2008-03-10 00:00:00

Medical Homes for Diabetes Raise Compliance, Reduce Disease-related Costs

Early results from two groundbreaking pilots validate the benefits of the patient-centered medical home model for patients with diabetes:

First, a unique data exchange between the largest insurer in New Jersey and an 850-physician organization resulted in the creation of a member-specific profile for each diabetes patient accessible at the point of care. Partners in Care (PIC) Medical Director Dr. James Barr said the one-year pilot that joined the disease management efforts of Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) with those of PIC physicians dramatically improved compliance levels and clinical outcomes for patients with diabetes — from 43 percent to 91 percent for the key HbA1c blood test. The program focused on New Jersey State Health Benefits Program members with diabetes. Dr. Barr said participating practices spent approximately 15 to 30 additional minutes per month with each patient in the pilot. This could be time spent with the provider or a staff member, he explained. The payor-provider collaboration has been so successful that Horizon BCBSNJ plans to extend the model to other chronic illnesses. The patient-centered medical home model makes the personal physicial responsible for all the patient’s healthcare needs for all stages of life — and arranging this care with other qualified professionals.

A second pilot for Medicaid patients in North Carolina saved the state $231 million in healthcare costs in 2005 and 2006. Roberta Burgess, nurse case manager for Community Care Plan of Eastern North Carolina through Heritage Hospital in Tarboro, N.C., said that provider toolkits and patient diabetes action plans developed for the program were key communication vehicles in the diabetes medical home project. She also said that case managers were effective liaisons between provider and patient, suppporting patients with information and sometimes even transportation. As a result, patients were better educated about care and self-management and better prepared for their doctors’ appointments. The program was one of seven winners in Harvard University’s 2007 Innovations in American Government Awards.

Filed under: — @ 2008-03-10 00:00:00
2008-03-05 00:00:00

MRSA Detection and Prevention News

We recently surveyed healthcare organizations on their reactions to MRSA outbreaks. We invite you to comment here on your strategies, as well as review two new advances this week in the detection and prevention of Methicillin-resistant Staphylococcus aureus (MRSA):

In The New York Times, Andrew Pollack spotlights a California company that has developed a rapid genetic test to detect MRSA:

Patients might not particularly like the new admission procedure at a growing number of hospitals: having what looks like an elongated Q-Tip stuck up their noses. But it smells great to Cepheid. Cepheid, a biotechnology company in Silicon Valley, sells a rapid genetic test to detect MRSA, an antibiotic-resistant ???superbug??? that has received considerable media coverage and kills more Americans than AIDS.

And healthcare workers in Canada are receiving electronic reminders to disinfect before touching patients, according to CBC News:

Researchers at the Toronto Rehabilitation Institute have developed a hand hygiene device. It consists of a sensor worn around the neck, infrared lights above the patient’s bed, and an alcohol gel dispenser attached to the waistband.

A healthcare worker wears the sensor and a beep is triggered when the person approaches a patient’s bed, reminding them to use the sanitizing gel. If the healthcare worker has already done so, the beep will not sound.

The system also records the time of entry and exit from each patient area and the number of times hands are disinfected. This data can be downloaded into a computer so individual staff members can check their overall hand hygiene and compare it anonymously against their peers.

Filed under: — @ 2008-03-05 00:00:00
2008-03-04 00:00:00

Americans Have Trouble Paying for Drugs or Skip Prescriptions Due to Cost

A new poll, the third in a series conducted jointly by USA Today and public opinion researchers at the Kaiser Family Foundation and the Harvard School of Public Health, finds Americans greatly value prescription drugs‘ potential benefits for their families, but most believe they cost too much money and many struggle to pay for needed medicines.

  • Four in 10 Americans (and half of those regularly taking at least one medication) report experiencing at least one of three cost-related concerns in their family: 16 percent say it is a “serious” problem to pay for prescription drugs; 29 percent say they have not filled a prescription in the past two years because of the cost; and 23 percent say they have cut pills in half or skipped doses in order to make a medication last longer. People are most likely to report one of these three issues if they lack drug coverage (52 percent), if they have low incomes (54 percent) or if they take four or more drugs regularly (59 percent).
  • Nearly eight in 10 Americans say that the cost of prescription drugs is unreasonable, and seven in 10 say pharmaceutical companies are too concerned about making profits and not concerned enough about helping people. Nearly two-thirds (64 percent) of the public say that there is not enough government regulation to limit the price of drugs. Nearly six in 10 say insurers should only pay for new drugs if they are proven to be not just safe but also more effective than existing ones.

