Washtenaw County Influenza Surveillance – 1/31/2014

Reports of confirmed influenza in Washtenaw County are decreasing. Locally, Washtenaw peaked during the week ending January 4th. Influenza A/H1N1 is still the dominant strain this season, with a few cases of influenza A/H3 and B reported as well.

Please see the local flu curve:


Hospitalizations and Deaths: Flu-related hospitalizations in Washtenaw residents are down. Influenza A has been detected in all hospitalized patients, with H1N1 the only subtype found. Average length of stay for patients who have been discharged is 4.7 days (range 1 to 16 days). For individuals where vaccine status is known, 38% were appropriately vaccinated. Almost all adults who were hospitalized had at least one underlying high-risk health condition, including an obesity rate of 44% (compared to a 26% obesity rate for Washtenaw County adults overall – HIP Survey 2010).

Hospitalizations and Deaths in Washtenaw Residents with Confirmed Influenza:

Total Hospitalizations (starting Sept 29, 2013): 85

Total ICU Admissions: 27%

Hospitalizations Week of 1/19 – 1/25/14: 3

Child Deaths* (0 – 17 years): 0

Adult Deaths* (18 years and older): 3

Washtenaw County Public Health still has flu vaccine available for all ages. Please call (734) 544-6700 for an appointment.

For local influenza information: http://www.ewashtenaw.org/flu

For Michigan influenza information: http://www.michigan.gov/flu

For national information: http://www.cdc.gov/flu

Jeffrey S. Kutcher, MD, to Speak at General Session on March 12, 2014

Dr. Jeffrey Kutcher is a sports neurologist in the Department of Neurology at the University of Michigan. He is the Director of Michigan NeuroSport, the university’s academic sports neurology program, where he oversees clinical care, education, and research activities. This academic year, his NeuroSport program began training the first fellow in sports neurology in the United States.

Dr. Kutcher is also a team physician for the University of Michigan and the USA Hockey National Team Developmental Program. He is also the Director of the National Basketball Association’s concussion program, Neurology Consultant to the US Ski and Snowboard Association, and has helped develop the concussion policies of the NCAA, as well as several college athletic programs and conferences. He co-led the effort to create the Sports Neurology section of the American Academy of Neurology and served as the section’s first chair.

Dr. Kutcher will speak on neurosport, head trauma and the connection between concussions and cognitive decline. The General Session will be held at the Ann Arbor City Club and is open to the general public. The evening will start at 6:00 p.m., and dinner will be served at 6:45 p.m. Dr. Kutcher will speak at 7:30 p.m. There is no charge for dinner for active WCMS members. There will be a $35 charge for retired members, non-members and guests wishing to attend the dinner. For reservations, please call the Society Office at 734-668-6241, or email the office as wcms@msms.org.

UMHS to Accept More Affordable Care Act Plans

ANN ARBOR, Mich. — Only weeks into the New Year, the first people covered under new Affordable Care Act insurance plans have begun to come to the University of Michigan Health System’s hospitals and health centers for appointments and procedures.

UMHS accepts most of the plans offered to individuals and small businesses on the private Marketplace, including those bought through http://www.healthcare.gov.

On Feb. 1, UMHS will begin to accept even more: specifically, a group of plans offered to individuals and businesses by the McLaren Health Plan.

For the full lists of individual and business plans UMHS accepts, see http://www.uofmhealth.org/ACAplans


Just before New Year’s Eve, the federal government approved the state of Michigan’s plan for expanding Medicaid – called the Healthy Michigan plan.

The effort to enroll people who are now eligible for Medicaid under new expanded income criteria will soon begin. In addition to those who will qualify for the first time, it’s expected that more people who were eligible for traditional Medicaid but hadn’t previously enrolled may also enroll.

Charity care & county health plans:

Patients who had received MSupport charity care from UMHS are getting assistance in transitioning to low-cost private plans or will receive assistance in signing up for expanded Medicaid. MSupport will continue for individuals who don’t qualify for either.

The Washtenaw Health Plan, and other county-sponsored plans around the state, are assisting many of their members in transitioning. The plans will remain in operation to serve those who don’t qualify for ACA-related insurance.

