The Science Of Campus Reopening: Can Testing Students Work?

The Science Of Campus Reopening: Can Testing Students Work?

Testing is a key weapon in the fight against COVID on campus. The students combined their love of science with their passion for space. Parents and teachers agree this is not what leaders presented when they proposed reopening schools. Many in Pinellas are complaining. We know the pandemic has forced “innovation” (read “telehealth”) in all of health care and especially in behavioral health. But as I have said, the reactive move to telehealth in itself is not innovation (see Innovation Does Not Stop With Telehealth). The 15- to 20-year lag between the development of a new and effective practice—and its common use at the community level—persists. As we look ahead and look beyond “video visits,” the question is how much and how will the consumer get services? What are the constraining factors? There is one big factor—the technology on both the consumer and organizational sides of the equation. We got a glimpse into the strides and the gaps in technology in a national survey (see The New Role Of Virtual Care In Behavioral Health) of more than 1,000 behavioral health care executives and staff conducted by Qualifacts and the National Council For Behavioral Health. The survey confirmed the dramatic spike in telehealth use by most provider organizations that had no other option to keep their doors open. Pre-pandemic, only 2% of organizations were providing 80% or more of their care virtually but today 60% of organizations are providing 80% or more virtual care. Post-pandemic, only 8% of provider organization executives expect their organizations to deliver more than 80% of care virtually, while the majority (43%) say virtual will constitute 40% to 60% of their overall service delivery. It’s also interesting that organizations with fewer than 100 employees tended to adopt virtual care at a higher percentage than larger ones. The consumer challenges On the consumer side of the equation, consumer use of telehealth rose from 11% in 2019 to 46% during the pandemic and 76% of consumers are “interested” in telehealth moving forward (see Telehealth: A Quarter-Trillion-Dollar Post-COVID-19 Reality?). However, in this new survey, community behavioral health provider organizations reported concerns about consumers not having the right technology and not being able to understand and use the technology even if it is available. Poor connectivity, lack of Internet access, and difficulty understanding technology were rated as the top three consumer challenges, from their perspective. The provider organization and staff challenges Only 26% of clinical staff that were surveyed reported that they “preferred” to deliver service virtually. They expressed the need for consumer engagement solutions to enhance care between sessions. And 47% of clinical staff are concerned about maintaining connections with peers and supervisors in a virtual care environment. This is consistent with the overall U.S. workforce. Even pre-pandemic, remote workers said their greatest challenges were collaboration and communication, and loneliness (see The 2020 State Of Remote Work). And six months of lockdowns and isolation have exacerbated the situation. Complicating the long-term use of virtual care are differences in executives’ and clinical professionals’ views of their technology capabilities and needs. There is agreement on the key requisites—a comprehensive telehealth platform, consumer engagement solutions to enhance care between sessions, telephonic interventions, consumer portals, and staff engagement sessions. But there is a divergence in how they perceive their electronic health record (EHR) system. Managers had a higher level of confidence (64%) in their EHR’s ability to support virtual care. But only 44% of staff felt the same way. Why the disconnect? One possible explanation is that while legacy EHRs are functional—allowing for service delivery, billing, and collections—workflows have not been reengineered for virtual care, resulting in inefficiencies for clinical staff. As we look ahead, what are the takeaways for the many executives of specialty provider organizations looking to make virtual service delivery an integral part of their long-term recovery strategy? On the consumer side, provider organizations will have to figure out how to assure consumer access to technology and how to engage consumers in a more virtual service landscape. For those consumers without the tools and bandwidth to participate in virtual care and remote monitoring, it is likely that provider organizations in value-based arrangements (with enough financial risk) will provide that technology. But even with “connection,” the bigger issue is finding the best practice engagement strategies that yield a return on investment. There is no doubt that engaged consumers have better health status and use fewer unnecessary health care resources (see Wellness Services & Consumer Engagement and Health Plans Invest In Consumer Engagement). The question is how much should health plans and their preferred provider organizations invest in engagement. On the clinical service side, taking a look at virtual service workflows will be critical (see Successfully Integrate Telehealth Into Your Clinical Workflow and New Service Lines, New Measures). And, assuming organizations will have a greater proportion of staff members being totally remote, supervision practices will need to be enhanced along with models for clinical team collaborations. If we are going to make the shift to virtual service delivery a permanent one, rethinking how work gets done and how it is managed is critical. For more on optimizing virtual care delivery at your organization, check out these resources in The OPEN MINDS Industry Library and our special-interest online communities: And for even more, join us at The 2020 OPEN MINDS Management Best Practices Institute. In the session Virtual Health: How To Expand Access & Build A Seamless Consumer Experience on August 24 at 2:30 pm EDT, you’ll learn how provider organizations are leveraging technology to create a personalized experience that helps consumers find and access the care they need, at the time and place that’s right for them. Three executives—Diego Garza, vice president of strategy and innovation and director of telehealth, MindPath Care Centers; George Kolodner, founder and medical director, Kolmac Outpatient Recovery; and Shawn Brooks, executive director, special projects, Centerstone will discuss adapting workflow processes for scheduling; obtaining consumer consent; and emergency intervention and communications between provider organizations, consumers, and schedulers. Tagged As: Source link

