Improving the Lives of Dialysis Patients in Rural Clinics

Nephrology is the subspecialty of internal medicine that focuses on the diagnosis and treatment of kidney diseases. And, like many other medical specialties, it’s facing a critical shortage of providers for a variety of reasons:

  • COVID-19 infections have increased the amount of kidney injuries in as many as 43% of patients in some hospitals, which in turn increases the demand for dialysis.
  • The increased demand has pushed providers and staff to their limits, resulting in even higher than usual turnover rates.
  • Dialysis specialists require extensive training and technical skills that can take months to learn.
  • Nephrologists and kidney specialists are increasingly located in urban areas, making it hard for people in rural settings to access them.

In Guatemala, there are over 230 patients receiving dialysis treatment in decentralized clinics located more than 200 kilometers away from the capital. These clinics are located in the municipalities of Cobán, Morales, and Zacapa and are more than three hours away from each other.

The clinics are staffed with technical assistants, nurses, and one internist on-site – but not enough specialists. Nephrologist Dr. Weynin Sierra is one nephrologist who travels weekly between the three clinics, spending several hours traveling. When the subject of using Hippo Virtual Care™ was broached, Dr. Sierra was eager to try it.

“Using the Hippo Virtual Care headset and platform will save us time, because right now, moving from one unit to another takes us 3-4 hours. This will help save us time, gasoline, and will allow us to expand our clinics,” he said.

Using Hippo Virtual Care, Dr. Sierra is able to conduct visits remotely by connecting with Dr. Byron Hernandez, an internist in Cobán who wears the hands-free voice-enabled headset during a patient examination, paired with our HIPAA-compliant virtual care software. Unlike traditional telehealth, Hippo Virtual Care provides a “U see what I see” perspective to the observer, as well as remote control functionality to orient the camera, allowing remote physicians to conduct an exam as if they were physically in the room.

For 30 minutes, Dr. Sierra is able to supervise the internist’s rounds – seeing, hearing, and speaking to his patients who are in a clinic 3-4 hours away – and deliver instructions to Dr. Hernandez in real time.

“Now that I was able to experience using the headset and the software … well, it really fulfills all my expectations. It’s an innovative system. It allows us to be with our patients in real time. It feels like you’re right there in the room with them."

By incorporating next-generation virtual care into clinical practice, patients in rural areas like the decentralized clinics in Guatemala can more easily access the specialist care they need. Hippo is bringing a new dimension to telenephrology, allowing complex care to reach patients even when they’re far away from clinical specialists.

Learn more about Hippo Virtual Care™ and how it can save your team time, money, and increase the quality of care you give to your patients.

5G Telemedicine & Medical Training

The need for virtual care to service rural and remote locations is growing at a rapid rate around the world – even more so during the pandemic. The Royal Dutch Shell Hospital in Port Harcourt, Nigeria is revolutionizing both the healthcare delivery and teaching experience of its patients, clinicians, faculty, and students in sub-Saharan Africa by leveraging several of Hippo’s virtual care solutions.

What was implemented

Hippo Virtual Medical Education™
While teaching in clinical practice inevitably occurs during rounding, consultations, and proctoring, it is also critical prior to caring for patients, especially for sub-specialty care such as neurology or neuroscience. Using Hippo’s voice-activated hands-free headset, faculty are able to teach important processes and procedures which can then be incorporated during patient care.

Hippo Virtual Consultation™
Attending clinicians are being supported remotely by specialists as they assess and provide direct care for patients in the hospital and in outpatient clinic settings. Hippo provides a unique “you are there” perspective which enables complete physical examination and interview, and direct viewing of devices, vital signs and laboratory results.

Hippo Virtual Rounding™
Inpatients are being remotely assessed by a senior physician on a routine basis to support clinicians at the bedside. This is especially critical when it comes to post-operative care or with critically ill patients. Students are also participating in virtual rounding – an essential part of the clinical learning process.

Hippo Virtual Proctoring™
Essential clinical skills and capabilities are being evaluated and assessed in real time using Hippo Virtual Proctoring, which ensures quality and safety. This practical assessment and teaching function is critical for developing new skills and for refreshing those skills which are used infrequently.

Hippo for First Responders™
Clinicians in an ambulance or mobile unit are receiving “as needed” clinical guidance from a physician in the emergency room enabling more rapid and accurate diagnosis and treatment in the field.

