The medical facts about Mike Pence’s debate red eye

Vice President Mike Pence on Wednesday night managed to make it to the debate stage despite the fact the White House is in the middle of a coronavirus outbreak that seems to continue to grow. 

During the debate against Democratic vice presidential nominee Kamala Harris, Pence’s left eye quickly became the talk of the internet after people noticed it appeared to be red and blurry throughout his performance.

While it’s not clear why the vice president’s eye looked a bit off and he recently tested negative for COVID-19, it prompted many users to speculate on whether it could be an indication Pence may be infected with the coronavirus, as pink eye is known to be a symptom. 

 

Typical symptoms of the coronavirus include fever, cough, nasal congestion, sore throat, fatigue and shortness of breath, according to the Centers for Disease Control and Prevention (CDC). 

Although it’s true conjunctivitis has been seen in coronavirus patients, it appears to be a rare occurrence. 

A meta-analysis published in the Journal of Medical Virology in May found conjunctivitis occurs in about 1.1 percent of all COVID-19 cases. 

The study found pink eye was more common in severe coronavirus cases. The symptom was seen in 3 percent of severe cases compared to just 0.7 percent of mild cases. 

Conjunctivitis can be highly contagious and is typically caused by bacteria and adenoviruses that can spread easily from person to person, so COVID-19 is certainly not the only possible infectious cause of eye redness. 

It’s also a giant leap to make the claim Pence was experiencing pink eye to begin with, let alone that it was brought on by the coronavirus. Redness in the eyes can be caused by a long list of possibilities such as dry eyes, allergies and broken blood vessels in the eye. 

As President Trump and several other White House officials, aides and advisers have tested positive for COVID-19 over the past week, Pence tested negative for the virus on Tuesday and “has remained healthy, without any COVID-19 symptoms,” according to his physician Jess Schonau. 

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Plexiglass barriers at Pence-Harris debate ‘are a joke,’ won’t stop coronavirus, medical experts say

The Commission on Presidential Debates is taking extra precautions at Wednesday night’s Vice Presidential debate given the coronavirus outbreak in the White House, but pictures of two curved plexiglass barriers they plan to use has some epidemiologists and airborne pathogen specialists scratching their heads.

Vice President Mike Pence and Sen. Kamala Harris will be seated more than 12 feet apart and separated by two plexiglass barriers. But those barriers are “entirely symbolic,” according to Dr. Bill Schaffner, an epidemiologist at Vanderbilt University.

The commission became worried after President Donald Trump and several White House staff contracted Covid-19 shortly after last Tuesday’s presidential debate. The Centers for Disease Control and Prevention said Pence was not in “close contact” with Trump, who announced that he was infected with the virus early Friday morning.

Nonetheless, a person familiar with the debate planning told NBC News that Harris’ campaign asked for the plexiglass to be used at the event at the University of Utah in Salt Lake City.

The plexiglass is “minimal protection,” Schaffner said in a phone interview, adding that the barriers are mostly “cosmetic.” 

However, he added that barriers are one part of a “layered approach” that includes testing and distancing of everyone on stage. Everyone in the debate hall is required to wear a mask and there will be no handshake or physical greeting between Pence and Harris, according to the commission. Altogether, he said, the steps have likely reduced the risk of spread occurring.

The plexiglass barriers are just one “part of the CPD’s overall approach to health and safety,” according to a fact sheet distributed by the commission.

The debate is due to take place indoors and, of course, plenty of talking is expected. That’s important because the CDC released new guidance on Monday that said the virus can spread through particles in the air between people who are further than six feet apart in certain environments. The CDC said the risk of that occurring increases indoors and when people are doing certain activities, including speaking.

Jeff Siegel, a professor of civil engineering at the University of Toronto and a specialist in indoor air quality, ventilation and filtration, said the risk of virus-carrying particles going airborne in an environment like a debate when people are talking loudly is “huge.”

“On the plus side, it’s a pretty big space, so there’s a big dilution effect,” he said over the phone, adding that Harris, Pence and the moderator, Susan Page, will be spaced out appropriately. The high ceiling and large room will also help to reduce risk, he said.

“But they’re not addressing things like ventilation,” Siegel said, adding that he hopes the debate hall has appropriately up-to-date air filtration and ventilation systems. “If I was Vice President Pence’s staff or Harris’ staff, I would certainly want to get a portable HEPA filter in there.”

