OAKLAND, Calif. -- A pilot program launching today between six Bay Area hospitals may provide a blueprint for a better way to treat patients who visit multiple emergency rooms on a regular basis -- through software that potentially could save the state millions.

The idea is to reduce duplicate tests and procedures, particularly for people with chronic conditions related to homelessness, drug abuse or psychiatric issues. Four hospitals in the East Bay run by Sutter Health are newly linked, through a system known as Premanage ED, with two public hospitals in the Alameda Health System.

"Now, I can receive a report that shows me their visit histories from those other places," said Dr. Arthur Sorrell, an emergency room physician, physician informaticist and physician chair of the Sutter Emergency Department Leadership Council. "It really allows us to very quickly drill down to what may be the essential issues for this patient."

The "virtual safety net" would tell doctors whom to call, for example, if a patient already is part of a particular clinic, homeless shelter or social-service agency.

Jim Hickman, chief executive of Better Health East Bay, the philanthropic arm of Sutter Health, said the system already is bearing fruit.

"We're seeing already real-time collaboration around patients that we didn't even know we share," he said. "Case managers are working, now online, to really keep patients on track with their care plans."

Supporters hope that more hospital systems across the state will join in. The program already is in widespread use in Washington, which reported savings to the state of $33 million in its first year, and in Oregon.


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Health-care advocates are vowing to continue their fight to expand Medicaid in Kansas - despite this week's election, which expanded the Republican supermajority.

Gov. Laura Kelly, D-Kansas, supports expanding the program to more low-income families under the Affordable Care Act - but conservative lawmakers passed a law forbidding the move.

April Holman, executive director of the Alliance for a Healthy Kansas, is among those calling for change.

"I think the bottom line is we have really been focused on building a grassroots movement that is too large and too loud for policymakers to ignore, and that's what we're going to continue to do, even with the most recent election results," she said.

Data from the Kansas Department of Public Health shows a maternal mortality rate of 11 deaths per every 100,000 live births. The agency found 13 maternal deaths from 2016 to 2018 and found all but one were preventable. And two-thirds of mothers were racial and ethnic minorities.

Holman noted that more than 14% of babies born to Black mothers in Kansas have low birth weights, and Black mothers are 200% more likely to have a low-birthweight baby.

"We think that in part that has to do with access to affordable health care, not only later in their pregnancy but also at the beginning and even pre-pregnancy," Holman continued.

The Kansas Health Institute estimates that almost 152,000 Kansans - including more than 45,000 children - would enroll in KanCare if Medicaid were to be expanded.


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Amid a nationwide shortage of respiratory therapists, an "earn while you learn" initiative is underway to build a skilled workforce in Virginia to meet growing respiratory care demands.

Sentara Health and Tidewater Community College have launched a respiratory therapy apprenticeship program, which covers educational expenses of nearly $18,000 over two years, while providing hands-on experience at Sentara Norfolk General Hospital.

Kristian Vasconcellos, one of the program's first apprentices, likes the linking of the classroom to the workspace.

"You know, us cleaning the vents or cleaning the machines or the equipment, I do get that experience of being in school and saying, 'Oh my gosh, I know what that is, I know how this works,'" Vasconcellos explained.

Students spend 32 hours each week in academic and clinical training and an additional eight hours working at the hospital, where they encounter a range of real-world medical situations involving asthma, sleep apnea and others. Industry experts have noted a growing need for respiratory therapists, especially following the COVID-19 pandemic, which has led to increased worker burnout and hospital staffing shortages.

Tara Almony, manager of respiratory care and pulmonary diagnostics at Sentara Norfolk General Hospital, expressed enthusiasm about the program's potential to ease the staffing shortage and prepare students for the realities of the job.

"We were looking and thinking outside the box of how we could be creative and how to bring respiratory therapists in, help them," Almony outlined. "Then also, how we as a Norfolk General could help them grow and kind of create a pipeline for ourselves in a way. "

The demand for respiratory therapists has surged, with the U.S. Bureau of Labor Statistics projecting a 14% increase in job openings by 2031. The median annual salary for a respiratory therapist is currently $77,960.


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A Wyoming helpline connects callers to a variety of health and human services, including help with health insurance during open enrollment.

Olivia Schon, deputy director of Wyoming 211, said the service fields 20 to 30 calls a day. Specialists then connect callers with appropriate resources from a database of nearly 3,000 options, ranging from small nonprofits to state and federal programs.

Schon pointed out the top issues people call about are rent and utility payment assistance programs, food insecurity and transportation to health providers. She noted initial conversations often unveil more areas in which the caller can use assistance.

"We average four times the amount of referrals going out based on phone calls coming in," Schon reported. "They call with what their first issue is and then they leave with more than one solution to other problems that they also have going on."

When callers need assistance enrolling in health insurance, they're connected with Wyoming 211's "sister program," Enroll Wyoming. Open enrollment starts Friday.

The rate of health insurance enrollment in Wyoming through the marketplace has increased 75% since 2020, according to KFF. In a round of federal funding announced in September for health insurance navigators, Enroll Wyoming received a $1.5 million grant to continue offering its services for free.

Caleb Smith, marketing director for Enroll Wyoming, said making important decisions around health care can be intimidating.

"It doesn't hurt to have somebody who's on your side," Smith explained. "Who's willing to act as an advocate for you to make sure that you have your questions answered, that you have what you feel like you need to be able to make an informed, empowered decision."

Wyoming 211 is available by dialing 211 from any phone in the state.