Medicine and Health Sciences Commons^™

Examining The Tax Landscape Of Recreational Cannabis: Trends And Considerations From The Past 10 Years Of Policy, Thomas A. Norton, Amanda K. Thompson-Abbott, Raymond Keener Iii, Alberto Coustasse

Accounting Faculty Research

This article aims to provide an overview of the taxation of recreational cannabis in states where it has been legalized for recreational purposes. By delving into the various approaches taken by different jurisdictions, analyzing the economic impacts, and examining the challenges and opportunities inherent in cannabis taxation, we seek to shed light on a topic that is rapidly shaping the future of the cannabis industry and the broader economy. From excise taxes to sales taxes and licensing fees to revenue allocation, the taxation framework surrounding recreational cannabis is a dynamic and evolving landscape. Potential federal excise taxes could further complicate …

The Impact And Potential Of Digital Health Technologies, Craig Kimble, Thomas Pile, Alberto Coustasse

Pharmacy Practice & Administration

Digital technologies and smart devices are now used in every aspect of our lives. Further innovation in the digital health realm is growing and has the potential to reduce inefficiencies in the health care system by sharing health data with providers, decreasing costs related to unnecessary health care visits and improving patients’ quality of life and clinical outcomes by better tailoring treatment to the individual’s health needs.

Navigating The Future Of Healthcare: Big Data's Impetus For Inpatient Quality Enhancement, Lakyn Hyre, Brian Cox, Alberto Coustasse

Management Faculty Research

This study aims to explore the impact of big data utilization on quality improvement in inpatient facilities, specifically assessing its influence on readmission rates, patient outcomes, and potential cost savings. This study utilized mixed methodologies with a literature review complemented by semi-structured interviews to gain perspectives about big data utilization on quality improvement in inpatient facilities. The Marshall University Institutional Review Board (IRB) approved the interview. This study’s conceptual framework (Figure 1) was adapted from the research framework of Yao, Chu, and Li (Yao et al., 2010). The framework displays the reasoning of and approach to big data and machine …

Revolutionizing Revenue Cycle Management: Ai's Impact On Healthcare Organizations, Rachel Pennington, Alberto Coustasse

Management Faculty Research

Revenue Cycle Management (RCM) stands as a cornerstone in healthcare, overseeing the intricate processes involved in capturing, managing, and collecting revenue generated from patient services. However, the landscape of RCM has long been plagued by inefficiencies. These inefficiencies underscore the urgency for innovative approaches, and the integration of AI emerges as a promising solution to streamline processes and optimize revenue capture.

Rural Hospital Closures Unraveling The Socioeconomic, Healthcare Access, And Community Impact On Local Communities, Jake Lestitian-Howard, Chase Ooten, Jay Poindexter, Colette Martin, Alberto Coustasse

Management Faculty Research

This study aimed to analyze the effects of rural hospital closures on employment level, economic indicators, and availability of care for communities. The research showed that rural hospital closures negatively impacted community economies and access to healthcare.

Ai-Driven Solutions Promote Medication Adherence, Eric Pulice, Alberto Coustasse

Management Faculty Research

A study conducted in 2019 showed that approximately 50% of the 187 million patients in the US health care system did not follow their medication plan as prescribed. This means they failed to adhere to the drug regimen or to take the medication for the entire prescribed duration. Adherence rates for most medications used to treat chronic conditions, such as diabetes and hypertension, usually fall in the range of 50% to 60%, even with patients who have good insurance and drug benefits. This rate of adherence leads to an estimated 125,000 avoidable deaths each year and $100 billion annually in …

Artificial Intelligence Is Revolutionizing Controlled Substance Diversion Detection, Brian Cox, Alberto Coustasse, Craig Kimble

Management Faculty Research

In community and institutional health care sectors, artificial intelligence (AI) use is expanding. AI is being tapped broadly in operations, customer service, and scheduling, with major pharmacy chains such as Kroger, CVS, and Walgreens, already starting to implement AI applications in their pharmacies. So far, Kroger has begun to use AI for employee onboarding and training processes, CVS is applying AI in negotiations with suppliers, and Walgreens is using it to streamline vaccine scheduling. With these advances in major pharmacy chains, the next extensive application for AI has become clearer: diversion monitoring. Diversion occurs in health care settings when a …

