Tag: Travel

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Virtual care becomes new standard in era of COVID-19

The coronavirus pandemic has forced a reshaping of the landscape of healthcare, requiring the medical community to look for new, safer approaches to patient care.

To keep patients and team members safe, virtual visits are now conducted via remote communication technology, such as Telehealth and Telemedicine. This is the new normal of patient doctor interaction, and represents a new era of healthcare delivery, and one that will continue into the foreseeable future.

As the pandemic continues, frontline workers at doctors’ offices and hospitals have been put to the ultimate test. In response, new and better programs of communications via Internet technology were enhanced, and audio check-ins restructured. Through telehealth and telemedicine, doctors and nurses can now engage patients via digital devices to meet basic healthcare needs.

During the height of the pandemic, most elective procedures at hospitals and doctors’ clinics were cancelled. With new variants of the virus threatening the country, a new challenge has been created. With elective procedures canceled, questions arose on how to safely care for emergency and non-emergency patients in a safe environment.

The solution was a broadening of virtual care to interact with patients, maintain safe environments, and adhere to mandated social distancing guidelines. The Centers for Medicare & Medicaid Services (CMS) increased access to Medicare telehealth services so beneficiaries could receive a wider range of care from their doctors without them having to travel to a healthcare facility.

“To protect both staff and patients, some medical practices closed their doors to in-person visits because of concerns over the risk of transmission,” said Randall M. Taubman, M.D., CPE, regional medical director at ClareMedica Health Partners LLC, Miami Lakes. “We remained open; our staff wore personal protective equipment (PPE) and each patient was thoroughly screened. Anyone screened as a possible COVID candidate was seen remotely.”

According to Dr. Taubman, video-based visits are preferred and more effective. “The doctor and the patient can see each other and it’s a more natural interaction,” he said. “Plus, if there are any physical changes, doctors can analyze the problem, and that’s a big benefit over an audio virtual visit.” Differences also exist between the way medical codes are applied and how video-based visits are billed.

Scheduling a remote health visit
Telehealth visits can be Web-based or done through a phone call to the office, but prior to the online interaction, most practices require verification of identity and insurance information. “Patients must consent to this form of care, and when they ‘meet’ with their doctor, the visit is conducted in much the same way as an in-person visit,” said Dr. Taubman. “The one exception is that doctors may ask additional questions about a patient’s general health and well-being.”

Before opting for a telehealth or telemedicine visit, patients should make a list of questions. They should also be prepared to explain any symptoms and list medications, dosages, and times they are taken daily.

“The best way to prepare for a virtual health visit is to find a quiet, private room where there are no distractions,” Dr. Taubman said. “Patients need to download any applications needed for the two-way communications and decide beforehand if the visit will be done on a computer, tablet, or phone. The doctor’s office needs to be aware of the patient’s choice. When prescribing medications, doctors still use electronic prescribing to send the script to a pharmacy — a routine practice even before the start of the COVID-19 pandemic.”

A new revenue stream
Reaching out to patients and serving them remotely is now a necessity to sustain physician practices. It is even a benefit to hospitals where there has been a revenue decline in long-standing money-making units such as operating rooms, interventional radiology, and outpatient services. Virtual care is now a proven means of caring for patients safely while tapping into a revenue source that helps offset the decline of in-person visits.

Over the months, regulatory and reimbursement barriers that hindered the widespread use of telehealth were relaxed, allowing providers more freedom to use virtual care for their patients. The Centers for Disease Control (CDC) says that during the first quarter of 2020, the number of telehealth visits increased by 50 percent. This allowed providers to scale their technology, learn more about various platforms, and reshape strategies that would be the most benefit to patients.

The difference between Telehealth and Telemedicine
The words “telehealth” and “telemedicine” are sometimes used interchangeably, but they don’t mean the same thing. The Health Resources Services Administration (HRSA) says telehealth is the “use of electronic information and telecommunications technologies to support long-distance clinical health services, patient and professional health-related education, public health, and health administration.” These technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and wireless communications. Telemedicine, however, refers to “specific remote clinical services.”

