American Anesthesiology Residency Programs: Website Usability Analysis.

BACKGROUND: The Association of American Medical Colleges has recently issued recommendations for the upcoming 2022-2023 application cycle that residency programs should conduct all interviews for this upcoming application cycle over the web. In light of these recommendations, many students will have limited exposure to anesthesiology programs and will rely on information gleaned digitally. This change means that the aspects of program websites used to provide information, such as size, structure, location, requirements, and contact information, will be crucial in helping prospective residents decide where and how to apply in the future. An evaluation of website usability, which includes initial appearance along with factors that influence its ease of navigation and convenience of use, can thus be applied to anesthesiology residency websites. Areas of need can be targeted to increase web presence and provide effective pathways to exhibit the different attributes of their programs to future applicants. OBJECTIVE: This study aimed to compile a list of US anesthesiology residency programs and their websites while objectively analyzing the websites using a formally published usability scoring system, as well as to identify positive and negative trends to offer areas of improvement among anesthesiology residency websites. METHODS: We included only 114 US anesthesiology residency program websites in our sample set, since some websites we analyzed showed errors or inconclusive. Website usability was separated into 4 distinct categories for analysis based on methodology outlined in previous literature on both health care website usability and residency website usability. The 4 categories were Accessibility, Marketing, Content Quality, and Technology. Each website was then analyzed and scored based on key components highlighted within the 4 categories. The multiple factors were then graded using a percentage system to create a comprehensive score for each program. RESULTS: The highest scoring category was Content Quality (mean 4.7, SD 2.48, SE 0.23). The lowest scoring category was Technology (mean 0.9, SD 0.38, SE 0.04). CONCLUSIONS: Through the application of a health care website usability framework, multiple anesthesiology residency programs were analyzed and scored in the areas of Accessibility, Marketing, Content Quality, and Technology, which allowed us to determine the effectiveness of the usability of these websites to convey information to their end user. Websites must communicate vital information, with usability at the forefront, to continue to grow, especially as the United States faces challenges due to the COVID-19 pandemic. Our recommendation is that anesthesiology programs should strive to improve website usability to increase the ease by which applicants can collect vital information about anesthesiology programs. A few proposed solutions include making changes such as decreasing error pages on websites, migrating away from using in-line cascading style sheets, and improving web page loading speeds to improve the Technology category.

Influence of ICU Surge and Capacity on COVID Mortality Across U.S. States and Regions During the COVID-19 Pandemic.

BACKGROUND: To describe the influence of COVID-19 caseload surges and overall capacity in the intensive care unit (ICU) on mortality among US population and census divisions. METHODS: A retrospective analysis of the national COVID ActNow database between January 1, 2021 until March 1, 2022. The main outcome used was COVID-19 weekly mortality rates, which were calculated and incorporated into several generalized estimation of effects models with predictor variables that included ICU bed capacity, as well as ICU capacity used by COVID cases while adjusting for ratios of vaccinations in populations, case density, and percentage of the population over the age of 65. RESULTS: Each 1% increase in general ICU capacity is correlated with approximately 5 more weekly deaths from COVID-19 per 100,000 population and each percentage increase in the number of patients with COVID-19 admitted to the ICU resulted in approximately 10 more COVID-19 deaths per week per 100,000 population. Significant differences in ability to handle caseload surges were observed across US census divisions. CONCLUSIONS: A strong association was observed between COVID-19 ICU surges, overall ICU surge, and increased mortality. Further research is needed to reveal best practices and public health measures to prevent ICU overcrowding amidst future pandemics and disaster responses.

Correction: The Story of #GetMePPE and GetUsPPE.org to Mobilize Health Care Response to COVID-19 : Rapidly Deploying Digital Tools for Better Health Care.

[This corrects the article DOI: 10.2196/20469.].

SAFER framework for moving forward on the medical device right to repair

Across various industries, the right to repair (RTR) movement has gained momentum as more than 20 states have proposed RTR laws to expand access to repair of consumer products. Medical device equipment shortages during the COVID-19 pandemic demonstrated that stronger repair mechanisms are necessary for the US health system to become more efficient, affordable and sustainable. We propose a 5-point SAFER framework including safety and security, adaptability, fiscal, environmental and regulatory factors for consideration in implementing medical device RTR. The healthcare community can help advance RTR legislation in a manner that serves our patients and healthcare system best.