Navigating The Path To Safe Compounding In Health Systems, Thomas Pile, Craig Kimble, Alberto Coustasse

Management Faculty Research

Across the country health systems are facing increasing drug shortages that are forcing pharmacists to rely far more heavily on compounding to meet the needs of patients. Additionally, several high-profile compounding incidents have helped highlight the importance of ensuring best practices are followed during sterile and nonsterile compounding to support patient safety and high-quality care. Specifically, in 2022, 160 drug shortages were reported in pharmacies. From January 1, 2023, to March 31, 2023, 47 drug shortages were reported, 55% of which were for injectables. In response, compounding has increasingly become a solution to bridge that gap.

Effects Of The Needle Exchange Program And Its Current Status In West Virginia, Thomas Norton, Amber Graves, Anthony Uriarte, Katherine Duty, Alberto Coustasse

Management Faculty Research

Excerpt:

One of the main problems that have impacted the state of healthcare in West Virginia has been the rising costs of treatments for bloodborne infections (Bates et al., 2019). Bloodborne pathogens and their resulting diseases have commonly spread by exchanging contaminated needles (Denault & Gardner, 2021). In West Virginia, Needle Exchange Programs (NEPs) have been implemented to reduce the transmission of certain infections, such as HIV, hepatitis B, and hepatitis C, which have been more common among drug users (Beck & Kersey, 2018). In 2015, West Virginia had the second-highest rate of cases of hepatitis C Virus (HCV) in …

The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis, Eric Pulice, Alberto Coustasse

Management Faculty Research

Introduction:

The World Health Organization [2019] defined burnout as a syndrome caused by chronic job stressors that are not successfully managed, characterized by exhaustion, depersonalization, job detachment, and feelings of inadequacy (WHO, 2019). According to Murthy [2022], the nursing burnout crisis was underway before COVID-19. Nurse burnout recognized pre-COVID-19 was due to systemic organizational problems such as inadequate organizational support and underinvestment in public health (Murthy, 2022).

A 2022 survey of 2500 nurses exhibited increased rates of burnout during the pandemic, with 75% of respondents experiencing burnout, while 65% of those surveyed expressed their desire to leave the healthcare field …

Harm Reduction In West Virginia: Do Needle Exchange Programs Reduce Disease And Decrease Costs?, Katie Duty, Amber Graves, Anthony Uriate, Stacie Deslich, Alberto Coustasse, Thomas Norton

Management Faculty Research

Needle Exchange Programs (NEP)s were created to help users exchange used needles for new sterile ones and become aware of treatment and rehabilitation options. This study aimed to determine the effectiveness of NEPs and their impact on reducing HIV and Hepatitis C infections in West Virginia and decreasing health care costs for the community. Based on studies conducted on the past implementation of needle exchange programs, it is suggested that there has been evidence that closing these programs can have a broad societal impact on the spread of HIV and hepatitis C and the associated costs. In addition, the community …

Magnet Hospitals: An Update On The Impact On Nursing Burnout, Jonathan Settle, Michael Davis, Alberto Coustasse

Management Faculty Research

Nurse burnout has been associated with worsened outcomes for nurses, such as increased turnover or quitting and lower job satisfaction. The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on nurse burnout, nurse turnover, and job satisfaction of nurses. This study utilized a literature review complemented by two semi-structured interviews. The results showed that Magnet hospitals kept lower levels of burnout, better job satisfaction, and less turnover than non-Magnet hospitals, but this was only the case for some studies of Magnet hospitals. Some outcomes could be attributed …

Neonatal Abstinence Syndrome: An Update On The Cost And Length Of Stay Associated With Treatment During The Hospital Stay, Kimberly Stanfield, Kylie Day, Sarah M. Clemente, Alberto Coustasse