HEPA filters are high-performing air filters that capture very small particles in the air. The commission did not return CNBC’s request for comment on the building’s

Colorado Medical Waste Receives Environmental Leadership Award

An Environmental Leader in the State of Colorado going above and beyond environmental compliance

The Colorado Department of Public Health and Environment (CDPHE) Division of Environmental Health and Sustainability awards Colorado Medical Waste with the Environmental Leadership Program Silver Award. The ELP is a statewide environmental recognition and reward program for facilities that voluntarily go above and beyond compliance of state and federal regulations and are committed to continual environmental improvement for their business and communities as well.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20201007005268/en/

The ELP logo stencil was sprayed at their facility in Aurora along with a photo taken of available employees. (Photo: Business Wire)

A video by Colorado Governor Jared Polis was presented to virtually celebrate the program’s new members. The ELP logo stencil was sprayed at their facility in Aurora along with a photo taken of available employees.

Inclusion in the CDPHE Environmental Leadership Program was awarded to Colorado Medical Waste for demonstrating its commitment to:

Using the natural oxidizing power of ozone, electricity, and an industrial shredder, waste volume is reduced by 90% to a sterile confetti residual with “ZERO” emissions as ozone reverts back to simple oxygen. Tons of medical waste streams are diverted from landfills, incinerators, and hazardous waste facilities. State of the art processes and technologies reduce the public health effects and environmental impact of traditional autoclave and incineration technologies. Efficacy tests prove ozone is 100x more effective than steam and an environmental alternative to incineration. Reduction of landfilled medical waste and incineration decreases methane greenhouse gas emissions and their contribution to global warming and climate change. Colorado Medical Waste and ozone processing bring medical waste management into the 21st century.

Beverly Hanstrom, the company CEO and owner says, “We are leading the industry and are at the forefront of environmental stewardship to reduce the carbon footprint of healthcare and medical waste. Our leadership raises awareness and exemplifies our passion and commitment to make a difference.”

Find us on:
Facebook: https://www.facebook.com/ColoradoMedicalWaste
Twitter: https://twitter.com/COmedwaste

Video – https://www.youtube.com/watch?v=6e9TxcTAO0c
Photos – https://www.coloradomedicalwaste.com/press-media/

Related Links:

Environmental Leadership Program: https://www.colorado.gov/cdphe/environmental-leadership-program
Environmental Leadership Brochure: https://drive.google.com/file/d/1RQq1EHIippch2lVgsn0C95ZDzHyll7wi/view?usp=sharing

View source version on businesswire.com: https://www.businesswire.com/news/home/20201007005268/en/

Contacts

Beverly Hanstrom, CEO/Owner
Colorado Medical Waste, Inc.
3131 Oakland St.
Aurora, CO 80010
303-794-5716
(303) 763-2339 Fax
Website: www.coloradomedicalwaste.com
Email: [email protected]
Links: Brochure | Video | LinkedIn

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Trump’s covid-19 medical treatment makes no sense

The medical obscurity began Friday, when we learned of the president’s diagnosis but got no information regarding prior tests and their results — important facts when trying to provide contact tracing and inform people if they might be at risk for a potentially deadly illness. Besides the positive test Thursday night, we then learned, Trump might have had symptoms earlier that day at a fundraiser in Bedminster, N.J., along with “low grade fevers and a cough” early Friday, which indicated that he had covid-19, the disease caused by the SARS-CoV-2 virus.

Behind the scenes, White House physicians, who can consult directly with any expert in the world they might want to reach, discussed potential treatments and opted for an experimental medication, an antibody cocktail made of artificial molecules that fight the spread of the virus in the body. Regeneron’s monoclonal antibody cocktail is not yet approved by the Food and Drug Administration; the treatment is not available to anyone outside of clinical trials. The drug was procured swiftly and directly from the company through the FDA’s compassionate use program, which is usually reserved for immediately life-threatening conditions or serious disease when no comparable or satisfactory alternative therapy options are available. That his doctors would risk using a drug that has not yet demonstrated its efficacy was a signal that either the president’s condition was much more serious than the White House was admitting or that his course of treatment was taking unusual turns.

Once Trump was admitted to Walter Reed National Military Medical Center on Friday night — ostensibly out of an abundance of caution — the president also received remdesivir, an expensive antiviral drug that’s in short supply for the nation’s 30,000 other hospitalized covid-19 patients, with an emergency use authorization (not full approval) from the FDA for patients who are critically ill with the disease.

