A review determined that the kidney, cardiac, and urgent care specialists failed on several occasions to heed HIPAA's risk analysis and management rules, HHS says.
Fresenius Medical Care North America will pay $3.5 million to the federal government and adopt corrective actions to address five separate data breaches, the Department of Health and Human Services announced Thursday.
HHS's Office of Civil Rights said their investigation showed that Fresenius failed to conduct an accurate and thorough analysis of risks and vulnerabilities to the confidentiality, integrity, and availability of all of its electronic medical records.
As a result of those procedural failures, HHS said, the Fresenius facilities improperly disclosed the electronic medical records of patients by providing unauthorized access, which is a violation of the privacy provisions of the Health Insurance Portability and Accountability Act.
Fresenius on Thursday issued the following statement: "We take the protection of our patients’ health information very seriously. It is a top priority for our company and a critical issue facing the entire healthcare industry."
"We recently entered into a settlement agreement with the U.S. Department of Health & Human Services Office for Civil Rights to informally resolve alleged HIPAA violations stemming from incidents that occurred in 2012, most of which involved theft of company computers and equipment."
"The settlement is not an admission that we violated HIPAA, and there is no evidence that any of our patients' health information was improperly accessed or misused. We have and will continue to take additional steps to protect patient data. We strive to enhance security, better train staff and reduce incidence of equipment theft.”
The breaches occurred between February and July of 2012 and were reported to HHS by Fresenius in January 2013.
The affected facilities are as follows:
Fresenius Medical Care Duval Facility in Jacksonville, FL, which failed to implement procedures to prevent unauthorized access, tampering, and theft;
Fresenius Medical Care Magnolia Grove in Semmes, AL which failed to properly oversee the receipt and removal of hardware and electronic media that contained patient information;
Fresenius Medical Care Ak-Chin in Maricopa, AZ, which failed to implement procedures to address security breaches;
Fresenius Vascular Care Augusta, (GA), which failed to implement safeguards against unauthorized access, tampering, and theft.
Fresenius Medical Care Blue Island (IL) Dialysis, which failed to implement safeguards against unauthorized access, tampering, and theft.
Fresenius’ Magnolia Grove and Augusta clinics also failed to install a mechanism to encrypt and decrypt electronic patient records, HHS said.
In addition to a $3.5 million fine, Fresenius will submit a corrective action plan that: addresses risk analysis and risk management; revises policies and procedures on device, media and facility access controls; develops an encryption report; and educates staff on policies and procedures, HHS said.
Fresenius provides kidney dialysis services for more than 170,000 patients in several states. Fresenius employs more than 60,000 people, with a care network that includes dialysis clinics, outpatient cardiac and vascular labs, urgent care centers, and hospitalist and post-acute providers.
Hospitalized drivers aged 60 to 69 in states with in-person renewal laws were 38% less likely to have dementia than drivers in states without such laws.
New evidence shows that mandating physicians to report dementia patients to state driver's license bureaus does not reduce hospitalizations from motor vehicle crashes.
The results, published today in Neurology, suggest that physician reporting laws – mandated or legally protected – either aren't working or lack any observable safety benefits.
"This was surprising, as we know that older drivers stop driving based on the advice of their physicians and, if reported to licensing authorities, few regain driving privileges," said lead author Yll Agimi, a health data scientist who did the research while a doctoral student at Pitt Public Health.
"Physicians are required to ensure the well-being of patients with dementia by also monitoring their driving competence," Agimi said. "That leads us to conclude that other licensing requirements may act as the principal means of identifying at-risk older drivers, before physicians identify and report a patient with a medical impairment, such as dementia."
The study analyzed the crash-related hospital admissions from the states reporting data between 2004 and 2009. Among 136,987 hospitalized older drivers, 5,564 had a diagnosis of dementia.
Hospitalized drivers aged 60 to 69 in states with in-person renewal laws were 38% less likely to have dementia than drivers in states without such laws and 23% to 28% less likely in states with vision testing at in-person renewal.
However, physician reporting laws were not associated with a lower likelihood of dementia among hospitalized drivers. These findings held even after the researchers accounted for other factors that could influence crash rates, ranging from police enforcement of safe driving to inclement weather, the study showed.
At the time of the study, Pennsylvania, Oregon and California required physicians to report drivers with dementia to licensing authorities. Twenty-seven states provided legal protection to physicians who report their patients, regardless of whether such reporting is required by law.
