Here and There

Wednesday, September 24, 2014

Telehealth can aid rural communities, cut costs

*First appeared in the Sept. 24 edition of the Laurel Chronicle newspaper

I had an interesting chat the other day with my friend and colleague who manages the state’s Broadband Connect Coalition, a group whose function includes mapping out ways in which increased broadband can improve the education, government, workforce, and healthcare sectors.

The leaders of the broadband group made a recommendation in 2011 that Mississippi ought to establish a trade association focused solely on health information technology, and the state obliged, albeit slowly. In 2014, the Mississippi Telehealth Association was formally established to develop telehealth policies and programs designed to improve healthcare outcomes.

When I think of telehealth, I envision chatting with a doctor via Skype. Turns out, telehealth encompasses much, much more. The federal government defines telehealth as the “use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.”

In our state, the University of Mississippi Medical Center is a leader on telehealth issues. According to UMMC, residents in more than half of Mississippi’s counties must drive 40 minutes (or more) to receive specialty healthcare. This poses a serious challenge to ensuring our residents receive quality healthcare in a timely fashion.

Insert telehealth technologies. They can help bridge the gap for the residents who live in these rural areas (which is funny to say, since we’re a predominantly rural state). For example, UMMC has used online video technology to provide remote medical care, including services such as wellness care and disaster response, to more than 500,000 Mississippians since 2003. Their services include over 30 different medical specialties, such as cardiology, dermatology, emergency medicine, and stroke, and extend to more than 100 clinical sites.

UMMC telehealth services are available in all but six Mississippi counties. According to the Medical Center, Jones County-based telehealth services are provided by South Central Regional Medical Center.

Earlier this year, a first-of-its-kind telehealth partnership was announced by Gov. Phil Bryant. The Diabetes Telehealth Network, a public-private initiative including UMMC, North Sunflower Medical Center, GE Healthcare, Intel-GE Care Innovations, and C-Spire, is providing remote care management to diabetes patients in the Miss. Delta with an eye toward improving outcomes and reducing costs.

In 2010, 12.1 percent of adults in this area reported a type 2 diabetes diagnosis, and 293 died from complications related to the disease. Estimates from the American Diabetes Association put a $2.74 billion price tag on expenses related to diabetes management.

Participants in the Diabetes Telehealth Network will input daily information, such as glucose and blood pressure, onto specialized tablets provided to them through the initiative. This information provides clinicians a “just-in-time” snapshot of patients’ health status, allowing them to easily adjust medical care, schedule phone calls, or set up video chats with patients as needed.

While the program is ongoing and final results are not yet available, this initiative shows great promise in improving access to quality healthcare, particularly in underserved areas like the Mississippi Delta.

Information Week expects the telehealth industry to grow sixfold by 2017, as remote patient monitoring ramps up across the nation. As telehealth increasingly becomes a part of our medical infrastructure, Mississippi must be prepared to meet challenges posed by this new delivery system. Already we know these challenges include licensure issues, such as reciprocity of state licenses, as well as universal standards of practice.

With the right support, these obstacles are surmountable. Political leaders in Mississippi have thrown their weight behind telehealth as a legitimate solution to improving healthcare. Congressman Gregg Harper has been a leader, authoring the Telehealth Enhancement Act of 2013. Sens. Thad Cochran and Roger Wicker have sponsored similar legislation in 2014.

Closer to home, the Miss. Legislature has also taken up the telehealth mantle. A bill passed in the last session requires health insurance providers to cover “store-and-forward” and remote patient monitoring at the same rate as in-person consultations. (Store-and-forward refers to platforms that allow providers to receive consultations from remote physicians on patient tests and scans.)

A study released this week and published in Telemedicine and e-Health shows that over a 14-year period, the use of telemedicine to manage chronic diseases yielded “clear benefits including fewer and shorter hospital stays, fewer emergency room visits, less severe illness, and even fewer deaths.”

With the ability to improve outcomes faster and cheaper, it’s no wonder telehealth is getting the attention of healthcare experts, industry publications, and policymakers.

Provided the technology continues to work as expected and keeps a sharp focus on patient care, telehealth – and all that it encompasses – is good news for Mississippians.

Thursday, September 18, 2014

My thoughts on corporal punishment

*First appeared in the Sept. 17 edition of the Laurel Chronicle newspaper

Adrian Peterson had a bad week. He’s been indicted on charges of child abuse related to whipping his son to the point of bleeding. Peterson, who plays professional football for the Minnesota Vikings, is fighting the charges. He’s told several news outlets that he was disciplined as a child in the same way and “never intended or thought [injury] would happen…I am not a perfect parent, but I am, without a doubt, not a child abuser.”

Is corporal punishment child abuse? It depends on your perspective – and, in Peterson’s case, both the jury and injury.

According to news reports, parents are allowed in every state to use corporal punishment as a means of discipline, so long as the force is “reasonable.” Mississippi law stipulates that reasonable corporal punishment will not cause serious bodily harm, such as bone fracturing, permanent disfigurement or scarring, internal bleeding or trauma to any organ, brain damage, and impairment of any bodily function.

