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July 30, 2009 Volume VI, No. 11

HIN Communications Editor Laura Greene

Dear Healthcare Intelligence Network Client,

A report from the CDC indicates that in 2007, healthcare-associated infections (HAIs) cost the industry an estimated $6.65 billion. Considering there are approximately 4.5 HAIs for every 100 hospital admissions, hospitals are doing all they can to reduce these occurrences. In this week's DM Update, find out what Johns Hopkins did to combat infectious disease in their hospitals. Also, read on to learn which population is more vulnerable to contracting some diseases and why.

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

This week's DM news:

Table of Contents

  1. Machine Designed to Reduce Infections
  2. African American Adult Vaccination Rates
  3. Reducing Acute & Chronic Care Costs
  4. Measuring Patient Engagement
  5. Healthcare Trends & Studies
  6. Enhanced Health Management
  7. Patient Education & Outreach

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Machine Designed to Reduce Infections and Cut Back on Expensive Hospital “Disposables"

Johns Hopkins experts in applied physics, computer engineering, infectious diseases, emergency medicine, microbiology, pathology and surgery have unveiled a seven-foot-tall, $10,000 shower-cubicle-shaped device that automatically sanitizes in 30 minutes all sorts of hard-to-clean equipment in the highly trafficked hospital ED. The novel device can sanitize and disinfect equipment of all shapes and sizes, from intravenous line poles and blood pressure cuffs, to pulse oximeter wires and electrocardiogram (EKG) wires, to computer keyboards and cellphones. The Johns Hopkins-designed and built self-cleaning unit for the decontamination (SUDS) has already been shown to initially disinfect noncritical equipment better than manual cleaning.

In the study, the Johns Hopkins team showed that SUDS was able to disinfect some 90 pieces of used ER equipment, placing as many as 15 items in the device and “fogging” the equipment with an aerosolized, commercially available disinfectant chemical, or biocide, called Sporicidin. None of the electronic circuitry appeared to be damaged by the decontamination process. Instruments tested were of the type that comes in direct contact with a patient’s skin, the body’s key barrier to infection. Repeated swabbing and lab culture testing of each decontaminated instrument showed that all items remained free of so-called gram-positive bacteria for two full days after cleaning, even after the equipment was returned to the ED and re-used. By contrast, testing of an equal number of similar items that were manually scrubbed down with a disinfectant solution, called Airex, showed that 25 percent of the devices had bacterial growth after two days, including growth of potentially dangerous gram-positive bacteria, as well as gram-negative type bacteria.

Study senior author and surgeon Bolanle Asiyanbola, M.D., says the four-year SUDS project was initially sparked by the rapid rise in use of expensive disposable items, a trend linked to efforts to prevent bacterial infections among and between patients in hospitals. Drawing on her experience in the operating room, where many batches of surgical clamps, retractors and scalpels have been sterilized, decontaminated and safely re-used for decades, Asiyanbola put together a team to end what she calls the “wasteful and unnecessary” practice of wiping down a lot of heavily used items with disinfectants and applying a lot of elbow grease. “If we can safely re-use equipment in the operating room, then we can do it elsewhere in the hospital for non-critical equipment,” she says.

“Our study results with the prototype offer strong evidence that more can be done to disinfect noncritical equipment through automated decontamination processes in heavily trafficked areas of the hospital,” says Dr. Asiyanbola. “We believe this SUDS device has the potential to further protect our patients and staff from hospital infections and save healthcare dollars by making it possible to clean and re-use more kinds of hospital equipment.”

To learn more about this research, please visit:
http://www.hopkinsmedicine.org/Press_releases/2009/07_30_09.html

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Disbelief Diminishes African American Adult Vaccination Rates

New data shows that African Americans fail to keep up with vaccinations into adulthood, making them more vulnerable to diseases. While African American adults place high priorities on immunizations for their children, they fail to protect themselves with disease-preventable vaccines. Most doubt the vaccine’s effectiveness and believe that it will not help them to fight off the infection, but will only make them ill from the injection.

The CDC states that immunizations rates for older African Americans are substantially lower than for the general older adult population. Researchers are examining factors including patients negative attitudes, misconceptions about vaccines, shortages of effective programs for vaccine delivery, that affect the likelihood of African Americans to acquire vaccinations.