Only five states do not require that drivers present in-person – which allows licensing personnel to assess driving fitness – for license renewal at least once within two or three renewal cycles. Two states require road testing at licensing renewal, and 36 states require vision testing.
"The results of our study point to age-based licensing requirements as an effective way to improve safety," said co-author Steven M. Albert, chair of the Department of Behavioral and Community Health Sciences at Pitt.
"But such requirements also may cause social isolation and depression, and may be seen as ageist and discriminatory," Albert said. "So it is very important that our findings spur further study to determine the best approach to ensure safe driving for all on the road while avoiding a negative impact on the mental health of older adults."
In its ongoing efforts to shed about $1.5 billion in debts, Community Health Systems sold one of its Tennessee hospitals to Rennova Health, which is facing its own financial issues after being delisted from Nasdaq this week.
It’s been an eventful week for Rennova Health.
On Tuesday, Rennova was delisted by Nasdaq for excessive stock splitting, and closed with a market cap of $112,793, and shares valued at less than $1 a pop.
On Wednesday the company that once specialized in urine testing services finalized the purchase of a Tennessee hospital owned by Community Health Systems, the Franklin, TN-based for-profit hospital chain that is selling dozens of hospitals to pay off about $15 billion in debts.
The acquisition of 85-bed Tennova Healthcare in Jamestown, TN, doubles the number of hospitals owned by Rennova Health, which in 2016 bought the financially troubled 25-bed Scott County Hospital in Oneida, renamed it the Big South Fork Medical Center, and reopened last August.
Financial terms of the Jamestown acquisition were not disclosed in the media release.
CHS said the deal is expected to close in the second quarter, subject to regulatory approval. Jamestown’s sale was one of the planned divestitures announced by CHS in its third quarter 2017 earnings call.
"This acquisition further demonstrates our commitment to expanding Rennova's rural hospital model to provide necessary services to patients while securing more predictable recurring revenues," Seamus Lagan, CEO of Rennova, said of the Jamestown deal.
Lagan said in that the Jamestown hospital "is approximately 38 miles (less than a one-hour drive) from our current hospital in Oneida and will benefit by receiving patients from Oneida that require operations and treatment not provided there. The synergy of management and services in a close geographic location creates numerous efficiencies for Rennova and will allow us to support a greater number of health care providers and residents in the local area."
An email sent by HealthLeaders Media to Rennova requesting an interview on Wednesday afternoon was not returned.
On it’s website, Rennova describes itself as a “dynamic, vertically integrated company delivering innovation-driven solutions to meet critical healthcare provider needs.”
However, the Palm Beach Post reports that the company has had a long history of financial problems and that for the first nine months of 2017, Rennova posted a net loss to shareholders of $85 million on revenue of just $3 million.
HHS plans to cut $1 billion in federal funding that underwrites New York State's Basic Health Program, which creates one more challenge for the nation’s largest municipal health system.
If the Trump administration makes good on its plans to cut about $1 billion in funding for New York State's Basic Health Program, then a big share of the burden of doing more with less will fall upon the state's safety net hospitals.
John Jurenko Jr., vice president of government relations at New York City Health and Hospital Corp., says about 73,000 patients at the nation's largest municipal health system rely on the BHP for coverage. If that funding goes away, Jurenko says, NYCHHC will have to find another way to provide the care. NYCHHC already provides approximately $1.4 billion in uncompensated care annually.
"Eliminating this program, which essentially could restrict access to coverage for some people in the state, runs against healthcare policy that you want people to have continuous coordinated care so they stay healthier, they stay out of hospitals, and out of the emergency departments when they come in at the end when they are really sick," he says. "This is very short-sighted for the federal government to do this."
About 700,000 New York state residents are covered under the BHP, which began in 2015 and which is also called the Essential Plan. The funding, created under the Affordable Care Act, targets people who earn between 133% and 200% of the federal poverty level: the working poor who make too much to qualify for Medicaid, but not enough to afford health insurance premiums. While the program was made available to all states, only New York and Minnesota have BHP programs. Minnesota's BHP covers about 100,000 people.
Earlier this week, Minnesota and New York filed a joint lawsuit against the Trump administration and the Department of Health and Human Services, claiming that the funding cut violates the Administrative Procedure Act protocols for making administrative payment decisions. In mid-December, HHS told New York state officials, via email, that they would not receive a payment of $266 million for the first quarter of 2018.
