legislative and Political Affairs, at kmcdonald@facs.org.

Additionally, the New York Chapter ACS has also provided support for legislation that is reflective of the national bill.  It's called Carter's Law. We encourage all members to contact their legislators to advance this important bill!