BORIM, HIIN, Unsustainable Losses, and more ...

Data Deadline Tonight Influences Remdesivir Distribution

Tonight, Monday, July 6, at 8 p.m. is an important deadline for hospitals to submit data to U.S. Health & Human Services (HHS) about patients with COVID-19 at their facilities. The data submitted through the TeleTracking portal will influence the federal government’s distribution of remdesivir around the country. Remdesivir has been shown to be helpful in the treatment of COVID-19. Last week, the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services sent a reminder notice of the deadline to its contacts at each hospital; MHA also reminded its membership. The next deadline will be Monday, July 20, at 8 p.m., and the cycle will reoccur every two weeks until the end of September.

BORIM Adjusts Two Important Orders

As the state’s response to COVID-19 continues, but shifts to accommodate the changing nature of the virus’ spread, the Board of Registration in Medicine (BORIM) recently issued two orders. The first extends its previous order that allows emergency temporary license applications for out-of-state physicians. The order has been extended through December 31, 2020, or 30 days after the governor’s order on this policy has expired or the state of emergency expires, whichever occurs last, in recognition that while the virus may have eased in Massachusetts, it is not going away.

On June 25, BORIM made permanent an important policy change regarding telemedicine that had been introduced temporarily at the beginning of the public health emergency. In the policy change, BORIM made clear that the practice of telemedicine does not require a face-to-face encounter between the physician and the patient prior to the telemedicine visit. Additionally, the policy clarifies that the standard of care applicable to a physician practicing telemedicine is the same standard as when the patient is seen in-person. Previously, BORIM had adopted this policy on an “interim” basis.

Ten HIIN Hospitals Made a Difference

Ten Massachusetts hospital received certificates of appreciation recently thanking them for their participation in the national Hospital Improvement Innovation Network (HIIN) and their success in reducing patient harm. More than 4,000 hospitals were part of one of the 16 HIINs created nationwide in 2017. MHA helped coordinate the Massachusetts effort whose goal was to reduce all-cause preventable harm by 20% and readmissions by 2%. Nationally, the HIIN program has contributed to 16,075 lives saved, 151,734 fewer patient harms, and $1.233 billion in cost savings. The 10 Massachusetts hospitals participating in the HIIN were: Brigham and Women’s Faulkner Hospital, Cooley Dickinson Health, Harrington Hospital, Hebrew Senior Life, Lawrence General Hospital, Milford Regional Medical Center, Newton-Wellesley Hospital, Sturdy Memorial Hospital, Signature Healthcare Brockton Hospital, and VA Boston Healthcare.

Opioid Crisis Continues; Baystate Noble Responds

Some areas of the country are showing increased rates of opioid-related deaths during the pandemic. Kentucky reported a 25% increase in overdoses in the first three months of the year, along with a spike in ED visits. West Virginia reported a 50% jump in overdose-related EMS calls in May compared to the previous year, and the national drug policy czar Jim Carroll said in a recent interview, “The pandemic has caused my level of concern to go up.”

In Massachusetts, the most recent opioid numbers show that from January through March 2020, there were 467 confirmed and estimated opioid-related overdose deaths, which is a 5.7 % decline compared to the first three months of 2019. (COVID-19 spiked in Massachusetts in April and May.)

The main takeaway is that while the healthcare system has been rightly focused on COVID-19, hospitals and other caregivers have attempted to maintain the prolonged care and treatment of those afflicted with opioid use disorder. A good example of this is from Baystate Noble Hospital, which last week distributed a total of $65,000 to address the health and social needs posed by opioid and other substance use disorders. Recipients of the one-time grants are: C.O.R.E. of Greater Westfield (Coalition for Outreach, Recovery and Education); Greater Westfield Committee for the Homeless, Inc.; Mental Health Association; and Public Health Institute of Western Massachusetts. The money, administered in partnership with the hospital’s Community Benefits Advisory Council, was received by the hospital as part of an FY2020 legislative earmark to focus on prevention and treatment of opioid related substance use disorders in the Greater Westfield area. Opioid and substance use disorders were identified as significant health needs in Baystate Noble Hospital’s 2019 community health needs assessment.

To read about other community benefits efforts in the state, please view MHA’s A Commitment to Community: Massachusetts Hospitals’ Community Benefit Initiatives.

Unsustainable Financial Losses

The American Hospital Association (AHA) has determined that U.S. hospitals will suffer $120.5 billion in financial losses from July 2020 through December 2020 due to the pandemic. These estimate losses are in addition to the $202.6 billion in losses the AHA estimated between March 2020 and June 2020. The $323.1 billion in losses that hospitals will experience in 2020 are “potentially catastrophic,” AHA says, but the situation may be worse since none of the loss estimates account for currently increasing case rates in certain states, or potential surges of the pandemic occurring later this year. MHA, using similar but not identical metrics, estimates that Massachusetts hospitals will lose at least $6 billion by Labor Day.


Last week, Massachusetts Member of Congress and senatorial candidate Joseph Kennedy III (D) joined the Congressional chorus from both sides of the aisle asking HHS to release the remaining $70-plus billion in CARES Act funding. “The COVID-19 crisis has devastated the financial stability of the Massachusetts healthcare system, and we cannot get fully back on track without additional federal relief. We are grateful for Congressman Kennedy’s urgency on this critical issue and his advocacy to secure timely funding for our providers,” said Steve Walsh, president & CEO of MHA.

Save the Date: MACRMI Forum Postponed to Sept. 21

Due to COVID-19, the Massachusetts Alliance for Communication and Resolution following Medical Injury (MACRMI) has postponed its 8th Annual Communication, Apology, and Resolution forum (CARe) virtual forum until Monday, September 21, 2020, from 2 to 4 p.m. This program is free and designated for CME and nursing credit. Invites and registration to follow, but mark your calendars today.

Optimizing Hospital Patient Flow & Throughput in the COVID-19 Era
Tuesday, July 14 & Wednesday, July 15; 3 to 5 p.m. EDT

Hospital-wide patient flow has always been essential in achieving value-based health and delivering safe, high-quality care. When COVID-19 hit the healthcare systems, massive change happened on the fly, but safety could not be compromised. Join us for this program looking at how hospitals are innovating and managing throughput in new ways in the COVID era. We’ll look at patient flow from all aspects of the hospital’s operations, featuring leaders doing great work and showing the various innovations that can make all the difference in throughput from admissions to discharge. This program is geared toward clinicians, process improvement staff, and leaders seeking ideas for improving patient flow in a most challenging environment. Register here.

Please look here for more upcoming MHA educational events.

John LoDico, Editor