Improving Care for Individuals Living With Intellectual Developmental Disabilities and Dementia

Ultimately, transformation of communities can only occur through educational efforts delivered to specific community sectors. Although the portion of people with Intellectual Developmental Disabilities who develop dementia as they age is equal to that of the general population, individuals with Down syndrome are at a much higher risk. This symposium will describe how a county health department partnered with the local County Board of Developmental Disabilities to systematically incorporate Dementia Friends for Intellectual Developmental Disabilities with Alzheimer’s disease training to their staff and provider network. We will describe who to get on board with the idea, how to organize, and how to deliver specific trainings. Outcomes related to increase in participant knowledge, increases in service provision and outcomes related to staff mentoring will be discussed.

Moving Online: Evidence-Based Programming During COVID

The COVID pandemic disrupted the way evidence-based health promotion programs (EBPs) are delivered to older adults who were the most at-risk group in terms of mortality and faced unprecedented threats to their independence and physical and mental health. Many organizations stopped in-person EBPS causing older adults to lose access to key social networks and health resources. It is a top public health priority to find new ways to keep older adults connected to their EBPs. Fit & Strong! (F&S!) is a group exercise/health education EBP for older adults with arthritis offered by CBOs in 32 states. CBOs stopped offering F&S! in-person in March 2020. Since the lockdown, we have worked closely with our provider network to develop and pilot a version that is remote/online and live, titled “F&S! @Home”. Instructors deliver F&S! @Home to older adults with minimal technological resources. We created a staging website for both providers/instructors and participants that is used to initiate the classes, enable providers to manage participants, collect data, and share support materials. The pilot began September 2020; since that time 15 classes have been offered to 147 participants. Administration on Community Living falls and arthritis outcomes data are being collected. Preliminary analyses of 45 participants and 8 instructors demonstrate a high rating of the program (mean score of 90.2 out of 100) with no adverse outcomes to date. This presentation will review the process of creating the online adaptation, lessons learned, and will review pre/post outcomes and participant and instructor evaluation feedback.

Who Is Liable When a Driverless Car Crashes?

Autonomous vehicles (AVs) will revolutionize mobility in the future. However, accidents will still happen and it will affect the practices of today’s tort laws. This work discusses all those aspects which should be considered in order to find out who is liable, i.e., an operator, owner, manufacturer, government entity, software provider, network provider, original equipment manufacturer (OEM), etc., as traditional tort rules will not help to find out the liability in case of an AV accident. The work comprehensively discusses different liabilities ranging from legal, civil, operator, criminal, moral, product, insurance, etc., to find out who is liable in case of an AV accident, as compared to the existing literature which generally discusses one or two aspects only. The work also presents the current state of legislation and discusses legal challenges to the lawmakers, insurance companies, consumer, and manufacturers, etc. The future mobility models and different scenarios of AV accidents have also been discussed in terms of legal liability and third party insurance claims. The role of regulatory bodies and different challenges has also been discussed along with recommendations. Finally, the work also proposes a new novel liability attribute model with a particular focus on ethical issues. The research proposes that liability should be attributed in such a way that it benefits everyone and everybody feels justified in case of an AV accident. The research also concludes that product liability will be the major issue in terms of insurance issues and the manufacturer should be held liable for product failure unless other evidence favors the manufacturer.

Using Health Insurance Network Provider Data and Public Data Sets to Identify SARS-CoV-2 Vaccinators in the USA