Key benefits

Location independence is delivering significant time and cost savings due to decreased travel time, a reduction in appointment delays/cancellations and decreased risk of contracting or spreading communicable diseases.

A superior remote learning experience is providing a “through the eyes of the clinician” viewpoint and immediate clinical feedback.

Students are demonstrating competency in skills and procedures, and receiving real-time guidance and feedback from clinical experts.

Hands-free, voice-activated, lightweight device allows faculty to lecture remotely to one or more students. Students are receiving discrete instructions and guidance from proctors to enhance performance through internal speakers.

Continuous communication is enabling faculty to receive and respond to students’ questions in real time through internal loudspeakers and digital microphones with noise cancellation.

Clinicians are able to view patient medical records or evidence-based guidelines on micro-display without turning away from the patient and without visual field constraint.

Avoiding crowded patient rooms is helping to deliver a superior patient and provider experience and increased safety.

Hippo Virtual Care is enabling the delivery of specialty services in a variety of diverse settings – in the community or in the home.

Technology becomes transformational if it’s used to solve problems. We must leverage Virtual Care platforms such as Hippo to democratize access to good quality healthcare around the world.

RNZ Global is a Healthcare Service Provider. Their services include establishment of Centres of Excellence for the care of patients with neurosurgical diseases (RNZ Neurosciences); Hospital Development, Operations and Management; Healthcare Innovation — Digital and Virtual Care; Health Education and Training; Distributorship of Innovative Healthcare Products; and Healthcare Manufacturing. They are at the forefront of revolutionizing healthcare in sub-Saharan Africa through using emerging and established technological advancements in medicine.

Hippo Tech Device Gives Podiatry Students a Live Clinical Experience in the Classroom

Closing the Gap

Barry University’s School of Podiatric Medicine has added an exciting innovative technological tool to its instruction toolbox to implement remote patient care learning.

The school is now using the Hippo virtual care device in our “Intro to Patient Care course in the Freshman Year”. Hippo is voice-activated, hands-free, and resembles goggles. It brings streaming doctor-patient visits from clinics to the classroom for a real-time clinical experience. 

It allows healthcare providers and educators to bridge the gap between physical and virtual care. Due to the limitations of meeting in-person during the COVID-19 pandemic, remote healthcare and learning became an essential part of growing and connecting as students and medical professionals. 

“The practice of medicine is ever-changing. Here at Barry University School of Podiatric Medicine, we are up to date with the latest technology to address this new world’s challenges.” Professor Dr. Rodriguez-Anaya explains. Due to limitations of meeting face-to-face, Barry recruited doctors to create educational videos. With the device, students can see patients in real-time as if they were in the clinic. The doctor can be heard through the device and the student can ask questions. Hippo offers students a physician’s point-of-view.

“Hippo technology allows us to continue our clinical education experience and expand into areas that we were not allowed before,” she says.

“The Hippo technology will enable us to stream doctor-patient visits to our classrooms, for real-time clinical experience for our first-year students. Beyond further elevating the cutting-edge educational experience for our students, we anticipate utilizing Hippo on medical mission trips, connecting underserved communities with our world-class providers.”

There are many additional perks to using Hippo that may not be immediately apparent, including community-building. Azariya McClendon, class of 2024, believes “Hippo will also help students early in their medical school career build long-lasting professional relationships with surrounding physicians.”

Shane Massey, also class of 2024, observes that the tool deepens opportunities for understanding curriculum. “Applying our learning to real life situations makes our educational experience less about simply passing classes and more about learning the skills and techniques necessary to becoming great physicians.” Alexis Mugno, who is a second year resident in the field at Jackson North, says these real world experiences will enrich “young student-doctor’s education and bedside manner.”

Patients need not worry, either. Hippo is HIPPA compliant and safe for users and patients. It’s linked to a secure stream that is password-protected and securely tied to one user.

Sheena Cherukara, who will graduate in 2024, says of the device, “I have a great feeling that this will heighten the field of podiatric medicine in the long run for many of us students, professors, and health care professionals.”

Barry University is a university founded in 1940 in Miami Shores, Florida. The university offers more than 100 degree programs in six schools and two colleges, including the Barry University School of Podiatric Medicine, one of only nine podiatric medical schools in the United States.

The Ugly Truth about Artificial Sweeteners

“Sugar pie honey bunch, you know that I love you,” is how the song “Can’t Help Myself” by The Four Tops begins. The singers were talking about their sweetie – a person – but many of us with a sweet tooth have a similar love for sugary treats. In recent years, sweets have become “less sugary” with the help of artificial sweeteners, but is this actually better for your health?