Management Faculty Research

Neonatal Abstinence Syndrome (NAS) has been costly for the healthcare system; every 19 minutes, a newborn was diagnosed in 2021. Medically Assisted Treatment (MAT)) for expecting mothers has been shown to decrease costs and length of stay for newborns NAS. This study utilized a literature review and a semi-structured interview. The research showed that medically assisted treatment with methadone or buprenorphine during pregnancy decreased costs, LOS, and severity of symptoms for newborns diagnosed with NAS. The findings showed a positive association between lower costs for the initial stay of infants whose mothers received MAT. MAT during pregnancy has been shown …

Relationship Between The Hospital Readmission Reduction Program And Readmissions, Postoperative Complications, And Cost, Cary A. Blick, Blake P. Williams, Drake T. Myers, Joshua Pomranke, Sarah M. Clemente, Alberto Coustasse

Management Faculty Research

Hospital readmissions have contributed significantly to rising healthcare costs in the United States. To curb rising costs, the Centers for Medicare and Medicaid Services introduced the Hospital Readmissions Reduction Program (HRRP), a penalty-based program designed to decrease healthcare costs. This research aims to determine if the HRRP has successfully reduced healthcare costs and increased quality outcomes associated with total knee arthroplasty (TKA) or total hip arthroplasty (THA) as defined by a reduction in readmission rates, postoperative complications, and overall costs. Although a positive correlation has been shown between outcomes and costs post-HRRP, more research is needed to tease out the …

Impact Of Emr/Ehr And Computer Decision Support Systems On Nursing Homes And Long-Term Care, Wendy Trzyna, Brian Cox, Alberto Coustasse

Management Faculty Research

Long-Term Care (LTCs) facilities and nursing homes have been an essential part of the healthcare industry to meet the needs of older adults. However, Electronic Medical Records (EMRs/ EHR within LTC facilities and nursing homes have lagged more than in other healthcare sectors. This research analyzed the impact of implementing EMR/EHR and Computerized Decision Support Systems within LTC facilities and nursing homes. In nursing homes and LTC facilities where EMR/EHR has been implemented, patient outcomes improved by reduced pressure ulcers and increased identification of patients at risk for malnutrition and falls. Integration of CDSSs with EMR/EHR improved documentation and prescribing …

Closed-System Transfer Devices Reduce Exposure To Contaminants, Ken Maxik, Craig Kimble, Alberto Coustasse

Management Faculty Research

Closed-system transfer devices (CSTDs) are used during the preparation of hazardous drugs (HDs) as a mechanism to reduce the transfer of drugs or vapors into the environment. When evaluating these systems, pharmacists should consider which drugs in the pharmacy would benefit the safety of health care workers and patients using the systems. Medication types include neoplastic agents, such as bleomycin, cisplatin, and methotrexate, and other agents, such as cyclosporine, oxytocin, and progesterone.

Evaluate 503b Facilities For Outsourced Compounds, Sarah Clemente, Brittany Riley, Alberto Coustasse

Pharmacy Practice & Administration

The US health care system has encountered long-standing, complex challenges, including growing costs, overuse of care, staffing shortages and supply chain weaknesses. COVID-19 revived these pressures, transforming the health care landscape. Medication and staffing shortages plague hospital systems, and pharmacies are not exempt. Most health systems have experienced high levels of pharmacy technician turnover, with most reporting a minimum turnover rate of 21% last year. In addition, medication shortages of critical medications and infusions create significant workflow barriers that hospitals must address to ensure patient safety. In the face of these obstacles, health systems are turning to 503B compounding facilities …

Radio Frequency Identification Enhances Patient Safety, Craig Kimble, Alberto Coustasse, Ken Maxik

Pharmacy Practice & Administration

Radio Frequency Identification (RFID) is a technology that uses tags and readers to identify and collect asset information. In pharmacies, this usually means RFID is used for high cost equipment or pharmaceuticals. RFID applications have been in use for many years but recently gained traction in health systems. RFID is becoming particularly effective in drug inventory and automation applications, such as medication carousels and pick-to-light systems.

