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6 Mass. Hospitals Collaborate On Ebola Response Plan

An entrance to Beth Israel Deaconess Medical Center in Boston. The hospital is one of six in the state that have formed a collaborative system to handle Ebola patients. (Steven Senne/AP)

An entrance to Beth Israel Deaconess Medical Center in Boston. The hospital is one of six in the state that have formed a collaborative system to handle Ebola patients. (Steven Senne/AP)

Updated at 5 p.m.

BOSTON — Massachusetts public health leaders said Friday that while the risk of Ebola remains very low in the state, six hospitals are prepared to handle one patient each, meaning the state could treat six patients at any given time.

The announcement clears up some confusion around which hospitals are ready to care for an Ebola patient if there is a confirmed case in Massachusetts.

The six hospitals collaborating to provide care include Bay State Medical Center in Springfield and five Boston facilities: Boston Medical Center, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Tufts Medical Center and Massachusetts General Hospital.

“Hundreds of people at each hospital have spent incalculable hours in the necessary planning, training and practice efforts that are needed to respond to the challenges posed by this disease,” said Dr. Paul Biddinger, vice chair of emergency preparedness at Mass General.

Boston Children’s Hospital says it expects to join the Ebola treatment collaborative, and UMass Memorial in Worcester may as well.

The other 59 acute care hospitals in Massachusetts would screen a patient, hold anyone who is at high risk or Ebola-positive in isolation, and then transfer the patient, says Public Health Commissioner Cheryl Bartlett.

“By creating this coordinated, collaborative system, we reduce the number of people who have to have that level of intensive training to care for an Ebola patient and this is one of the reasons for our announcement today,” Bartlett said.

Massachusetts hospitals do not expect to take Ebola patients from other states. Bartlett says the Centers for Disease Control has asked each state to be ready to care for its own.

All this costly planning is making some physicians, nurses and other hospital staff nervous.

“We’re fighting fear with facts and being direct with our staff members,” said Dr. Eric Goralnick, medical director of emergency preparedness at the Brigham. “Obviously there is a lot of anxiety around this issue. We’re being aggressive around communications, and listening and listening and listening, and educating, and focused on training, exercising and preparing for this.”

There is no uniform policy for staff who treat Ebola patients in Massachusetts hospitals, but several say personnel could come and go as they would on any shift. Each doctor, nurse or lab worker would monitor their temperature twice a day.

Hospitals that take Ebola patients expect a financial hit as patients avoid “the place that is treating Ebola.” In announcing the collaborative hospital effort Friday, the Department of Public Health stressed the work it has done to prepare for Ebola, but some hospitals say they need more help with equipment, training and the possible loss of business.

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Against Odds, Menino Fought Successfully To Merge 2 City Hospitals

At rear left is Boston Mayor Thomas Menino, pictured standing near, Sen. Edward M. Kennedy, D-Mass., shakes hands with nurse Janet Killarney while visiting the Boston Medical Center in 2004. (Charles Krupa/AP)

At rear left is Boston Mayor Thomas Menino, pictured standing near, Sen. Edward M. Kennedy, D-Mass., shakes hands with nurse Janet Killarney while visiting the Boston Medical Center in 2004. (Charles Krupa/AP)

In 1996, it took all of Boston Mayor Thomas Menino’s political muscle to pull off what some consider a managerial miracle. Despite intense union opposition, a reluctant city council and concerns about health care costs, Menino fought successfully for the merger of two city hospitals that had been founded in the mid-19th century.

Today, Boston Medical Center stands as an enduring legacy to Menino’s efforts to serve the health needs of the city’s neediest citizens.

On Thursday a steady stream of ambulances, people in wheelchairs and children pushed in strollers entered and left the Menino Pavillion on the Boston Medical Center campus.

“Me and all my children go here. It’s a great hospital,” said Jasmine Vigo, who was leaving the Menino Center with her infant son.

“He was wheezing. I wanted to make sure it wasn’t like a viral infection or something like that. He didn’t,” she said.

Vigo said she had all four of her children in the Menino building.