Both play a critical role in the new era of patient care. Virtual care allows doctors to communicate with patients at a variety of locations that include their residence, a nursing home, an emergency room, or specific divisions within hospitals such as wards, special care units, and even psychiatric units. In addition, access to remote care greatly reduces the potential of exposure to the virus and lowers demands on frontline workers.

Types of remote visits
The three basic types of access routinely used are: Medicare Telehealth (MTH) visits, Virtual Check-ins (VCI); and E-Visits (EV). MTH utilizes telecommunication systems between the provider and patient and may include office visits, out-patient visits, or consultations. The VCI is a brief phone check-in with a practitioner to discuss whether an in-office visit is required, or a remote evaluation can be conducted where a patient can submit images (as in the case of dermatology) to his or herdoctor for  evaluation. The EVs are a format to communicate between patient and provider via an online patient portal.

Telehealth popularity
According to the CDC, the number of telehealth visits in the U.S. increased by 50 percent during the first quarter of 2020 and providers reshaped their strategies to engage with patients. “The use of telehealth is a trend that I don’t foresee diminishing even if COVID improves,” commented Dr. Taubman. “It can help with physician shortage and travel issues in the medical industry, so I believe it’s here to stay.”

According to a Telehealth Impact Claims Analysis conducted by the COVID-19 Healthcare Coalition Telehealth Impact Study Work Group, the latest numbers on telehealth claims in Florida peaked at around 700,000 in April of 2020, and the primary diagnosis of circulatory issues exceeded 200,000. Claims nationwide for circulatory issues in the country exceeded five million in February of last year, and total claims exceeded 12 million.

New advances in digital health technology have transformed patient treatment models internationally. Greater access and more efficiency are the keys to serving patients in the era of COVID-19.

 

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New exhibits at Boca Raton Museum of Art

In keeping with the spirit of the times, the Boca Raton Museum of Art is hosting six new exhibitions, many of them featuring works by women and artists of color. Three exhibits opened in October and the other three will open Jan. 26, 2021.

Two shows were extended beyond the quarantine and will continue through Jan. 3: Edward Steichen: In Exaltation of Flowers, and Works on Paper: Drawn from the Collection.

“This year has been an unprecedented journey for cultural institutions,” says Irvin Lippman, executive director of the museum. “We are fortunate to be able to provide new initiatives and exhibitions and, most importantly, a safe haven for visitors — a place of repose and enjoyment.”

“Our latest exhibits are part of recent acquisitions underscoring that the museum’s collection continues to evolve with new works by women and artists of color who challenge us to see the world anew,” says Lippman.

One of those women is Jamaican-American artist Renee Cox, known for her collection, “Flipping the Script,” which speaks to race, religion, and gender roles.

Cox flips the script again in her new work titled, “The Signing,” part of the Museum’s latest exhibition. The 15-facetime. long photograph reimagines Howard Chandler Christy’s iconic painting, “Scene at The Signing of the Constitution of the United States.”

In Cox’s interpretation, people of color, wearing traditional African clothing and period clothing from the 1700s or contemporary items, stand in for the founding fathers.

Another artist of color – the late Benjamin Patterson, one of the founding members of the Fluxus art movement during the 1960s-70s, which claims Yoko Ono as one of its own, has his work, “My Thirteen Presidents,”showcased at the museum.

Patterson depicts American presidents, along with their astrological signs, who served during his lifetime (1934- 2016) from Roosevelt to Obama.

Also on display and spanning an entire wall in the first floor gallery is Norwegian artist, Trine Lise Nedreaas’s 22-minute three-panel synchronized film, “The Entertainers” featuring the video, “The Mask,” in which a subject, Arthur, transforms himself into his alter-ego, Arthuro the Clown.