Filed under: — @ 2008-03-04 00:00:00
2008-03-04 00:00:00

Many Patients Can Reach LDL Cholesterol Goal Through Dietary Changes Alone

Patients worried about their cholesterol may want to visit a registered dietitian (RD) to get some sound advice about how to shape up eating habits, according to a new national study led by University of Michigan Health System researchers. The new results, published in the February issue of the Journal of the American Dietetic Association, are based on data from 377 patients with high cholesterol who were counseled by 52 RDs at 24 sites in 11 states.

  • In the group of 175 patients who started the study with triglycerides less than 400 milligrams per deciliter of blood (mg/dL), and who had their cholesterol measured before they changed or added medication, 44.6 percent either reduced their levels of ???bad??? cholesterol by at least 15 percent, or reached their cholesterol goal.
  • A significant number of patients reduced the fat in their diets to less than 30 percent of calories, as recommended for heart health. Many participants also lost weight and/or increased the number of days each week on which they exercised for 30 minutes or more.

Filed under: — @ 2008-03-04 00:00:00
2008-02-29 00:00:00

Employee Health Promotion No Headache for this Manufacturer

In a recent discussion about the importance of creating a workplace culture of health, David Sensibaugh, Eastman Chemical Company’s director of Integrated Health, described how his organization addressed the indirect impact of workers’ headaches and migraines on the safety of a manufacturing environment:

It is important to note that whenever we have accidents, like most manufacturing companies will tend to do on occasion, we review the cause, the results and the factors around the accident. We have found that in addition to unsafe behavior, health is a contributing factor to accidents on the job. Of the different types of health factors, a migraine is one of those.

We also participated in a health and productivity questionnaire survey that did much to help us understand the indirect cost of poor health within our population. A subset of that is the migraine element, which showed that about 28 percent of our employees suffered from migraines or headaches, and that the cost of that to our population is over $4 million annually.

That led us to participate in a headache education project. It was a joint effort between Eastman Integrated Health, HealthFitness and Johnson & Johnson Health Care. We had a company-wide marketing effort and employee information sessions, some which were held byan outside migraine expert from Vanderbilt Medical Center. The expert also held a physician dinner to help people in our community understand why this was an important issue and what we were trying to do with it here. Then we allowed people to voluntarily participate in this migraine study.

The study began with a pre-survey to help get an assessment of people???s headaches, their headache status, the severity of their headaches, their knowledge of headaches and headache treatment and so forth. Then we followed that up for period of about three months with educational materials provided by Johnson and Johnson. There was a small incentive to complete this study, a $25 gift card. After those three months of education and study there was a follow-up survey that was sent out, and then we had a headache severity survey that is currently being completed. Over 500 employees voluntarily participated in this study. The results of that will be forthcoming.

Filed under: — @ 2008-02-29 00:00:00
2008-02-28 00:00:00

Childhood Obesity Increasing at Alarming Rates

According to the American Heart Association, 9 million children and adolescents between 6 and 19 years old are considered overweight, and the prevalence of overweight among this age range has increased more than 10 percent between 1971 to 1974 and 2001 to 2004. If that isn’t enough, nearly 14 percent of preschool children are overweight as well. These statistics paint a grim picture for many children, as overweight adolescents have a 70 percent to 80 percent chance of becoming overweight adults. As of 2006, 142 million American adults are overweight or obese.

This week’s Disease Management Update looks at studies involving obesity in children as well as in adult males and the not-so-obvious side effects this condition can have.

Filed under: — @ 2008-02-28 00:00:00
2008-02-27 00:00:00

Web 2.0 in a Nutshell: Learn, Find, Share.

Blogs. Podcasts. Wikis.

MySpace. Facebook. YouTube.