Enrollment help from UMHS available to all:

Any patient, visitor or community member can get help in enrolling in a private or Medicaid plan from UMHS Patient Financial Counselors by calling (877) 326-9155 between 9 a.m. and 8 p.m. Monday-Friday or emailing PFC-Counselors@med.umich.edu.

Walk-in help is available at several locations around the U-M medical campus and health centers.

The UMHS Regional Alliance for Healthy Schools (RAHS) also has several trained counselors available to offer by-appointment help. Call 734-998-5795 between 8 a.m. and 4 p.m. Monday-Friday, or email UMHS-RAHS@umich.edu.

A group of more than 60 U-M students trained in talking with members of the public has been assisting with outreach to people who have sought free care from U-M providers through the Hope Clinic and Student Run Free Clinic, as well as others. This outreach effort, organized through the Washtenaw Health Initiative which is partly supported by UMHS, will continue.

Key Affordable Care Act dates and deadlines:

Jan. 1 – People who signed up for private plan coverage by Dec. 24 had coverage beginning this date.

Jan. 15 – People who sign up for a private plan by this date – including those who signed up after Dec. 25 — will have coverage beginning Feb. 1.

Feb. 15 – People who sign up for a private plan by this date will have coverage beginning March 1.

March – Enrollment in Healthy Michigan (expanded Medicaid) plans is expected to begin.

March 15 – People who sign up for a private plan by this date will have coverage beginning April 1.

March 31 – Open enrollment ends for private individual/family plans on the Marketplace; coverage will begin May 1.

March 31 is also the deadline for all Americans to meet the requirement of having health insurance for all or most of 2014. Most people who don’t meet this deadline will have to pay a fee on top of their income taxes in early 2015.

April – Coverage under Healthy Michigan (expanded Medicaid) plans is expected to begin.

All year – Someone who has a qualifying life event (such as the birth of a baby or marriage) can enroll in a Marketplace plan, or change plans, even when open enrollment is closed.

WCMS Externship Scholarship Program Now Accepting Applications From Students and Mentors

The WCMS Externship Scholarship Program is now accepting applications for scholarships, as well as looking for WCMS members interested in mentoring undergraduate students, and businesses interested in donating funds to support the scholarships. The program is targeted toward undergraduate students interested in a career in medicine. Applications will also be accepted for students interested in other health care fields such as nursing, pharmacy, physician assistant, and psychology. Preferential selection will be given to students who are Washtenaw County residents, but other counties will be considered.

Anyone interested in the program, whether as an applicant, mentor, or donor, should contact the Society Office at 734-668-6241.

WCMS Externship Scholarship Program:

Goal: The goal of the WCMS Externship Scholarship is to provide volunteers exposure for undergraduate students interested in medicine. The secondary goals are to provide physicians the opportunity to mentor students and to promote the WCMS in the community.

Target Population: The preferred applicant is an undergraduate student interested in a career in medicine. Preferential selection will be given for those students that are Washtenaw County residents. Applications will be accepted for students interested in other health care fields such as nursing, pharmacy, physician assistant, and psychology as well as from other counties.

Target Mentors: Mentors are practicing physicians and a Washtenaw County Medical Society Member. Locations may be an office, clinic or facility provided appropriate patient privacy documents and any other employee resource needs are met. Mentors that are not practicing physicians and a Washtenaw County Medical Society Member will be considered on an individual basis.

Target Donors: Donations are targeted from any business or individual interested in supporting the scholarship.

Application process:
The undergraduate student must have completed one semester of college prior to applying to the WCMS scholarship program. The application is a current resume or curriculum vitae and a letter stating the applicant’s goals in healthcare addressed to the wcmsexternship@gmail.com. The acceptable applicants will then have an interview and be placed with appropriate mentors. The acceptable student will sign the “Volunteer Externship Agreement”.

The mentor will provide a curriculum vitae and a one page letter addressed to wcmsexternship@gmail.com stating the proposed role of the extern in their practice and how many externs they would like to mentor. Acceptable mentors will sign the “Externship Subscription Agreement”.

Evaluation process:
The externs will have an exit interview with an evaluation sheet. http://www.surveymonkey.com/s/29J3BZB Mentors will have an exit interview with an evaluation sheet. http://www.surveymonkey.com/s/YGQ2FSB

A letter of recommendation will then be made for the extern and the extern will receive a stipend for educational purposes.