On the museum’s second floor, Delray Beach-based ceramicist and steel sculptor, Jeff Whyman’s, “Out of Nature,” features a selection of his one-of-a-kind ceramics using clays from California and Washington, and fabricated in kilns from Illinois, Missouri, and Florida, all yielding different results.

Whyman creates his works all in one moment while the clay is still wet. He uses the wheel to throw his vessels while spontaneously adding a mix of materials: sea glass, Chinese crystals, and mineral oxides.

Coming in January are “Glasstress Boca Raton 2021,” featuring Chinese dissident artist Ai Weiwei’s Blossom chandelier sculpture, that will travel by boat from Italy to Boca Raton, “An Irresistible Urge to Create: The Monroe Family Collection of Florida Outsider Art,” and “Paul Gervais: Faces and Forms.”

Read more about all of the upcoming shows at bocamuseum.org/art/ upcoming-exhibitions.

 

 

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Planning your post-pandemic vacation

Summer of 2020 will likely not be remembered for the vacations you took. We have all been dealing with stress from the unseen contagion that has been aging us more than it should.

Amidst a conversation with a friend with whom we vacation with regularly, he said, “It’s your turn to plan the next trip. 2021 is coming up, and we should have a vaccine by then.”

Planning for a vacation in the past has involved searching for destinations, booking online, and simply going. This year, with all the rules, special conditions, and offers, I felt it would be best to seek professional help.

I reached out to Carlos and Renee Boozer, from Cruise Planners. They are full-service travel planners and offered a lot of valuable insight into the current state of the vacation planning industry.

“Most river cruises on the Mississippi river are sold out ’til July 2021,” Carlos mentioned, “unless there is a cancellation.” Not having to travel internationally, the Mississippi trip is growing in popularity.

Another popular option for our New Normal is RVing. I learned travel planners can help you rent an RV, and ensure you have all you need to camp in a national park with style. It’s not only a good option for a family vacation but also a group of friends.

A Caribbean cruise would normally be a great way for a group of friends to enjoy the islands. With the pandemic, the Caribbean cruise protocols and plans are still pretty much in flux. According to Carlos, the cruise industry is offering extra perks to excite their customers into taking advantage of 2021 and 2022.

Another option is to check out one of the many resorts in the Caribbean. All-inclusive resorts were a favorite for us and provided a great way to experience the local culture, with a well-defined budget. Many of the top tier resorts like Sandals and Beaches offer a concierge service to help ensure you clear immigration and customs smoothly. With all the rules governing international travel being constantly adjusted, having the guidance of local professionals will make your trip much less stressful.

After a season of too much Youtube, I am looking forward to next summer. Hopefully, a vaccine for COVID-19 will be widely available in time, and we can again gather with family and friends while sharing a cool summer cocktail. Working with a travel agency like Cruise Planners will make it easier to navigate through the complicated rules for each country and avoid surprises.

By Li Pan

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A big fisherman in any pond

George Poveromo of Parkland, whose television show “George Poveromo’s World of Saltwater Fishing” airs on Discovery Channel, shows off a nice kingfish.

George Poveromo has caught big fish in oceans, bays, inlets, rivers, and estuaries throughout the coastal United States, as well as from Canada to Brazil to Cuba. But when he’s not on assignment as Editor-at-Large for Salt Water Sportsman magazine or taping episodes of his “George Poveromo’s World of Saltwater Fishing” television show on Discovery Channel, he likes nothing better than relaxing while enjoying the tranquility of his home in Parkland.

A native of North Miami, where he grew up fishing with his father, Poveromo and his wife, Edie, moved to Parkland in 1994, where they raised their daughters Lindsay and Megan.

That the country’s foremost saltwater fishing expert, whose
TV show has aired for 20 years and whose Salt Water Sportsman National Seminar Series has been held for 33 years (visit www.georgepoveromo.com), lives in a quiet residential neighborhood closer to the Everglades than the Atlantic Ocean has many of his readers, viewers and social media followers wondering why.