New media is everywhere, and the healthcare industry is no exception. A growing number of healthcare organizations are using such Web 2.0 technologies to advertise their services and provide healthcare consumers with access to more interactive health education.

During this webinar, John Sharp, project manager forIT Web services with the Cleveland Clinic, sheds some light on Web 2.0 and all it encompasses — and what it means to healthcare.

???It’s about participation, usability and design. The core principles that define Web 2.0 are Web-based and easily accessible. One of the most important principles is that you control your own data, whereas in what is called Web 1.0, information was controlled by the Web site owner. Web 2.0 Web sites are open to complete participation by users.

Health 2.0 is a newer concept that takes the Web 2.0 technologies and imports them into healthcare. For instance, social networking is now available for patients, healthcare consumers or providers. Podcasts are available for medical and patient education and other uses in healthcare, wellness for instance. Wikis are available for medical references. Blogs are written by physicians and other medical experts. Tagging of medical topics, photos and videos is happening all over the Web.???

But even as a comparatively new form of media, Web 2.0 is already evolving into something bigger and better, says Dave Bennett, director ofWeb resource services at the Medical University of South Carolina (MUSC).

???A lot of people are talking about Web 2.0, and I am often asked when we are going to reach Web 3.0. We’re moving in that direction with many of the new technologies that we see online. With Web 2.0, we move away from static content to dynamic content in the forms of video and audio.”

University of Alabama Health System???s Internet Marketing Manager Susan Reid notes that engaging your audience is essential to Web 2.0 success.

???The difference between Web 2.0 [and Web 1.0] is now you have to engage the audience where they are. There are many ways to do that: email, social networks, blogs bulletin boards, Wikis, video and audio, RSS feeds, mobile phones. The key is going out and engaging them where they are.???

Filed under: — @ 2008-02-27 00:00:00
2008-02-26 00:00:00

Depressed Teens Respond Well to Combination Therapy

More than half of teenagers with the most debilitating forms of depression that do not respond to treatment with selective serotonin reuptake inhibitors (SSRIs) show improvement after switching to a different medication combined with cognitive behavioral therapy, researchers at UT Southwestern Medical Center and their colleagues in a multicenter study have found. The 334 study participants, ranging in age from 12 to 18 and coming from six sites across the country, suffered from depression on average for about two years. The teenagers, who were evaluated between 2000 and 2006, exhibited moderate to severe major depressive disorder, many with suicidal ideation.

  • Nearly 55 percent of teenagers who failed to respond to a class of antidepressant medications known as SSRIs, responded when they switched to a different antidepressant and participated in cognitive behavioral therapy, which examines thinking patterns to modify behavior.
  • About 41 percent of participants responded after switching to either a different SSRI or to venlafaxine, a different kind of depression medication.

Filed under: — @ 2008-02-26 00:00:00
2008-02-26 00:00:00

Baby Boomers Confused About Medicare

According to new research from the National Association of Insurance Commissioners (NAIC), many baby boomers are confused about their post-retirement health insurance options, including their Medicare eligibility. The first waves of baby boomers turn 62 this year and begin claiming Social Security benefits.

  • Only 36 percent correctly knew that Medicare eligibility begins at age 65. Twenty-one percent thought Medicare coverage began at age 62; 9 percent said age 67; 6 percent said age 59??; and 28 percent said they were unsure of the age.
  • A large majority of baby boomers ??? 84 percent ??? said that access to health insurance was important when choosing a retirement date. However, only 43 percent said that Medicare eligibility was an important factor in determining when they would retire.

Filed under: — @ 2008-02-26 00:00:00
2008-02-25 00:00:00

Physician Practices Face Multiple Demands

In recent weeks a clearer picture has emerged of the challenges facing physician practices — from electronic health records use to medical home adoption to quality data reporting. As physicians attest in two different stories this week, adapting practice work flow to embrace these trends can be daunting. Fortunately, public and private pilot programs do offer willing practices the chance to get their feet wet before participation is mandated. And to echo Dr. Bruce Bagley’s question, if there is an opportunity to increase revenue and improve patient care, why wouldn’t a practice participate?

Click here to read this week’s Healthcare Business Weekly Update in its entirety.

Filed under: — @ 2008-02-25 00:00:00
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