Is The 340b Hospitals Battle At The Supreme Court Over?, Casey W.. Baker, Susan W. Lanham, Alberto Coustasse

Accounting Faculty Research

Under the Federal 340B Program, hospitals and eligible health care clinics that serve low income or rural populations can qualify for federally negotiated manufacturer discounts on purchases of prescription drugs. Approximately 50,000 entities participate in the 340B program, where pharmaceutical manufacturers are instructed to supply outpatient medications to participating providers at discounted rates of 20% to 50%. Participating hospitals depend on profits from the differential between their reimbursement for these drugs and the discounted rates they disburse to finance affordable patient care in underserved communities. On June 15, 2022, the US Supreme Court ruled that major cuts to 340B payments …

Gabapentin Presents High Potential For Misuse, Alberto Coustasse, Stacie Deslich, Susan W. Lanham, Brittany Riley

Management Faculty Research

The FDA Approved Gabapentin in 1993 as a non-controlled substance and it has remained a non-controlled substance at the federal level. The drug was created as an anticonvulsant and used to treat seizure disorders. The medication has also been used to treat hot flashes, neuropathic pain, pain, postoperative nausea, substance abuse issues, and vomiting. It is estimated that approximately 1% of people in the United States misuse gabapentin. This fact has compelled certain states to generate legislative initiatives designed to monitor the use and/or reclassify gabapentin. In 2019, US pharmacies dispensed 69 million prescriptions for gabapentin.

Prescribing Controlled Substances Goes Electronic, Alberto Coustasse, Craig Kimble, Ken Maxik

Management Faculty Research

With the Affordable Care Act in 2010 came interoperability and meaningful use requirements. Part of these requirements included the implementation of electronic medical records (EMRs), which was a crucial part of achieving these standards. With EMRs, prescribers began sending electronic prescriptions. EMRs can provide advanced decision support when writing prescriptions, and they include features such as auto populating the quantity prescribed, formulary information, therapeutic duplications, warnings about interactions, or other potential clinical or regulatory issues. This system results in enhanced patient care and a more streamlined dispensing process. In addition, electronic prescriptions for controlled substances (EPCS) has become more widely …

A Rare Metastatic Primary Rectal Melanoma In A Geriatric Male, Onyinye Ugonabo, Mujtaba Mohamed, Ebubechukwu Ezeh, Joseph Simmons, Jonathan Cuda, Shima Ghavimi

Internal Medicine

Primary rectal melanoma (PRM) is an uncommon malignancy whose etiology remains unknown. Most patients present with rectal bleeding. Distant metastasis is commonly seen in the lung and liver. The incidence rates for locoregional lymph node metastases on initial presentation are almost 60%. Histology and immunochemistry are useful and are the gold standard for diagnosis. The prognosis is very poor due to the late presentation of patients. Optimum surgical treatment remains controversial. Abdominoperineal resection was considered traditionally but over time, has been found to have no survival benefit. Current literature and studies, therefore, recommend wide local excision. The beneficial effects of …

The Women Of Owen Clinic And Their Impact On Rural Mental Health, Mallory Stanley

Manuscripts

The mid-1900s was a pivotal moment in reforming mental health treatment in American Psychiatry. This movement becomes particularly clear when examining the championing work of two women, Dr. Thelma V. Owen and Dr. M. G. Stemmermann, at a rural mental health facility located in Huntington, WV: Owen Clinic Institute. While mental health stigma was at an extreme high among the general population, many factors aligned to allow for a new era of mental health care, including deinstitutionalization, World War II, and the advocation of professionals in the field. In West Virginia, no two people were more outspoken and active in …

20220322: Mu School Of Medicine Origins, Dr. Maurice Mufson's Files, 1976-2021, School Of Medicine

Guides to University Archives

These items include materials from a former faculty member at Marshall University School of Medicine (Dr. Maurice Mufson) from 1976-2021. Items were received in 2022and include notable materials from Dr. Mufson's personal achievements as well as his documents from the development and establishment of the Medical School. This is not an exhaustive list. Please download the finding aid for a list of contents.

