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Was Anything Learned at Tomah?
On Tuesday The Senate Committee on Homeland Security and Government Affairs issued 2 reports on its investigations into the oversight of the Tomah VAMC, which found that the VA and VA Office of Inspector General (OIG) both failed to adequately address the facility’s problems despite ample warnings of dangerous conditions. It was not until after the death of Marine Jason Simcakoski from an opioid overdose in March 2014 and a 2015 report from the Center for Investigative Reporting that Tomah leadership and opioid prescribing practices came under close scrutiny.
Although numerous complaints surfaced in the past, according to the Senate committee reports, little if anything was done to fix the problems. According to a staff report from committee Chairman Ron Johnson (R-Wisc.), “Despite receiving various complaints over the course of several years, federal law enforcement agencies and other executive branch entities failed to identify or address the root causes.”
In his opening statement, Senator Johnson laid much of the blame on OIG. “The failure of the Office of the Inspector General to live up to its mission is really the root cause of why these problems continue to go on,” said Johnson.
The majority staff report also asserted that a “culture of fear and whistleblower retaliation at the Tomah VAMC allowed overprescription and other abuses to continue unaddressed. The belief among Tomah VAMC staff that they could not report wrongdoing compromised patient care.”
The staff of minority staff member Thomas Carper (D-Del.) also noted in a report that the efforts to address the problems at the Tomah VAMC “were not effective.” Still, according to the minority report recommendations were made, but “Tomah VAMC senior leadership declined to implement both VISN 12 recommendations (such as conducting an administrative investigative board review for Dr. Houlihan) and VA OIG suggestions aimed at addressing problems at the facility.”
According to Senator Carper, chronic understaffing, a shortage of qualified mental health care professionals, and a lack of adequate oversight may have contributed to Tomah’s problems. Nevertheless, Carper pointed out ,“our staff found that the VA OIG’s decision to administratively close an investigation it conducted at Tomah without publicly releasing a report made it more difficult for the VA and the public to identify and correct what was going wrong.”
In addressing the hearing, VA Deputy Secretary Sloan Gibson pledged to change the culture of the facility. “In order to create a more transparent culture and improve communication with Tomah VAMC employees,” Sloan told the committee, “leadership has taken a number of actions, including town hall meetings, supervisory forums, and expanded all-employee communications.”
Deputy Secretary Gibson also touted the VA’s efforts to address overprescription of opioids. According to Gibson, since 2012:
- 151,982 fewer patients are receiving opioids (22% reduction);
- 51,916 fewer patients are receiving opioids and benzodiazepines together (42% reduction);
- 94,045 more patients on opioids have had a urine drug screen to help guide treatment decisions (37% increase); and
- 122,065 fewer patients are on long-term opioid therapy (28% reduction).
Newly confirmed Inspector General of the VA Michael Missal also tried to focus on the future. “My office has learned important lessons from the Tomah health care inspections that should help us better meet our mission going forward,” he told the committee. “The changes that we have made should increase the confidence that veterans, veterans service organizations, Congress, and the American public have in the OIG.”
On Tuesday The Senate Committee on Homeland Security and Government Affairs issued 2 reports on its investigations into the oversight of the Tomah VAMC, which found that the VA and VA Office of Inspector General (OIG) both failed to adequately address the facility’s problems despite ample warnings of dangerous conditions. It was not until after the death of Marine Jason Simcakoski from an opioid overdose in March 2014 and a 2015 report from the Center for Investigative Reporting that Tomah leadership and opioid prescribing practices came under close scrutiny.
Although numerous complaints surfaced in the past, according to the Senate committee reports, little if anything was done to fix the problems. According to a staff report from committee Chairman Ron Johnson (R-Wisc.), “Despite receiving various complaints over the course of several years, federal law enforcement agencies and other executive branch entities failed to identify or address the root causes.”
In his opening statement, Senator Johnson laid much of the blame on OIG. “The failure of the Office of the Inspector General to live up to its mission is really the root cause of why these problems continue to go on,” said Johnson.
The majority staff report also asserted that a “culture of fear and whistleblower retaliation at the Tomah VAMC allowed overprescription and other abuses to continue unaddressed. The belief among Tomah VAMC staff that they could not report wrongdoing compromised patient care.”
The staff of minority staff member Thomas Carper (D-Del.) also noted in a report that the efforts to address the problems at the Tomah VAMC “were not effective.” Still, according to the minority report recommendations were made, but “Tomah VAMC senior leadership declined to implement both VISN 12 recommendations (such as conducting an administrative investigative board review for Dr. Houlihan) and VA OIG suggestions aimed at addressing problems at the facility.”
According to Senator Carper, chronic understaffing, a shortage of qualified mental health care professionals, and a lack of adequate oversight may have contributed to Tomah’s problems. Nevertheless, Carper pointed out ,“our staff found that the VA OIG’s decision to administratively close an investigation it conducted at Tomah without publicly releasing a report made it more difficult for the VA and the public to identify and correct what was going wrong.”
In addressing the hearing, VA Deputy Secretary Sloan Gibson pledged to change the culture of the facility. “In order to create a more transparent culture and improve communication with Tomah VAMC employees,” Sloan told the committee, “leadership has taken a number of actions, including town hall meetings, supervisory forums, and expanded all-employee communications.”
Deputy Secretary Gibson also touted the VA’s efforts to address overprescription of opioids. According to Gibson, since 2012:
- 151,982 fewer patients are receiving opioids (22% reduction);
- 51,916 fewer patients are receiving opioids and benzodiazepines together (42% reduction);
- 94,045 more patients on opioids have had a urine drug screen to help guide treatment decisions (37% increase); and
- 122,065 fewer patients are on long-term opioid therapy (28% reduction).
Newly confirmed Inspector General of the VA Michael Missal also tried to focus on the future. “My office has learned important lessons from the Tomah health care inspections that should help us better meet our mission going forward,” he told the committee. “The changes that we have made should increase the confidence that veterans, veterans service organizations, Congress, and the American public have in the OIG.”
On Tuesday The Senate Committee on Homeland Security and Government Affairs issued 2 reports on its investigations into the oversight of the Tomah VAMC, which found that the VA and VA Office of Inspector General (OIG) both failed to adequately address the facility’s problems despite ample warnings of dangerous conditions. It was not until after the death of Marine Jason Simcakoski from an opioid overdose in March 2014 and a 2015 report from the Center for Investigative Reporting that Tomah leadership and opioid prescribing practices came under close scrutiny.
Although numerous complaints surfaced in the past, according to the Senate committee reports, little if anything was done to fix the problems. According to a staff report from committee Chairman Ron Johnson (R-Wisc.), “Despite receiving various complaints over the course of several years, federal law enforcement agencies and other executive branch entities failed to identify or address the root causes.”
In his opening statement, Senator Johnson laid much of the blame on OIG. “The failure of the Office of the Inspector General to live up to its mission is really the root cause of why these problems continue to go on,” said Johnson.