His medical team never explained why they chose to start that treatment, either. On Saturday, White House physician Sean Conley assured the nation that Trump was not “presently on supplemental oxygen,” without answering questions about whether he ever had been; we later learned that the president had at least two episodes of lower oxygen saturation. Those incidents prompted the addition of a high-dose steroid, dexamethasone, which is also approved by the FDA under an emergency use authorization but is also reserved for patients with severe covid-19 who require supplemental oxygen. Dexamethasone also has a significant number of side effects, particularly for older patients, who can often experience delirium or psychoses as a direct result of the steroids.

As a doctor who’s treated covid-19, the decision to use those three major agents — an antibody cocktail, an antiviral drug and a high dose of steroids — indicated one thing clearly to me: Trump must have been getting sicker in the hospital. Each of the three major drugs used attack a different aspect of the disease; they attack the virus itself as well as the body’s response to the virus. But all the treatments have

US medical supply chains failed, and COVID deaths followed

Nurse Sandra Oldfield’s patient didn’t have the usual symptoms of COVID-19 — yet. But then he tested positive for the virus, and it was clear that Oldfield — a veteran, 53-year-old caregiver — had been exposed.

She was sent home by Kaiser Permanente officials with instructions to keep careful notes on her condition. And she did.

“Temperature 97.1,” she wrote on March 26, her first log entry. Normal.

She and her colleagues said they had felt unsafe at work and had raised concerns with their managers. They needed N95 masks, powerful protection against contracting COVID-19. Kaiser Permanente had none for Sandra Oldfield. Instead, she was issued a less effective surgical mask, leaving her vulnerable to the deadly virus.


Many others were similarly vulnerable, and not just at this 169-bed hospital in Fresno. From the very moment the pandemic reached America’s shores, the country was unprepared. Hospitals, nursing homes and other health care facilities didn’t have the masks and equipment needed to protect their workers. Some got sick and spread the virus. Some died.

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EDITOR’S NOTE — This story is part of an ongoing investigation by The Associated Press, the PBS series “FRONTLINE,” and the Global Reporting Centre that examines the deadly consequences of the fragmented worldwide medical supply chain and includes the film “America’s Medical Supply Crisis,” premiering on PBS and online Oct. 6 at 10 p.m. EST/9 p.m. CST.

Full Coverage: Deadly Shortages

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The Associated Press and “FRONTLINE” launched a seven-month investigation — filing Freedom of Information Act requests, testing medical masks, interviewing dozens of experts from hard-hit hospitals to the White House — to understand what was behind these critical shortages.

Medical supply chains that span oceans and continents are the fragile lifelines between raw materials and manufacturers overseas, and health care workers on COVID-19 front lines in the U.S. As link after link broke, the system fell apart.

This catastrophic collapse was one of the country’s most consequential failures to control the virus. And it wasn’t unexpected: For decades, politicians and corporate officials ignored warnings about the risks associated with America’s overdependence on foreign manufacturing, and a lack of adequate preparation at home, the AP and “FRONTLINE” found.

As the pandemic rolled into the U.S., Asian factories shut down, halting exports of medical supplies to the U.S. Meanwhile, government stockpiles were depleted from a flu outbreak a decade earlier, and there was no way to rapidly restock. The federal government dangerously advised people not to wear masks, looking to preserve the supply for health care workers. Counterfeits flooded the market.

Now, with more than 210,000 Americans dead and the president himself infected with the virus, the U.S. grieves the consequences. And nurses are still being told to reuse masks designed to be thrown away after each patient.

At home with her aged dog Freckles at her side, Sandra Oldfield recognized the symptoms as she recorded them in her log over 11 days:

“Chills”

“Weakness”

“Dizziness”

She lost her appetite. Her handwriting grew shaky. Someone called

Defying medical consensus, Trump is discharged from hospital

Walter Reed National Military Medical Center
Walter Reed National Military Medical Center

A general view of the facade of Walter Reed National Military Medical Center where President Donald Trump was admitted for treatment of COVID-19 on October 4, 2020 in Bethesda, Maryland. Samuel Corum/Getty Images

Update: On Monday evening President Donald Trump walked from the Walter Reed National Military Medical Center wearing a full facial mask, gave a thumbs up to reporters and left in his motorcade.

