NCMS Morning Rounds 6-6-19

Welcome to your Thursday

NCMS Morning Rounds.

June 6, 2019

Reaching Those at Risk for Hepatitis A

The North Carolina Department of Health and Human Services (NCDHHS) has prioritized reaching patients at risk for hepatitis A infection, particularly those in the state-operated Alcohol and Drug Abuse Treatment Centers.

Hepatitis A is a vaccine-preventable viral infection, and those at highest risk include people who use injection or non-injection drugs, individuals experiencing homelessness and men who have sex with men. The virus also is spread through ingestion of or contact with an object contaminated with stool from an infected person, contaminated food or water that was prepared by an infected person or not cooked thoroughly, personal contact, and sexual contact.

The Department’s Division of Public Health and Division of State-Operated Healthcare Facilities wants to raise awareness about hepatitis A outbreaks occurring in North Carolina and nationally, and to increase vaccination for people with a high risk for infection.

The Centers for Disease Control and Prevention (CDC) reports more than 17,000 cases of hepatitis A have been identified nationwide since 2016 and at least 170 deaths have resulted from infection. An increase in the spread of cases through person-to-person contact was first noted in North Carolina in 2018. Since then, 76 cases had been linked to the infection in 21 counties statewide, with 72 percent of those infected requiring hospitalization.

“The best way to prevent hepatitis A is through vaccination,” said State Epidemiologist Zack Moore, MD. “We’ve seen how devastating these outbreaks have been in other states, and North Carolina has the unique opportunity to prevent a large-scale outbreak here by reaching those who are at the highest risk for hepatitis A.”

Vaccination programs, such as the one implemented in the state-operated facilities, are highly effective and have the potential to reach large populations of North Carolinians who are at risk of infection. Since hepatitis A vaccine was not recommended as a routine childhood vaccine in all states until after 2005, many adults, including those at high risk due to drug use, are not vaccinated. Many of these susceptible individuals present to health care facilities to seek treatment for alcohol or drug use disorder.

Learn more about N.C. Immunization Programs.

June is National Safety Month

Throughout June, the National Safety Council works to raise awareness of and reduce the causes of injury and death at work, on the road and in our homes and communities. This year the National Safety Month focus is on hazard recognition, slips, trips and falls and fatigue and impairment.
The Council offers free downloadable resources highlighting a different safety topic for each week in the month as well as ideas for activities for your staff and patients to educate them on safe habits. Learn more and access the resources.

NC Internists Visit DC

A group representing the North Carolina Chapter/American College of Physicians (ACP) visited Capitol Hill on May 15, as part of the ACP’s annual two-day legislative advocacy conference. The group participated in issue briefings, heard remarks by members of Congress and spent a day on Capitol Hill. The group visited the office of each North Carolina member of the Senate and House to address issues, including:

  • Prior Authorization, Step Therapy and Administrative Burdens
    • High Cost of Prescription Drugs
    • Insurance Market Stabilization
    • Public Consequences of Firearms
    • Funding for Programs Such as the National Health Service Corps and the CDC
    • Title X Funding
    • Medical Education and Training Debt
    • Medicare Advanced Payment Model (APMs) Incentives

Attendees included four residents and two medical students: T. Rupert Ainsley, MD, First Health Physician Group, Sanford; Laila Awny, MD, Mission Health, Marion; Vahini Chundi, MD, Resident Physician, Moses Cone Hospital, Greensboro; Justin Helberg, MD, Resident Physician, Moses Cone Hospital, Greensboro; Lacy Hobgood, MD, Governor-Elect, NC Chapter, ACP, ECU/Brody School of Medicine, Greenville; Brooks Keene, MD, Resident Physician, Carolinas Medical Center, Charlotte; Rita Kuwahara, MD, Resident Physician, Emory, Durham; Peter Lichstein, MD, Governor, NC Chapter, ACP, WFU School of Medicine, Winston-Salem; Vanessa Lukas, Medical Student, WFU School of Medicine, Winston-Salem; Marion McCrary, MD, Novant Health, Durham; Alexander Melvin, DO, Resident Physician, Moses Cone Hospital, Greensboro; Shaleen Thakur, Medical Student, WFU School of Medicine, Winston-Salem; W. Alan Skipper, CAE, Senior Executive Director, NC Chapter, ACP.

In the News

The White Coat: A ‘Defining Symbol’ or Threat to Patient Health?, The Advisory Board Forum, 5-30-19

Learning Opportunity

Registration for the NC Institute of Medicine’s (NCIOM) 2019 Annual Meeting opens on June 24, so mark your calendar to register then for the meeting, which will be held on Sept. 5 in Raleigh. The meeting will focus on the state’s Medicaid transformation, and will bring together stakeholders from across health care, consumer advocacy, public health, social services and other sectors to address the many questions about what this new system will look like. Discussion topics will include the Healthy Opportunities Pilots, the NCCARE360 resource platform, navigating the transition, monitoring, oversight, evaluation and special populations, as well presentations by representatives from each of the Medicaid Prepaid Health Plans. Learn more.


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