The majority staff report also asserted that a “culture of fear and whistleblower retaliation at the Tomah VAMC allowed overprescription and other abuses to continue unaddressed. The belief among Tomah VAMC staff that they could not report wrongdoing compromised patient care.”
The staff of minority staff member Thomas Carper (D-Del.) also noted in a report that the efforts to address the problems at the Tomah VAMC “were not effective.” Still, according to the minority report recommendations were made, but “Tomah VAMC senior leadership declined to implement both VISN 12 recommendations (such as conducting an administrative investigative board review for Dr. Houlihan) and VA OIG suggestions aimed at addressing problems at the facility.”
According to Senator Carper, chronic understaffing, a shortage of qualified mental health care professionals, and a lack of adequate oversight may have contributed to Tomah’s problems. Nevertheless, Carper pointed out ,“our staff found that the VA OIG’s decision to administratively close an investigation it conducted at Tomah without publicly releasing a report made it more difficult for the VA and the public to identify and correct what was going wrong.”
In addressing the hearing, VA Deputy Secretary Sloan Gibson pledged to change the culture of the facility. “In order to create a more transparent culture and improve communication with Tomah VAMC employees,” Sloan told the committee, “leadership has taken a number of actions, including town hall meetings, supervisory forums, and expanded all-employee communications.”
Deputy Secretary Gibson also touted the VA’s efforts to address overprescription of opioids. According to Gibson, since 2012:
- 151,982 fewer patients are receiving opioids (22% reduction);
- 51,916 fewer patients are receiving opioids and benzodiazepines together (42% reduction);
- 94,045 more patients on opioids have had a urine drug screen to help guide treatment decisions (37% increase); and
- 122,065 fewer patients are on long-term opioid therapy (28% reduction).
Newly confirmed Inspector General of the VA Michael Missal also tried to focus on the future. “My office has learned important lessons from the Tomah health care inspections that should help us better meet our mission going forward,” he told the committee. “The changes that we have made should increase the confidence that veterans, veterans service organizations, Congress, and the American public have in the OIG.”
Diagnosing Anthrax in Minutes
A simple point-of-care finger prick test to diagnose anthrax infection is moving into the final stages of development. Unlike current tests, which can take days for lab analysis, this one shows results within minutes. Immediate response is crucial in cases of anthrax exposure. Untreated, inhaled anthrax can be deadly within days.
The test is being developed by SRI International (Menlo Park, CA) under an 18-month, $2.5 million agreement with HHS’s Biomedical Advanced Research and Development Authority . Based partly on a similar version developed at the CDC, the SRI test uses blood samples on small cartridges. After 15 minutes, the cartridge is placed in a palm-sized reader, which displays results. The convenient size, says HHS, makes it ideally suited for bedside use or by first responders.
A simple point-of-care finger prick test to diagnose anthrax infection is moving into the final stages of development. Unlike current tests, which can take days for lab analysis, this one shows results within minutes. Immediate response is crucial in cases of anthrax exposure. Untreated, inhaled anthrax can be deadly within days.
The test is being developed by SRI International (Menlo Park, CA) under an 18-month, $2.5 million agreement with HHS’s Biomedical Advanced Research and Development Authority . Based partly on a similar version developed at the CDC, the SRI test uses blood samples on small cartridges. After 15 minutes, the cartridge is placed in a palm-sized reader, which displays results. The convenient size, says HHS, makes it ideally suited for bedside use or by first responders.
A simple point-of-care finger prick test to diagnose anthrax infection is moving into the final stages of development. Unlike current tests, which can take days for lab analysis, this one shows results within minutes. Immediate response is crucial in cases of anthrax exposure. Untreated, inhaled anthrax can be deadly within days.
The test is being developed by SRI International (Menlo Park, CA) under an 18-month, $2.5 million agreement with HHS’s Biomedical Advanced Research and Development Authority . Based partly on a similar version developed at the CDC, the SRI test uses blood samples on small cartridges. After 15 minutes, the cartridge is placed in a palm-sized reader, which displays results. The convenient size, says HHS, makes it ideally suited for bedside use or by first responders.
CVS MinuteClinics: A Cure for Long Wait Times at Veterans Affairs?
Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain to offer urgent care services to more than 65,000 veterans.
The experiment begins today at the VA’s operations in Palo Alto, California.
Veterans can visit 14 “MinuteClinics” operated by CVS in the San Francisco Bay area and Sacramento, where staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications, which can be filled at CVS pharmacies.
The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications. Whether the partnership will spread to other VA locales isn’t yet clear.
The collaboration comes amid renewed scrutiny of the nation’s troubled VA health system, which has tried without much success to improve long wait times for veterans needing health care.
Despite a $10 billion “Veterans Choice” program allowing veterans to receive care outside the closed VA system, vets nationwide wait for an appointment even longer than they did before the program started in 2014, according to a federal audit.
The MinuteClinic partnership is not part of the Veterans Choice program.
“The concern has always been, how do we make sure veterans get the care they need in a timely way and in a way that works for the veteran?” said Dr. Stephen Ezeji-Okoye, the Palo Alto VA’s deputy chief of staff. The deal indicates that the VA is willing to try outside partnerships to meet veterans’ needs, he said. “We want to have not just timely access but geographic access to care.”
Sarah Russell, the Palo Alto VA’s chief medical informatics officer, came up with the idea, said Ezeji-Okoye.
The VA will integrate MinuteClinics’ patient records with its own electronic health records to provide consistency of care, Ezeji-Okoye said.
The Palo Alto VA fares better than some other facilities nationwide in providing timely care to veterans, according to VA data, and Ezeji-Okoye said most patients with urgent care needs are seen quickly.
But the system was so busy in the past year that about 11 percent of appointments at its network of hospitals and clinics — which stretch south from Sonora to Monterey — could not be scheduled within 30 or fewer days, which is considered an acceptable timeframe, VA data show. That includes appointments that would require urgent care.
More than 5,000 appointments system-wide were scheduled more than 30 days out, but each hospital and clinic’s performance varied widely. At a Fremont clinic, less than 2 percent of appointment requests could not be scheduled within 30 days. At the VA’s rural Modesto clinic, by contrast, more than 17 percent of requests were not be scheduled within 30 days.
Once the MinuteClinic operation is well underway, Ezeji-Okoye anticipates that between 10 and 15 veterans — from among the estimated 150 who call the Palo Alto VA’s advice nurse hotline daily — will be treated at the retail clinics on any given day.
About 95,000 veterans are eligible to use the Palo Alto system, one of the VA’s largest in the Western United States. About 65,000 use it every year.
The $330,000 pilot project will be evaluated after one year. CVS’ MinuteClinic president, Dr. Andrew Sussman, hopes it can be rolled out nationally if it succeeds. CVS is by far the biggest player in retail pharmacy clinics, operating 1,135 of them in 35 states.
“We’d love to have that opportunity to expand after we go through this phase,” Sussman said. “We’re well suited to help because of our large footprint and ability to see people on a quick basis.”
