The American journal of managed care
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During a surge of COVID-19 cases, the majority of care delivery at a large academic medical center moved to virtual care. Due to COVID-19-associated regulatory changes, virtual care is now delivered through telephone and videoconferencing platforms. Although virtual platforms allow patients to access care while socially distancing, patients with limited English proficiency (LEP) face structural barriers to these platforms, including lack of access to technology, need for medical interpreters, unfriendly patient portals, and increased privacy concerns. ⋯ Strategies for addressing privacy concerns for patients with LEP included developing a low-literacy script and other actions that address patient concerns about Immigration and Customs Enforcement and mitigate perceived risk, as well as identifying a virtual platform that meets privacy regulations and does not require a patient to download an application to their phone or computer to join. Strategies for integrating medical interpreters into virtual visits included assessing existing virtual platforms for the ability to host a third party, changing the electronic health record software (Epic) interface, and convening directors of interpreter departments at each site to ensure comprehensive system rollout. Health care organizations that rely heavily on virtual visits to provide patient care will need to take all these challenges into consideration for patients with LEP.
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To assess the ability of accountable care organizations (ACOs) to use electronic health record (EHR) data for quality. ⋯ ACOs have diverse structures that often result in the usage of multiple EHR systems. This has the potential to cause serious delays when CMS begins requiring ACOs to report their quality measures through their EHRs in 2022.
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Hereditary angioedema (HAE) is a serious, potentially fatal disease of recurrent swelling of various subcutaneous and submucosal tissues throughout the body. Swelling is mediated by uncontrolled regulation of bradykinin, making it pathologically distinct from other forms of angioedema. Diagnosis can be challenging, but distinctions in clinical presentation and laboratory studies can confirm clinical suspicion. ⋯ As a result, there has been a dramatic expansion of treatment options specifically designed for HAE in recent years. Novel treatments are effective in treating swelling attacks, preventing recurrence, and improving patient quality of life. However, significant differences in the risks, benefits, and cost of treatments must be weighed in the determination of clinical protocols to determine optimal utilization of healthcare resources.