A man gets tested for COVID-19 with nasal swab. (Photo by Barry Chin/The Boston Globe via Getty … [+] Images)

An annual tradition is about to be disrupted. In a normal year, colleges and universities across the country would be welcoming first-year students and witnessing the return of hundreds of thousands of undergraduates. Due to Covid-19, this year approximately 30% of North American institutions will offer only or primarily remote online instruction. The remaining are engaged in a task that has not been attempted in a hundred years: reopening campus in the midst of a raging pandemic.

A key weapon in the fight against Covid-19 on campus is campus testing.

Most of the testing for SARS-CoV-2 in the United States has been done by commercial laboratories and public health departments. However, having the relevant expertise and facilities in-house, many colleges and universities have developed their own testing programs. 

The goals of such programs are at least two-fold. First, testing can be used for surveillance. In surveillance, the goal is to provide a reliable estimate of the amount of transmission in a community so that campus leaders can make informed decisions. Second, testing can be used for containment. With containment, the goal is to mitigate transmission by identifying infected individuals — particularly asymptomatic infections, which cannot otherwise be detected — so that they may be isolated.

Some of these programs are quite ambitious, seeking to test as many as 10,000 people per day. Because such large campus-wide testing programs have never been attempted before, there is no empirical evidence about how well they work. In the absence of direct empirical information, mathematical models are sometimes used to marshall the available indirect evidence and make predictions. The accuracy of such predictions depends greatly on how well calibrated they are and, of course, calibration requires data. 

One such model was developed by Yale professor David Paltiel and his colleagues and published on July 31 in the open access journal JAMA Network Open. The model was built for a medium-sized college (around 5000 students) and divides the campus population into three “pools”: a group that are engaged in regular campus activities and are also subject to regular testing, an isolated group of people who have tested positive, and the group that has either recovered from infection (and assumed therefore to be immune) or died.

The model is built using standard techniques from mathematical epidemiology, using variables to represent the incubation period, transmissibility of the pathogen, time to recovery, and other details. A Google Spreadsheet allows anyone to manipulate these assumptions of the model.

Structure of the Yale model of SARS-CoV-2 transmission on a college campus.

The transmission part of the model is relatively standard. What is most interesting are two features missing from most other models.

First, the authors consider that tests are not perfect. Particularly, future tests are likely to be less sensitive (more prone to false negatives), but much cheaper. Maybe it’s possible to make up for a poor test by testing more frequently and still come out ahead both economically and epidemiologically.

Second, the authors looked at the cost-benefit tradeoff for testing at different intensities and considered societal “willingness-to-pay” to prevent the loss of lives to determine the cost-effectiveness of various testing programs. 