It is unclear, however, what the VA’s nationwide plans are. The Veterans Health Administration office did not respond to Kaiser Health News’ request for comment.
Blake Schindler, a retired Army major who lives in Santa Clara near one of the participating MinuteClinics, was intrigued, but cautious about the MinuteClinics. He counts himself lucky because unlike some other veterans, he has access to the U.S. military’s TRICARE health insurance program for active and some retired service members.
“It could make a big difference, but how much access are the veterans going to have? That was the big problem with the Veterans Choice program; it didn’t end up the way it was supposed to,” said Schindler, 58.
“I’m always hopeful when I hear about these things; I keep an open mind until I have experience with it,” he added.
Interested veterans served by the VA Palo Alto can call its advice nurse line at 800-455-0057.
This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.
This story also ran on NPR.
Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain to offer urgent care services to more than 65,000 veterans.
The experiment begins today at the VA’s operations in Palo Alto, California.
Veterans can visit 14 “MinuteClinics” operated by CVS in the San Francisco Bay area and Sacramento, where staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications, which can be filled at CVS pharmacies.
The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications. Whether the partnership will spread to other VA locales isn’t yet clear.
The collaboration comes amid renewed scrutiny of the nation’s troubled VA health system, which has tried without much success to improve long wait times for veterans needing health care.
Despite a $10 billion “Veterans Choice” program allowing veterans to receive care outside the closed VA system, vets nationwide wait for an appointment even longer than they did before the program started in 2014, according to a federal audit.
The MinuteClinic partnership is not part of the Veterans Choice program.
“The concern has always been, how do we make sure veterans get the care they need in a timely way and in a way that works for the veteran?” said Dr. Stephen Ezeji-Okoye, the Palo Alto VA’s deputy chief of staff. The deal indicates that the VA is willing to try outside partnerships to meet veterans’ needs, he said. “We want to have not just timely access but geographic access to care.”
Sarah Russell, the Palo Alto VA’s chief medical informatics officer, came up with the idea, said Ezeji-Okoye.
The VA will integrate MinuteClinics’ patient records with its own electronic health records to provide consistency of care, Ezeji-Okoye said.
The Palo Alto VA fares better than some other facilities nationwide in providing timely care to veterans, according to VA data, and Ezeji-Okoye said most patients with urgent care needs are seen quickly.
But the system was so busy in the past year that about 11 percent of appointments at its network of hospitals and clinics — which stretch south from Sonora to Monterey — could not be scheduled within 30 or fewer days, which is considered an acceptable timeframe, VA data show. That includes appointments that would require urgent care.
More than 5,000 appointments system-wide were scheduled more than 30 days out, but each hospital and clinic’s performance varied widely. At a Fremont clinic, less than 2 percent of appointment requests could not be scheduled within 30 days. At the VA’s rural Modesto clinic, by contrast, more than 17 percent of requests were not be scheduled within 30 days.
Once the MinuteClinic operation is well underway, Ezeji-Okoye anticipates that between 10 and 15 veterans — from among the estimated 150 who call the Palo Alto VA’s advice nurse hotline daily — will be treated at the retail clinics on any given day.
About 95,000 veterans are eligible to use the Palo Alto system, one of the VA’s largest in the Western United States. About 65,000 use it every year.
The $330,000 pilot project will be evaluated after one year. CVS’ MinuteClinic president, Dr. Andrew Sussman, hopes it can be rolled out nationally if it succeeds. CVS is by far the biggest player in retail pharmacy clinics, operating 1,135 of them in 35 states.
“We’d love to have that opportunity to expand after we go through this phase,” Sussman said. “We’re well suited to help because of our large footprint and ability to see people on a quick basis.”
It is unclear, however, what the VA’s nationwide plans are. The Veterans Health Administration office did not respond to Kaiser Health News’ request for comment.
Blake Schindler, a retired Army major who lives in Santa Clara near one of the participating MinuteClinics, was intrigued, but cautious about the MinuteClinics. He counts himself lucky because unlike some other veterans, he has access to the U.S. military’s TRICARE health insurance program for active and some retired service members.
“It could make a big difference, but how much access are the veterans going to have? That was the big problem with the Veterans Choice program; it didn’t end up the way it was supposed to,” said Schindler, 58.
“I’m always hopeful when I hear about these things; I keep an open mind until I have experience with it,” he added.
Interested veterans served by the VA Palo Alto can call its advice nurse line at 800-455-0057.
This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.
This story also ran on NPR.
Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain to offer urgent care services to more than 65,000 veterans.
The experiment begins today at the VA’s operations in Palo Alto, California.
Veterans can visit 14 “MinuteClinics” operated by CVS in the San Francisco Bay area and Sacramento, where staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications, which can be filled at CVS pharmacies.
The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications. Whether the partnership will spread to other VA locales isn’t yet clear.
The collaboration comes amid renewed scrutiny of the nation’s troubled VA health system, which has tried without much success to improve long wait times for veterans needing health care.
Despite a $10 billion “Veterans Choice” program allowing veterans to receive care outside the closed VA system, vets nationwide wait for an appointment even longer than they did before the program started in 2014, according to a federal audit.
The MinuteClinic partnership is not part of the Veterans Choice program.
“The concern has always been, how do we make sure veterans get the care they need in a timely way and in a way that works for the veteran?” said Dr. Stephen Ezeji-Okoye, the Palo Alto VA’s deputy chief of staff. The deal indicates that the VA is willing to try outside partnerships to meet veterans’ needs, he said. “We want to have not just timely access but geographic access to care.”
Sarah Russell, the Palo Alto VA’s chief medical informatics officer, came up with the idea, said Ezeji-Okoye.
The VA will integrate MinuteClinics’ patient records with its own electronic health records to provide consistency of care, Ezeji-Okoye said.
The Palo Alto VA fares better than some other facilities nationwide in providing timely care to veterans, according to VA data, and Ezeji-Okoye said most patients with urgent care needs are seen quickly.
But the system was so busy in the past year that about 11 percent of appointments at its network of hospitals and clinics — which stretch south from Sonora to Monterey — could not be scheduled within 30 or fewer days, which is considered an acceptable timeframe, VA data show. That includes appointments that would require urgent care.
More than 5,000 appointments system-wide were scheduled more than 30 days out, but each hospital and clinic’s performance varied widely. At a Fremont clinic, less than 2 percent of appointment requests could not be scheduled within 30 days. At the VA’s rural Modesto clinic, by contrast, more than 17 percent of requests were not be scheduled within 30 days.
Once the MinuteClinic operation is well underway, Ezeji-Okoye anticipates that between 10 and 15 veterans — from among the estimated 150 who call the Palo Alto VA’s advice nurse hotline daily — will be treated at the retail clinics on any given day.
About 95,000 veterans are eligible to use the Palo Alto system, one of the VA’s largest in the Western United States. About 65,000 use it every year.
