Nebraska physicians and their patients have been dealing with the state's 12-week abortion ban since it went into effect just over a year ago.

It replaced the 2010 law which prohibited abortions past the 20th week of pregnancy and was considered one of the country's most extreme abortion laws at the time.

Dr. Emily Patel, a maternal-fetal medicine specialist, said many things can go wrong after the first trimester.

"We are really punishing women who end up having pregnancy complications or fetal anomalies or genetic conditions that are discovered after 12 weeks," Patel contended. "Saying to them, 'Well, I'm sorry, you don't have access to the same care you could have gotten if you were within that first trimester, or if you were out of our state receiving your prenatal care there.'"

When it comes to potential complications, Patel pointed out the first diagnostic test cannot be done until the 10th through the 12th week of pregnancy, and definitive genetic testing on the fetus itself cannot be done until the 16th week, well into the second trimester.

Patel noted the 12-week ban has already had short-term effects, including requiring Nebraska women to go out of state to receive their care, and she fully expects it will have long-term effects as well.

"I think it's really important that people understand that this has reduced access to care in our state," Patel asserted. "It's going to continue to further reduce access to care, especially in smaller communities, just due to the simple fact that it's going to be really hard to recruit providers."

In 2022, a March of Dimes report labeled nearly 52% of Nebraska counties "maternity care deserts," compared with around 31% of counties nationwide.

Patel admitted the current political atmosphere can make her role challenging, but she is glad she is still able to discuss patients' options with them. Some states now prohibit doctors from doing so. She emphasized the best thing she can hope for as a provider is for voters to really consider what is at stake and vote to protect the rights of patients and the doctors who care for them in November.

She stressed the current 12-week ban has implications for every woman living in Nebraska who becomes pregnant.

"Until somebody is faced with that decision, they wouldn't know that they would need access to it, or maybe even be thinking about it," Patel explained. "In a way, this can affect really anybody at any time, and we just want to be able to offer the same level of care to every patient."

Nebraska voters may have up to four abortion-related initiatives to choose from in November. Only one of them, the "Nebraska Right to Abortion Initiative," backed by the Protect Our Rights coalition, would allow abortions past the first trimester.

A bill in the Tennessee General Assembly is reigniting debate over how rural hospitals can staff anesthesia providers. House Bill 979 would address the shortage of anesthesiologists in rural Tennessee by allowing hospitals in counties with fewer than 105,000 residents to directly employ physician anesthesiologists.

Hospitals now have to use third-party anesthesiology services.

Dr. Louis Chemin III, anesthesiologist and physician with Tennessee Anesthesiology Consultants Exchange, supports physician supervision in what's known as the "Anesthesia Care Team" model. He said anyone hired as an anesthesiologist would be required to follow strict medical guidelines.

"Currently under state law, a hospital cannot employ an anesthesiologist, a radiologist, a pathologist or an emergency medicine physician. If this bill were to pass, it would allow hospitals in these rural communities the option to hire an anesthesiologist," he contended.

Chemin said the bill would allow a hospital anesthesiologist to perform anesthesia in one operating room, or to supervise the process in up to four operating rooms.

On Wednesday, the bill passed the House with a vote of 72 to 5, with 11 members "present but not voting." It now heads to the state Senate.

When a physician anesthesiologist provides medical direction to Certified Registered Nurse Anesthetists or Anesthesiologist Assistants, Chemin explained, they must comply with seven steps outlined by the Centers for Medicare and Medicaid Services to qualify for reimbursement under Medicare.

"This law means that if a hospital employs an anesthesiologist, that they must allow the anesthesiologist to practice in a way that is safe and is in agreement with these seven steps," he continued.

Chemin added that these requirements would ensure the anesthesiologist's active involvement in the patient's care and safety.


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A new report found Missouri's public health agencies are not sharing information effectively and fixing the problem could lead to better health care for people in the state.

The Missouri Department of Health and Senior Services released its first assessment of the state's digital health system, highlighting ways to improve how health data is shared and used. The evaluation uncovered significant gaps in sharing critical information such as disease rates, hospital visits, birth outcomes and access to care.

Joshua Wymer, chief health information and strategy officer for the department, shared key insights from the report.

"Data is still often siloed," Wymer pointed out. "There was an opportunity with data to advance inoperability, there's an opportunity to always be better at privacy and security because we know that the threat of that is always evolving."

The report recommended establishing clear rules and strong leadership for better data management. More than 200 organizations took part in the assessment, through 25 meetings across nine regions.

A separate study found health care providers said patient access to electronic health records improved communication and treatment discussions. Wymer also shared what citizens expect from the systems as health data grows in importance.

"They expect their data to not only be available and readily accessible, but they expect it to be private and secure," Wymer reported. "And they expect an experience that moves closer and closer to them and their routine and their priority."

The assessment revealed Missouri's public health agencies have different digital capabilities but are ready to adopt new data systems.


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Wednesday is National Healthcare Decisions Day and advocates are calling attention to Florida's pressing need for advance care planning, particularly among vulnerable groups.

About one in five Floridians is over 65 and the state also struggles with one of America's highest uninsured rates, at 10.7%, significantly above the 8% national average.

Brandi Alexander, chief engagement officer for the national end-of-life advocacy group Compassion & Choices said Latino residents have nearly double the uninsured rate of white Floridians. She noted there are good reasons for anyone to plan for their future health care needs.

"Nearly half of the population are people of color in Florida," Alexander pointed out. "A 2021 study found that the preventable mortality rate for Black individuals was 1.5 times higher than it was for their white peers."

The annual awareness day encourages families to discuss and document their medical preferences before a crisis strikes. Florida's 52 licensed hospice organizations serve patients through hundreds of care teams statewide, according to state health data. Alexander emphasized clarifying care wishes can alleviate burdens on families and reduce preventable suffering.

Alexander added normalizing the conversations can empower patients and reduce disparities.

"The more we have tools and the more we normalize the conversation, we can start changing some of the negative stigma that comes with talking about death," Alexander stressed. "Because once you're talking about it and you know what options are available to you, you can then really advocate for yourself within the health care system - and that's how we really create change."

Free resources, including advance directive forms and multilingual guides, are available through the state health department and advocacy groups like Compassion & Choices.