Roughly 19 states allow corporal punishment within public schools. In Mississippi, teachers and other district personnel may reasonably use “physical force as a means to maintain discipline and enforce school rules for self-protection or for the protection of other students from disruptive students.” It’s up to school districts to decide whether or not to employ this type of punishment.

Back to Peterson. His case will be handled in both a court of law and of public opinion, and that’s the genesis of this column. I don’t care to opine on his specific case (particularly as I don’t know all the details), but I’ve been amazed by the immediate rush to judgment on both sides of the paddle.

For what it’s worth, here are my thoughts on corporal punishment.

The Staples Household believes strongly in corporal punishment. As a child, I was often on the receiving end of this type of discipline. Switches were my mother’s specialty, and she’d even “allow” me to pick out my own. My father offered no such choice. His trusty belt sufficed.

I was whipped so many times that I don’t remember specifics. What I do remember is that the punishment system was rigged in my brother’s favor, as he never got as many whippings as I did. (Perhaps the bigger question, then, is not whether corporal punishment is child abuse, but whether it is evenly distributed among siblings. I’ll volunteer for that case study.)

All joking aside, corporal punishment in my family didn’t do irreparable harm to my brother or me. It didn’t make us violent madmen. It served its purpose quite well: We broke the rules, and we paid the painful price. Did it completely stop us from disobeying? No, but we defied the laws of Papa Sam with a more acute sense of the risks involved.

Because of my upbringing, I don’t raise eyebrows when I hear a child has been whipped for disobedience. That’s just a normal part of childhood, based on the sum of my experiences.

But I don’t agree with those who contend all forms of physical force used on children are “reasonable.” Obviously, if you break a bone or disfigure a face, you’ve gone too far. There are some limits, and parents should be held accountable when they exceed those boundaries.

On the other hand, I don’t agree with the over-reactive group which believes all forms of corporal punishment are abusive. I don’t believe that whipping children (in a reasonable way) is cause for a lifetime of therapy or requires an immediate reporting to childcare services.

Extremists on both sides irritate me. I’m not a parent, and I’m not advocating for either child-rearing strategy. It’s up to each family to determine what works and what doesn’t.

Sure, I’ve got my biases. I grew up thinking most of the kids who didn’t get spanked were brats, and most of the parents who didn’t spank their kids were pushovers. I also got exposed to irony at a much earlier age than the non-spanked kids who never heard their parents claim, “This hurts me more than it hurts you.”

However the Peterson case pans out, I hope we’ll remember that Adrian Peterson’s parenting strategy is not a bellwether for corporal punishment in America.

Wednesday, September 10, 2014

Paying my last respect to Terry Brown

*First appeared in the Sept. 10, 2014 edition of the Laurel Chronicle newspaper

My friend Sen. Terry Brown passed away last week after a brief but intense battle with lung cancer. Doubtful many people in the Jones County area know Sen. Brown, but his life – and legislative legacy – is one worth knowing. I hope to pay him one last respect by sharing a few memories.

It’s hard for me to imagine a legislative session without Sen. Brown – Terry, as he was known. His bass voice booming through the hallways, Terry wasn’t one for quiet entrances. As a wide-eyed teenager, I didn’t know what to think about him when we first met several years ago. Is this guy crazy? Does he always yell? Can he really help steer legislation through committee?

The answer, I soon learned, was yes. He was in fact a little crazy (and proud of it, you see); he always shouted (Lt. Gov. Tate Reeves says Terry never had an “inside voice”); and his ability to garner support for legislation was virtually unmatched.

He was one-of-a-kind in every sense of the phrase.

Terry represented Lowndes County in the Legislature, serving most recently as the Miss. Senate’s unanimous choice for President Pro Tempore, which is a Latin term that basically means he was second in command. Prior to the Senate, Terry served in the Miss. House from 1988 to 2000.

I got to work with Terry when he was chairman of the old Fees, Salaries, and Administration Committee (it’s been reconstituted as the Accountability, Efficiency, and Transparency Committee). Terry’s committee oversaw bills that would remove agencies from the regulations of the State Personnel Board, which Gov. Barbour thought – and Terry agreed – would help streamline government.

Terry would make sure this bill passed his committee and the full Senate floor, only to watch it die in the then-Democrat majority House of Representatives – year after year after year. No matter, though, because he thought it was the right thing to do. Let’s shove it in their face, he would say. Let’s make them answer questions as to why they don’t want to save taxpayer dollars.

Terry could be abrasive, that’s for sure. But his brusque nature was rather endearing once you got to know him. On more than one occasion did I hear someone exclaim: That senator just cussed me! On more than one occasion did I hear the response: Who, that giant fellow over there? Yeah, that’s Terry. I think it means he likes you.

Terry liked to give people nicknames. For coastal residents, the nickname was simply “fish-eaters.” The nickname caught on, and now several coastal residents (particularly legislators) refer to themselves as “fish-eaters.”