Artificial sweeteners – aspartame, sucralose, stevia, and others – are commonly used in diet sodas, processed treats, candies, cookies, coffee drinks, and more. Anything labeled “diet” or “low sugar” has typically swapped regular sugar for an artificial sweetener. Though this might make the nutrition label seem healthier (less grams of sugar, less calories, etc.), artificial sugar has been consistently connected to poor health outcomes.

The most significant health issues tied to artificial sweeteners have to do with weight, blood sugar, and cardiovascular health. For starters, many public health officials have linked the obesity epidemic in the US with the popularity of diet colas. Unfortunately, the use of the word “diet” in the name of these sodas is a misnomer: artificial sugars have actually been connected to weight gain, rather than weight loss. Moreover, artificial sweeteners impair the body’s metabolism processes to the point that some experts consider them obesogens, or chemicals that enhance fat build-up in the body and contribute to obesity.

Similar to the detriments related to weight, artificial sugars also disrupt blood sugar levels. Two in particular, saccharin and sucralose, peaked blood sugar levels, as compared to other artificial sugars, as discovered in a 2022 study. The consumption of artificial sweeteners is also tied to the rapidly increasing rate of Type 2 Diabetes in the US.

Finally, a recent study in the British Medical Journal outlined the impact of artificial sweeteners on heart health. Regular intake of artificial sweeteners was connected to a 9% increase in risk of cardiovascular disease, and an 18% increase in risk of a stroke. As cardiovascular disease is the leading cause of death in the US, it’s imperative that we take the effects of these sweeteners more seriously if we want to see our individual and collective health improve.  

So, what can you eat, and what should you avoid? Below we’ve outlined the main artificial sweeteners you’ll find in your food, and which ones you should avoid, which to have in moderation, and which to use!



1. Aspartame

Aspartame is the most commonly used artificial sweetener, accounting for 60% of artificial sweetener usage in the US. Notably, it has been connected to a marked increase in the risk of stroke, upwards of 15%. Moreover, one review has connected aspartame intake to an increased risk of developing Type 2 diabetes, depression and other mood disorders, and neurodegenerative disorders (Alzheimer’s, Parkinson’s, and more).

2. Sucralose

Sucralose is found in Splenda. Similar to aspartame, sucralose consumption runs the risk of diabetes, weight gain, and cardiovascular disease. It has also been linked to the development of IBS and Crohn’s disease; it’s hypothesized that this is due to its negative effects on the gut microbiome. It is also unclear how sucralose may break down if cooked at high temperatures; some believe it generates potentially cancerous compounds when heated.

3. Saccharin

Again, saccharin enhances the risk of diabetes, weight gain, and heart disease. Specifically, however, saccharin has also been connected to renal (kidney) impairment, as well as decreased liver function. A 2019 study concluded it was unsafe to include in a human diet.

4. Acesulfame Potassium

Unsurprisingly, regularly consuming acesulfame potassium runs the risk of developing heart disease, Type 2 diabetes, and obesity. In particular, it has been connected to negative impacts on the gut microbiome, which is necessary for maintaining a healthy weight and good mental health. Acesulfame potassium is also known as Ace-K or Acesulfame K.

5. High Fructose Corn Syrup

High-fructose corn syrup (HFCS) is an artificial sugar made from corn syrup. There is mounting evidence that HFCS is contributing to our obesity crisis. Not to mention that HFCS is linked to diabetes, heart disease and other health issues.

Dr. Robert Lustig, a well-known neuroendocrinologist at the University of California San Francisco, is on a crusade to change health policy about the dangers of HCFS. This famous lecture was viewed over 24M times (5X by me…)


In Moderation:

1. Regular sugar! In the form of cane sugar, agave, & honey

What should you opt for instead? Regular sugar! High sugar intake is still linked to issues like weight gain, diabetes, and heart disease; however, our bodies have evolved to consume regular glucose from natural sources in small amounts. If you’re looking to sweeten your coffee or tea, stir in a touch of honey or agave. When baking, use regular cane sugar, instead of trying to cut corners with one of the highly processed artificial sugars mentioned above.

Moderation with sugar is the keyword here and keep in mind that adding a few extra calories with regular sugar instead of the “zero calorie” artificial substitute is actually better for your health. In any case, aim to stay below the World Health Organization’s recommendation of 25 grams of sugar per day.