The eight-story brick building, bearing the former mayor’s name, contains clinics for adults and obstetrics. Its emergency room is the busiest in the Northeast. Meanwhile, its pediatric clinic provides health care to 30,000 kids a year — and that’s just at this one building on the sprawling Boston Medical Center campus.

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The Bionic Mind: Building Brain Implants To Fight Depression, PTSD

Liss Murphy this summer, with husband Brian, son Owen and sheepdog Ned. (Courtesy)

Liss Murphy, who had surgery to implant Deep Brain Stimulation for depression in 2006 and got much better, on Cape Cod in summer, 2014, with husband Scott, son Owen and sheepdog Ned. (Courtesy)

Ten years ago, with little warning, Liss Murphy fell victim to paralyzing depression, a “complete shutdown.”

She was 31, living in Chicago and working in public relations. The morning of Aug. 13, 2004, she had gone in to the office as usual. “It was Tuesday, and I remember the day so clearly,” she says. “The sun — everything — and I walked out — it was about 11 o’clock — and I never went back. The only time I left the house was to see my psychiatrist, who I saw three times a week.

“I have a hard time believing it was depression, in a way, because it was so pervasive and powerful,” she says. “It invaded every aspect of my life. It took so much away from me. And it happened so fast, and it was so degrading — it took everything from me.”

Murphy came home to Boston, and she tried everything — medications, talk therapy, even repeated rounds of electroshock. But she was barely able to get out of bed for months — then years. Her husband and family and top-flight doctors cared for her, but she sank so low she tried twice to commit suicide.

Finally, a psychiatrist told her about a cutting-edge trial to implant stimulation devices deep in the brains of patients with severe depression. She signed up. In June of 2006, she had the operation.

“My greatest hope that day was to have something go horribly wrong and die on the table,” she says. “I didn’t care.”

She didn’t die. Over the next few months, she got better. These days, eight years after the surgery, if you saw Liss Murphy walking her Old English Sheepdog, Ned, or playing with her 3-year-old son, Owen, only the faint silver scars on her clavicles would hint at anything unusual: That’s where the batteries that power her brain stimulator are implanted.

“We’re taking a wall of computers, basically, and putting it into something that would easily fit inside a box of Tic-Tacs.”
– Jim Moran, Draper Laboratory

But though the surgery changed Murphy’s life, “the trial, on average, didn’t work,” says Dr. Emad Eskandar, the Massachusetts General Hospital neurosurgeon who operated on her. “When you pooled everyone together it didn’t work. But there were like five people out of the 10 we did that had remarkable benefits and went into complete remission. We couldn’t continue with the study because on the average it failed, but for those people in whom it worked, boy did it work.”

Now, as part of a $70-million project funded by the military, researchers are aiming to take brain implants for psychiatric disorders to the next level.

Over the next five years, they aim to build a device that can sit inside a patient’s head, pick up the onset of depression or post-traumatic stress disorder, and head it off before it hits. One implant researcher calls it “a moonshot for the mind.” Continue reading

Where Baker, Coakley Stand On Health Care

Democrat Martha Coakley and Republican Charlie Baker, before a televised debate Tuesday in Boston (Barry Chin/Boston Globe/Pool/AP)

Democrat Martha Coakley and Republican Charlie Baker, before a televised debate Tuesday in Boston (Barry Chin/Boston Globe/Pool/AP)

It’s nearly half the state budget, almost 20 percent of the state’s economy and a perennial top concern for voters. The issue is health care, and so far, neither Democrat Martha Coakley nor Republican Charlie Baker has taken the lead on this topic with voters in the gubernatorial race.

“Coakley has perhaps a slight edge on the general health care issue, as well as the affordability issue, but neither campaign has really broken away” on health care, said Steve Koczela, president of the MassINC Polling Group. “It’s not like taxes, which go big for Baker. It’s not like education, which tends to go a bit bigger Coakley. It’s an issue that is still very closely fought.”

So where do the gubernatorial candidates stand on some of the key concerns in health care? Below is a summary of the candidates’ proposals for how to treat the health of the state.

