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December 30, 2010 Volume VII, No. 25

HIN Communications Editor Jessica Papay

Dear Healthcare Intelligence Network Client,

Welcome to our second annual "Best Of" issue of the DM Update. According to our data, the most-read stories of 2010 focused on the effect of sleep duration on heart health, the disease with the greatest economic impact and an online health education program named best care/disease management site earlier this year.

Enjoy this second look at these stories, and accept our best wishes for a healthy and profitable 2011.

Your colleague in the business of healthcare,
Jessica Papay
Editor, Disease Management Update

The year's top DM news:

Table of Contents

  1. Heart Disease & Sleep
  2. Cancer Greatest Economic Impact
  3. Healthcare Spending Curve
  4. Pharmacist in Diabetes Medical Home
  5. Best Chart of 2010: What's the ROI from Health Coaching?
  6. 2010 Benchmarks in Health Coaching
  7. Online Health Education Program
  8. Reducing Hospital Readmissions in 2010

Please pass this along to any of your colleagues or, better yet, have them sign up to receive their own copy and learn about our other news services.

Missed the last issue? Read it here.

Join our Community:

Please send comments, questions and replies to jpapay@hin.com.

Melanie Matthews, mmatthews@hin.com

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Best of 2010: Too Much, Too Little Sleep Can Lead to Heart Disease

If individuals are sleeping less than five hours or more than nine hours, they could be putting themselves at an increased risk for heart disease, according to a study conducted by researchers at the West Virginia University School of Medicine. The study examined more than 30,000 adults who participated in the 2005 National Health Interview Survey.

Researchers found that both short and long sleep durations to be independently associated with heart disease. The results were adjusted for age, sex, race-ethnicity, smoking, alcohol intake, BMI, physical activity, diabetes, high blood pressure and depression. According to the researchers, "We showed that both short and long sleep durations are related to cardiovascular disease separately in all major racial-ethnic subgroups in the United States. This was the first time the relationship between sleep and heart disease had been investigated in such a large study with representations from all major racial-ethnic groups in the United States."

The researchers said that those who sleep less than five hours are twice as likely to develop heart disease. On the opposite end of the spectrum, those who sleep nine hours or more a day are one-and-a-half times more likely to develop heart disease than those who sleep seven hours a day. Though the study showed a correlation between sleep and heart disease, a cause for the increased risk was not found. “We hope these findings encourage primary care physicians to evaluate the sleep patterns of patients as a risk factor for heart disease and would like to see public health initiatives focused on improving sleep to reduce the burden of heart disease,” said the researchers.

To learn more about this research, please visit:

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Best of 2010: Cancer Has Greatest Economic Impact of All Causes of Death Worldwide

For the first time, research shows that cancer has the most devastating economic impact of any cause of death in the world — costing the global economy nearly $1 trillion a year. The American Cancer Society and LIVESTRONG® have released a first-of-its-kind study on the economic cost of all causes of death globally, including cancer and other noncommunicable and communicable diseases. According to WHO projections, this year, cancer will become the world's leading cause of death, followed by heart disease and stroke. This report shows that cancer has the greatest economic impact from premature death and disability of all causes of death worldwide.

For this study, researchers used WHO data that combine the death and disability dimensions of illness into a single summary called a DALY (disability adjusted life year) for 17 types of cancer as well as the 15 leading causes of death. These data show that there were 83 million years of "healthy life" lost due to death and disability from cancer. To reduce this death toll by one DALY, WHO recommends to invest as much as three times per capita gross domestic product to make an intervention cost-effective. The data from this study provides compelling new evidence that balancing the world's global health agenda to address cancer will not only save millions of lives, but also billions of dollars. In 2008, cancer accounted for nearly $1 trillion in economic losses from premature death and disability. The economic toll from cancer is nearly 20 percent higher than heart disease, the second leading cause of economic loss ($895 billion and $753 billion respectively). This analysis does not include direct medical costs, which would further increase, and possibly double, the total economic cost caused by cancer. The lost years of life and productivity caused by cancer represent the single largest drain on national economies, compared to other causes of death, including HIV/AIDS and other infectious diseases.

Death and disability from lung cancer, colon/rectal cancer and breast cancer account for the largest economic costs on a global scale, and the greatest burden in high-income countries. In the low-income countries, cancers of the mouth and oropharynx, cervix and breast have the greatest impact. Available interventions to prevent, detect, and/or treat these common cancers could not only save lives but also improve economic development prospects in many nations. Cancers of the lung, bronchus and trachea by far account for the largest drain — nearly $180 billion yearly — on the global economy. If current trends continue, tobacco will kill 8 million per year by 2030, with more than 80 percent of the deaths taking place in low- to middle-income countries. About one third of those deaths will be from cancer. Unfortunately, tobacco kills thousands of nonsmokers every year as well — among them an estimated 200,000 who are exposed to it in the workplace.