Objective: Mass vaccination planning is occurring at all levels of government in advance of regulatory approval and manufacture of a SARS-CoV-2 vaccine for distribution sometime in 2021. We outline a methodology in which both health insurance provider network data and publicly available data sources can be used to identify and plan for SARS-CoV-2 vaccinator capacity at the county level.Methods: Sendero Health Plans, Inc. provider network data, Texas State Board of Pharmacy data, US Census Bureau data, and H1N1 monovalent vaccine data were utilized to identify providers with demonstrated capacity to vaccinate the population in Travis County, Texas to achieve an estimated SARS-CoV-2 herd immunity target of 67%.Results: Within the Sendero network, 2,356 non-pharmacy providers were identified with 788 (33.4%) practicing in primary care and 1,569 (66.6%) practicing as specialists. Of the total, 686 (29.1%) provided at least one immunization between January 1, 2019 and September 30, 2020. There are 300 pharmacies with active licenses in Travis County with 161 (53.7%) classified as community pharmacies. We estimate that 1,707,098 doses of a 2-dose SARS-CoV-2 vaccine series will need to be administered within Travis County, Texas to achieve the estimated 67% herd immunity threshold to disrupt person-to-person transmission of the SARS-CoV-2 virus based on 2020 census data.Conclusion: A community-based health insurance plan can use data from its provider network and public data sources to support the CDC call to action to identify SARS-CoV-2 vaccinators in the community, including physicians, nurse practitioners, physician assistants, and pharmacies in order to provide macro level estimates of SARS-CoV-2 administration and throughput.

Boosting the Network Performance using Two Security Measure Scenarios for Service Provider Network

Network security is defined as a set of policies and actions taken by a network administrator in order to prevent unauthorized access, penetrated the defenses and infiltrated the network from unnecessary intervention. The network security also involves granting access to data using a pre-defined policy. A network firewall, on the other hand, is a network appliance that controls incoming and outgoing traffic by examining the traffic flowing through the network. This security measure establishes a secure wall [firewall] between a trusted internal network and the outside world were a security threat in shape of a hacker or a virus might have existed

Going the Extra Mile? How Provider Network Design Increases Consumer Travel Distance, Particularly for Rural Consumers

Context: The practical accessibility to medical care facilitated by health insurance plans depends not just on the number of providers within their networks but also on distances consumers must travel to reach the providers. Long travel distances inconvenience almost all consumers and may substantially reduce choice and access to providers for some. Methods: The authors assess mean and median travel distances to cardiac surgeons and pediatricians for participants in (1) plans offered through Covered California, (2) comparable commercial plans, and (3) unrestricted open-network plans. The authors repeat the analysis for higher-quality providers. Findings: The authors find that in all areas, but especially in rural areas, Covered California plan subscribers must travel longer than subscribers in the comparable commercial plan; subscribers to either plan must travel substantially longer than consumers in open networks. Analysis of access to higher-quality providers show somewhat larger travel distances. Differences between ACA and commercial plans are generally substantively small. Conclusions: While network design adds travel distance for all consumers, this may be particularly challenging for transportation-disadvantaged populations. As distance is relevant to both health outcomes and the cost of obtaining care, this analysis provides the basis for more appropriate measures of network adequacy than those currently in use.

Implementing major system change in specialist cancer surgery: The role of provider networks

Objective Major system change (MSC) has multiple, sometimes conflicting, goals and involves implementing change across a number of organizations. This study sought to develop new understanding of how the role that networks can play in implementing MSC, using the case of centralization of specialist cancer surgery in London, UK. Methods The study was based on a framework drawn from literature on networks and MSC. We analysed 100 documents, conducted 134 h of observations during relevant meetings and 81 interviews with stakeholders involved in the centralization. We analysed the data using thematic analysis. Results MSC in specialist cancer services was a contested process, which required constancy in network leadership over several years, and its horizontal and vertical distribution across the network. A core central team composed of network leaders, managers and clinical/manager hybrid roles was tasked with implementing the changes. This team developed different forms of engagement with provider organizations and other stakeholders. Some actors across the network, including clinicians and patients, questioned the rationale for the changes, the clinical evidence used to support the case for change, and the ways in which the changes were implemented. Conclusions Our study provides new understanding of MSC by discussing the strategies used by a provider network to facilitate complex changes in a health care context in the absence of a system-wide authority.