The $330,000 pilot project will be evaluated after one year. CVS’ MinuteClinic president, Dr. Andrew Sussman, hopes it can be rolled out nationally if it succeeds. CVS is by far the biggest player in retail pharmacy clinics, operating 1,135 of them in 35 states.
“We’d love to have that opportunity to expand after we go through this phase,” Sussman said. “We’re well suited to help because of our large footprint and ability to see people on a quick basis.”
It is unclear, however, what the VA’s nationwide plans are. The Veterans Health Administration office did not respond to Kaiser Health News’ request for comment.
Blake Schindler, a retired Army major who lives in Santa Clara near one of the participating MinuteClinics, was intrigued, but cautious about the MinuteClinics. He counts himself lucky because unlike some other veterans, he has access to the U.S. military’s TRICARE health insurance program for active and some retired service members.
“It could make a big difference, but how much access are the veterans going to have? That was the big problem with the Veterans Choice program; it didn’t end up the way it was supposed to,” said Schindler, 58.
“I’m always hopeful when I hear about these things; I keep an open mind until I have experience with it,” he added.
Interested veterans served by the VA Palo Alto can call its advice nurse line at 800-455-0057.
This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.
This story also ran on NPR.
CDC Media Campaign Helps Americans Quit Smoking
Three years ago, the CDC launched “Tips From Former Smokers,” the first federally funded anti-smoking paid media campaign. The ads included striking real-life stories of smokers’ struggles with smoking-related health issues, such as cancer, gum disease, premature birth, and stroke. Since its launch, the campaign has helped at least 400,000 smokers quit according to CDC Director Tom Frieden, MD, MPH. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign alone.
The 2014 campaign aired in 2 phases from February to April and July to September. In a survey, about 80% of U.S. adult cigarette smokers said they had seen at least 1 television ad from phase 2 of the campaign.
Tips is “extremely cost-effective and a best buy, saving both lives and money,” said Frieden. “With a year-round campaign we could save even more lives and money.”
As effective as the campaign is, it’s up against a tough antagonist that refuses to surrender. Corinne Graffunder, DrPH, director of the CDC’s Office on Smoking and Health added, “The money spent in 1 year on ‘Tips’ is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”
Moreover, young people are, in a sense, cannon fodder. “We know that 90% of all adult smokers first try cigarettes as teens,” Graffunder said. According to the CDC’s 2015 National Youth Tobacco Survey, overall tobacco use among middle- and high school students has not changed since 2011; 4.7 million were current users of a tobacco product in 2015. E-cigarettes are now the most commonly used tobacco product by adolescents, the CDC found, and its use continues to climb.
Three years ago, the CDC launched “Tips From Former Smokers,” the first federally funded anti-smoking paid media campaign. The ads included striking real-life stories of smokers’ struggles with smoking-related health issues, such as cancer, gum disease, premature birth, and stroke. Since its launch, the campaign has helped at least 400,000 smokers quit according to CDC Director Tom Frieden, MD, MPH. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign alone.
The 2014 campaign aired in 2 phases from February to April and July to September. In a survey, about 80% of U.S. adult cigarette smokers said they had seen at least 1 television ad from phase 2 of the campaign.
Tips is “extremely cost-effective and a best buy, saving both lives and money,” said Frieden. “With a year-round campaign we could save even more lives and money.”
As effective as the campaign is, it’s up against a tough antagonist that refuses to surrender. Corinne Graffunder, DrPH, director of the CDC’s Office on Smoking and Health added, “The money spent in 1 year on ‘Tips’ is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”
Moreover, young people are, in a sense, cannon fodder. “We know that 90% of all adult smokers first try cigarettes as teens,” Graffunder said. According to the CDC’s 2015 National Youth Tobacco Survey, overall tobacco use among middle- and high school students has not changed since 2011; 4.7 million were current users of a tobacco product in 2015. E-cigarettes are now the most commonly used tobacco product by adolescents, the CDC found, and its use continues to climb.
Three years ago, the CDC launched “Tips From Former Smokers,” the first federally funded anti-smoking paid media campaign. The ads included striking real-life stories of smokers’ struggles with smoking-related health issues, such as cancer, gum disease, premature birth, and stroke. Since its launch, the campaign has helped at least 400,000 smokers quit according to CDC Director Tom Frieden, MD, MPH. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign alone.
The 2014 campaign aired in 2 phases from February to April and July to September. In a survey, about 80% of U.S. adult cigarette smokers said they had seen at least 1 television ad from phase 2 of the campaign.
Tips is “extremely cost-effective and a best buy, saving both lives and money,” said Frieden. “With a year-round campaign we could save even more lives and money.”
As effective as the campaign is, it’s up against a tough antagonist that refuses to surrender. Corinne Graffunder, DrPH, director of the CDC’s Office on Smoking and Health added, “The money spent in 1 year on ‘Tips’ is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”
Moreover, young people are, in a sense, cannon fodder. “We know that 90% of all adult smokers first try cigarettes as teens,” Graffunder said. According to the CDC’s 2015 National Youth Tobacco Survey, overall tobacco use among middle- and high school students has not changed since 2011; 4.7 million were current users of a tobacco product in 2015. E-cigarettes are now the most commonly used tobacco product by adolescents, the CDC found, and its use continues to climb.
Veteran Suicide Prevention Efforts Under Scrutiny
In a House Veterans’ Affairs Committee hearing on efforts to prevent veteran suicide, the VA confirmed that it is focused on ensuring it has enough mental health care providers. The VA currently employs 5,500 psychologists and 3,203 psychiatrists. According to Maureen F. McCarthy, MD, deputy chief, VHA Office of Patient Care Services, the VA currently has 236 psychiatrist vacancies.
Veteran service organizations, House members, and the VA all agreed that hiring and retaining qualified mental health care providers is an essential component in reducing suicides. “We are aware that access to mental health care is one significant part of preventing suicide,” McCarthy said in prepared testimony. “VA is determined to address systemic problems with access to care in general and to mental health care, including substance use disorders in particular. VA has recommitted to a culture that puts the veteran first.”
As House members, veteran service organizations, and the VA have all admitted, the frequently quoted 22 veterans suicides each day statistic is based on dated and limited data. To better understand the scope of the problem, the VA is working with the CDC to obtain a more current and accurate count of veteran suicides—a move that many veterans advocacy groups have called for.
“Vietnam Veterans of America calls for an updated veteran suicide report that includes data from all 50 states and U.S. territories, and also strongly suggests that VA mental health services develop a nationwide strategy to address the problem of suicides among our older veterans—particularly Vietnam-era veterans,” Thomas J. Berger, PhD, executive director of the Veterans Health Council of the Vietnam Veterans of America (VVA) told the committee in his prepared remarks.
According to Dr. McCarthy, the data will be available later this summer and will accessible to researchers. “We so wanted to have this information to you by this hearing. We don’t,” she said.
Challenges Remain
Ensuring access to care is one of the VA’s chief challenges. “We have to change our messaging to be more welcoming to all veterans,” Dr. McCarthy told the committee. “There are still veterans out there that do not know that they are eligible for benefits.”