Opioid Use Disorder Education for Students and the Future of Opioid Overdose Treatment.

Opioid use disorder (OUD) is a major public health concern in the United States. The opioid crisis has taken hundreds of thousands of lives in the past 20 years, and it is predicted to take millions more. With the rising death tolls, it is essential that health care providers are able to use proper tools to treat OUD efficiently and effectively through medication-assisted treatment (MAT), particularly buprenorphine. Despite changes to buprenorphine regulations making it more accessible, clinicians have been slow to use buprenorphine to treat OUD. We believe that training student clinicians in evidence-based MAT and buprenorphine practices will address the training and competence barriers that hinder clinicians from prescribing buprenorphine to treat OUD. Students are in an ideal position to receive and benefit from this training and influence the medical community to better treat OUD.

A Software Package and Data Set for the Personal Protective Equipment Matching Problem During COVID-19

During the COVID-19 pandemic, Get Us PPE provided a platform aimed at connecting prospective donors of personal protective equipment (PPE) to prospective recipients of PPE. Requests by donors and recipients were collected over time, and periodically, the PPE matching problem was solved in order to instruct each donor to ship a certain quantity of PPE to a given recipient. The objectives of the PPE matching problem include maximizing the recipients' fill rate, minimizing the total shipping distance, minimizing the holding time of PPE, and minimizing the number of shipments of each donor. This paper presents a software framework to facilitate the development of methodologies to solve the PPE matching problem and their testing on a real-world data set collected by Get Us PPE during the COVID-19 pandemic. Both software and data set are available on GitHub.

Looking back on forward-looking COVID models.

Covid Act Now (CAN) developed an epidemiological model that takes various non-pharmaceutical interventions (NPIs) into account and predicts viral spread and subsequent health outcomes. In this study, the projections of the model developed by CAN were back-tested against real-world data, and it was found that the model consistently overestimated hospitalizations and deaths by 25%-100% and 70%-170%, respectively, due in part to an underestimation of the efficacy of NPIs. Other COVID models were also back-tested against historical data, and it was found that all models generally captured the potential magnitude and directionality of the pandemic in the short term. There are limitations to epidemiological models, but understanding these limitations enables these models to be utilized as tools for data-driven decision-making in viral outbreaks. Further, it can be valuable to have multiple, independently developed models to mitigate the inaccuracies of or to correct for the incorrect assumptions made by a particular model.

Get Us PPE: A Self-Organizing Platform Ecosystem for Supply Chain Optimization during COVID-19

The COVID-19 pandemic caused a global health emergency that triggered an acute shortage of Personal Protective Equipment (PPE), putting essential healthcare workers at risk. Starting March 2020, given the skyrocketing prices of PPE in the open market, healthcare institutions were confronted with the dire need to reshape their PPE procurement strategy. One avenue that financially constrained healthcare institutions pursued were donation platforms that offered access to donated PPE by individuals and organizations. We document a real-life case study of one of the most prominent donor platforms that emerged during this period: Get Us PPE. From 20 March 2020 to 2 July 2021, Get Us PPE received 23,001 total individual requests for PPE from every US state and some US territories. In response to these 23,001 requests, Get Us PPE delivered 17,540,571 units of PPE. The number of PPE units delivered was still less than 25% of the total units of PPE requested, indicating the enormity of the PPE shortage. Using this case study, we identify key supply chain issues that manifest during emergencies and highlight the formation of a platform ecosystem to resolve these issues. We also observed a robust supply chain network design that addresses key supply chain sustainability metrics such as minimizing material waste and transportation miles, while balancing other stakeholder factors such as donor and recipient characteristics as well as shipment complexity. We argue that the roadmap followed by Get Us PPE could serve as a template for organizations that emerge in the context of future humanitarian crises.

Get waivered remote: Nationwide, remote DEA-x waiver course in response to COVID-19.

