Disease Management Update
Volume V, No. 28
November 6, 2008

Dear Healthcare Intelligence Network Client,

Despite every effort by the healthcare community to prevent disease, some conditions have been on the rise in the past decade. This week's DM Update highlights the rise in the chronic conditions of diabetes and rheumatoid arthritis and what this trend means nationwide.

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

Please pass this along to any of your colleagues or, better yet, have them sign up to receive their own copy at http://www.hin.com/freenews2.html where you can also learn about our other complimentary news services.

Table of Contents

  1. New Cases of Diagnosed Diabetes on the Rise
  2. Disease Management Q&A: Getting PCPs Onboard with DM
  3. HealthSounds Podcast: Coaching Trends in 2009
  4. Rheumatoid Arthritis Rising Among Women
  5. Survey of the Month: Healthcare Profitability Ideas for an Ailing Economy
  6. Patient Registries: The Track to Better Quality Healthcare

1. New Cases of Diagnosed Diabetes on the Rise

The rate of new cases of diagnosed diabetes rose by more than 90 percent among adults over the last 10 years, according to a study by the CDC. In the past decade, new cases of diagnosed diabetes has increased from 4.8 per 1,000 people during 1995 to 1997 to 9.1 per 1,000 in 2005 to 2007 in 33 states.

“This dramatic increase in the number of people with diabetes highlights the increasing burden of diabetes across the country,” says lead author Karen Kirtland, Ph.D., a data analyst with CDC's Division of Diabetes Translation. “This study demonstrates that we must continue to promote effective diabetes prevention efforts that include lifestyle interventions for people at risk for diabetes. Changes such as weight loss combined with moderate physical activity are important steps that individuals can take to reduce their risk for developing diabetes.”

State-specific, age-adjusted estimates of new cases of diabetes ranged from 5 per 1,000 people in Minnesota to 12.7 per 1,000 in West Virginia. The number of news cases was highest in Puerto Rico at 12.8 per 1,000. States with the highest age-adjusted incidence were predominately Southern states: Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas and West Virginia.

To learn more about this research, please visit:

2. Disease Management Q&A: Getting PCPs Onboard with DM

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Dr. Gary Smithson, M.D., M.B.A., independent consultant for WorldDoc.

Question: How do you assist PCPs in incorporating quality initiatives like an HRA and DM into their work flows? Response: (Dr. Gary Smithson) We need to reimburse PCPs for the time they take for these activities. Why should doctors spend so much of their time on these things? They’re already pressed to see patients and engage in “nonreversible” activities. There’s a tremendous opportunity for consultants who understand the operation of large and small medical groups. They can work with the medical group to research questions such as: What time do you take out of your day to respond to e-visits? What time to you take to look at care gaps that may be occurring? What are you doing about them? How do you engage the rest of your staff? How do you leverage work down to your nurses and clerks? Accommodating the use of these new technologies will require some detailed focus at the practice level. This is a new, burgeoning, potential industry.

For more details on using HRAs to reduce risk and generate ROI, please visit:

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

There are other free email newsletters available from HIN!

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 monthly e-newsletter will cover the pilots, practice transformations, tools and technology that will guide healthcare organizations toward clinical excellence.

To sign up for our free email newsletters, please visit http://www.hin.com/freenews2.html

3. HealthSounds Podcast: Coaching Trends in 2009

According to Roger Reed, executive vice president of market operations with Gordian Health Solutions, about two-thirds of the coaching population would prefer not to use the telephone as their preferred coaching modality. Consequently, a new generation of health coaches needs to be able to "serve it up to the individual any way they want it," using new methods and techniques, such as alternative medicine, coaching without a coach and other Health 2.0 developments. Reed also predicts how online personal heatlh coaching methods will affect traditional coaching methods.

To listen to this complimentary HIN podcast, please visit:

4. Rheumatoid Arthritis Rising Among Women

After four decades on the decline, rheumatoid arthritis is on the upswing among women in the United States, according to a Mayo Clinic study that included 350 adult patients from Olmsted County, Minn., whose average age was 56.5 years. The majority — 69 percent — were women.

From 1955 to 1994, the incidence of rheumatoid arthritis had continually been on the decline. That apparently changed beginning in the mid-1990s. When Mayo researchers analyzed patient data from early 1995 to the start of 2005, they found that both the incidence and prevalence (percentage) of the condition were rising. Compared to the previous decade when approximately 36 women out of every 100,000 developed rheumatoid arthritis each year, the new study showed a jump to 54 women in the more recent decade. The incidence for men remained at about 29 per 100,000. Overall, the percentage of the entire population with the condition rose from 0.85 percent to 0.95 percent.

"This is a significant finding and an indicator that more research needs to be done to better understand the causes and treatment of this devastating disease," says Sherine Gabriel, M.D., Mayo Clinic rheumatologist and lead investigator on the study. Researchers say it's not clear why this is happening, but an environmental factor may have a role in the shifting incidence and prevalence among women.

To learn more about this research, please visit:

5. Survey of the Month: Healthcare Profitability Ideas for an Ailing Economy

Despite the dawn of a new administration, rising costs and a volatile economic climate are forcing healthcare organizations to explore alternative revenue streams to boost bottom lines and recover from lower net investment income levels. Complete HIN's Survey of the Month on Healthcare Profitability in an Ailing Economy by November 30 and you’ll get a free executive summary of the compiled results. Your responses will be kept strictly confidential. In exchange for your time and participation, you will also receive a $25 discount off the complete "Healthcare Trends & Forecasts in 2009" report when it is published in December 2008.

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

6. Patient Registries: The Track to Better Quality Healthcare

Patient registries are clinical information systems that physicians use to identify and track patients with a defined disease or condition. Besides creating realistic views of clinical practices, patient outcomes, safety and comparative effectiveness, patient registries support evidence development and decision-making and are associated with improved management of chronic illness.

To download this complimentary white paper, please visit:
Contact HIN:
Editor: Laura M. Greene, lgreene@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com

For more information on the products and services available through the Healthcare Intelligence Network, contact us at (888) 446-3530 / (732) 528-4468, fax (732) 292-3073 or email us at info@hin.com.
All contents of this message Copyright 2008