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June 4, 2009 Volume VI, No. 3

HIN Communications Editor Laura Greene

Dear Healthcare Intelligence Network Client,

As this week kicks off Men's Health Month, this week's Disease Management Update looks at a disease that affects men and the identified genes that can cause the condition.

Also this week, HIN's own Melanie Matthews reports on the role of care management in healthcare reform from the National Medicare Readmissions Summit and the 2009 Medicaid Congress. And stay tuned for next week's issue when Matthews shares insight on the toolkit needed for health reform from Dr. Ken Thorpe, professor and chair, Rollins School of Public Health at Emory University and former HHS deputy assistant secretary.

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

This week's DM news:

Table of Contents

  1. Genes Associated with Testicular Cancer Risk
  2. Care Management's Role in Health Reform
  3. Quality Improvement with PAM
  4. Care Coordination Challenges
  5. Healthcare Trends
  6. Laughter is the Best Medicine
  7. Healthcare Trends Mid-2009

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Melanie Matthews, mmatthews@hin.com

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First Testicular Cancer Risk Genes Found

Researchers have found the first inherited genetic risk factors for testicular cancer. Scientists at the Institute of Cancer Research (ICR) compared the genes of 730 men who had developed testicular cancer with the genes of healthy men. They found many of the men who had suffered testicular cancer shared common DNA variants on chromosomes 5, 6 and 12 that the healthy men did not have. This study is an important step towards developing a targeted screening program for relatives of men who have had testicular cancer.

Men who inherit any of these genetic variants are at a higher risk of developing testicular cancer than those who do not. Inheriting the strongest of the three factors increases men’s risk by two- to threefold, while inheriting all of them increases the risk by up to fourfold.

“We have known for some time that men whose father, brothers or sons had testicular cancer are much more likely to get it themselves, and we have been searching for this genetic link,” said Dr. Elizabeth Rapley, a lead scientist on this research. “In this research, we have identified three genetic factors linked to an increased risk of testicular cancer. We believe there are more still to be found and we are working on identifying the rest.”

To learn more about this research, please visit:

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Care Management's Role in Health Reform

Care management and care transitions are critical to achieving cost savings in healthcare, according to a panel discussion in conjunction with this week’s National Medicare Readmissions Summit and the 2009 Medicaid Congress.

“Getting to the Value Quadrant of Healthcare Reform,” sponsored by Pharos Innovations, highlighted several programs already achieving positive returns from a more focused approach to care management.

Dr. Joseph Kdevar, founder and director of the Center for Connected Health at Partners Healthcare, shared results from a Partners program that provided accurate information on patient diagnosis to the physicians that was reported back to the patient in a manner that was motivating to the patient combined with data-driven coaching, which resulted in significant reductions in readmission rates...

To read the rest of this story, please visit:

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Quality Improvement with PAM

American Health Holdings relies on the Patient Activation Measure™ to assesses a patient’s level of engagement in their own overall DM, but it does more than just that. PAM scores are also used to gauge the success of the DM program and its coaches. Director of DM and Wellness Services Diane Bellard discusses PAM — who is using it, how to deal with a decrease in PAM levels, how it fits with a patient's readiness to change and PAM's role in an organization's overall quality improvement.

To listen to this complimentary HIN podcast, please visit:

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Care Coordination Challenges

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Roberta Burgess, a nurse case manager with Community Care Plan of Eastern Carolina (CCPEC).

Question: Can you describe your organization's care management services?

Response: An important feature of Community Care of North Carolina is the emphasis on the direct care management services provided by the care managers, the care coordinators and the case managers. This care coordination consists of follow-up phone calls, home visits, one-on-one, self-management reminder letters, educational materials, scheduling appointments, arranging transportation and transporting clients. We coordinate with the hospitals that are in our particular community and others. For example, a case manager from a hospital in another city in North Carolina may tell me they have a child that needs to be seen back here, or needs to have blood work done, because they may be having a procedure. They’ll ask if there is anywhere in my area where that child can be seen that will cut costs and still get them the most effective care so that they don’t have to come all the way back. We work together to make sure people don’t fall between the cracks and miss appointments because they have to travel so far. There are many things we do together on a state level of case managers and care coordinators. Not all case managers and case workers are nurses — some of them are social workers, at all different levels. Everybody works together; we’re all in a system and we all use the same systems to document our efforts. It helps as far as contacting everybody, keeping everybody informed and making sure that the doctors know what’s going on. It’s a way that we can make sure the care is integrated and that they’re not doing the same things.

For more details on diabetes medical homes, please visit:

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Baby Boomers’ Impact on Healthcare

When healthcare looks back upon 2008, it will no doubt remember a year that was all about the money — sky-high fuel costs, a faltering economy and physician reimbursement worries. This summary of responses to HIN’s healthcare trends 2009 e-survey, conducted in the weeks leading to the election of Barack Obama as the country’s 44th president, captures the concerns of 169 healthcare organizations trying to run their businesses in the midst of a full-blown recession. This white paper also documents 53 of the most successful program ideas in 2008.

To download this complimentary white paper, please visit:

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Laughter is the Best Medicine

Laughter is not only an effective stress reliever, but can be heart-healthy, according to two studies from the American College of Sports Medicine.

One of the studies took an inverted approach to previous research on the harmful cardiovascular tolls of stress and negative mood. A small group of healthy adults were instructed to watch either a comedy or documentary film and were monitored for carotid artery activity during the films. Subjects who watched the comedy benefited from improved “arterial compliance,” the amount of blood that moves through the arteries at a given time. Conversely, decreased arterial compliance is often associated with high blood pressure and heart disease. A second study found similar results in vascular function. When another group watched either a comedy or a somber documentary, blood vessels became more dilated during the comedy. Constricted blood vessels often lead to high blood pressure.

“Arterial compliance was improved for a full 24 hours after subjects watched a funny movie,” said lead researcher on the first study Jun Sugawara. “Laughing is likely not the complete solution to a healthy heart, but it appears to contribute to positive effects.”

“Not only did comedies improve vascular dilation, but watching a documentary about a depressing subject was actually harmful to the blood vessels,” said Takashi Tarumi, lead researcher on the second study. “These documentaries constricted blood vessels by about 18 percent.”

To learn more about this research, please visit:

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Healthcare Trends Mid-2009

Healthcare organizations are recalibrating business plans and priorities mid-year in response to the recession, pending healthcare reform efforts, federal stimulus funds for health IT and state Medicaid programs and rising unemployment. Find out how other healthcare organizations are reacting to the current financial, legislative and reimbursement environment by completing HIN's Survey of the Month on Healthcare Trends in 2009: Mid-Year Adjustment by June 30. You’ll get a free executive summary of the compiled results. Your responses will be kept strictly confidential.

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

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