PROBLEM: As of 2020, less than 5% of physicians in the United States have a drug enforcement administration-X waiver to prescribe buprenorphine. The coronavirus-2019 pandemic restricted in-person gatherings, including traditional drug enforcement administration-X waiver courses. As a result, in-person conferences have needed to adopt remote formats. Many programs identified a gap between educational delivery and the faculty skills required to deliver content remotely. APPROACH: To address the need for high-quality remote learning, Get Waivered designed and implemented a novel experience for clinicians, called Get Waivered Remote. An educational session was live-streamed via Zoom™. To foster interactivity, like in-person didactic conferences, participants were polled to facilitate discussion among presenters, learners, and facilitators during the broadcast. OUTCOMES: The RE-AIM framework was used for evaluation. Our program had a Reach encompassing 814 users that participated during the live-streamed event; Effectiveness with 73.79% reporting being somewhat familiar or very familiar with the practice of opioid dependency treatment with approved buprenorphine medications; Adoption with 95.15% reporting a favorable experience and 92.23% reporting it was similar or more enjoyable than their usual teaching; Implementation with 450 messages sent by 281 users to engage with presenters and other learners via Zoom chat in real time. NEXT STEPS: Get Waivered Remote provides a proof-of-concept that a broadcast with a concurrent, interactive remote learning platform is feasible, low cost, and simple to execute. Further study is required to assess the ability of our group to maintain this innovation and also to measure its impact on the treatment of opioid use disorder.

Website usability analysis of United States emergency medicine residencies.

OBJECTIVES: The Council of Residency Directors (CORD) in Emergency Medicine (EM) has recommended that all residency programs should conduct virtual interviews for the 2020 to 2021 application cycle due to the COVID-19 pandemic. While factors such as geographical region, city, program size, or hospital affiliation are not modifiable, EM residencies can bridge the information gap created by a lack of face-to-face interaction by representing themselves digitally. Measuring usability provides an objective method for EM residencies to improve their Web presence and effectively represent themselves to applicants. METHODS: Our sample set included 55 U.S. EM residency program websites. Using methodology replicated from previous literature on health care website usability, we divided usability into four categories for quantifiable analysis: accessibility, marketing, content quality, and technology. Analysis was performed on each website and scored in all four categories. A "general usability" score was calculated for each website using a composite of the key factors within the four categories. Using a weighted percentage across all of the factors, an overall score was calculated. RESULTS: Content quality was the overall highest scoring category (mean ± SD = 5.4, SE = 0.33). The overall lowest performing category was technology (mean ± SD = 0.8 ± 0.09, SE = 0.01). CONCLUSIONS: Measuring usability can help EM residency programs identify ways to improve their Web presence. To effectively promote their programs, residencies need quality content that communicates their key features. Our recommendation is for all residency programs to periodically perform website audits and apply the usability measures outlined to improve their digital presence, especially during times when face-to-face interactions will be limited.

Algorithmic matching of personal protective equipment donations with healthcare facilities during the COVID-19 pandemic.

GetUsPPE.org has built a centralized platform to facilitate matches for PPE donations, with an active role in matching donors with the appropriate recipients. A manual match process was limited by volunteer hours, thus we developed an open-access matching algorithm using a linear programming-based transportation model. From April 14, 2020 to April 27, 2020, the algorithm was used to match 83,136 items of PPE to 135 healthcare facilities in need across the United States with a median of 214.3 miles traveled, 100% of available donations matched, met the full quantity of requested PPE for 67% of recipients matched, and with 46% matches under 30 miles traveled. Compared with the period April 1, 2020 to April 13, 2020, when PPE matching was manual, the algorithm resulted in a 280% increase in matches/day. This publicly available automated algorithm could be deployed in future situations when the healthcare supply chain is insufficient.

Digital triage: Novel strategies for population health management in response to the COVID-19 pandemic.

The COVID-19 pandemic has created unique challenges for the U.S. healthcare system due to the staggering mismatch between healthcare system capacity and patient demand. The healthcare industry has been a relatively slow adopter of digital innovation due to the conventional belief that humans need to be at the center of healthcare delivery tasks. However, in the setting of the COVID-19 pandemic, artificial intelligence (AI) may be used to carry out specific tasks such as pre-hospital triage and enable clinicians to deliver care at scale. Recognizing that the majority of COVID-19 cases are mild and do not require hospitalization, Partners HealthCare (now Mass General Brigham) implemented a digitally-automated pre-hospital triage solution to direct patients to the appropriate care setting before they showed up at the emergency department and clinics, which would otherwise consume resources, expose other patients and staff to potential viral transmission, and further exacerbate supply-and-demand mismatching. Although the use of AI has been well-established in other industries to optimize supply and demand matching, the introduction of AI to perform tasks remotely that were traditionally performed in-person by clinical staff represents a significant milestone in healthcare operations strategy.