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NYC Health + Hospitals has redirected more than 2,400 911 calls since the public health system launched its telehealth service last March. NYC H+H works with city emergency medical services via its virtual ExpressCare platform to evaluate low-acuity 911 callers who may not need an ambulance. About 1,300 of those rerouted calls were during an ambulance ride directed toward a NYC H+H emergency department, where the patient decided with an emergency medicine provider to not go to the hospital. (Kacik, 9/30)

Labor unions representing at least 27,000 Kaiser Permanente employees in California and Oregon are readying their memberships to vote on whether they will go on strike, union leaders said. The votes come as union contracts expire Thursday. Under national labor law, healthcare unions are required to give employers 10 days' notice of a strike. The United Nurses Associations of California/Union of Health Care Professionals, which includes 24,000 registered nurses, pharmacists, rehab therapists, midwives and optometrists, will hold its vote Oct. 1 through Oct. 10. The Oregon Federation of Nurses and Health Professionals, which represents 3,400 healthcare workers, will start its vote Oct. 4. Both unions are part of the 21-union Alliance of Health Care Unions that represents 52,000 Kaiser workers. (Christ, 9/30)

According to the American Association of Colleges of Nursing (AACN) more than 80,000 qualified applications from baccalaureate and graduate nursing programs were turned away nationwide during 2019-2020. Katelyn Barley is an assistant professor of nursing at Notre Dame of Maryland and teaches senior level nursing students. Barley says hands on learning is critical for students, "they do need the in person and hands on skills, absolutely. For the students that graduated during the pandemic and maybe had that cut short, they had experiences in the hospital during their orientation to help get them to where they needed to be." (Whitfield, 10/1)

When Teiranni Kidd walked into Springhill Medical Center on July 16, 2019, to have her baby, she had no idea the Alabama hospital was deep in the midst of a ransomware attack. For nearly eight days, computers had been disabled on every floor. A real-time wireless tracker that could locate medical staff around the hospital was down. Years of patient health records were inaccessible. And at the nurses’ desk in the labor and delivery unit, medical staff were cut off from the equipment that monitors fetal heartbeats in the 12 delivery rooms. Doctors and nurses in the unit texted each other with updates. “We have no computer charting for I don’t know how long,” one manager informed a nurse in a message later filed in court. “They are printing out the labs in the laboratory and sending them by paper,” another worker wrote. One overwhelmed nurse texted, “I want to run away.” (Poulsen, McMillan and Evans, 9/30)

Think of it as digital health’s chicken and egg problem. Which comes first: national distribution of your algorithm, or clinical evidence that it works? For a startup, it is almost impossible to have one without the other. The medical artificial intelligence company Dascena is among many early-stage companies in the throes of this debate. (Ross, 10/1)

KHN: Hospitals Confront Climate Change As Patients Sick From Floods And Fires Crowd ERs

When triple-digit temperatures hit the Pacific Northwest this summer, the emergency room at Seattle’s Harborview Medical Center was ill prepared. Doctors raced to treat heat-aggravated illness in homeless people, elderly patients with chronic ailments, and overdosing narcotics users. “The magnitude of the exposure, this was so far off the charts in terms of our historical experience,” said Dr. Jeremy Hess, an emergency medicine physician and professor of environmental and occupational health sciences at the University of Washington. (Green, 10/1)