Healthier Options:

1. Stevia

Stevia is considered a natural sweetener, as it’s made from the leaves of certain flowers as opposed to being chemically synthesized. It is 200 times sweeter than sugar – less is more when it comes to Stevia. It was commonly used in South American and Asian countries years before it became popular in the US. You can purchase Stevia in liquid or powder form at the grocery store.

2. Monk Fruit

Monk fruit, also known as luo han guo, is another popular natural sweetener. It comes from the luo han guo plant, and like Stevia, it is 100-200 times sweeter than cane sugar. It has no impact on blood sugar levels, and to date, there aren’t any known negative impacts to health. You can purchase monk fruit at the grocery store or online in liquid, powder, or granule forms to supplement sugar or artificial sweetener use.

3. Allulose

Allulose is also naturally sourced, as it’s the sugar found in maple syrup, raisins, figs, and molasses. Unlike Stevia and monk fruit, it’s about 70% as sweet as sugar. It’s low in calories, and has no effect on blood sugar levels. Allulose can be harder to find at the grocery store, so try your local health foods store or Amazon to add it to your pantry.

When in doubt: ditch the artificial sweeteners, have regular sugar in moderation, and replace your artificial sugars with natural options. In any case, aim to have sweet treats – naturally sweetened or not – in moderation, and limit processed foods (even if they use natural sweeteners) when you can. Opting for natural sweeteners and balancing your sugar intake is a fantastic way to improve your health in the short and long term!

Blue Zones and the Keys to Healthy Longevity

Occasionally on the news, you’ll see a headline about a woman who lived to 112, or perhaps someone in your county who just hit their 100th birthday. But what if there were whole communities of people who lived to 100 and beyond? What if becoming a centenarian was the norm in your town, rather than the exception?

That’s precisely the case in Blue Zones, a name for areas where people regularly live to be one hundred years old. Blue Zones were originally identified by two gerontologists, Gianni Pes and Michel Poulain. They noticed that certain parts of Sardinia in Italy had extremely high concentrations of men who lived to be 100 – the highest in the world, actually. Then they began to find other areas with similarly high numbers of 100 year-olds, and termed these areas “Blue Zones.”

Blue Zones are found across the world. The most well documented regions include: Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece; and Loma Linda, California.

So what makes a Blue Zone a Blue Zone, apart from the concentration of elderly folks? Researchers found similar qualities amongst these Blue Zones. And in this blog, we’ll share these secrets, with tips on how to bring these traits into your own life.

1. Move regularly in your daily schedule

People in Blue Zones aren’t healthier because they go to the gym for 90 minutes each day or complete triathlons. Instead, movement is a normal part of their day. Whether that’s walking to the store, a family member’s house or community center, movement is bound into the fabric of their life.

Oftentimes, people in Blue Zones also have gardens that they tend to by hand, rather than opting for machines or other conveniences that decrease the exercise of the work.

How can you embody this trait of Blue Zones? Consider things like…

  • Walking your dog a few times / day
  • Biking to nearby stores instead of driving
  • Starting a garden to grow your own fruits and veggies

2. Prioritize belonging and your loved ones

In each of these communities, members have been able to establish a sense of purpose. It goes by different names in each culture, but the meaning remains the same: these centenarians have been able to find a purpose that motivates them to get up each day.

If you feel unsure about your purpose, consider the following questions:

  • When do I feel the most lit up and happy in my day-to-day life?
  • What gives me the greatest sense of fulfillment each week?
  • How can I better prioritize these things in my daily life?

When finding your purpose, allow yourself to follow the things that bring you a natural sense of contentment or joy. For some people, this is work related, for others, it has to do with family. Prioritize your fulfillment and see the purpose that unfolds in front of you.

3. Learn to manage your stress

Yes, 100 year-olds experience stress, too. Stress is universal to the human experience. The difference in Blue Zones, however, is that people have practices bound into their daily routines to decrease stress.

For instance, those in Okinawa take a few minutes to honor their ancestors. Those in Ikaria take a midday nap. Sardinians opt for a glass of wine in the afternoon. All of these activities minimize stress that’s built up in the day.

Consider your own daily schedule: How do you manage stress? What do you do each day to minimize it? If you don’t have anything you do each day, think about…

  • Adding 5-10 minutes of reflection, meditation or prayer
  • Starting a yoga or stretching practice
  • Giving yourself permission to take a nap!
  • Calling a friend to catch up

Find what de-stresses you and add it into your daily routine.