On Making Health Care More Affordable:

BAKER: He argues that giving patients information about how much tests and procedures cost, in advance, will help us become informed consumers of care. We’ll spend less money, because we’ll choose to have a baby, for example, at the hospital with the lowest cost and best quality scores. As of Oct. 1, health plans in Massachusetts are required to post what they pay each hospital and doctor.

Baker would take a next step. “I’d like to get to the point where hospitals just post prices and people can see them plain as day,” Baker said. “As governor, I’m going to lean really hard on this.”

Some health care analysts say Baker’s strategy for reducing health care costs could backfire. Patients may assume that the most expensive hospital is the best even though that’s generally not true. And letting Brockton Hospital, for example, know that it is paid about half of what Massachusetts General Hospital receives for a C-section may mean Brockton Hospital demands more money, instead of MGH saying, “OK, I’m going to lower my prices to compete.” In addition, some of the expensive hospitals say their higher prices subsidize teaching and research.

COAKLEY: She argues she is uniquely positioned to tackle health care spending. She created a health care division in the attorney general’s office, issued the first detailed reports on health care costs and used her leverage to negotiate a deal that would limit the price increases Partners HealthCare could demand in the near future.

“The agreement that we have reached, to be approved by the court, caps costs and lowers costs as opposed to maintaining the status quo, which we all agree is too expensive,” Coakley said during a campaign debate on WBZ-TV. Continue reading

No Mandatory Ebola Quarantine In Mass.

A licensed clinician participates in a CDC training course in Alabama earlier this month for treating Ebola patients. (Brynn Anderson/AP)

A licensed clinician participates in a CDC training course in Alabama earlier this month for treating Ebola patients. (Brynn Anderson/AP)

Massachusetts has no plans to follow New York and New Jersey in requiring a three-week quarantine for health care workers and others who have had contact with Ebola-stricken patients.

“It’s probably a step further than we need here in the Commonwealth,” Gov. Deval Patrick said in comments provided by his press office, “but we’re prepared. It’s certainly a step further than what the CDC has recommended.”

Patrick said his counterparts, Andrew Cuomo in New York and Chris Christie in New Jersey, may have more reason to be concerned about Ebola.

“I understand why they are going to the extent they are going to, because two of the five receiving airports are in New York and New Jersey,” Patrick said.

Illinois Gov. Pat Quinn joined Cuomo and Christie Friday in imposing a quarantine on travelers who could be infected with Ebola.

A nurse placed under quarantine in New Jersey Friday described a chaotic scene at Newark Airport.

In Massachusetts, Patrick and Boston Mayor Marty Walsh have focused on calming public fear about Ebola.

“I understand that folks are anxious,” Patrick said again on Saturday. “We have worked very hard to make sure that our medical professionals have all of the guidance that we have, and that training is happening where and as it should, that public safety officials are fully briefed and prepared. From all accounts from the professionals, the risk is very, very low in Massachusetts.”

That assessment is based on the expectation that there is not much travel between Boston and West Africa right now, that Ebola does not easily spread, and that hospitals are prepared to handle any cases that may arise.

“It is obviously dangerous,” Patrick said, but “you have to be directly exposed to the bodily fluids of someone who is showing symptoms of Ebola, not someone who has been near somebody with Ebola. If people are showing any of those symptoms — nausea, high fever — they should get themselves to an emergency room quickly, and there are protocols for testing.”

Gottlieb Leaving Partners HealthCare For Partners In Health

Partners CEO Dr. Gary Gottlieb

Partners CEO Dr. Gary Gottlieb

The CEO at Partners HealthCare, the state’s largest private employer, plans to step down.

Dr. Gary Gottlieb agreed Friday to become the CEO at Partners in Health, a global health organization whose latest project is an Ebola response effort in West Africa.

Gottlieb is scheduled to make the transition on July 1, 2015. His decision comes amid acourt review of Partners’ controversial expansion plans and questions about Gottlieb’s ability to manage political dynamics outside the hospital network.

His supporters point out that Gottlieb has just begun his second five-year contract, and they say Partners board members urged Gottlieb to stay. But some current and former Partners leaders say dissatisfaction with Gottlieb’s leadership has been building for months and that the Partners in Health job offers Gottlieb a graceful way out.