Despite mixed signs about whether he is actually healthy, President Donald Trump announced Monday that he would going to leave Walter Reed National Military Medical Center, where he had been treated since last week for COVID-19.

“I will be leaving the great Walter Reed Medical Center today at 6:30 P.M. Feeling really good!” Trump announced on Twitter. “Don’t be afraid of Covid. Don’t let it dominate your life. We have developed, under the Trump Administration, some really great drugs & knowledge. I feel better than I did 20 years ago!”

His tweet came shortly after he criticized the media in a separate post, tweeting minutes earlier that “the Media is upset because I got into a secure vehicle to say thank you to the many fans and supporters who were standing outside of the hospital for many hours, and even days, to pay their respect to their President. If I didn’t do it, Media would say RUDE!!!”

Trump was referencing an event that took place on Sunday, when Trump left the hospital in his motorcade in order to briefly wave to onlookers before returning to Walter Reed. That incident prompted scrutiny over the risks posed to the Secret Service agents who shared space with the coronavirus-infected Trump in the nearly-airtight, chemical weapon–proof vehicle that he drove in.

Although Trump insists that he is feeling fine, that analysis is contradicted by other reports, and is also contradicted by the normal timeline of coronavirus infection. Coronavirus patients are vulnerable for seven to ten days after their first symptoms, and those with severe symptoms — as Trump seems to have had, based on some of his own doctors’ reports — are often hospitalized for that length. If one believes the administration’s stated timeline of symptom appearance, that would suggest Trump should stay under observation in the hospital until at least October 8. 

At one point the president reportedly took the steroid dexamethasone to combat his low blood oxygen levels, a common side effect of moderate to severe COVID-19 infection. Dexamethasone is generally used to stop a patient’s immune system from fatally overreacting to a disease. Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California–San Francisco, told Salon by email on Monday that “dexamethasone is only approved for patients with very severe disease mechanically ventilated in the hospital.” She noted the oddity of having him take this drug despite his doctors’ statements that his case was not severe. “This drug can cause harm in more mild disease,” she added.

Gandhi is not alone

Immune Cells Show the Way in This Medical Mystery

A 54-year-old man presents to a foot and ankle clinic in Maryland with a diffuse, hard lesion in the middle of the arch of his left foot; it is tender to the touch and painful to walk on.

He explains that it began developing gradually about 3 years earlier as a dry, scaly spot, and that the skin later cracked but there was no pain. He says he had not been concerned, since he had a history of having severe eczema and dry patches of skin in the same spot on his foot.

However, his efforts to treat the eczema with topical cortisone cream and “over-the-counter acid” have been ineffective, he said, adding that he became concerned when the lesion slowly grew thicker and harder.

The patient’s surgical and medical histories include thyroidectomy (for thyroid cancer) at age 28, a diagnosis of bipolar disorder, headaches/migraines, and high blood pressure. His family history is unremarkable, and clinical assessment reveals no major abnormalities.

Dermatological Examination

Dermatological assessment shows a 3.0-cm, scaly, keratotic patch with slight erythema in the plantar central region of the left arch, which is notably tender to palpation. There is no evidence of skin atrophy or lymphadenopathy. Laboratory test results are within normal limits.

Clinicians perform a skin punch biopsy and send the sample for histological evaluation.

The report notes infiltration of atypical lymphocytes in the upper dermis. Most of the atypical lymphocytes are round or ovoid with a cerebriform nuclear contour but with no clear nuclear membrane or nucleoli.

Single units or small clusters of these have infiltrated up into the epithelial layers (epidermotropism), down into the eccrine sweat glands (syringotropism) and the walls of the blood vessels in the dermis.

image

Histopathology and immunostaining profiles of mycosis fungoides palmaris et plantaris: (A) An infiltrate of the atypical lymphocytes in the upper dermis (hematoxylin and eosin [H&E], 40×1). (B) Round or ovoid atypical lymphocytes with cerebriform nuclear contour and no clear nuclear membrane or nucleoli (HE, 400×1). (C) Atypical lymphocytes infiltrating into the epidermis (epidermotropism) (HE, 100×1). (D) Atypical lymphocytes infiltrating into eccrine sweat glands (syringotropism) (HE, 100×1). (E) Perivascular infiltration of the atypical lymphocytes in the dermis (HE, 100×1). (F) Strong CD4 expression in atypical lymphocytes (3, 3 -diaminobenzidine [DAB], 100×1). (G) Reduced CD7 expression in atypical lymphocytes (DAB, 100×1). (H) Reduced CD8 expression in atypical lymphocytes (DAB, 100×1).