4. Follow the 80% rule

People in Blue Zones typically follow eating patterns that set them up for long-term health. For instance, they often follow the 80% rule: the idea that you should stop eating once you’re 80% full. Often, it can take our bodies time to register the amount of food ingested and can delay the process of telling us when we’re “full.” Stopping at 80% ensures you don’t overeat.

Additionally, the smallest meal is at dinner time – likely before it. This is contradictory to the US, where dinner is often the biggest meal of the day.

Try out the 80% meal for yourself and aim to have a larger lunch and a smaller dinner!

5. Favor plants in your diet

Blue Zone diets typically are high in legumes – AKA beans. The fiber content and protein of beans provides plant-based nutrition. You should increase your intake of beans to once per day or at minimum, a few times per week, to embody a Blue Zone diet.

Additionally, there isn’t a high meat intake in Blue Zones. Typically, meat is only eaten five times per month in average portions.

Takeaways? Eat more beans and plants, and less meat to emulate a centenarian’s diet.

6. Drink moderately

People in Blue Zones do in fact drink alcohol, and frequently! However, they limit it to 1-2 glasses at a time, and it’s typically social. They’ll have a glass of wine with friends or family over dinner, and binge drinking isn’t a result.

If you do drink, keep it light, and aim for higher quality alcohol. Sardinian Cannonau wine could be the next glass you order with dinner!

7. Prioritize belonging and your loved ones

The majority of centenarians felt belonging with a larger group – typically a faith-based organization that they were involved with weekly. Additionally, they prioritized their families, keeping their elders in the house or nearby as they aged. Most typically, they also had a committed life partner, and spent ample time with their family.

The main tip here? Make time for the people and groups that matter in your life. The sense of love, belonging, and fulfillment that can come from relationships transcends all aspects of health and wellness. It’s what serves as the cornerstone of the human experience, and people in Blue Zones honor that.

If you follow these tips, perhaps you’ll live to be 100. Even if you don’t, your quality of life, sense of inner peace, and overall health will certainly increase. Choose a few of these to implement this week and see how your mental and physical health transforms.

Hippo Virtual Care Making A Difference to Wound Care at Michigan Medicine

At Hippo, we’re always looking to highlight innovative people in the healthcare community. We recently sat down with Dr. Alton R. Johnson, Jr. to talk about his role as a current Fellowship Innovator in the 2023 “Research | Innovation | Scholarship | Education” (RISE) program at the University of Michigan and to discuss how Hippo Virtual Care has helped Dr. Johnson achieve his goals for the program.


Meet Dr. Johnson

Dr. Johnson, DPM, FACPM, FASPS, CWSP, is a Clinical Assistant Professor, Podiatrist, Podiatric Surgeon, and Wound Care Specialist at the University of Michigan Medical School in Ann Arbor, Mich. He is one of 10 current 2023 RISE Fellowship Innovators. He loves a lot of things about his job, but there’s one thing in particular that brings him great satisfaction: “There is nothing more gratifying than healing a patient that has a chronic wound. The physical, psychological, and financial burden that comes with caring for a chronic wound cannot be qualified, so my goal is to heal these wounds as soon as possible.”


What is RISE?

The purpose of RISE is to innovate education for better health. Per their website: “RISE aspires to create a Michigan Medicine culture where bold, scalable education innovations impact health and science, and thrive through collaboration and access to a broad, diverse network of resources, expertise, and stakeholders.”

The RISE program, Dr. Johnson explained, is exclusive to Michigan Medicine. They guide the selected innovators for the 12-month calendar year to develop and implement a health science education idea that will impact science, health, and/or healthcare. “Throughout the year, we meet monthly to learn and implement innovation strategies, translational education, and pedagogical principles,” he shared.


Dr. Johnson’s involvement in RISE

After applying and interviewing for the RISE program in the fall of 2022, Dr. Johnson was accepted into the third RISE cohort in January 2023. The proposed project, he explained, is creating “workflows” for podiatric and wound care-related pathologies, procedures, and surgeries to aid with active learning of medical students and residents. “Once I have developed templates oriented for podiatric medicine and wound care, the goal is to execute the ‘workflows’ using augmented reality (AR) during medical education and clinical experiences.”

