Tag Archives: oregon

Faced with shortages, paramedics turn to expired drugs

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporting on how drug shortages are impacting paramedics, The Associated Press’ Jonathan Cooper discovered things had deteriorated to the point that, he writes, “Paramedics reported asking some of those facing medical emergencies: ‘Is it OK if we use this expired drug?’

Based in Oregon, Cooper found that, in fact, paramedics around the northwest have been forced to dig up supplies of expired drugs to meet critical needs. He writes that, while manufacturers don’t seem to be willing to discuss drug effectiveness beyond declared lifespans, “Medications are only guaranteed to work as intended until their expiration date. When stored properly, most expired drugs won’t be harmful to patients but will become less effective with time, according to medical professionals.”

State public health officials, who license ambulances and in some cases dictate the medications they must carry, are loosening their rules to help emergency responders deal with the various shortages. Oregon health officials last week began allowing ambulances to carry expired drugs, and southern Nevada has extended the expiration dates for drugs in short supply. Arizona has stopped penalizing ambulance crews for running out of mandated medications.

Some agencies have reported keeping their drug kits fully stocked by substituting alternative medications, some of which have additional side effects or higher costs, or by diluting higher dosages to get the less-concentrated dose needed.

Past shortages have included key painkillers and sedatives. Current critical needs include epinephrine and morphine – and you don’t have to be a pharmacist to imagine why a shortage of those might be problematic for front-line medics.

Manufacturing quality lapses, production shutdowns for contamination and other serious problems are behind many of the shortages, according to manufacturers and the FDA. Other reasons include increased demand for some drugs, companies ending production of some drugs with small profit margins, consolidation in the generic drug industry and limited supplies of some ingredients.

Posting ER wait times online: Gimmick or service?

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for HealthLeaders Media, Cheryl Clark looked at the growing number of hospitals that are posting their emergency room wait times online.

Clark describes the practice as a “marketing strategy” that may help hospitals snag market share and improve the patient experience, and quotes physicians calling it a “gimmick” that may actually hurt patients by encouraging them to delay ER visits until the line gets shorter. Clark also spotlights a more disturbing version of the system, one which allows patients to pay online to reserve a spot at the head of the ER waiting line.

waittime
Sacred Heart Medical Center in Eugene, Ore., uses a system of infrared tags to monitor ER wait times and post them online.

(Another system) allows patients to buy, for $24.99, the ability to register online for a place at the head of the emergency room wait line at participating hospitals. The concept, called InQuickER—”Skip the ER Waiting Room”—was developed three years ago as a customer service program.

The patient prints out a confirmation number with instructions for what time to be at the hospital so they don’t have to wait.

So far, three hospitals have signed up: Emory-Adventist Hospital in Smyrna, GA, Florida Hospital Waterman in Tavares, FL, and Infirmary West in Mobile, AL.

Congressional health coverage solid, not exclusive

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Oregonian‘s Charles Pope heard all the talk, especially from Sen. Ron Wyden (D-Oregon), about the desirability of the health coverage members of Congress enjoy and decided to clear up a few misconceptions on the subject.

sen-ron-wyden
Sen. Ron Wyden speaks at Health Journalism 2009 in March in Seattle.
(Photo by Clare McLean, University of Washington Medicine)

The coverage Wyden and friends enjoy, while excellent, is no different than that available to millions of other federal employees. These employees are expected to contribute and copay just like most insurance consumers, and don’t get any truly unusual bonuses.

Federal employees do enjoy some advantages over the rest of us, however, primarily because they work for one of the nation’s largest employers and thus enjoy a level of bargaining power that yields a breadth of options not available to those who work for small or medium-sized businesses. Government workers in Washington, D.C., have 23 plans to choose from, Pope said, while in places like Oregon, they still have about a dozen options.