Disease Management Update
Volume IV, No. 49
April 3, 2008

Dear Healthcare Intelligence Network Client,

With yesterday being Autism World Awareness Day, this week's Disease Management Update looks at the brain development disorder of autism. This disorder remains very much a mystery to many healthcare providers and patients, but its prevalence is growing. One in 150 individuals is diagnosed with autism each year, making it more common than pediatric cancer, diabetes and AIDS combined. Visit HIN's blog to read about the lengths some parents are going to to minimize their child's risk of autism.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at:

Table of Contents

  1. Maternal Antibodies May Contribute to Autism
  2. Disease Management Q&A: Integrating Personal Health Records
  3. HealthSounds Podcast: PQRI in 2008
  4. NAA Calls for Immediate Recall of All Mercury-containing Vaccines
  5. Survey of the Month: Personal Health Records for Consumers
  6. Healthcare IT and HIPPA

1. Maternal Antibodies May Contribute to Autism

A team of researchers at Johns Hopkins University suggest that one cause or trigger of autism may be maternal antibodies that cross over through the placenta and are directed against the brain tissues of the fetus, adversely affecting brain development.

Dr. Harvey S. Singer and colleagues noted that children with autism have antibodies in the blood that react against brain tissue. The team measured the antibody-brain reaction in blood samples from 100 mothers with and 100 mothers without a child diagnosed with autism. Mothers of children with autism had a stronger reactivity or more areas of reactivity between antibodies and brain proteins compared with mothers without an autistic child. The presence of maternal antibodies also correlated with having a child with developmental regression, a primary feature of autism.

To learn more about this study, please visit:

2. Disease Management Q&A: Integrating Personal Health Records

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Caryn Jacobi, R.N., associate vice president of operations for Illinois, McKesson Health Solutions.

Question: How do your programs utilize action plans and personal health records (PHRs)?

Response: (Caryn Jacobi) These tools are very meaningful to help focus the need, both during the provider visit and then afterwards, so all of our members receive action plans specific to their conditions. That’s a very meaningful vehicle to communicate and help people understand what they need to focus on, and it is a very crucial part of any care coordination effort, removing barriers. It is key to dedicate a lot of time helping patients keep their appointments — to call the day of or the day before to ensure that those appointments will be kept. Assisting with transportation, childcare, basic needs like food, shelter and safety are all of utmost importance in the minds of our clients and often areas we have to address before we can even start talking about any DM-specific conditions. Seek providers with open access, evening hours, weekend hours, even those that make home visits — we’ve found that some of our members haven’t been out of the home and able to visit their provider on a regular basis. Seeking providers that can make home visits has been part of our removing barriers to outreach.

The health records that we have are manual at this point. Mutually accessible, unified health records are something that we’re promoting at McKesson across all of our clients. We’ve seen some early adoption by some programs, and we very much want to see it spread like wildfire. With the personal health record, we’re focusing on hospitalized patients who are being discharged to the community. There are four specific areas we’re trying to emphasize and have the hospital-based nurse as well as the community-based staff focus on. We’ve had good results with that thus far, but there are limitations to a paper-based form, especially when multiple providers are involved. The biggest challenge that we face is getting all of the primary care physicians and specialists to contribute to that one record. This is a challenge, but one worth taking.

For more strategies on keeping contact with hard-to-reach DM clients, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: PQRI in 2008

In this week's disease management podcast, Dr. Bruce Bagley, American Academy of Family Physicians (AAFP) medical director of quality improvement, estimates that nearly 75 percent of AAFP members are already using electronic health records (EHRs), even though the Centers for Medicare & Medicaid Services (CMS)does not currently require physicians in the Physician Quality Reporting Initiative (PQRI) to have them. Dr. Bagley advises PQRI participants to proactively examine their own reported data to chart a performance improvement plan rather than wait until mid-2008 for feedback from CMS.

To listen to this complimentary HIN podcast, please visit:

4. NAA Calls for Immediate Recall of All Mercury-Containing Vaccines

Parents of children diagnosed with autism are calling upon the Food and Drug Administration (FDA) to remove all mercury-containing vaccines from the shelves. Parents of autistic children have been saying for years that their normally developing children sustained injuries from vaccines containing thimerosal, a preservative that is nearly 50 percent ethyl-mercury by weight.

“The government continues to allow the use of thimerosal in vaccines, even after recommending its removal back in 1999," said Ann Brasher, vice president of the National Autism Association (NAA). "An estimated 90 percent of flu vaccines still contain 25 micrograms of mercury, and just last month the Centers for Disease Control and Prevention (CDC) recommended annual flu shots for all children up to age 18. Flu shots are also recommended for pregnant women, causing prenatal exposure. Our children’s level of exposure to mercury through vaccines is going up when it should have been removed entirely years ago."

To see more about this study's results, please visit:

5. Survey of the Month: Personal Health Records for Consumers

Complete our online survey on personal health records for consumers by April 30, and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Healthcare IT and HIPPA

The far-reaching arm of HIPAA strictly mandates healthcare professionals to take measures to protect personal patient information. Well-publicized data breaches at hospitals and physicians' offices, coupled with the emphasis on personal health records, makes HIPAA compliance more challenging than ever. This white paper will tell you how your hospital system or practice can utilize thin client technology and server-centric computing to protect private patient information and achieve and enhance HIPAA compliance. In an age of constant security threats, healthcare IT departments must do all they can to prevent data breaches, as well as the consequential HIPAA sanctions and possible lawsuits.

To download this complimentary white paper, please visit:
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