The project’s secondary goal is to aid with the enhancement of educational experiences of visiting nurses that use real-time evaluation, management, and assessment of homebound wound care patients.

Hippo’s role in RISE

Throughout 2023, Dr. Johnson will utilize the Hippo Virtual Care voice-activated headset and platform to develop and execute his novel innovation ideas. “I am in the piloting stages and will be publishing the findings soon,” he said. “The feedback from users and patients has been overwhelmingly positive so far, mainly in the areas of accuracy, focused evaluation, and patient assessment.”

Dr. Johnson said that Hippo’s device and proprietary software has boosted the confidence of the residents and fellows that utilize it for patient workups, which has translated to more meaningful patient care experiences.

We asked Dr. Johnson to share what he liked best about Hippo Virtual Care, and he responded, “My favorite thing is that it’s HIPAA-compliant, which puts both providers and nursing staff at ease when it comes to protecting patient-sensitive information.”


Future uses for Hippo Virtual Care

Dr. Johnson sees many opportunities to use Hippo Virtual Care in the future. “With the current and impending physician shortages, Hippo Virtual Care could be a valuable solution for any health system. As time goes on, it will be more of a challenge to get face-to-face care from a specialty physician like myself. Utilizing safe and effective technology platforms like Hippo Virtual Care will likely be the solution for the foreseeable future.”

About Dr. Alton R. Johnson Jr., DPM, FACPM, FASPS, CWSP

Dr. Johnson is a Clinical Assistant Professor, Podiatrist, Podiatric Surgeon, and Wound Care Specialist at the University of Michigan Medical School in Ann Arbor, MI. He is one of 10 current RISE Fellowship Innovators, and has been the recipient of several awards including the 2022 American Podiatric Medical Association President’s Award, the 2022 Kent State University College of Podiatric Medicine Young Physician Professional Achievement Award, and the 2022 Association for the Advancement of Wound Care Emerging Leader Award.

5 Tips for Managing Stress and Preventing Burnout in the Workplace

Are you tired of work? Have you been experiencing burnout in the workplace? If yes, you are not alone; a recent survey revealed that 77% of respondents – nearly 4 out of 5 people – have experienced burnout at work. For those of you working in the medical, human services, and education sectors, it is even more likely that you need a break.

So what is burnout? If you think you are experiencing it, online surveys such as the Maslach Burnout Inventory or seeking a mental health professional can help you clarify. But in simple terms, World Health Organization characterizes it with three dimensions:

  • Energy depletion or exhaustion;
  • Negative feelings or lack of pleasure at your job, such as becoming cynical or critical;
  • Reduced efficacy at work, such as low productivity or struggling with concentration.

These symptoms could have dire consequences if left ignored or unaddressed. According to the Mayo Clinic, sustained burnout can lead to the following:

  • Mental health and mood issues, such as fatigue, insomnia, sadness and anger, and alcohol and substance misuse; and
  • Physical issues, such as heart disease, high blood pressure, Type 2 Diabetes, and vulnerability to illnesses.

Fortunately, many employers are pushing for policies to ensure employee mental wellness, such as increased time off and after-school childcare. In this blog, we’ll cover five additional tips to manage work stress and help you get through tough times at work.


Build Strong Relationships

We, humans, are social creatures. Like any other environment, social support at work and outside of work is necessary for workplace well-being. Research has shown that good social interactions regulate our hypothalamic-pituitary-adrenocortical (HPA) system – the stress response system in our body, protecting us from psychological and physical diseases.

There are many scientific studies proving that good relationships decreases burnout at work. For example, a psychology study revealed that good coworker relationships are associated with lower burnout and higher job satisfaction. Obviously, not everyone is comfortable with making friends at work, but we still recommend that you try to connect with even a few that you share commonalities with. Or, in most cases, you may NOT LIKE the people you work with – they may be hostile, competitive, undermining your efforts etc. As this happens to most of us, it’s important to find a buddy (or two) who can also be a mentor and help you manage the politics in the workplace. Every job that I’ve had over the years, there was ALWAYS at least one key person that I was well connected to – this helped me navigate the challenges and difficulties.


Stay Active

Sometimes, mental exhaustion can hit in the middle of the day. Instead of reaching for another cup of coffee, try getting some movement! There are many research studies showing the cumulative benefits of staying active. For instance, a research study on 99 adults showed that 30 minutes of moderate aerobic exercise on a stationary bike improved mood and cognitive flexibility afterwards. This means a light run or a brisk hike during your lunch break is enough to energize you and help you mentally prepare to get back to work.