Another one of the challenges is streamlining the transition from the military to the VA. “VA research has indicated that rates of suicide among those who use VA services have not shown increases similar to those observed in all veterans and the general U.S. population,” McCarthy explained. “This research suggests that an improved health care transition between DoD and VA could help mitigate suicide risk as well as other increased risks of morbidity.” According to McCarthy, the VA and DoD are working to create a seamless transition for mental health medications from the DoD to the VA, following a safety review
Following up on the Preventing Veterans Suicide – A Call to Action summit, in March, VA announced 8 steps it planned to take to improve its suicide prevention programs. They are:
1. Elevating VA’s suicide-prevention program with additional resources to help manage and strengthen current programs and initiatives;
2. Meeting urgent mental health needs by providing veterans with same-day evaluations and access by the end of calendar year 2016;
3. Establishing a new standard of care by using measures of veteran-reported symptoms to tailor mental health treatments to individual needs;
4. Launching a new study, “Coming Home from Afghanistan and Iraq,” that will look at the impact of deployment and combat as it relates to suicide, mental health, and well-being;
5. Using predictive modeling to guide early interventions for suicide prevention;
6. Using data on suicide attempts and overdoses to guide strategies to prevent suicide;
7. Increasing the availability of naloxone rescue kits throughout VA to prevent deaths from opioid overdoses;
8. Enhancing veteran mental health access by establishing 3 regional telemental health hubs; and
9. Continuing to partner with the DoD on suicide prevention and other efforts for a seamless transition from military service to civilian life.
“While these initiatives are laudable, VVA also believes strongly that they cannot fully succeed without a significant increase in the recruitment, hiring, and retention of VA mental health staff, as well as timely access to VA mental health clinical facilities and programs, especially for our rural veterans,” Berger told the committee.
In a House Veterans’ Affairs Committee hearing on efforts to prevent veteran suicide, the VA confirmed that it is focused on ensuring it has enough mental health care providers. The VA currently employs 5,500 psychologists and 3,203 psychiatrists. According to Maureen F. McCarthy, MD, deputy chief, VHA Office of Patient Care Services, the VA currently has 236 psychiatrist vacancies.
Veteran service organizations, House members, and the VA all agreed that hiring and retaining qualified mental health care providers is an essential component in reducing suicides. “We are aware that access to mental health care is one significant part of preventing suicide,” McCarthy said in prepared testimony. “VA is determined to address systemic problems with access to care in general and to mental health care, including substance use disorders in particular. VA has recommitted to a culture that puts the veteran first.”
As House members, veteran service organizations, and the VA have all admitted, the frequently quoted 22 veterans suicides each day statistic is based on dated and limited data. To better understand the scope of the problem, the VA is working with the CDC to obtain a more current and accurate count of veteran suicides—a move that many veterans advocacy groups have called for.
“Vietnam Veterans of America calls for an updated veteran suicide report that includes data from all 50 states and U.S. territories, and also strongly suggests that VA mental health services develop a nationwide strategy to address the problem of suicides among our older veterans—particularly Vietnam-era veterans,” Thomas J. Berger, PhD, executive director of the Veterans Health Council of the Vietnam Veterans of America (VVA) told the committee in his prepared remarks.
According to Dr. McCarthy, the data will be available later this summer and will accessible to researchers. “We so wanted to have this information to you by this hearing. We don’t,” she said.
Challenges Remain
Ensuring access to care is one of the VA’s chief challenges. “We have to change our messaging to be more welcoming to all veterans,” Dr. McCarthy told the committee. “There are still veterans out there that do not know that they are eligible for benefits.”
Another one of the challenges is streamlining the transition from the military to the VA. “VA research has indicated that rates of suicide among those who use VA services have not shown increases similar to those observed in all veterans and the general U.S. population,” McCarthy explained. “This research suggests that an improved health care transition between DoD and VA could help mitigate suicide risk as well as other increased risks of morbidity.” According to McCarthy, the VA and DoD are working to create a seamless transition for mental health medications from the DoD to the VA, following a safety review
Following up on the Preventing Veterans Suicide – A Call to Action summit, in March, VA announced 8 steps it planned to take to improve its suicide prevention programs. They are:
1. Elevating VA’s suicide-prevention program with additional resources to help manage and strengthen current programs and initiatives;
2. Meeting urgent mental health needs by providing veterans with same-day evaluations and access by the end of calendar year 2016;
3. Establishing a new standard of care by using measures of veteran-reported symptoms to tailor mental health treatments to individual needs;
4. Launching a new study, “Coming Home from Afghanistan and Iraq,” that will look at the impact of deployment and combat as it relates to suicide, mental health, and well-being;
5. Using predictive modeling to guide early interventions for suicide prevention;
6. Using data on suicide attempts and overdoses to guide strategies to prevent suicide;
7. Increasing the availability of naloxone rescue kits throughout VA to prevent deaths from opioid overdoses;
8. Enhancing veteran mental health access by establishing 3 regional telemental health hubs; and
9. Continuing to partner with the DoD on suicide prevention and other efforts for a seamless transition from military service to civilian life.
“While these initiatives are laudable, VVA also believes strongly that they cannot fully succeed without a significant increase in the recruitment, hiring, and retention of VA mental health staff, as well as timely access to VA mental health clinical facilities and programs, especially for our rural veterans,” Berger told the committee.
In a House Veterans’ Affairs Committee hearing on efforts to prevent veteran suicide, the VA confirmed that it is focused on ensuring it has enough mental health care providers. The VA currently employs 5,500 psychologists and 3,203 psychiatrists. According to Maureen F. McCarthy, MD, deputy chief, VHA Office of Patient Care Services, the VA currently has 236 psychiatrist vacancies.
Veteran service organizations, House members, and the VA all agreed that hiring and retaining qualified mental health care providers is an essential component in reducing suicides. “We are aware that access to mental health care is one significant part of preventing suicide,” McCarthy said in prepared testimony. “VA is determined to address systemic problems with access to care in general and to mental health care, including substance use disorders in particular. VA has recommitted to a culture that puts the veteran first.”
As House members, veteran service organizations, and the VA have all admitted, the frequently quoted 22 veterans suicides each day statistic is based on dated and limited data. To better understand the scope of the problem, the VA is working with the CDC to obtain a more current and accurate count of veteran suicides—a move that many veterans advocacy groups have called for.
“Vietnam Veterans of America calls for an updated veteran suicide report that includes data from all 50 states and U.S. territories, and also strongly suggests that VA mental health services develop a nationwide strategy to address the problem of suicides among our older veterans—particularly Vietnam-era veterans,” Thomas J. Berger, PhD, executive director of the Veterans Health Council of the Vietnam Veterans of America (VVA) told the committee in his prepared remarks.
According to Dr. McCarthy, the data will be available later this summer and will accessible to researchers. “We so wanted to have this information to you by this hearing. We don’t,” she said.