Because of the high level of uncertainty about what on-campus transmission will look like, Paltiel and colleagues studied three different scenarios: an intermediate “base case”, a pessimistic “worst case”, and an optimistic “best case”. In all these cases they found very frequent testing to be cost effective. That is, given what people are generally willing to pay to secure their health and well being, to be consistent, they should also be willing to pay for testing. In my view, their base case is pretty realistic. For this case, the economically optimal testing program is to test everyone every two days at a total cost of about $2.5 million yielding a cost per case averted of about $500.

Some of their other findings are also relevant to university leaders seeking to welcome students back to campus in the coming weeks. Under no circumstances were the authors able to find a scenario where symptom-based screening alone would be sufficient to contain transmission. This includes their “best case” scenario that assumed the effective reproduction number could be kept below 1.5 through other non-pharmaceutical interventions like social distancing and wearing masks. Another potential problem is that deploying so many tests will inevitably generate false positive results. These will eventually be weeded out through subsequent testing, but in the meantime there will be the need to provide isolation facilities, which could overwhelm housing capacity.

Testing everyone every two days is a tremendous undertaking and few universities are actually attempting it. The University of Illinois is one of the rare ones, with a massive testing program made possible by a saliva-based test that they developed.

It is also possible that the Paltiel study overstates the problem. A related commentary by Elizabeth Bradley and colleagues, based on their study of Vassar College, suggests that the effective reproduction number can be reduced to just 1.25 using inexpensive interventions like social distancing and mask wearing, contact-tracing, and other strategies. If this is the case, containment may be achieved by testing students just once a month, which seems much more feasible.

That colleges and universities may generally assume such a low reproduction rate — even with intensively promoted and widely adopted non-pharmaceutical interventions like face masks and reduced student density in classrooms — seems to me to be doubtful. Rather, what is more likely is a significant amount of Covid-19 on campus in the months to come.

Full coverage and live updates on the Coronavirus

Source: www.forbes.com

Author: John Drake


Five Carthage College students work with NASA, win $10,000 for tech invention

Five Carthage College students work with NASA, win $10,000 for tech invention

It always goes back to a high school science teacher.

At least that’s what Carthage College physics major Celestine Anada said. And her classmates and research colleagues, Taylor Peterson and Cassi Bossong, couldn’t agree more.

“My high school physics teacher was just a phenomenal scientist and teacher as well, and he really got me to fall in love with physics and what you can do with it, and it kind of just grew from there,” Anada said. 

Each student ultimately joined the Carthage College Space Sciences program, an undergraduate research effort funded through the Wisconsin Space Grant Consortium.

The program has about 10 students working on various projects. Students filter in and out, always transferring what they learned to new recruits so projects can continue.

With two other Carthage students, Bennet Bartel and Nick Bartel, the group decided to refine what’s known as the modal propellant gauging device that Carthage has been working on with NASA since 2011. Instead of focusing just on rockets, they decided to take the device to a different level: aircraft. 

“The motor propelling gauging device is a robust and reliable technique to measure liquid in stationary and sloshing vessels using acoustics,” Peterson said. “For motor propelling gauging, or MPG, all we need are a few sensors to adhere outside of the tank so going inside of the tank doesn’t have to happen. It is far more efficient and lightweight.” 

Their new idea is not only efficient and cost-saving, but it is also a winner. Their invention recently won the MIT-Lemelson “Move It” award for $10,000. 

The MIT-Lemelson award honors collegiate inventors around the country and is open to teams of undergraduate students or individual graduate students who have technology-based inventions pertaining to a significant sector of the economy: health care; food/water and agriculture; transportation and mobility; and consumer devices and products. 

The team’s device, which aims to improve the safety of air and space travel, provides “real-time fuel gauging for aircraft, expanding the original method used for spacecraft developed by their faculty adviser and colleagues at NASA,” the MIT-Lemelson website says. 

Since most traditional fuel gauging methods penetrate the walls of the tank and need to be inside, a lot of weight is added to the aircraft and therefore, there is a chance for leakage. 

The team was not expecting to win.

“We are a small, liberal arts school with less than 10,000 people and most schools that win it are bigger schools that you always hear about on the news for science and engineering, so it’s crazy,” Bossong said. 