Don’t have 30 minutes? That’s fine, too. Science has already proven that 10 minutes of walking a day can literally lead to a longer life. Or try some at-home yoga after work; many Youtube videos are only 10 minutes long, and as long as you watch out for injuries and stretch effectively afterwards, they are amazing ways to boost your mood while staying healthy! Here is one for beginners.


Good Sleep Habits

Ever noticed you feel more cranky when you’re sleep deprived? Studies have shown that sleep loss is linked to burnout in the clinical field, and this holds true in other workplaces as well. On the other hand, quality sleep helps you grow new neural pathways in the brain, and thus enhances attention, creativity and decision making.

For good physical and mental health, the National Sleep Foundation recommends around 7-9 hours of sleep per night. However, the necessary hours do vary between people, according to sleep expert Russel Foster, so focusing on building good sleep habits suitable for your energy levels is more important. Go to bed and wake up at similar times every day, across weekdays and weekends; invest in some curtains to keep your bedroom dark; adjust your room temperature to be cooler; and avoid caffeine and nicotine, including chocolates and soda, in the late afternoon and evenings. Finally, focus on progress and not perfection. Sleeping well three days a week is still better than none!


Practice Mindfulness

Mindfulness refers to the state of awareness where you focus on feelings and sensations of the present moment. According to research, mindfulness protects us against stress and burnout, helps cultivate better self-compassion, and even reduces blood pressure and cortisol (the stress hormone) levels.

Practicing mindfulness is easy to do but hard to put into practice. If you’re like me and your mind is always going and it’s hard to shut down, you can schedule some time out of the day and do it for just five minutes. The Mayo Clinic has outlined instructions for each on this website; or, here is a simple, 5-minute Body Scan exercise for you to try during a break. This will help you maintain a peaceful mind through and after work.


Establish Work-Life Boundaries

Work-life balance has never been easy but with more of us working from home resulting from the pandemic, establishing appropriate professional boundaries is even more important. These boundaries can be mental, such as setting certain “work hours” for yourself and tracking the tasks you allow yourself to do; or physical, such as turning off email notifications after work. If you work from home, changing in and out of work attire, and establishing an office space or corner can also help separate work and personal life. Some people even carry two phones so they are not ‘bombarded’ with notifications and messages during off-hours. You shouldn’t have to pay the price of working from home by working around the clock. And you will be more productive at work with a balanced life in the long run.

Workplace burnout is extremely common but know that you are not alone in today’s “gotta-get-everything-done-right-now” society. Hopefully, these five tips will help you prevent burnout from creeping into your professional life.

Remember that you work to live, not the other way around!

American Hospital Association Urges DEA to Issue Special Registration for Telemedicine Controlled Substances

The American Hospital Association (AHA), on behalf of its nearly 5,000 member hospitals and health systems, sent a letter urging the Drug Enforcement Agency (DEA) to take immediate action to allow telemedicine prescribing of controlled substances before the Public Health Emergency (PHE) waivers expire. The letter exhorts the DEA to publish the proposed rule for a special telemedicine registration, something the DEA has said it would do since 2009 (yes, 13 years ago; not a typo). 

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At Children’s Mercy, telemedicine boosts access to highly sought-after subspecialists

by Bill Siwicki

Children’s Mercy Kansas City is a pediatric health system with the highest-level designations in neonatal and pediatric intensive care, trauma and emergency services, fetal health and transport services.



Children’s Mercy supports the children of Kansas and Missouri, with the next children’s hospitals being hours away in all directions. This extensive geographical region has forever been a significant challenge for patients and their families to access pediatric specialty care.

“The high demand for pediatric specialty providers and the constraints many families face regarding transportation, time off from work and school, and finances, made it obvious that traditional models of outreach healthcare were not sustainable,” said Morgan Waller, director of telemedicine business and operations at Children’s Mercy.

“Supportive leadership and persistent visionaries decided telemedicine was the solution to this continuously growing problem of too few specialists and pediatric patients with complex healthcare needs scattered and isolated all over rural Kansas and Missouri,” she added.



Because of the distance barrier to care and recognizing that the value telemedicine can provide to achieve the Triple Aim goals of improving specialist access, quality of care and affordability, Children’s Mercy Kansas City began to identify telemedicine and technology options to help treat patients across the regions served.