Challenges Remain
Ensuring access to care is one of the VA’s chief challenges. “We have to change our messaging to be more welcoming to all veterans,” Dr. McCarthy told the committee. “There are still veterans out there that do not know that they are eligible for benefits.”
Another one of the challenges is streamlining the transition from the military to the VA. “VA research has indicated that rates of suicide among those who use VA services have not shown increases similar to those observed in all veterans and the general U.S. population,” McCarthy explained. “This research suggests that an improved health care transition between DoD and VA could help mitigate suicide risk as well as other increased risks of morbidity.” According to McCarthy, the VA and DoD are working to create a seamless transition for mental health medications from the DoD to the VA, following a safety review
Following up on the Preventing Veterans Suicide – A Call to Action summit, in March, VA announced 8 steps it planned to take to improve its suicide prevention programs. They are:
1. Elevating VA’s suicide-prevention program with additional resources to help manage and strengthen current programs and initiatives;
2. Meeting urgent mental health needs by providing veterans with same-day evaluations and access by the end of calendar year 2016;
3. Establishing a new standard of care by using measures of veteran-reported symptoms to tailor mental health treatments to individual needs;
4. Launching a new study, “Coming Home from Afghanistan and Iraq,” that will look at the impact of deployment and combat as it relates to suicide, mental health, and well-being;
5. Using predictive modeling to guide early interventions for suicide prevention;
6. Using data on suicide attempts and overdoses to guide strategies to prevent suicide;
7. Increasing the availability of naloxone rescue kits throughout VA to prevent deaths from opioid overdoses;
8. Enhancing veteran mental health access by establishing 3 regional telemental health hubs; and
9. Continuing to partner with the DoD on suicide prevention and other efforts for a seamless transition from military service to civilian life.
“While these initiatives are laudable, VVA also believes strongly that they cannot fully succeed without a significant increase in the recruitment, hiring, and retention of VA mental health staff, as well as timely access to VA mental health clinical facilities and programs, especially for our rural veterans,” Berger told the committee.
Quick Screen for Adolescents at Risk for Alcohol Abuse
Simply asking, “how often have you had a drink in the past year,”could be enough to identify a young person at risk for alcohol problems, according to a study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
University of Pennsylvania researchers conducted the study, collaborating with practitioners at 6 rural primary care clinics in Pennsylvania. Using a computer-based questionnaire, they screened nearly 1,200 participants aged 12 through 20 years for alcohol use disorder (AUD).
The researchers found 10% of those aged > 14 years met the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnostic criteria for AUD in the past year. Adolescents aged between 12 and 17 years who reported drinking at least 1 standard drink on 3 or more days in the past year were at highest risk: 44% had AUD.
The 3-day guideline had 91% sensitivity and 93% specificity. A negative screen (fewer than 3 drinking a days in the past year) effectively ruled out AUD, with 99% not having the disorder.
For young people aged 18 to 20 years, the best screen was to ask whether they had engaged in drinking on 12 or more days in the past year. Of those who reported that level of drinking, 31% had AUD.
The researchers also assessed screening methods outlined in NIAAA’s Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide and found the guidelines to be effective screens for AUD. They concluded that screening for frequency of alcohol use followed by a diagnostic evaluation for those who screen positive would be a “simple, brief, and cost-effective clinical assessment procedure.”
“Primary care physicians are encouraged to screen adolescents for alcohol problems, yet many do not, citing time constraints and other issues,” said NIAAA Director George Koob, PhD. “This study demonstrates that simple screening tools such as those in NIAAA’s Youth Guide are efficient and effective.”
Simply asking, “how often have you had a drink in the past year,”could be enough to identify a young person at risk for alcohol problems, according to a study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
University of Pennsylvania researchers conducted the study, collaborating with practitioners at 6 rural primary care clinics in Pennsylvania. Using a computer-based questionnaire, they screened nearly 1,200 participants aged 12 through 20 years for alcohol use disorder (AUD).
The researchers found 10% of those aged > 14 years met the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnostic criteria for AUD in the past year. Adolescents aged between 12 and 17 years who reported drinking at least 1 standard drink on 3 or more days in the past year were at highest risk: 44% had AUD.
The 3-day guideline had 91% sensitivity and 93% specificity. A negative screen (fewer than 3 drinking a days in the past year) effectively ruled out AUD, with 99% not having the disorder.
For young people aged 18 to 20 years, the best screen was to ask whether they had engaged in drinking on 12 or more days in the past year. Of those who reported that level of drinking, 31% had AUD.
The researchers also assessed screening methods outlined in NIAAA’s Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide and found the guidelines to be effective screens for AUD. They concluded that screening for frequency of alcohol use followed by a diagnostic evaluation for those who screen positive would be a “simple, brief, and cost-effective clinical assessment procedure.”
“Primary care physicians are encouraged to screen adolescents for alcohol problems, yet many do not, citing time constraints and other issues,” said NIAAA Director George Koob, PhD. “This study demonstrates that simple screening tools such as those in NIAAA’s Youth Guide are efficient and effective.”
Simply asking, “how often have you had a drink in the past year,”could be enough to identify a young person at risk for alcohol problems, according to a study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
University of Pennsylvania researchers conducted the study, collaborating with practitioners at 6 rural primary care clinics in Pennsylvania. Using a computer-based questionnaire, they screened nearly 1,200 participants aged 12 through 20 years for alcohol use disorder (AUD).
The researchers found 10% of those aged > 14 years met the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnostic criteria for AUD in the past year. Adolescents aged between 12 and 17 years who reported drinking at least 1 standard drink on 3 or more days in the past year were at highest risk: 44% had AUD.
The 3-day guideline had 91% sensitivity and 93% specificity. A negative screen (fewer than 3 drinking a days in the past year) effectively ruled out AUD, with 99% not having the disorder.
For young people aged 18 to 20 years, the best screen was to ask whether they had engaged in drinking on 12 or more days in the past year. Of those who reported that level of drinking, 31% had AUD.
The researchers also assessed screening methods outlined in NIAAA’s Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide and found the guidelines to be effective screens for AUD. They concluded that screening for frequency of alcohol use followed by a diagnostic evaluation for those who screen positive would be a “simple, brief, and cost-effective clinical assessment procedure.”
“Primary care physicians are encouraged to screen adolescents for alcohol problems, yet many do not, citing time constraints and other issues,” said NIAAA Director George Koob, PhD. “This study demonstrates that simple screening tools such as those in NIAAA’s Youth Guide are efficient and effective.”
Thanks to IHS Funding Program, “Sustained Achievements” in Diabetes Prevention
American Indian and Alaska Native people have among the highest rates of diabetes in the country. The IHS Special Diabetes Program for Indians (SDPI) has supported and encouraged innovative interventions across the country to prevent and reduce diabetes, which the IHS says have “changed the diabetes landscape across the Indian health system.”