Immunostaining of the atypical lymphocytes shows almost uniformly strong positive staining for CD3, CD4 antibodies and about 30% positivity for CD7 and CD8; staining for CD20 was negative.

Clinicians note an approximately 3:1 ratio of CD4- to CD8-positive cells. Results of periodic acid-Schiff staining for fungal elements are negative for both spores and hyphae; yet the histomorphology and immunostaining profiles are judged to be consistent with mycosis fungoides palmaris et plantaris (MFPP).

The team discusses the treatment options with the patient, and he is referred to a dermatologist. The patient receives topical psoralen plus ultraviolet A (PUVA) photochemotherapy, which results in complete remission.

At 5-year follow-up, the

CNN medical analyst: I’d perform psychiatric evaluation on Trump if he were my patient

Dr. Leana Wen, a CNN medical analyst and visiting professor at George Washington University, said she would perform a psychiatric evaluation on President TrumpDonald John TrumpQuestions remain unanswered as White House casts upbeat outlook on Trump’s COVID-19 fight White House staffers get email saying to stay home if they experience coronavirus symptoms White House says ‘appropriate precautions’ were taken for Trump’s outing to see supporters MORE if he were her patient and left the hospital while still infected with the novel coronavirus “to go for a car ride.”

“If @realDonaldTrump were my patient, in unstable condition + contagious illness, & he suddenly left the hospital to go for a car ride that endangers himself & others: I’d call security to restrain him then perform a psychiatric evaluation to examine his decision-making capacity,” she tweeted on late Sunday.

 

Earlier Sunday, Trump, who was admitted to the Walter Reed National Military Medical Center for treatment last week after confirming he and first lady Melania TrumpMelania TrumpGOP lawmaker calls on Pelosi to apologize for response to Trump contracting coronavirus White House gave New Jersey officials list of 206 people at Trump’s Thursday fundraiser events Photo of Mark Meadows rubbing his head during update on Trump’s health goes viral MORE tested positive for coronavirus, was seen riding in a motorcade and waving at supporters during a “surprise” trip around the hospital.

Trump and Secret Service agents were seen wearing masks inside the vehicle. 

Deputy White House press secretary Judd Deere said Trump “took a short, last-minute motorcade ride to wave to his supporters outside and has now returned to the Presidential Suite inside Walter Reed.”

The official added that “appropriate precautions were taken in the execution of this movement to protect the President and all those supporting it, including PPE. The movement was cleared by the medical team as safe to do.”

Deere declined to say if the president requested the move. 

The drive-by sparked criticism online from those who said the move put others who rode in the vehicle with Trump  at unnecessary risk. 

“Every single person in the vehicle during that completely unnecessary Presidential ‘drive-by’ just now has to be quarantined for 14 days,” James Phillips, an attending physician at Walter Reed. “They might get sick. They may die. For political theater. This is insanity.”

Wen previously served as president of Planned Parenthood before being removed from the organization last year due to “philosophical differences” she said she had with new board chairs “over the direction and future” of the organization. She was the first physician to head Planned Parenthood in years.

–Updated at 7:47 a.m.

Spotlight on Walter Reed Medical Center brings back powerful memories for US wounded warriors

In the critical days since President Trump announced that he and the first lady had been infected with the novel coronavirus, the eyes of the world have been fixed on one place: a sprawling parcel of manicured green lawns and matchbox-like ivory dwellings known as the Walter Reed National Military Medical Center (WRNMMC).

It was announced on Friday evening that “as a precautionary measure” Trump would be transferred to the facility, also known as the President’s Hospital and the Nation’s Medical Center. Throughout the tense weekend, the president extolled the virtues of the hospital staff, illuminating the “incredible institution.”

Named after Maj. Walter Reed, an Army researcher who helped prove that an earlier viral epidemic, yellow fever, was transmitted by mosquitoes – it comes with a storied history. President Ronald Regan stayed at the former Walter Reed when he had his surgery in 1989, PresidentRichard Nixon battled pneumonia in his isolated chambers there in 1973, and the slain body of President John F. Kennedy was transported from Dallas to the hospital on that frosty November day in 1963.