“After assessing options, which at the time Children’s Mercy began this initiative, in 2011, were very limited, it was decided that InTouch Health, a division of Teladoc Health, offered the best telemedicine platform to support regional telemedicine outreach clinics,” Waller recalled. “It was the dedication to quality, reliability and patient/provider experience that set Teladoc Health apart.

“Without any doubt, the devices InTouch Health offered a decade ago, in conjunction with their proprietary network, delivered unprecedented provider and patient experiences,” she continued. “To truly have a solution to the access challenges for these pediatric patients, Children’s Mercy needed to be able to replicate the same standard of care virtually, as that delivered in person, up to the highest level of encounter.”

That means providers hundreds of miles away must be able to listen to breath sounds; look into the eyes, nose, mouth and ears; and view the scalp and skin up close or magnified, and do so uninterrupted by poor network quality or other technology noise.

“To argue for sustainability, investing in the highest quality technology ensured early adopters within Children’s Mercy would lead the way and inspire new subspecialists to leverage virtual care services to treat more complex conditions and meet the needs of more patients across the region,” she explained.



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Telemedicine-enabled clinics were established in two locations in Kansas and two in Missouri with plans for more. The facilities are identical to traditional healthcare clinics, with the addition of Teladoc Health real-time, two-way interactive audiovisual technology that supports the use of JedMed digital ancillary exam devices.

BSN and RN tele-facilitators trained in multiple specialty assessments support the patients in person and the providers located in Kansas City to ensure that the standards of care are met (up to level 5 clinical encounters) for these complex appointments.



“Telemedicine improves access to highly sought-after subspecialists,” Waller stated. “Rather than traditional outreach programs where providers would fly or drive for hours to see clusters of patients in rural areas, telemedicine allows providers to see patients during the time they would otherwise be in transit, and the reach is theoretically limitless.

“Since establishing the telemedicine department in 2012, the number of subspecialty encounters via telemedicine has steadily grown,” she continued. “Prior to COVID, almost 2% of all ambulatory subspecialty care was facilitated via telemedicine. Children’s Mercy has continued to support the patients and families in Missouri, Kansas and the surrounding region by maintaining their commitment to telemedicine and regional outreach.”

Appreciating what a critical role the specially trained BSN and RN tele-facilitators serve in meeting the hospital’s standard of care, and patient and family and provider experiences, for complex care delivered over distance, Children’s Mercy has continued to onboard these talented nursing professionals.

“Additionally, telemedicine has shown the ability to lessen the financial burden for families by eliminating the costs of traveling considerable distances for care, food, lodging and/or childcare,” Waller noted. “Parents and children miss significantly less time from work and school when seen in a telemedicine clinic.

“Having a mature, centralized telemedicine department also allowed Children’s Mercy to rapidly switch to telemedicine appointments in the home during the spring of 2020,” she added. “Within three weeks, the organization had all subspecialty practices and allied health services (51 separate service lines) ready to not only care for patients and families remotely, but to schedule, document and bill these encounters (not including the limitations of some electronic solutions at the time).”

At the height of the lockdown, Children’s Mercy Kansas City converted 65% of ambulatory appointments to telemedicine in the home. Still, as the pandemic wanes, demand for telemedicine continues.



“Many organizations still are not utilizing telemedicine to its full potential,” Waller cautioned. “It is disappointing that the increased awareness and understanding of telemedicine brought to the world by way of the pandemic has been limited to the patient home experience.

“Although an equally valuable practice, direct-to-patient telemedicine has limitations,” she continued. “If the country and the world is going to cope with worsening shortages of physicians and healthcare providers, going beyond the traditional models of care for all types of services is necessary.”

Leaders in healthcare will be those who seek out high-quality telemedicine technologies that connect to peripheral high-definition camera-enabled exam devices and digital stethoscopes while utilizing available bandwidth efficiently to maintain connectivity, regardless of extraneous conditions, she added.

“They will enable RN tele-facilitators to practice within the full scope of their licenses to partner with physicians, advanced practice nurses and physician assistants to deliver highly specialized care for complex patient conditions in the least intrusive ways possible,” she said.

“They will outfit all patient care areas with the virtual sophistication required to replicate the standard of care via telemedicine for all services offered in person,” she concluded. “And leaders in healthcare will recognize that achieving a mature delivery system in 2022 and beyond requires a dedicated team of telemedicine professionals working alongside traditional experts in healthcare at every level.”