“I was asked that question a lot, and I’m still occasionally asked that question: ‘What are you doing in Parkland? You’re a saltwater guy. You’re an ocean guy,’” said Poveromo, who keeps his 33-foot Mako fishing boat Marc VI at Garnett Storage in Coral Springs. “When we came up to Parkland, it was like a little bit more of a country kind of atmosphere here. I said, ‘This is a nice place, and I think it’s perfect.’

“I trailer a boat, so one day I could go out of Hillsboro (Inlet in Pompano Beach), the next day I might want to go out of Haulover (Inlet in North Miami Beach) or I might go down to the Keys or go to Palm Beach, so I’m still as flexible as I always was. I think moving to Parkland was a very good choice. And when you do it as much as I do it, it’s sometimes good just to catch a break away from the saltwater environment.”

Poveromo, 62, got hooked on saltwater fishing more than
five and a half decades ago. His father, Mel, a dentist in Bay Harbor Islands, used to take him after work to the nearby Broad Causeway to fish in Biscayne Bay from the seawall. Using a kid-sized rod and reel and a small hook baited with pieces of shrimp, Poveromo caught tiny snappers and grunts.

“I used to love to do that. I think I have Biscayne Bay water going through my veins,” Poveromo said. “My dad was the only one in the family that had the crazy fishing passion, and no one else inherited that except for me.”

When Poveromo was old enough to fish with his father in his boat, they’d fish off Miami or trailer the 23-foot vessel to Key West and run about 30 miles west to the Marquesas. They’d catch snappers and groupers around shallow rock piles, anchor, cook fish for dinner, sleep on the boat and fish the next day before heading back.

“To this day I still try to get down there at least once a year to fish the Marquesas because of all the fond memories,” Poveromo said.

He pursued his passion for fishing while a student at The University of Miami, where he majored in broadcast journalism. Not because he wanted to host a TV fishing show, but because his classes were fairly easy and he could schedule all of them on Tuesday and Thursday, which gave him the opportunity to fish Monday, Wednesday, and Friday.

Little did Poveromo know how that education at sea would pay off.

Through his success fishing in Mako owner tournaments, he caught the attention of Mako Marine’s marketing director Bill Munro. While a senior at UM, Poveromo was invited by Munro to fish in the Mako Outdoor Writers tournament, an informal gathering that featured editors of the country’s most prestigious fishing magazines. That led to Poveromo writing articles for Outdoor Life and Salt Water Sportsman magazines, and he was hired as a full-time staff writer for the latter publication in 1983.

“So if it wasn’t for Bill Munro and Mako,” Poveromo said with a smile, “I might’ve been forced to become a dentist like my dad wanted me to be.”

Poveromo stayed busy fishing, writing and organizing the seminar series out of North Miami for 10 years, where Edie gave birth to Lindsay. When close friends moved to Broward County, Edie entertained the idea of following their friends north and having Lindsay attend some of Broward’s excellent public schools.

One day, a gentleman from Parkland called Edie to order a seminar ticket, and as Poveromo related, she said, “Parkland, where is that? He said, ‘Oh, I don’t want to tell you, it’s one of the best-kept secrets around.’ She goes, ‘I’m a native Floridian, I’ve never heard of Parkland.’ And he told her, ‘It’s the most magnificent area. It’s just starting to grow. There’s space; you can breathe out here, the school system’s superb. You need to go up and just look at the area.’

“So we took a drive up and looked at the area and then Edie did her research of the school systems. We were fairly close to our friends, and Edie said, ‘That’s the place we’re going to. We’re going to Parkland.’ And that’s what led us here from North Miami.

“I can never see myself moving anywhere else.”

