Disease Management Update
Volume V, No. 30
November 20, 2008

Dear Healthcare Intelligence Network Client,

According to the CDC, heart disease is the leading cause of death and a major cause of disability in the United States. This week's DM Update looks at an alarming trend in heart disease risk — and a prescription for improved quality of life for this population.

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. Past Gains in Reducing Risk of Heart Disease Have Flattened
  2. Disease Management Q&A: Behavior Modification for Specific Disease
  3. HealthSounds Podcast: The Rules of Engagement: Reaching Reluctant Physicians
  4. Exercise Improves Quality of Life for Heart Failure Patients
  5. Survey of the Month: Healthcare Profitability Ideas for an Ailing Economy
  6. Changing Lives with Lifestyle Management

1. Past Gains in Reducing Risk of Heart Disease Have Flattened

The positive U.S. health trend documented over the past 30 years of reduction in risk for heart disease is not as strong as is widely perceived. In fact, the trend has flattened, according to a new analysis of national data by Mayo Clinic. This suggests that the public health challenge of curbing heart disease may be greater than is commonly thought, says Francisco Lopez-Jimenez, M.D., cardiologist and lead researcher.

The researchers compared national heart disease risk factor data from three time periods to track change over time in risk reduction. The early period documented changes in risk between 1976 and 1980 and a midpoint of 1988 to 1994. The last period documented changes in risk from the midpoint to 1999 through 2004. Comparing changes from the early stage to the midpoint documented a decline in the overall risk to develop heart disease; but comparing change from the midpoint to the late period showed the trend flattening.

"This study may surprise people because the data show that the risk of heart disease is not going down as we expected," said Dr. Lopez-Jimenez. "The estimated risk in our nation was coming down nicely in the 1980s. Then around 2000 it began changing --- the trend lines flattened. While we had done a nice job with lowering cholesterol, blood pressure and stopping smoking, over time the improvement in these risk factors slowed and others like diabetes and obesity emerged, threatening to undo the early progress we made in reducing risk of heart disease. Most of the gains in reducing heart disease risk have been offset by the increased prevalence of diabetes and obesity."

To learn more about this research, please visit:

2. Disease Management Q&A: Behavior Modification for Specific Disease

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Sean Sullivan, president and CEO of Institute for Health and Productivity Management.

Question: In the organizations that have been working on behavior modification, which diseases have you focused on and what was the criteria used in choosing these diseases?

Response: (Sean Sullivan) We’re finding, in talking to employers, that we need to organize things into a slightly larger picture for them. For example, if you think about pre-diabetics and diabetic risks, there are many connections to cardiovascular risks, hypertension, hyperlipidemia and obesity. We are trying to organize that whole cluster into what we call “metabolic health” so we can think in larger terms about a diversity of factors that ultimately add up to healthy metabolism.

For more details on modifying behaviors to optomize DM outcomes, please visit:

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3. HealthSounds Podcast: The Rules of Engagement: Reaching Reluctant Physicians

To Dr. Todd Rowland, director of medical informatics at Bloomington Hospital and executive director of HealthLINC, the definition of an "engaged physician" includes working with others to find solutions to the problems of the healthcare industry at large. A self-described engaged physician, Dr. Rowland gives advice on how to become an engaged physician, discusses the impact of technology on physician engagement and shares how his organization has changed as a result.

To listen to this complimentary HIN podcast, please visit:

4. Exercise Improves Quality of Life for Heart Failure Patients

Heart failure patients who regularly exercise fare better and feel better about their lives than do similar patients who do not work out on a regular basis, say researchers at Duke University Medical Center. The findings, reported at the annual meeting of the AHA's Scientific Sessions 2008, go a long way toward addressing concerns about the value of exercise for the nation's 5 million patients with heart failure. They also raise important policy questions for the country's Medicare program and other insurers.

"Past studies have sent mixed signals about the merit of exercise for patients with heart failure. The HF-ACTION study (A Controlled Trial Investigating Outcomes Exercise TraiNing) shows that exercise is not only safe for patients, but also helps to improve the quality of their lives, overall," says Kathryn Flynn, Ph.D., a health services researcher at Duke Clinical Research Institute and lead author of the study.

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. Changing Lives with Lifestyle Management

Abandoning behaviors that are detrimental to one’s health is no simple feat. That's why numerous healthcare organizations are launching lifestyle management programs for individuals with life-threatening conditions such as diabetes, heart disease and obesity. This executive summary provides the general character of more than 60 such initiatives, including the differing approaches and techniques in identification, treatment and outcome assessment. To download this complimentary white paper, please visit:

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.
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