Terry referred to me as “nerd.” Everything I did was prefaced by “nerd”: Nerd reading, nerd walking, etc. Everything I used was a nerd utensil: Nerd pencil, nerd pen, and, my personal favorite, nerd canister (this was in reference to a water bottle I used).

He called the shots just as he saw them, and he was usually right.

Politics were important to Terry, and he was as conservative as they come. Yet his jovial nature and unique sense of humor endeared him to his legislative colleagues on both sides of the aisle. His funeral was attended by as many Democrats as Republicans – one last testament to the bipartisan nature of his engaging personality.

Gov. Barbour told the Clarion Ledger that he knew Terry since the Fordice administration, that he was one of his most faithful supporters, and that Terry supported him even in times “when maybe his own inclination was not the same as mine.”

Terry was one of the most loyal people I knew. He was loyal to Gov. Barbour, loyal to Lt. Gov. Reeves, loyal to friends, and most of all, loyal to his constituents back home. He’s a big reason why Columbus has had so much economic development success in recent years, including major employers like PACCAR, Airbus, and Severstal.

One of my favorite stories about Terry was told during his funeral. Lt. Gov. Reeves recalled that Terry helped him on the campaign trail several years ago. One day they were speaking at a Republican women’s club, and Terry introduce the candidate as follows:

“Now listen here. They made a mistake in letting you women vote, but as long as you’re going to vote, I hope you’ll pick my man Tate Reeves for Treasurer.”

It reminds me of what Gov. Barbour said: Terry could be “so impolitic, but was always fun and funny. And if he thought of something and it was politically incorrect, he didn’t let that stop him from expressing it.”

Terry was a skilled legislator who was respected by his peers in both legislative chambers. He made friends easily, was liked by all, and was an institution unto himself.

Terry’s legislative seat will be filled and his position in the Senate will be taken. But Terry Brown – the man, the legislative legend, the legacy – will never be replaced.

Wednesday, September 3, 2014

A few positives in a sea of negativity

*First appeared in the Laurel Chronicle newspaper on September 3, 2014

It’s hard to watch the news without observing a local tragedy, an international crisis or, as of late, both. The constant barrage of negativity does a number to my psyche and, I imagine, yours. The world’s on fire, they say, and we’re starting to believe them.

More often than not, the steady stream of bad news is a byproduct of the phenomenon of 24-hours news coverage. Frantic car chase in a city 500 miles from you? Stay tuned; we have details on the suspect’s sweater vest. Infectious virus located on an isolated island? Stay tuned; we’ll give you thirteen ways your neighbor may be infected.

I don’t often watch the talking heads, but only because I doubt I’ll hear news that isn’t designed to push a certain agenda. (If left unchecked, my cynicism gets the best of me.)

But cynics aren’t part of the solution to any problems. The endless news cycles may drown us in information, but at least we’re (probably) more informed at the end of the reports. An informed citizenry is a powerful one, so in some ways keeping up with the goings-on of local, national, and international events is a civic responsibility.

That being said, today I have no desire to impart with you any snotty political jokes, no tales of tragedy, no problem to analyze. I’ll simply remind you about a few positive things happening in the Magnolia State. This is what you might call a classic “feel good” piece.

Last week, it was reported that Mississippi women fared pretty doggone well in a new study on women’s equality. WalletHub found that 25 percent more women hold a bachelor’s degree, making us the state with the highest education gap tilted toward women. In our state, women tend to live, on average, about 20 percent longer than men, which is another piece of good news (for half of us, anyway).

Mississippi’s ranking on the “education and health” component was top of the nation. That’s great news, ladies.

A Gallup poll measuring well-being recently found that Mississippi was among the top eleven states that had made the steadiest improvement in this area since 2010, when the recession officially ended. Gallup measured things like emotional health, work environment, and life evaluation. In other words, we’re happier.

The Tax Foundation observed in a recent study that the real value of $100 in Mississippi, where we enjoy lower cost-of-living than elsewhere, is about $115. This means we can buy more stuff with a Benjamin than those unfortunate dwellers of other states. Wonder if those Labor Day sales are still ongoing?

Good news isn’t just at the statewide level; in fact, Jones County had its own flavor of a positive (and historic) event last week. The South Jones Braves football team saw its female field goal kicker, Mary Kate Smith, perform flawlessly in her first game with the team. Even this former Northeast Jones Tiger thinks that’s pretty cool.

Speaking of tigers, I’m reminded of the baby boom going on at the Jackson Zoo. In 2014 alone, the zoo has welcomed a new Sumatran tiger cub, a baby springbok (similar to a gazelle); a beaver kit; red wolf cubs; red river hog piglets; and even a baby orangutan.

There’s nothing more feel good than the birth of baby animals, so I had to throw that in there, guys. Come on. No laughing.

Is this column a bit silly? For sure. But perhaps it will give you something positive to think on next time you watch a missile soar across the cable television.