“I was kind of in disbelief,” said Peterson, who was in one of her classes when she got the congratulatory email. “There were a lot of applicants and top schools, it kind of felt unreal and all the hard work definitely paid off.” 

As for what the team will use the $10,000 for is still undecided.

Bossong’s love of space “started when I was five years old, when my grandparents took me to the U.S. Space and Rocket Center in Alabama,” she said. “That’s where I fell in love with space and stars and all of that crazy stuff.” 

When she went to high school, her inspiration was further solidified.

“I had a really amazing physics teacher who kind of just sealed the deal for me and made me want to pursue a career in space,” Bossong said. 

For Peterson, after having a great physics teacher in high school, it was only natural to continue her path in the field of science. 

“I decided to make physics my major and I came into Carthage wanting to do astrophysics, but then when I found out about these projects. I joined as soon as I could and kind of found love for aerospace and engineering,” Peterson said. 

Though the pandemic has put minor bumps in the road for how the team will continue its work, Bossong said it is nothing they can’t get past as they have special permission to be on Carthage’s campus with protocols in place to continue their work. 

Source: www.jsonline.com


Online, in-person students will share a teacher. ‘I don’t see how it can work.'

Online, in-person students will share a teacher. ‘I don’t see how it can work.’

Laura Gibson faces a teaching dilemma, times two, this fall.

Worried about her ailing mother in Tennessee, Gibson asked the Pinellas County school district to let her teach virtual classes only, so she could tend to her family on a moment’s notice if needed. She was denied.

Instead, Gibson returned to Thurgood Marshall Fundamental Middle in St. Petersburg, where she learned that half of her sixth-graders will attend each period online, and half in person. It’s an arrangement that, in many ways, represents the least feasible teaching option she might have imagined.

“I’m not quite sure how I will be able to be an effective teacher,” said Gibson, whose husband has encouraged her to leave. “I don’t see how, practically and realistically, it can work.”

She is far from alone.

Teachers and parents have inundated Pinellas School Board members with complaints that the combining of virtual and face-to-face students was not what the district promised when it rolled out its reopening model. The Hillsborough and Pasco school districts are encountering similar concerns. But with less extensive plans for what’s being termed “simultaneous teaching,” those districts have not seen the reaction Pinellas is getting.

“The way it was presented to teachers and parents was, it was going to be in-person or online,” said Laura McCrary, whose son will begin his junior year at Countryside High. “My son has autism. … How is he going to get (his accommodations) met in MyPCS Online when the teacher has got to pay attention to the students in the classroom?”

Mary Ellen Shaffer, whose daughter attends Mildred Helms Elementary, said parents were told that kids who took the virtual learning option would have a dedicated teacher.

“My concern is that the priority, and rightly so, would go be children that are live and right in front of you,” said Shaffer, who sits on the Largo school’s PTA board. She worried the model will be difficult for students at home, and stressful for teachers who are asked to do so much this fall.

Kevin Hendrick, the school district’s chief academic officer, acknowledged the situation is far from ideal.

“Nothing that we are doing is optimal,” Hendrick said, noting how the spread of COVID-19 has thrown the “usual” out the door.

Unlike past years, health and safety take increased precedence over everything else, he said. That meant rethinking teaching assignments from the original proposal that separated online and in-person classes.

“The best way to keep our schools open and keep our employees safe … is to have the fewest number of students in the classroom at one time,” Hendrick explained.

Schools were given the option of how to organize their offerings. Some, such as Safety Harbor Middle, worked to keep their classes distinct as much as possible.

Many others reviewed their teaching rosters and student enrollment plans, and decided to go with the simultaneous approach.

Hendrick used Campbell Park Elementary’s first-grade sections as one example, showing how the school-based team considered several options before settling on one that allowed a new teacher to have only face-to-face students while the others split their load.

The district included five pages of ideas for simultaneous teaching in its MyPCS Online teacher guide. For technology and direct instruction, it says, “think simple.”

That means sitting in front of the computer with the camera on, projecting any materials both on the screen and in the classroom. Small groups can chat together while the teacher works with others, Hendrick said.