TRUMP THANKS SUPPORTERS GATHERED OUTSIDE HOSPITAL: ‘I’M ABOUT TO MAKE A LITTLE SURPRISE VISIT’

The hospital is also the go-to for the vice president, members of Congress and Supreme Court justices. But its legacy is most often entwined with treating members of the U.S. military and their families. So for those who have spent significant chunks of their lives at the eponymous, now state-of-the-art Walter Reed, it’s a name that conjures up many memories – a place of both healing and pain, a place that signifies the many wounds of war, visible and invisible.

“Back then, we went from five to 10 severely wounded and amputated to nearly 50 in a matter of just a few months,” said Johnny “Joey” Jones, a former U.S. Marine and Fox News contributor who lost his legs to an IED while in Afghanistan in summer 2010. “But no one can care for a Marine like a hospital corpsman. The staff there is truly a godsend to those in their wards.”

President Trump photographed working from a conference room at Walter Reed National Military Medical Center on Saturday, Oct. 3, 2020, after testing positive for the coronavirus.

President Trump photographed working from a conference room at Walter Reed National Military Medical Center on Saturday, Oct. 3, 2020, after testing positive for the coronavirus.

The facility as it stands now is the combination of the Walter Reed Army Medical Center — which opened in 1906 — and Bethesda’s National Naval Medical Center. They were merged in 2011 at the direction of Congress to form the WRNMMC, quite simply tagged “the new Walter Reed” by many others who have been forced to take up residence inside the heavily sterilized walls.

Retired Lt. Colonel Rudolph Atallah, who served as the Africa counterterrorism director and Morocco/Tunisia country director in the office of the Secretary of Defense, said the Walter Reed was his personal stomping grounds for more than a decade and also tendered with great care and pragmatism to his ex-wife, who was diagnosed with Hodgkin’s lymphoma cancer.

“It is a special place. Being a military hospital,

With an anthropologist’s eye, Duke pioneers a new approach to medical AI

If not for an anthropologist and sociologist, the leaders of a prominent health innovation hub at Duke University would never have known that the clinical AI tool they had been using on hospital patients for two years was making life far more difficult for its nurses.

The tool, which uses deep learning to determine the chances a hospital patient will develop sepsis, has had an overwhelmingly positive impact on patients. But the tool required that nurses present its results — in the form of a color-coded risk scorecard — to clinicians, including physicians they’d never worked with before. It disrupted the hospital’s traditional power hierarchy and workflow, rendering nurses uncomfortable and doctors defensive.

As a growing number of leading health systems rush to deploy AI-powered tools to help predict outcomes — often under the premise that they will boost clinicians’ efficiency, decrease hospital costs, and improve patient care — far less attention has been paid to how the tools impact the people charged with using them: frontline health care workers.

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That’s where the sociologist and anthropologist come in. The researchers are part of a larger team at Duke that is pioneering a uniquely inclusive approach to developing and deploying clinical AI tools. Rather than deploying externally developed AI systems — many of which haven’t been tested in the clinic — Duke creates its own tools, starting by drawing from ideas among staff. After a rigorous review process that loops in engineers, health care workers, and university leadership, social scientists assess the tools’ real-world impacts on patients and workers.

The team is developing other strategies as well, not only to make sure the tools are easy for providers to weave into their workflow, but also to verify that clinicians actually understand how they should be used. As part of this work, Duke is brainstorming new ways of labeling AI systems, such as a “nutrition facts” label that makes it clear what a particular tool is designed to do and how it should be used. They’re also regularly publishing peer-reviewed studies and soliciting feedback from hospital staff and outside experts.

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“You want people thinking critically about the implications of technology on society,” said Mark Sendak, population health and data science lead at the Duke Institute for Health Innovation.

Otherwise, “we can really mess this up,” he added.

Getting practitioners to adopt AI systems that are either opaquely defined or poorly introduced is arduous work. Clinicians, nurses, and other providers may be hesitant to embrace new tools — especially those that threaten to interfere with their preferred routines — or they may have had a negative prior experience with an AI system that was too time-consuming or cumbersome.

The Duke team doesn’t want to create another notification that causes a headache for providers — or one that’s easy for them to ignore. Instead, they’re focused on tools that add clear value. The easiest starting point: ask health workers what would be helpful.

“You don’t start by writing code,” said