MSMS Makes Online Submissions Available for 2014 HOD Resolutions

The Michigan State Medical Society (MSMS) is now accepting resolutions for the 2014 House of Delegates online. All resolutions must be submitted to MSMS by March 1, 2014. To submit your resolution, please click on: http://www.msms.org/AM/Template.cfm?Section=Home&Template=/Customsource/HOD/resolutions.cfm

Instructions on how to write a resolution can be found at:

WCMS members are encouraged to go thru the Society for support and endorsement prior to submission. If you would like to have your resolution on the WCMS Executive Council February 6th Agenda, please submit to the Society Office by Wednesday, February 5, by 5:00 p.m.

AMA/RAND Study on Factors Affecting Physician Satisfaction

The results of a study commisioned by the American Medical Association and put out by the RAND Corporation on factors affecting physician performance, were released October 9, 2013. The study examined physicians’ perceptions of the quality of care, use of electronic health records (EHRs), practice organization, and overall physician satisfaction. One of the key findings of the study was that while physicians see promise in EHRs, they are often frustrated by EHRs due to concerns about interoperability of systems and the amount of physician time devoted to data entry. 43 percent of physicians surveyed reported that using the EHR slowed them down while providing clinical care, while more than 33 percent felt that EHR use interfered with communication between physicians and patients during visits. However, 54 percent of physicians reported that an EHR improves communication between doctors and patients outside the clinical visit, and 61 percent reported that an EHR can lead to care improvement. The recommendations of the RAND study included changing the meaningful use program to incease flexibility among providers and create incentives for EHR vendors to make their products more user-friendly.


Influenza Cases Continue to Rise

Health officials are reporting a rapid increase in the number of individuals seeking treatment for flu. Over 63 area residents have been hospitalized, with two adult deaths. Thirty of those hospitalizations have occurred in the last two weeks, and many hospitalized patients are younger adults. The vaccination status of all hospitalized patients is not known; however, in the cases where it is known, most are unvaccinated. Area health officials are strongly encouraging everyone six months or older to seek seasonal flu vaccination if they have not already.

“Seasonal activity has more than doubled over the past few weeks, as many more are coming to St. Joe’s physician offices, urgent care centers and emergency departments with flu-like symptoms,” says Dr. Anurag Malani, Medical Director, Infection Prevention & Control, Saint Joseph Mercy Health System.

Most confirmed cases have the H1N1 strain, which is included in the current seasonal vaccine. Seasonal flu vaccine is widely available throughout the area. While it can take up to two weeks after vaccination for an individual to build his or her immunity, vaccination can still provide protection this flu season. Rates of illness will likely increase as school and normal activities resume this week.

“People think that if they are young and healthy, they can just deal with the flu. Unfortunately, that isn’t always true. This year’s flu is hitting the 18-59 year old group particularly hard, just as it did in 2009. Fortunately, this time around we have a good vaccine. I urge everyone who can to get it,” says Dr. Alice Penrose, MD, MPH, Medical Director for Washtenaw County Public Health.

The University of Michigan Health System has also reported a sharp uptick in flu activity among younger patients. U-M Health System issued a statement on Jan 3 citing more than a dozen patients in intensive care with severe flu-related illness, encouraging vaccination and restricting hospital visitors (http://www.uofmhealth.org/news/archive/201401/flu).

WCMS 2013 4th Quarter Bulletin Published

4th Quarter 2013 Bulletin

Washtenaw County Flu Activity, January 2014

Influenza reports continue to increase in Washtenaw County residents. Influenza A is dominant so far this season, with A/H1N1 subtyped in the majority of cases. A few influenza B cases have been diagnosed. Respiratory illness rates in schools and child care centers are low.

Hospitalizations associated with influenza infection are climbing quickly. The age range of hospitalizations in Washtenaw residents to date is 13 to 81 years, with almost half under the age of 50 (this is typical for A/H1N1).

Influenza-Associated Hospitalizations and Deaths
in Washtenaw Residents: 2013-14*

Total Hospitalizations: 39

Hospitalizations Week ending Dec 28: 16

Total adult deaths: 0

Total child deaths: 0

*Flu Season starting Sept 29, 2013