"The Essential Plan is a lifeline for over 700,000 low-income New Yorkers. The abrupt decision to cut these vital funds is a cruel and reckless assault on New York’s families – and we will not allow it," New York Attorney General Eric T. Schneiderman said in prepared remarks. "I won't stand by as the federal government continues to renege on its most basic obligations in a transparent attempt to dismantle the Affordable Care Act. We’re suing to defend these vital funds and the quality, affordable health care they ensure for New Yorkers."
Jurenko says that many of the people on New York’s Essential Plan would be hard pressed to find affordable coverage without help, and would likely have to rely upon charity care.
"If it were to go away, it would make our jobs harder because we would see more and more uninsured folks," he says. "That's bad financially and bad for the patients in terms of the continuity of care, and it seems to run counter to what state and federal policies on the healthcare side had been; where it was to ensure access to coordinated healthcare services where you don't want to have people coming in for episodic care in the emergency department."
It's unlikely that New York can step in to fund the program, he says, because state legislators are already wrestling with a $4 billion shortfall. With few other options on the table, Jurenko says NYCHHC may have to make do with less.
Last year NYCHHC served a patient base of 1.2 million people, about 410,000 of whom were uninsured, Jurenko says. "We would not want to see that number go up. We have been doing everything we can to try to get more and more people who are eligible but not enrolled to get them coverage. This only makes matters worse," he says.
"Our CFO has already lost all his hair, because it's very hard to plan with all this uncertainty," he says. "But our commitment to New Yorkers is unwavering. We will always serve New Yorkers regardless of their ability to pay."
"But, it makes it hard because at the end of the day someone has to pick up the tab for the care," he says. "We will have to pick up any shortfall on the financial side for people who come in and are uninsured. Our staff in our facilities, our hospitals and community health centers, would be working with individuals to see if they're eligible for public health insurance."
"We are not going to eliminate programs. It will make it more financially difficult for us if we have larger numbers of uninsured, but we are still going to provide services to them."
Medicare Advantage markets are more robust, with higher private insurer participation and lower average premium growth than the Affordable Care Act marketplaces.
The success of Medicare Advantage could be a roadmap for the struggling ACA marketplaces, an analysis from the Urban Institute suggests.
Researchers examined why MA plans thrived in 2017 as marketplace plans struggled, and how the programs differ—including insurer participation, the risk-adjustment system, and provider payments. They concluded that adopting policies to increase enrollment in marketplace plans as well as insurer participation could make the ACA marketplaces stronger and more stable.
The Medicare Advantage market included 19 million enrollees in 2017, or 33% of the total Medicare population. These enrollees stick with their plans year after year and are generally not very sensitive to changes in price. Medicare Advantage also has a risk adjustment system that is relatively favorable to plans and is not budget-neutral, the study found.
Conversely, ACA marketplaces include more intense competition between insurers, have more price-sensitive enrollees, enroll fewer covered lives in the non-group market, calculate benchmark premiums differently, and have less favorable risk adjustment for insurers.
"ACA marketplaces and Medicare Advantage may seem similar, since they are both highly regulated direct to consumer insurance markets," said Katherine Hempstead, senior adviser at the Robert Wood Johnson Foundation, which funded the study.
"Yet Medicare Advantage has been much more successful, due in large part to regulatory features that give insurers greater certainty about bidding, risk adjustment, and provider payment," she said.
The study offers five policy recommendations based on Medicare Advantage’s success to strengthen the marketplaces for long-term stability, including:
Raise enrollment in marketplace plans by increasing premium and cost-sharing subsidies and eliminating short-term plans;
Cap provider payment rates at Medicare rates or a fixed percentage above them;
Standardize cost-sharing within metal tiers, or limit the number of plan designs available;
Lift the budget neutrality requirement for risk adjustment in the marketplaces;
Use a higher benchmark than the second-lowest-cost silver plan for calculating premium tax credits.
The fourth level of stroke center certification is a collaboration with the American Heart Association/American Stroke Association, and identifies hospitals that meet standards for performing mechanical endovascular thrombectomies.
David Baker, MD, executive vice president for Health Care Quality Evaluation at The Joint Commission, said the new certification program was developed after surveys showed that one-third of certified primary stroke centers routinely performed endovascular thrombectomies.
"Multiple studies have proven EVT treatment to be effective in saving lives and lowering disability from stroke, particularly if performed within six hours of the last time the patient was known to be well," says Baker.
"This certification was developed in response to a revolutionary technology and trying to make sure that everyone has good access to that technology in a timeframe that is going to achieve optimal outcomes," he said.