HIGHLIGHTS

During his storied career, George Poveromo has had some amazing fishing experiences. Among the highlights:

  • Produced a TV show fishing on his boat with members of the military at the U.S. Naval Station at Guantanamo Bay, Cuba.
  • Caught a 143-pound wahoo fishing in San Salvador, Bahamas, and caught a 113-pounder there three years later.
  • Caught a 701-pound giant bluefin tuna out of Prince Edward Island, Canada.
  • Released a blue marlin estimated to weigh between 700- 800 pounds in Costa Rica.
  • Had a swordfish yank him overboard while fishing in Islamorada when a passing boat’s wake caused him to lose his balance. With help from his cameraman Kevin Tierney, who jumped in the water, Poveromo got back in the boat and, 30 minutes later, landed the 256-pound swordfish.

 

FISHING TIPS

TV show host, seminar organizer, and writer, George Poveromo shared these secrets for saltwater fishing success in South Florida:

Use fresh line: “One of the simplest tips, and I even hate to say it because it just sounds so simple but you’d be shocked at how many people don’t adhere to it except the really good anglers, always make sure your fishing line is new and fresh. When you fight a good fish like a sailfish on a 20-pound test (line), even though that line looks good, the line’s been compromised. It might start off at 20 pounds, but then the breaking strength might fall to 15, 14 pounds, depending on how much it was compromised,” Poveromo said. “What’s going to happen, eventually, is you’re going to hook that trophy fish and if you’re using worn line, chances are that fish could probably go right through it. Line is one of the cheapest things to put on your fishing reel. So change out line religiously, especially after any quality fish you catch.”

Finding fish: “The Gulf Stream is the lifeblood, and it’s essential to know where the true western edge of the Stream is because it meanders. It moves close, it moves farther off,” said Poveromo, who recommended subscribing to SiriusXM Marine fish mapping or ROFFS fishing forecasts. “That warm water current flowing north, you want to find the edge where it meets that nearshore cooler water.
It creates upwellings, and all the upwellings bring these tiny microorganisms in; then the fish that feed on them come in. When you have baitfish along these zones, the bigger gamefish shouldn’t be far behind. If the true western edge is in 600 feet, that’s a good time to troll for dolphin. If it’s in 90 feet, that’s going to be a good edge to fish for sailfish.”

Fish around baitfish: “Always look for bait and signs like working birds,” said Poveromo, who also studies his electronic fish finder for pockets of bait. “If you see flying fish pushing, shut down the boat and fish. There has to be some dolphin around.”

Fish deep: Especially during the heat of a summer day. Poveromo said that if you find a weedline, fish some live baits on the surface and put at least one live goggle-eye down 250-300 feet. Bigger dolphins often hang out below schools of smaller dolphins. “We caught a 34-pound bull dolphin doing that in Islamorada,” he said. “A lot of those big dolphins are down in that cooler water. It makes a big difference.”

By Steve Waters

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The “New Normal” changing travel

Let’s go Rafting!

A friend on the west coast texted the invitation. The annual gathering for rafting is on, with Colorado allowing those activities based on their reopening. After holing up at home for three months, never venturing beyond two miles from where I sleep, it was exciting. Soon I was searching for flights.

Changes in Flying

I have lived through change in travel. During spring break over 25 years ago, I was with a group of college dorm mates driving south from Canada. Crossing the border, the only question the friendly agent asked the five of us was, “Are you all Canadians?” A quick nod, a verbal yes, and we were off, headed down I-95 to Florida for the first time.

Since then, I have traveled often between Canada, the US, and overseas. Air travel felt not much different than hopping on a bus. The world felt smaller.

Just over a month after the horrible attack on 9/11, I was flying through London on my way to Rome, and for the first time, I experienced the enhanced security that was being established.

Over two hours in a line to go through the security check during transfer was very stressful. Times had changed forever.

Over time, things have improved. I was traveling regularly, and sometimes I would go two weeks around the world internationally. I got used to spending more time in airline lounges. TSA precheck and Global Entry made my life going through security easier. I again started to be comfortable arriving less than one hour before the gate closed.