He will take a dramatic pay cut, from more than $2 million a year to $200,000 a year at Partners in Health.

Gottlieb serves on the board at Partners in Health, has visited the group’s projects in Haiti and Rwanda, and calls it the most important global health initiative in the world.

“This is a singular opportunity to lead that organization at a time when it is clear that improving sustainable health care throughout the world is critical to all of us,” Gottlieb said.

Gottlieb says he began thinking seriously about moving to Partners in Health this summer, and decided to make the change earlier in the fall after hearing Partners in Health co-founder Paul Farmer describe what was happening in West Africa.

“With Ebola, maternal deaths had increased because there was no place for people to deliver babies,” said Gottlieb. “Malaria deaths had increased because there was no way to provide the appropriate care for what is a more ordinary terrible disease. The notion that building sustainable health care was essential for real social justice and real change had become even more obvious.” Continue reading

Study Raises Questions About Military Service Causing Chronic Suicidal Tendencies

A new study commissioned by the U.S. Army has found that the mental health of soldiers isn’t as different from civilians as the researchers previously thought.

Earlier this year, researchers said that soldiers, who were surveyed at different times during their Army careers, had higher rates of mental disorders before they enlisted than the rates of mental illness in the general population.

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Uber Pilots Program To Bring Flu Shots To Your Door

In this April 3, 2014 photo, a smartphone is mounted on the glass of an Uber car in Mumbai, India. Riding on its startup success and flush with fresh capital, taxi-hailing smartphone app Uber is making a big push into Asia. The company has in the last year started operating in 18 cities in Asia and the South Pacific including Seoul, Shanghai, Bangkok, Hong Kong and five Indian cities. (Rafiq Maqbool/AP)

A smartphone with the Uber app is mounted on the glass of an Uber driver. (Rafiq Maqbool/AP)

If you used Uber in Boston today, you may have noticed a new feature. The car service company was offering what it calls UberHEALTH to bring free flu shots to users’ doors.

The service was part of a one-day pilot program in Boston, New York and Washington D.C., the company announced on its blog.
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Colleges Are Inconsistent In Handling Athlete Concussions, Harvard Study Finds

Colleges remain inconsistent in the way they handle athletes’ concussions, according to a Harvard University study that comes more than four years after the NCAA began requiring schools to educate their players about the risks of head trauma and develop plans to keep injured athletes off the field.

In a survey that included responses from 907 of the NCAA’s 1,066 members, researchers found that nearly one in five schools either don’t have the required concussion management plan or have done such a poor job in educating their coaches, medical staff and compliance officers that they are not sure one exists.

West Virginia's Terrell Chestnut is examined by medical staff during an NCAA college football game against Baylor earlier this month. He later left the game with a concussion. (Chris Jackson/AP)

West Virginia’s Terrell Chestnut is examined by medical staff during an NCAA college football game against Baylor earlier this month. He later left the game with a concussion. (Chris Jackson/AP)

“Collectively, the institutions without a concussion management plan are responsible for the well-being of thousands of college athletes each year,” according to the study co-written by Harvard researcher Christine Baugh and published this week in the American Journal of Sports Medicine. “For stakeholders to follow an institution’s concussion management plan – or to have confidence that others are following the plan – they must first know that it exists.”

The findings in the study reinforce the images fans have seen in stadiums since the problem with concussions became more widely known: Wobbly players are sent back onto the field without proper medical clearance as coaches remain ignorant to their injury – perhaps willfully. The authors recommend that the NCAA bolster its 2010 policy to require schools to make their plans public, to better educate coaches about concussion symptoms and to require that schools not only come up with plans but actually apply them.

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Surgeon General Nominee Murthy Loses Support Of Key Backers

Dr. Vivek Murthy (Charles Dharapak/AP/File)

Dr. Vivek Murthy (Charles Dharapak/AP/File)

One of the country’s leading medical journals is withdrawing support for a Brigham and Women’s Hospital physician nominated by President Obama to become the next surgeon general.

The New England Journal of Medicine (NEJM) endorsed Vivek Murthy in May, but an editorial published Wednesday withdraws that support.

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