The guide also stresses using Canvas, the district’s new learning management system, as the place for running classes, making and receiving assignments, and other tasks. That would be a goal even without the online component, Hendrick said, as the schools aim to make coursework more accessible to all students. Who knows when COVID-19 might force them home, too?

In all, he said he expected the model to work as teachers and students become comfortable with it.

Gibson, the sixth-grade teacher, had her concerns, though. She wondered how she could pay adequate attention to students in two places at one time, noting it’s hard enough to manage a classroom. And she has gifted students.

She also questioned how her students would be able to hear one another, much less collaborate, in the setup. And she observed that her in-person students won’t have computers available to them, unlike their peers at home.

“The practical aspects of this have not been explained to anyone,” Gibson said.

Nor does the arrangement jibe with teachers’ memorandum of understanding with the district, Pinellas Classroom Teachers Association president Nancy Velardi said.

“They did say at the table that perhaps occasionally this might happen as a very rare occurrence where there is only one teacher to teach a subject,” Velardi said. “Now they’re giving it to everybody. This is certainly not what we discussed.”

She suggested that parents, students and teachers should be upset with the change. “I think everybody is getting shortchanged.”

The union hasn’t taken any formal action, Velardi said, instead waiting to see if the administration alters its course.

“If we have to, we will do a class action grievance or lawsuit,” she said.

The situation isn’t as dire in Hillsborough County, where everyone is still trying to figure out what course schedules look like. But Hillsborough Classroom Teachers Association executive director Stephanie Baxter-Jenkins said she anticipated the issue might arise there, too, in time.

“It is not easy to do both,” Baxter-Jenkins said. “We want it to be in very limited circumstances. But I don’t think that’s going to be what’s going to happen.”

Pasco County schools, meanwhile, are trying to keep simultaneous teaching to a minimum, district spokesman Steve Hegarty said. Where possible, he added, the district has adopted new technology to make it more accessible.

It’s called Swivl, and is being used primarily in career-technical classes. Supervisor Lori Romano said the district has tested the system, which uses multiple microphones and a camera that follows the teacher using GPS trackers, and found it simple to use, with easy ability for communicating with all students.

Pasco bought 237 units for career-technical teachers, and another 70 for International Baccalaureate, Advanced Placement and Cambridge instructors. So far, Romano said, teachers have largely welcomed it.

That’s not readily available in Pinellas.

McCrary, whose son attends Countryside High, said she believed Pinellas officials took the lazy way out by allowing for the simultaneous teaching, rather than trying other approaches. At first, she said, it upset her.

But she decided not to get too angry, especially at the people inside her son’s school.

“The state has caused this mess,” she said. “I don’t think parents should blame teachers or administrators. … Everybody’s plate is full.”

Source: www.tampabay.com

Author: Jeffrey S. SolochekEducation reporter


Source: pressboxonline.com


Making The Virtual Care Shift Work — It’s All About The Technology

Making The Virtual Care Shift Work — It’s All About The Technology

We know the pandemic has forced “innovation” (read “telehealth”) in all of health care and especially in behavioral health. But as I have said, the reactive move to telehealth in itself is not innovation (see Innovation Does Not Stop With Telehealth). The 15- to 20-year lag between the development of a new and effective practice—and its common use at the community level—persists. As we look ahead and look beyond “video visits,” the question is how much and how will the consumer get services? What are the constraining factors? There is one big factor—the technology on both the consumer and organizational sides of the equation.

We got a glimpse into the strides and the gaps in technology in a national survey (see The New Role Of Virtual Care In Behavioral Health) of more than 1,000 behavioral health care executives and staff conducted by Qualifacts and the National Council For Behavioral Health. The survey confirmed the dramatic spike in telehealth use by most provider organizations that had no other option to keep their doors open. Pre-pandemic, only 2% of organizations were providing 80% or more of their care virtually but today 60% of organizations are providing 80% or more virtual care. Post-pandemic, only 8% of provider organization executives expect their organizations to deliver more than 80% of care virtually, while the majority (43%) say virtual will constitute 40% to 60% of their overall service delivery. It’s also interesting that organizations with fewer than 100 employees tended to adopt virtual care at a higher percentage than larger ones.