Limited flights

A three to four hour flight with my trusty mask, and a quick in and out through the airport, separated me from a fun weekend with guys I had only seen on video chat, rafting down the cold waters in Colorado. Or so I thought.

Soon I realized, the number of direct flights to Denver from Florida is near zero. In fact, there was only one flight and it landed near midnight. Which means I would need to stay a night that I wasn’t planning, or take a chance at a connection at one of the hubs.

After a day of back and forth, playing out the odds in my mind, I decided to drop out.

The world no longer feels small

I started to wonder, will traveling change after this?

Not able to just travel to NYC to see my sister, or Pennsylvania to visit my parents, or the wedding of a friend in Canada makes me realize the vast distance that now separates us. We are all fighting our individual battles against COVID-19, the illness and the psychological stress.

In a couple of years, I hope we will look back to the current day as a blip in our ever-shrinking world. But for now, we are blessed to live where others come to vacation, and expand your local connections. It’s amazing what you can find in our little corner of South Florida, and many interesting experiences that you can have and still obey the safety rules to minimize risk. We will continue to share our experiences in adapting to the New Normal, and you can send in yours if you want to share by sending an email to submissions@theparklander.com, or click on submit on our homepage.

By Li Pan

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Stay Healthy Overseas – Remember These Tips to Ensure You Are Well Prepared For Happy And Healthy Travels

Stay Healthy Overseas

At least 4-6 weeks before traveling, especially somewhere exotic, it is important stay healthy overseas by visiting a travel medicine specialist or a doctor familiar with travel medicine. While websites such as the Center for Disease Control and Prevention can provide basic information relevant to your travel location, it is important that you consult a specialist. These specialists will be able to make more specific recommendations regarding vaccination and/or medications based on factors such as: your destinations, the length of your trip, your age, medical history, and any activities you may have planned. When looking for a travel medicine provider, you can first consult your primary care physician who will be able to refer you to a proper specialist. There are also private clinics that specialize in pre-travel advice and preparation, which can be found through the International Society of Travel Medicine or American Society of Tropical Medicine and Hygiene.

When you begin packing, some important self-care items to include would be SPF-appropriate sunscreen, insect repellent, small first aid kit, pain/fever reliever, feminine hygiene products, and hand sanitizer. While many of these items may be available during your travels, they may not be the formulation you are accustomed to and are often very expensive.

 Healthy Travels

With regard to medications it is important to bring all of your prescription and over-the counter medications in their original bottle with enough supply for the duration of the trip plus a few extra days should any issues arise. It is also important to pack all medications in your carry-on baggage.Call your health insurance company before traveling to check what extent your policy covers your health needs in a different state or abroad. Make sure to include copies of your health insurance card in your travel documents. Depending on your standard health insurance coverage, you may want to consider purchasing additional travel health insurance. The price of the premium will vary by trip but can be very reasonable for the peace of mind it provides.

Two of the most important steps you can take to stay healthy overseas and prevent illness is to stay hydrated and wash your hands. However, if you or someone you are traveling with unfortunately becomes ill while traveling, it is important to seek help as soon as possible. If you are on a group trip or a cruise, you can alert the group leader or cruise health provider to the situation. If you are traveling on your own, you can first contact the U.S. embassy or consulate, which will be able to refer you to appropriate local doctors and medical facilities. Detailed information on doctors abroad can be found in The Official ABMS Directory of Board Certified Medical Specialists, published for the American Board of Medical Specialties, or the International Society of Travel Medicine website. It is also helpful to contact your health insurance company to alert them of your situation, to expedite coverage, and they may be able to provide additional resources. Maintain copies of all medical records and bills you receive during your medical care, and be sure to follow up with your primary care physician when you return home.

By spending the extra time to prepare, you will be able to fully enjoy your travel adventures knowing you are ready not only to have an unforgettable time but also to properly address your health needs should they arise.
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