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Youth Throwing Athletes Do Not Show Bilateral Differences In Medial Elbow Width Or Flexor Tendon Thickness, Rudolph M. Morrow, Gary Mcilvain, Jenifer Johnson, Mark Timmons

Kinesiology Faculty Research

Background: Medial elbow laxity develops in throwing athletes due to valgus forces. Medial elbow instability in professional, collegiate, and high school athletes is well documented; however, the medial elbow of young throwing athletes has received less attention. This study investigated the medial elbow and common flexor tendon during applied elbow valgus stress of youth baseball players.

Methods: The study included 15 participants. The medial elbow width and thickness of the common flexor tendon were measured on ultrasound images.

Results: No significant side differences in medial elbow width or common flexor tendon were found at rest or under applied valgus stress. …

Tele-Icu In The Unites States: Is A Cost-Effective Model?, Michael Robie, Stephanie Cole, Archana Suwal, Alberto Coustasse

Management Faculty Research

Introduction: The United States Society of Critical Care Medicine has announced a shortage of all critical care intensivists due to the increased need for critical care for the aging population with comorbidities and improved life expectancy. This shortage has led to tele-ICU programs that have allowed intensivists to care for patients simultaneously remotely.

Methods: This study aimed to assess the potential for the hospital implementation of tele-ICU to determine its overall healthcare cost-effectiveness. The methodology was a review that followed a systematic search approach utilizing 42 sources.

Results: The study findings showed that tele-ICU contributed to reduced hospital LOS by …

Race And Sex Associations With Tacrolimus Pharmacokinetics In Stable Kidney Transplant Recipients, Kathleen M. Tornatore, Calvin J. Meaney, Kristopher Attwood, Daniel A. Brazeau, Gregory E. Wilding, Joseph D. Consiglio, Aijaz Gundroo, Shrley S. Chang, Vanessa Gray, Louise M. Cooper, Rocco C. Venuto

Pharmaceutical Science and Research

Study Objective: This study investigated race and sex differences in tacrolimus pharmacokinetics and pharmacodynamics in stable kidney transplant recipients.

Design and Setting: A cross-sectional, open-label, single center, 12-h pharmacokinetic-pharmacodynamic study was conducted. Tacrolimus pharmacokinetic parameters included area under the concentration-time curve (AUC_0–12), AUC_0–4, 12-h troughs (C_{12 h}), maximum concentrations (C_max), oral clearance (Cl), with dose-normalized AUC_0–12, troughs, and C_max with standardized adverse effect scores. Statistical models were used to analyze end points with individual covariate-adjustment including clinical factors, genotypic variants CYP3A5*3, CYP3A5*6, CYP3A5*7(CYP3A5*3*6*7 …

Store, Handle, And Administer Vaccines Safely To Prevent Errors, Craig Kimble, Kenneth Maxik, Alberto Coustasse

Management Faculty Research

Insufficient training, multiple manufacturers, and noninterchangeable products increase the risk of vaccine-related errors. Increasing the complexity are the addition of boosters with different doses, personnel new to the vaccine administration process, changes in dosing, easily misidentified labeling or products, vaccines given together, and the interchanging of booster products.2,3 As a result, there is an increased need to be alert in safety efforts with vaccine administration and storage. Pharmacy staff members must work together to improve safety and prevent vaccine-related errors.

Prenatal Exposure To Methamphetamine Causes Vascular Dysfunction In Adult Male Offspring, Hasitha Chavva, Adam M. Belcher, Daniel A. Brazeau, Boyd Rorabaugh

Pharmaceutical Science and Research

Methamphetamine use during pregnancy can have negative consequences on the offspring. However, most studies investigating the impact of prenatal exposure to methamphetamine have focused on behavioral and neurological outcomes. Relatively little is known regarding the impact of prenatal methamphetamine on the adult cardiovascular system. This study investigated the impact of chronic fetal exposure to methamphetamine on vascular function in adult offspring. Pregnant female rats received daily saline or methamphetamine (5 mg/kg) injections starting on gestational day 1 and continuing until the pups were born. Vascular function was assessed in 5 month old offspring. Prenatal methamphetamine significantly decreased both the efficacy …