Other factors that weigh in on the African American community are the accessibility to locations that provide vaccinations. Many areas where African Americans make up the majority of the population are poverty-stricken, with few resources to provide the necessary healthcare provisions for a healthcare education. The lack of vaccine protection results in deaths and thousands more hospitalizations for the African American population.

To learn more about this research, please visit:
http://www.capitalwirepr.com/pr_description.php?id=f3bb6ccd-df9e-5db7-f38c-4a76dd9a651a

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Reducing Acute & Chronic Care Costs Through an Effective Health Risk Stratification Model

Predictive modeling and health risk stratification can help providers identify members for case management and disease management interventions, says Dr. William Vennart, vice president of medical management and national medical director with CareAdvantage Inc. These methods ensure that patients receive treatment for their chronic conditions early on and, in turn, reduce unnecessary utilization and lower acute and chronic care costs.

To listen to this complimentary HIN podcast, please visit:
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Measuring Patient Engagement

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Randall Williams, M.D., F.A.C.C., chief executive officer with Pharos Innovations.

Question: How is patient engagement measured?

Response: We measure it in two ways: by the individual we have on the phone saying that they agree and are willing to participate in the program, and on an ongoing basis by their participation rates in using the technology to interact with the care manager every single day. Our engagement rates for this program over time achieved 90 percent persistence rates in the program at three months. For the upfront agreement rates, or engagement on the front end, we see about a 50 percent rate from the Medicaid population and about a two-thirds acceptance rate from the Henry Ford population experience.

For more information on measuring patient engagement, please visit:
http://store.hin.com/product.asp?itemid=3915

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Medical Home Monitor tracks the construction of medical homes around the country and their impact on healthcare access, quality, utilization and cost. As providers and payors reframe care delivery, this bi-weekly e-newsletter will cover the pilots, practice transformations, tools and technology that will guide healthcare organizations toward clinical excellence.

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Medication Adherence Interventions

The story is in the statistics: 65 percent of all prescriptions show non-compliance; 33 percent of all prescriptions are not even filled; Medication-related hospital admissions cost $100 billion every year. Yet, studies show that education interventions can be effective in improving adherence. Learn how medication adherence interventions can improve outcomes while lowering costs.

To download this complimentary white paper, please visit:
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Alliance Provides Enhanced Health Management

CVS Caremark and Inverness Medical Innovations, through its Alere health management business, have partnered to deliver more timely, highly coordinated and personalized health management services. The alliance means chronically ill patients served by CVS Caremark's Accordant Common DM programs will be managed and have access to expanded offerings provided by Alere. Alere customers will gain access to direct service by MinuteClinic retail health clinic nurse practitioners and CVS pharmacists. Customers of both companies will have access to a broad array of services ranging from those provided through the high touch, in-home monitoring, telephonic and Web-based offerings of Alere, to the face-to-face counseling provided at approximately 500 MinuteClinics and nearly 7,000 CVS/pharmacy locations around the country.

The companies said the alliance will improve participants' healthcare outcomes while helping payors and employers more efficiently manage costs. This can be achieved as participants are engaged through multiple delivery channels — including convenient and less costly venues like retail clinics.

This alliance will allow for more timely, coordinated and personalized DM, by improving communications. For example, if an Alere nurse identifies a patient with heart disease who is not taking medications as prescribed, or who is not taking medicine for a common co-morbid condition, the nurse will communicate that gap in care to a retail CVS pharmacist or MinuteClinic nurse practitioner, when the patient is scheduled to pick up a prescription or needs a test or screening at a clinic. The patient will be counseled to take action to improve their care by the appropriate provider.

"This alliance strengthens the clinical options we offer our customers," said Dr. Troyen Brennan, executive vice president and chief medical officer of CVS Caremark. "Our patients gain access to Alere's expanded suite of services, such as wellness, prevention and health management programs. These also include programs tailored to meet the needs of women and children. Alere's customers will benefit from direct access to our nurse practitioners at MinuteClinic and CVS pharmacists at our retail stores."

To learn more about this research, please visit:
http://info.cvscaremark.com/newsroom/press-releases/cvs-caremark-and-inverness-medical-innovations-launch-strategic-alliance-pro

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Patient Education and Outreach

Educating patients about their health conditions, plan of care and wellness and prevention strategies not only empowers them to manage their condition and care but also can reduce medical complications, medication costs and unnecessary healthcare utilization. Complete HIN's Survey of the Month on Patient Education and Engagement by August 31 and receive 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:
http://www.surveymonkey.com/...

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