Even before the covid-19 pandemic, virtual consultations (also called telemedicine consultations) were on the rise, with many healthcare systems advocating a digital-first approach. At the start of the pandemic, many GPs and specialists turned to video consultations to reduce patient flow through healthcare facilities and limit infectious exposures. Video and telephone consultations also enable clinicians who are well but have to self-isolate, or who fall into high risk groups and require shielding, to continue providing medical care. The scope for video consultations for long term conditions is wide and includes management of diabetes, hypertension, asthma, stroke, psychiatric illnesses, cancers, and chronic pain. Video consultations can also be used for triage and management of a wide range of acute conditions, including, for example, emergency eye care triage. This practice pointer summarises the evidence on the use of video consultations in healthcare and offers practical recommendations for video consulting in primary care and outpatient settings.

Although health care billing claims data have been widely used to study health care use, spending, and policy changes, their use in the study of infectious disease has been limited. Other data sources, including from the Centers for Disease Control and Prevention (CDC), have provided timelier reporting to outbreak experts. However, given the scope of SARS-CoV-2—the causative agent responsible for the novel coronavirus disease 2019 (COVID-19) pandemic—and the multidimensional impact of the crisis on the health care system, analyses relying on health care claims data have begun to appear. Claims-based COVID-19 studies have a role, but it is critical to understand the limitations of these data. We are concerned that many weaknesses are not recognized by those familiar with other forms of patient-level data. Below, we examine several major considerations and make suggestions about where claims data may be best leveraged to inform policy and decision making.

Epidemiological modeling has emerged as a crucial tool to help decision-makers combat COVID-19, with calls for non-pharmaceutical interventions such as stay-at-home orders and the wearing of masks. But those models have become ubiquitous and part of the public lexicon — so Nirav Shah and Jason Wang write that they should follow an impact-oriented approach.

Stanford Health Policy’s Joshua Salomon, a professor of medicine and senior fellow at the Freeman Spogli Institute for International Studies, and colleagues developed a mathematical model to examine the potential for contact tracing to reduce the spread of the coronavirus. They modeled contact tracing programs in the context of relaxed physical distancing under different assumptions for case detection, tracing coverage and the extent to which contact tracing can lead to effective quarantine and isolation.

In a recent perspective published by the New England Journal of Medicine(NEJM), Stanford Law student Alexandra Daniels analyzed a growing body of federal litigation brought by prisoners with the hepatitis C virus (HCV) who are seeking access to treatment for their condition. With co-author and mentor, Law Professor David Studdert — also a professor of medicine at Stanford Health Policy — Daniels documented the dire public health problem of HCV in prisons.

In March 2020, when many U.S. states and localities issued their first emergency orders to address Covid-19, there was widespread acceptance of the government’s legal authority to respond quickly and aggressively to this unprecedented crisis. Today, that acceptance is fraying. As initial orders expire and states move to extend or modify them, legal challenges have sprouted. The next phase of the pandemic response will see restrictions dialed up and down as threat levels change.  As public and political resistance grows, further legal challenges are inevitable.

Vaccine hesitancy, the reluctance or refusal to receive vaccination, is a growing public health problem in the United States and globally. State policies that eliminate nonmedical (“personal belief”) exemptions to childhood vaccination requirements are controversial, and their effectiveness to improve vaccination coverage remains unclear given limited rigorous policy analysis. In 2016, a California policy (Senate Bill 277) eliminated nonmedical exemptions from school entry requirements. The objective of this study was to estimate the association between California’s 2016 policy and changes in vaccine coverage.