Baker spoke with HealthLeaders Media about the new TSC certification. The following is an edited transcript.
HLM:What hospitals should consider this certification program?
Baker: Right now, one third of our primary stroke centers are doing mechanical thrombectomies. We are looking for the strongest hospitals in that group; the ones that are able to do high-quality thrombectomies and post-procedure care. They've got substantial volume with strong experience. Importantly for us, this was originally developed to address areas where there wasn’t good access to a comprehensive stroke center.
HLM: What are the advantages to mechanical thrombectomies?
Baker: In 2015 three landmark studies showed that for patients that have the worst strokes, basically clots in one of the big blood vessels in the neck or the brain, a very large part of the brain is affected by this and the patients will be devastated by this.
These studies showed, and I am not overstating this, some of the most dramatic improvements that we have seen with any therapy. So, if you can get somebody to a hospital who can do this procedure -- they put a catheter into the large vessel, and they remove that blood clot so it restores blood flow to that area of the brain that is affected -- if you look at the numbers of people who were able to regain almost complete function, it's a vast improvement.
HLM: What should hospitals look at internally when deciding to pursue this?
Baker: This is probably something that would be taken up by hospitals that are already doing these procedures. They are going to have to make sure they can provide 24/7 coverage. Ideally, there should be a working relationship with EMS so that they know that if they gear up and can do this with 24/7/365 coverage and the costs associated with that, that they are going to get the volume of patients.
The calculation is how many patients are we seeing? How many more patients would we see if we got this designation, and will our emergency transport system recognized that? Particularly in some of these rural areas, if there was something there it would get a lot of traffic.
HLM: How does this accelerate access to proper care?
Baker: Again, two-thirds of the primary stroke centers are not doing mechanical thrombectomies. So you're EMS and you’ve got three primary stroke centers that you could go to but you don't know which one is capable of doing the mechanical thrombectomy. You go to the closest center, they evaluate the patients and then they have to transfer the patient to presumably a comprehensive stroke center to do the procedure. That is a huge delay that dramatically affects how much function a patient can regain.
This certification tells EMS who is capable of doing this. The hard part is in the field for EMS to determine who has one of these large vessel occlusions? Who has a clot in a major artery? There are a few rules that they can use and they need to learn how to use them. But, if EMS can identify those patients in the field, instead of going 90 minutes to a comprehensive stroke center I can go 20 minutes to a TSC and know that the patient is going to get good care.
HLM: How do you measure ROI for this certification?
Baker: That's going to depend on the local situation. You have to look at all the different aspects, the 24/7 coverage, the imaging procedures, and technology that is required and then be able to do your own estimate of ‘OK if we think we are going to get 15 or 20 cases per year brought in by EMS is it going to make sense?’
HLM: How long does the certification process take?
Baker: There is huge variability. There are some that thought they would be ready for survey within a month or two. Others it's taken them three or four months. It all depends upon what the baseline state is, so that is a difficult question to answer.
Physician-researchers offer practical, common-sense, easy-to-implement actions to improve outcomes, shorten hospital stays, and lessen the amount of opioids needed to control pain post-discharge.
Research presented this week at the American Society of AnesthesiologistsPRACTICE MANAGEMENT 2018meeting found that anesthesiologists can take a lead role in improving the patient experience -- from the decision to have surgery through discharge and beyond -- which can improve outcomes and reduce costs.
Colorectal and bariatric surgery patients benefited from an enhanced recovery after surgery (ERAS) program, left the hospital sooner and required fewer opioids to control pain, according to new research from Providence Anesthesiology Associates in Charlotte, NC.
PAA compared the results of 621 patients undergoing colorectal or bariatric surgery who participated in an ERAS program to historical data prior to the implementation of the ERAS.
Colorectal patients in the ERAS group stayed in the hospital 2 days compared to 4.5 days for non-ERAS patients. Bariatric patients in the ERAS group stayed 1 day vs. 2.15 for non-ERAS patients. Patients in both ERAS groups used significantly fewer opioids after surgery than those in the non-ERAS groups and had shorter stays in the post anesthesia care unit. Costs were reduced by 20% per case among the colorectal surgery ERAS patients compared to non-ERAS patients.
The ERAS program included preoperative patient education beginning in the surgeon's office and more extensively at the preadmission testing clinic, carb loading the night before surgery and three hours before the procedure, administering preoperative Alvimopan to restore bowel function after surgery, and employing pain methods other than opioids including transversus abdominal plane blocks to reduce or eliminate opioids after surgery.