The consumer challenges

On the consumer side of the equation, consumer use of telehealth rose from 11% in 2019 to 46% during the pandemic and 76% of consumers are “interested” in telehealth moving forward (see Telehealth: A Quarter-Trillion-Dollar Post-COVID-19 Reality?). However, in this new survey, community behavioral health provider organizations reported concerns about consumers not having the right technology and not being able to understand and use the technology even if it is available. Poor connectivity, lack of Internet access, and difficulty understanding technology were rated as the top three consumer challenges, from their perspective.

The provider organization and staff challenges

Only 26% of clinical staff that were surveyed reported that they “preferred” to deliver service virtually. They expressed the need for consumer engagement solutions to enhance care between sessions. And 47% of clinical staff are concerned about maintaining connections with peers and supervisors in a virtual care environment. This is consistent with the overall U.S. workforce. Even pre-pandemic, remote workers said their greatest challenges were collaboration and communication, and loneliness (see The 2020 State Of Remote Work). And six months of lockdowns and isolation have exacerbated the situation.

Complicating the long-term use of virtual care are differences in executives’ and clinical professionals’ views of their technology capabilities and needs. There is agreement on the key requisites—a comprehensive telehealth platform, consumer engagement solutions to enhance care between sessions, telephonic interventions, consumer portals, and staff engagement sessions. But there is a divergence in how they perceive their electronic health record (EHR) system. Managers had a higher level of confidence (64%) in their EHR’s ability to support virtual care. But only 44% of staff felt the same way. Why the disconnect? One possible explanation is that while legacy EHRs are functional—allowing for service delivery, billing, and collections—workflows have not been reengineered for virtual care, resulting in inefficiencies for clinical staff.

As we look ahead, what are the takeaways for the many executives of specialty provider organizations looking to make virtual service delivery an integral part of their long-term recovery strategy? On the consumer side, provider organizations will have to figure out how to assure consumer access to technology and how to engage consumers in a more virtual service landscape.

For those consumers without the tools and bandwidth to participate in virtual care and remote monitoring, it is likely that provider organizations in value-based arrangements (with enough financial risk) will provide that technology. But even with “connection,” the bigger issue is finding the best practice engagement strategies that yield a return on investment. There is no doubt that engaged consumers have better health status and use fewer unnecessary health care resources (see Wellness Services & Consumer Engagement  and Health Plans Invest In Consumer Engagement). The question is how much should health plans and their preferred provider organizations invest in engagement.

On the clinical service side, taking a look at virtual service workflows will be critical (see Successfully Integrate Telehealth Into Your Clinical Workflow and New Service Lines, New Measures). And, assuming organizations will have a greater proportion of staff members being totally remote, supervision practices will need to be enhanced along with models for clinical team collaborations. If we are going to make the shift to virtual service delivery a permanent one, rethinking how work gets done and how it is managed is critical.

For more on optimizing virtual care delivery at your organization, check out these resources in The OPEN MINDS Industry Library and our special-interest online communities:

And for even more, join us at The 2020 OPEN MINDS Management Best Practices Institute. In the session Virtual Health: How To Expand Access & Build A Seamless Consumer Experience on August 24 at 2:30 pm EDT, you’ll learn how provider organizations are leveraging technology to create a personalized experience that helps consumers find and access the care they need, at the time and place that’s right for them. Three executives—Diego Garza, vice president of strategy and innovation and director of telehealth, MindPath Care Centers; George Kolodner, founder and medical director, Kolmac Outpatient Recovery; and Shawn Brooks, executive director, special projects, Centerstone will discuss adapting workflow processes for scheduling; obtaining consumer consent; and emergency intervention and communications between provider organizations, consumers, and schedulers.

Source: newsfortomorrow.com

Author: News Master


The Science Of Campus Reopening: Can Testing Students Work?


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