This landmark economic study comes at a time when cancer and other non-communicable diseases are gaining more attention from the global health community and in the wake of a U.N. General Assembly call for a high-level meeting on the issue in September 2011. Noncommunicable diseases account for 60 percent of the world’s deaths, yet according to the Center for Global Development, they receive less than 1 percent of the public and private funding for health. As the death and disability toll from lung cancer remains high across income levels of nearly all nations, efforts like the Framework Convention on Tobacco Control (FCTC) could have a significant impact in reducing economic losses. The FCTC, the world’s first global health treaty and signed by 168 countries, aims to reduce deaths from tobacco usage by regulating the sale and marketing of tobacco products and protecting people from tobacco smoke.

To learn more about this research, please visit:

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Bending the Healthcare Spending Curve for 2011

Healthcare reform offers two major opportunities for healthcare to bend the spend curve and improve profitability, says Steven Valentine, president of The Camden Group. Valentine also weighs in on the current state of healthcare, and why organizations can't think about healthcare reform without considering the current economy.

To listen to this complimentary HIN podcast, please visit:

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Pharmacist in Diabetes Medical Home

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Roberta Burgess, RN, nurse case manager for Community Care Plan of Eastern Carolina with Heritage Hospital in Tarboro, North Carolina.

Question: What is the pharmacist’s role in the diabetes medical home and what is the cost impact?

Response: In our program, our pharm D will contact the case manager directly if it looks like our clients are overusing a certain medication, especially when it comes to their diabetes. They will contact us if it looks like they’re taking too much insulin, and they’re still having complications or having problems. We have to contact their doctor and find out what they were given. The cost of the pharmacy goes up when you first start working with a client who has not been controlled. It goes up because they’re going to become more compliant. As they become complication-free, their hemoglobin, their lipid panel and their medication all start to decrease. They will be on a steady medication and not get more prescriptions from different doctors. In the beginning it’s going to be higher, and toward the end it will start to come down.

For more information on the diabetes medical home and patient-centered care, please visit:

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

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HealthSounds Podcasts delivers a free weekly audio interview with a healthcare innovator to your e-mail box. Listen to thought leaders answer key questions about the most pressing issues and trends in healthcare — healthcare reform, implications of Web 2.0 for healthcare, medical home models and much more.

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Best Chart of 2010: What's the ROI from Health Coaching?

Despite the fragile economy — and perhaps because of it — health and wellness coaching programs are flourishing. We wanted to see what ROI is generated from health coaching programs.

Click here to view the chart.

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2010 Benchmarks in Health Coaching

This white paper captures the ways in which 161 organizations are implementing health coaching in 2010 — including the top three areas targeted by health coaching — as well as the financial and clinical outcomes that result from this health improvement strategy. These benchmarks are based on organizations' responses to the Healthcare Intelligence Network August 2010 e-survey on health coaching.

To download this complimentary white paper, please visit:

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Best of 2010: Ounce of Prevention — Interactive Health Education Program Named Best Care/Disease Management Site

Health Education Answers, Lilly USA's interactive health and wellness tool, has received an eHealthcare leadership award of distinction for best care/disease management site for its ability to help consumers manage a chronic condition, encourage two-way communication between patient and healthcare practitioners and provide opportunities to monitor clinical care.

Available in Spanish and English and with portions in Mandarin, Health Education Answers is a free Web-based program based on research-supported patient education material that adheres to national clinical guidelines. Patients accessing the program can progress through several health and DM modules, including ADHD, bipolar disorder, depression, diabetes, diabetes complications, heart health, weight management, medication safety, men's health, schizophrenia, smoking and addictions, wellness and women's health.

The program also includes an optional health risk assessment (HRA), which helps patients identify and understand their individual health needs and at-risk behaviors. Based on the results, Health Education Answers directs patients to the most applicable education modules that provide tips for improvement.

The tool, which is also available on DVD-ROM, can be customized to meet each organization's individual needs, including incorporating the organization's logo, approved color palette, specific content selections and a personalized welcome message.

More than 1,100 entries were received from a wide range of healthcare organizations, online health companies, pharmaceutical/medical equipment firms, suppliers and business improvement initiatives. In addition, Health Education Answers received the 2009 Health Care Standard of Excellence Award from the Web Marketing Association and in 2008 received NCQA health information product certification for HRAs and interactive consumer health tools.

To learn more about this research, please visit:

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Reducing Hospital Readmissions in 2010

Just a couple of days remain to describe your organization's efforts to reduce hospital readmissions by taking HIN's second annual Reducing Hospital Readmissions Benchmark Survey. Respond by December 31 and receive an e-summary of the results from more than 50 healthcare companies once the survey is completed.

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

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