"Our results demonstrate the benefits of physician anesthesiologists and surgeons working collaboratively to lower costs and improve our patients' outcomes," said Vicki Morton, DNP, director of clinical and quality outcomes at PAA.
Another study from the University of Pittsburgh Medical Center study found that pre-surgical consultation with pain medicine specialist eases anxiety about post-surgical pain management for some chronic pain and substance abuse patients.
The study reviewed 12 spinal fusion patients who consulted with an anesthesiologist pain specialist before surgery. The patients either had a history of substance abuse and were on outpatient addiction maintenance therapy, had a history of high opioid use before surgery, or specifically requested a pain clinic consultation.
Each met with the physician anesthesiologist, who consulted with the surgeon and patient to formulate a plan for the most appropriate pain management after surgery.
The patients reported they were less stressed about surgery, less anxious during the perioperative period and more satisfied with pain control after surgery.
"Some of these patients refuse to leave the hospital after surgery until they feel they are on the right pain regimen, and therefore stay longer," said Trent Emerick, MD, director of quality improvement and innovation, Chronic Pain Division, in the Department of Anesthesiology at the UPMC. "We believe that by working to address these issues before surgery we can decrease costs while improving satisfaction."
Researchers at Beaumont Health in Royal Oaks, MI, believe that evaluating older patients for frailty should be part of standard anesthesia pre-surgical screening. They recommended using a short screening questionnaire, such as Fried's Frailty criteria, because frailty can be an independent predictor of postoperative complications.
Patients who are identified as frail before surgery should be optimized before undergoing the procedure through nutrition, strength training, improving balance and mobility, counseling and medications, the researchers said.
"A healthy 80-year-old is not the same as a healthy 30-year-old, but they often are assessed for surgery in the same way," said Laura Lepczyk, DO, a clinical anesthesia resident at Beaumont.
"Further, some 80-year-olds are strong and vibrant and others are weak," she said. "A frailty assessment before surgery can help providers determine whether a patient is strong enough for surgery and if not, help determine if the patient's health can be optimized to enable the procedure."
Enrollees show signs of pent-up demand with acute healthcare needs early in their enrollment, but over time costs increase substantially and shift toward chronic care.
Spending for the Medicaid expansion population increased steadily over time for beneficiaries who remained enrolled in the program, according to a new analysis from Avalere Health.
The study found that the average monthly costs for expansion enrollees who gained coverage in the first half of 2014 were $324 during the first six months of coverage. Two-and-a-half-years later, for those who were still enrolled, the average monthly costs over six months rose to $389—a 20% increase.
The analysis also found that younger enrollees are more likely to disenroll, which means that healthier enrollees may be disenrolling or losing Medicaid eligibility, while expansion enrollees with sustained enrollment in the program are more likely to have chronic health needs.
"Contrary to some expectations that Medicaid expansion enrollees would be relatively healthy, beneficiaries who have remained on the program have increasing healthcare needs, likely due to previously unidentified or untreated conditions," said Caroline Pearson, senior vice president at Avalere. "Healthier, lower-cost enrollees may be more likely to churn off Medicaid after a shorter period of time."
The share of spending for inpatient hospital care and emergency room visits decreased over time among the expansion population, especially in the first few months of coverage. However, spending increased for chronic care services, such as prescription drugs. Among those enrolled in early 2014, inpatient spending initially made up the largest share of costs, but was surpassed by prescription drug spending by the eighth month of enrollment.
Avalere said those finding suggest that expansion enrollees, largely uninsured before 2014, had significant medical needs when they enrolled, or that many expansion enrollees enrolled as a result of an inpatient encounter. As beneficiaries spend more time with insurance coverage and establish relationships with physicians, their healthcare costs shift toward outpatient visits and prescription drugs, and away from hospitalizations, which reflect acute health needs.
Avalere examined claims data from January 2014 through December 2016 from three Medicaid managed care organizations offering coverage in states that expanded Medicaid on Jan. 1, 2014.
The Affordable Care Act gave states the option to offer Medicaid to childless adults aged 19-64 who earn less than $16,643, which is 138% of poverty. Medicaid covers approximately 76 million Americans, about 15 million of whom are on the expanded population. Eighteen states have declined to expand their Medicaid programs.
The 455-bed nonprofit medical center and teaching hospital was one of the last independent hospitals on Long Island. It becomes the eighth hospital in Mount Sinai Health System.