This year, SDPI is awarding approximately $137 million to 301 Tribes, Tribal organizations, Urban Indian organizations, and IHS facilities for programs to prevent and treat diabetes in American Indians and Alaska Natives (AI/ANs).
Based on local needs and priorities, the grant programs have increased access to diabetes services and helped improve key outcomes, the IHS says. For example, between 1997 and 2010 access to diabetes clinics rose from 31% to 71%, access to registered dietitians rose from 37% to 77%, and access to culturally tailored diabetes education programs from 36% to 99%.
Similarly, in the 13 years the program has been in existence, its results have seen “sustained achievements” in diabetes outcomes, such as declines in blood sugar and cholesterol levels. Between 1995 and 2006, the incident rate of end-stage renal disease in AI/AN people with diabetes fell by 27.7%—more than in any other racial or ethnic group.
American Indian and Alaska Native people have among the highest rates of diabetes in the country. The IHS Special Diabetes Program for Indians (SDPI) has supported and encouraged innovative interventions across the country to prevent and reduce diabetes, which the IHS says have “changed the diabetes landscape across the Indian health system.”
This year, SDPI is awarding approximately $137 million to 301 Tribes, Tribal organizations, Urban Indian organizations, and IHS facilities for programs to prevent and treat diabetes in American Indians and Alaska Natives (AI/ANs).
Based on local needs and priorities, the grant programs have increased access to diabetes services and helped improve key outcomes, the IHS says. For example, between 1997 and 2010 access to diabetes clinics rose from 31% to 71%, access to registered dietitians rose from 37% to 77%, and access to culturally tailored diabetes education programs from 36% to 99%.
Similarly, in the 13 years the program has been in existence, its results have seen “sustained achievements” in diabetes outcomes, such as declines in blood sugar and cholesterol levels. Between 1995 and 2006, the incident rate of end-stage renal disease in AI/AN people with diabetes fell by 27.7%—more than in any other racial or ethnic group.
American Indian and Alaska Native people have among the highest rates of diabetes in the country. The IHS Special Diabetes Program for Indians (SDPI) has supported and encouraged innovative interventions across the country to prevent and reduce diabetes, which the IHS says have “changed the diabetes landscape across the Indian health system.”
This year, SDPI is awarding approximately $137 million to 301 Tribes, Tribal organizations, Urban Indian organizations, and IHS facilities for programs to prevent and treat diabetes in American Indians and Alaska Natives (AI/ANs).
Based on local needs and priorities, the grant programs have increased access to diabetes services and helped improve key outcomes, the IHS says. For example, between 1997 and 2010 access to diabetes clinics rose from 31% to 71%, access to registered dietitians rose from 37% to 77%, and access to culturally tailored diabetes education programs from 36% to 99%.
Similarly, in the 13 years the program has been in existence, its results have seen “sustained achievements” in diabetes outcomes, such as declines in blood sugar and cholesterol levels. Between 1995 and 2006, the incident rate of end-stage renal disease in AI/AN people with diabetes fell by 27.7%—more than in any other racial or ethnic group.
Unraveling the Genetic Mystery of Pneumocystis
NIH researchers have sequenced nearly the entire genome of Pneumocystis—the cause a deadly infection that helped identify the HIV/AIDS epidemic. Pneumocystis is still a significant risk for those patients as well as for transplant recipients and other immunosuppressed patients.
Pneumocystis has puzzled researchers for years—especially how it developed its “unique” mechanisms of adaptation to life in mammals. “Having the genome information helped us recognize the unusual biology of Pneumocystis and how it co-exists with its mammalian hosts,” said Liang Ma, MD, first author of the paper on the study. Through analysis, the researchers now better understand where the organism lives—it’s “highly adapted to existence in the host lung with strict dependence on the mammalian host for nutrients and a stable environment.” They can also get a better idea of how it avoids elimination by the host’s immune system.
The researchers say their study helps map out a clearer picture of the genomes, compared with prior studies, with high-quality, near chromosomal draft genomes—the “highest level of genomic mapping.” That high quality helped them identify metabolic pathways critical to the growth and survival of the organism, as well as pathways in other closely related fungi that Pneumocystis does not have. The pathways likely disappeared as Pneumocystis evolved to become highly dependent on its host to stay alive, the researchers say.
Their detailed description of genes that are present or missing should facilitate attempts to culture the organism, they note. Culturing could help speed drug development and allow for genetic manipulation to modify the genes involved.
NIH researchers have sequenced nearly the entire genome of Pneumocystis—the cause a deadly infection that helped identify the HIV/AIDS epidemic. Pneumocystis is still a significant risk for those patients as well as for transplant recipients and other immunosuppressed patients.
Pneumocystis has puzzled researchers for years—especially how it developed its “unique” mechanisms of adaptation to life in mammals. “Having the genome information helped us recognize the unusual biology of Pneumocystis and how it co-exists with its mammalian hosts,” said Liang Ma, MD, first author of the paper on the study. Through analysis, the researchers now better understand where the organism lives—it’s “highly adapted to existence in the host lung with strict dependence on the mammalian host for nutrients and a stable environment.” They can also get a better idea of how it avoids elimination by the host’s immune system.
The researchers say their study helps map out a clearer picture of the genomes, compared with prior studies, with high-quality, near chromosomal draft genomes—the “highest level of genomic mapping.” That high quality helped them identify metabolic pathways critical to the growth and survival of the organism, as well as pathways in other closely related fungi that Pneumocystis does not have. The pathways likely disappeared as Pneumocystis evolved to become highly dependent on its host to stay alive, the researchers say.
Their detailed description of genes that are present or missing should facilitate attempts to culture the organism, they note. Culturing could help speed drug development and allow for genetic manipulation to modify the genes involved.
NIH researchers have sequenced nearly the entire genome of Pneumocystis—the cause a deadly infection that helped identify the HIV/AIDS epidemic. Pneumocystis is still a significant risk for those patients as well as for transplant recipients and other immunosuppressed patients.
Pneumocystis has puzzled researchers for years—especially how it developed its “unique” mechanisms of adaptation to life in mammals. “Having the genome information helped us recognize the unusual biology of Pneumocystis and how it co-exists with its mammalian hosts,” said Liang Ma, MD, first author of the paper on the study. Through analysis, the researchers now better understand where the organism lives—it’s “highly adapted to existence in the host lung with strict dependence on the mammalian host for nutrients and a stable environment.” They can also get a better idea of how it avoids elimination by the host’s immune system.
The researchers say their study helps map out a clearer picture of the genomes, compared with prior studies, with high-quality, near chromosomal draft genomes—the “highest level of genomic mapping.” That high quality helped them identify metabolic pathways critical to the growth and survival of the organism, as well as pathways in other closely related fungi that Pneumocystis does not have. The pathways likely disappeared as Pneumocystis evolved to become highly dependent on its host to stay alive, the researchers say.
Their detailed description of genes that are present or missing should facilitate attempts to culture the organism, they note. Culturing could help speed drug development and allow for genetic manipulation to modify the genes involved.