South Nassau Communities Hospital will become the flagship hospital on Long Island for the Mount Sinai Health System under an acquisition announced Wednesday.
Financial terms were not detailed, but Mount Sinai said it will provide $120 million for South Nassau’s five-year master facility plan, which will expand surgical facilities, intensive care units, and South Nassau's emergency department, according to a joint media release.
"The addition of South Nassau to our Long Island network represents our commitment to broadening access to innovative treatment and research in this region," said Kenneth L. Davis, president and CEO of Mount Sinai Health System.
"This transformative partnership will complement our existing network of talented clinicians and facilities," Davis said. "We are thrilled about what this means for patients and families on Long Island, and look forward to working closely with our Long Island partners to continue advancing care in the region."
South Nassau's board of directors will retain governance over the day-to-day operations of the 455-bed hospital, until now one of the last independent hospital on Long Island. South Nassau CEO Richard J. Murphy will report to the board and to Davis. The South Nassau Board will include two new members from Mount Sinai's Board, and two members of South Nassau's Board will join the Mount Sinai Board.
The two health systems signed a nonbinding letter of intent last May. Now, a state regulatory review is underway, but hospital officials said they anticipate final approval within months.
"We are in the midst of tremendous growth and expansion at South Nassau," Murphy said. "Our plans to renovate and nearly double the size of our emergency department in Oceanside are already underway, as are plans for a new, four-story, high-intensity building in Oceanside, as well as expanded medical services in Long Beach. The relationship with Mount Sinai will accelerate our plans and provide essential services to patients throughout Long Island."
South Nassau, a nonprofit medical center and teaching hospital, has 3,500 employees and 900 affiliated physicians. It will become the eighth hospital in Mount Sinai’s $7 billion health system, which includes the Icahn School of Medicine, seven other hospitals, 300 ambulatory practices and more than 6,500 physicians.
"Long Islanders shouldn't always have to travel into Manhattan for advanced cardiovascular, cancer, orthopedic, or neurological care," said South Nassau Board Chairman Joseph Fennessy, who led the negotiations. "Our goal from the outset was to find a partner seeking to expand services on Long Island who, like us, puts patients first, employing cutting-edge science and treatments."
Sanford World Clinic now operates in nine countries in more than 30 locations with services that include primary and pediatric care, research, and health system operations.
Sanford Health will expand its international healthcare services to seven countries on four continents in 2018, the health system has announced.
"With these partnerships, we are creating unique opportunities for shared learning," said Kelby Krabbenhoft, president and CEO of Sanford Health. "This is not something we are pursuing for financial gain, but we believe this type of collaboration will help further our mission of health and healing."
This year, Sanford Health will enter New Zealand, Ireland, Vietnam, Costa Rica and South Africa and increase its presence in China and Ghana. Last year Sanford acquired a minority stake in Munich-based ISAR Klinikum, which provides clinical applications for stem cell therapies.
Sanford Health’s international healthcare arm, Sanford World Clinic, will now be in nine countries with more than 30 locations. Launched in 2007, the initiative supported by philanthropy and is designed to foster partnership with healthcare leaders in the development of sustainable services around the world.
"We want to go where we can be impactful and create partnerships that will stand the test of time," said Dan Blue, MD, executive vice president of Sanford World Clinic. "We have outstanding partners in each of these countries who share a common goal – to advance health care around the world."
Sanford World Clinic identifies three to five new partnerships each year. Each collaboration is different in terms of scope of service and type of agreement and range from primary and pediatric care to research and health system operations.
New Zealand: Sanford and Omni Health Limited will open a general practice clinic in February, within Auckland’s Central Business District.
Ireland: Sanford and Hermitage Medical Clinic will establish a clinical research office to extend precision oncology services through a clinical research protocol supported by Sanford Research in the United States.
Costa Rica: Sanford is providing strategic and operational support to the fast-growing Hospital Metropolitano health system.
Vietnam: Sanford is collaborating with Victoria Healthcare to support clinical and health care management education programs for Victoria physicians, nurses and staff.
South Africa: Sanford is supporting the development of clinical research and educational programs in fetal alcohol spectrum disorders at Stellenbosch University and in partnership with a series of collaborators.
Ghana: Sanford is continuing its partnership with the Ghanaian government to expand upon its current 23 clinics.
China: Sanford will provide oncology support for the Ciming Health Checkup Group. This collaboration will be a remote physician-to-physician partnership.