Task Force Criticizes NIH Oversight
According to multiple reports, NIH Director Francis Collins will replace senior management at the Mark O. Hatfield Clinical Research Center at the National Institutes of Health in Bethesda, Maryland, in response to a report from an independent working group that criticized this NIH facility for its fragmented governance and accountability, lack of funding transparency, inadequate facilities, and lack of compliance expertise. According to the report, these problems, if not addressed could “potentially impact patient safety and research outcomes.”
The 870,000-square-foot Hatfield Building has 200 inpatient beds and 82 day-hospital stations and sees 10,000 new research participants yearly, making it one of the largest research and clinical facilities in the world.
The task force was brought in to review procedures following a 2015 incident that found fungal contaminants in drugs produced by the pharmaceutical development section (PDS). Although no patients were harmed by the contaminants, the department was closed. “It became evident that the lapses in safety and compliance in the sterile manufacturing components of the pharmacy were likely symptomatic of more systemic issues in the structure and culture of the [Clinical Center] and NIH intramural clinical research,” According to the authors of the report.
The task force made multiple recommendations. Although its report did not call for new leadership, it stressed the importance of creating a new mission and values statement and enhancing clinical research leadership authority and responsibility. The report also called for creating a research support and compliance office, systems to monitor and enforce safety and quality standards, a hospital board, and a clinical practice committee. The report also tasked the NIH to identify and eliminate potential gaps among clinical services and to keep PDS closed.
VA/DoD to Help Lead New Cancer Initiative
“The regulatory deficiencies observed… are examples of sustained weaknesses in structure, facilities, practices and compliance,” the authors of the report concluded. However, “if the recommendations proposed herein, together with those already being implemented by NIH management, are implemented, the [NIH Intramural Research Program] can provide the essential degree of patient safety while continuing its record of extraordinary scientific accomplishment.”
According to multiple reports, NIH Director Francis Collins will replace senior management at the Mark O. Hatfield Clinical Research Center at the National Institutes of Health in Bethesda, Maryland, in response to a report from an independent working group that criticized this NIH facility for its fragmented governance and accountability, lack of funding transparency, inadequate facilities, and lack of compliance expertise. According to the report, these problems, if not addressed could “potentially impact patient safety and research outcomes.”
The 870,000-square-foot Hatfield Building has 200 inpatient beds and 82 day-hospital stations and sees 10,000 new research participants yearly, making it one of the largest research and clinical facilities in the world.
The task force was brought in to review procedures following a 2015 incident that found fungal contaminants in drugs produced by the pharmaceutical development section (PDS). Although no patients were harmed by the contaminants, the department was closed. “It became evident that the lapses in safety and compliance in the sterile manufacturing components of the pharmacy were likely symptomatic of more systemic issues in the structure and culture of the [Clinical Center] and NIH intramural clinical research,” According to the authors of the report.
The task force made multiple recommendations. Although its report did not call for new leadership, it stressed the importance of creating a new mission and values statement and enhancing clinical research leadership authority and responsibility. The report also called for creating a research support and compliance office, systems to monitor and enforce safety and quality standards, a hospital board, and a clinical practice committee. The report also tasked the NIH to identify and eliminate potential gaps among clinical services and to keep PDS closed.
VA/DoD to Help Lead New Cancer Initiative
“The regulatory deficiencies observed… are examples of sustained weaknesses in structure, facilities, practices and compliance,” the authors of the report concluded. However, “if the recommendations proposed herein, together with those already being implemented by NIH management, are implemented, the [NIH Intramural Research Program] can provide the essential degree of patient safety while continuing its record of extraordinary scientific accomplishment.”
According to multiple reports, NIH Director Francis Collins will replace senior management at the Mark O. Hatfield Clinical Research Center at the National Institutes of Health in Bethesda, Maryland, in response to a report from an independent working group that criticized this NIH facility for its fragmented governance and accountability, lack of funding transparency, inadequate facilities, and lack of compliance expertise. According to the report, these problems, if not addressed could “potentially impact patient safety and research outcomes.”
The 870,000-square-foot Hatfield Building has 200 inpatient beds and 82 day-hospital stations and sees 10,000 new research participants yearly, making it one of the largest research and clinical facilities in the world.
The task force was brought in to review procedures following a 2015 incident that found fungal contaminants in drugs produced by the pharmaceutical development section (PDS). Although no patients were harmed by the contaminants, the department was closed. “It became evident that the lapses in safety and compliance in the sterile manufacturing components of the pharmacy were likely symptomatic of more systemic issues in the structure and culture of the [Clinical Center] and NIH intramural clinical research,” According to the authors of the report.
The task force made multiple recommendations. Although its report did not call for new leadership, it stressed the importance of creating a new mission and values statement and enhancing clinical research leadership authority and responsibility. The report also called for creating a research support and compliance office, systems to monitor and enforce safety and quality standards, a hospital board, and a clinical practice committee. The report also tasked the NIH to identify and eliminate potential gaps among clinical services and to keep PDS closed.
VA/DoD to Help Lead New Cancer Initiative
“The regulatory deficiencies observed… are examples of sustained weaknesses in structure, facilities, practices and compliance,” the authors of the report concluded. However, “if the recommendations proposed herein, together with those already being implemented by NIH management, are implemented, the [NIH Intramural Research Program] can provide the essential degree of patient safety while continuing its record of extraordinary scientific accomplishment.”
Ensuring the Treatment Fits the Patient
Richard Weinshilboum, MD, has established a research program at the Mayo Clinic that uses genomic techniques, including genomewide association studies and whole genome DNA sequencing, which uses samples from large numbers of patients treated with a specific anticancer or antidepressant drug. He sat down with Federal Practitioner to discuss the role genetic testing plays in personalized medicine.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Individualized therapy: 1:11
Common genetic variations: 2:41
Using genomics for preemptive treatment: 6:06
Privacy concerns: 7:44
Cost effectiveness: 8:43
Applying genomics: 10:06
Richard Weinshilboum, MD, has established a research program at the Mayo Clinic that uses genomic techniques, including genomewide association studies and whole genome DNA sequencing, which uses samples from large numbers of patients treated with a specific anticancer or antidepressant drug. He sat down with Federal Practitioner to discuss the role genetic testing plays in personalized medicine.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Individualized therapy: 1:11
Common genetic variations: 2:41
Using genomics for preemptive treatment: 6:06
Privacy concerns: 7:44
Cost effectiveness: 8:43
Applying genomics: 10:06
Richard Weinshilboum, MD, has established a research program at the Mayo Clinic that uses genomic techniques, including genomewide association studies and whole genome DNA sequencing, which uses samples from large numbers of patients treated with a specific anticancer or antidepressant drug. He sat down with Federal Practitioner to discuss the role genetic testing plays in personalized medicine.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Individualized therapy: 1:11
Common genetic variations: 2:41
Using genomics for preemptive treatment: 6:06
Privacy concerns: 7:44
Cost effectiveness: 8:43
Applying genomics: 10:06
