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August 12, 2010 Volume VII, No. 6

HIN Communications Editor Jessica Papay

Dear Healthcare Intelligence Network Client,

We all know how popular texting has become among the young, but what many may not know is that texting is now being used to remind young diabetic patients to take their medications. This new texting trend is highlighted in this week's issue, along with the link between heart disease and sleeping habits, and ways the CDC is supporting HIV prevention efforts.

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

This week's DM news:

Table of Contents

  1. Diabetes Meds & Texting
  2. Heart Disease & Sleep
  3. Case Management & Patient Contact
  4. Medication Reconciliation
  5. Top Tools for Obesity Management
  6. 2010 Benchmarks in HRA Use
  7. Community HIV Prevention
  8. Health Coaching 2010

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

Publisher:
Melanie Matthews, mmatthews@hin.com

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Texting Increases Medication Compliance Among Adolescent Diabetes Patients

A pilot study that uses weekly, customized text messages to remind adolescent diabetes patients about their personal treatment activities found an increase in overall treatment adherence and improved blood glucose levels. The study was developed by Jennifer Dyer, M.D., M.P.H., an endocrinologist at Nationwide Children’s Hospital.

Dr. Dyer began developing this pilot study after realizing the potential of a simple reminder, in the form of a text message, which can be sent to her teenage patients. During the study, she sent personalized questions and reminders specific to diabetes adherence activities in addition to friendly, supportive messages to her patients. By asking questions about glucose testing, meal bonuses and frequency of high and low glucoses, Dr. Dyer has seen an increase in teens taking their medications. "This form of communication allows for real-time health management, which is extremely valuable for patients that suffer from a chronic illness like diabetes," said Dr. Dyer.

The average teen sends about 50 texts each day, while 75 percent of teen cell phone users have a cell phone plan with unlimited texting capabilities. Studies have shown that adolescent patients have a greater difficulty adhering to treatment and medication activities than adults. Thus, there is a significant correlation between increased independence and decreased treatment adherence in adolescents. The rate of medication non-adherence among adolescent recipients is approximately four times higher than that among adult recipients.

To learn more about this research, please visit:
http://www.nationwidechildrens.org/news-room-articles/...

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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 U.S. 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 U.S."

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:
http://health.wvu.edu/newsreleases/news-details.aspx?ID=1542

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Patient Contact, Monitoring and Follow-up in Case Management

One of the advantages of co-locating healthcare case managers in various care settings is the improved level of communication for a patient as they move through the continuum of care, says Jan Van der Mei, regional director of continuum case management for Sutter Health Sacramento Sierra Region. Ms. Van der Mei describes the major issues, such as medication reconciliation and patient and family education, that case managers face while helping patients to understand their health conditions and goals of care as they navigate the Sutter system. She also discusses how case managers can educate patients to avoid hospital readmissions through interventions and symptom management.

To listen to this complimentary HIN podcast, please visit:
http://www.hin.com/podcasts/podcast.htm#124

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Medication Reconciliation in Geisinger Care Transitions

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Janet Tomcavage, R.N., M.S.N., vice president of health services for Geisinger Health Plan.

Question: What is Geisinger’s process for medication reconciliation?

Response: First of all, the case manager does medication reconciliation at every visit. If it’s an outpatient visit, we ask them to bring their medications in with them, including over the counter. We like to go through every medication bottle and understand the purpose, reason and timing of each medication. If they don’t bring their medications with them, we will go through the medication list and assure. We do two other things: we use our predictive modeling tool, because it reports the refill rate of their medications and helps to alert the case managers when someone says they’re taking their medications but they’re really not. Or we call the pharmacy that we know. We always try and find out which pharmacy they’re using. If we suspect that someone is not taking their medications, we call the pharmacy to find out their refill pattern. On the inpatient side, we work hard to get the discharge summary because that gives us at least a starting point for medications. We go through each and every medication and reconcile it: Should they be on it on the outpatient side? Is there any duplication of medications? We make sure that the patients understand the purpose, timing and frequency of refills.

For more information on Geisinger's care transitions in the medical home, please visit:
http://store.hin.com/product.asp?itemid=3946

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

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There are other free email newsletters available from HIN!

HealthCoach Huddle, a monthly e-newsletter, brings you the most up-to-date news on health coaching, from coaching strategies to interviews and quotables from the industry's leading health coaches.

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5 Top Tools for Obesity & Weight Management

Obesity and weight management programs can help to reduce the physical and financial strain of overweight and obesity on health status, worker productivity and healthcare costs in the midst of the nation's full-fledged obesity epidemic. We wanted to find out the most common elements of organizations' obesity initiatives.


Click here to view the chart.

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2010 Benchmarks in Health Risk Assessment Use

This white paper captures trends in the use of aggregate data from health risk assessments (HRAs) by 116 healthcare organizations to design and deliver health promotion and disease management interventions to targeted individuals in response to the Healthcare Intelligence Network June 2010 HRA e-survey.

To download this complimentary white paper, please visit:
http://www.hin.com/library/registerhra10.html

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CDC Awards $42 Million for Community-Based HIV Prevention Efforts

The CDC has awarded $42 million to 133 community-based organizations (CBOs) to help implement HIV prevention efforts among populations at greatest risk. The average award is approximately $323,000 per year for five years. Because CBOs have the cultural knowledge and local perspective to reach people who might not otherwise access HIV testing or other prevention services, partnership with these organizations represents a critical part of CDC's fight against HIV. Additionally, these organizations help ensure that HIV prevention efforts are reaching those at greatest risk and who need HIV prevention services the most.

Funds will be used by CBOs to implement effective HIV prevention programs for individuals living with HIV and those at high risk of infection. Funding will also be used to increase HIV testing and knowledge of status in these communities. In addition, a limited portion of the funding will be given to some CBOs to assist in monitoring program impact and behavioral outcomes.

Nationally, African-Americans, Latinos, gay and bisexual men, and injection drug users are the groups most disproportionately affected by HIV, and these funds will help to ensure that local prevention efforts reach these populations:

  • By risk group, 49 percent of the organizations receiving funding focus their efforts on men who have sex with men. Thirty-eight percent of the CBOs primarily focus on heterosexual men and women, 5 percent focus on injection drug users, and the remaining organizations focus on a combination of these groups, with 1 percent focusing on other groups.
  • CBOs that focus efforts on people of color account for the majority of organizations receiving funding. Fifty-eight percent focus on African-Americans, with Latinos accounting for 23 percent, whites accounting for 11 percent, Asian/Pacific Islanders accounting for 3 percent, Native Americans accounting for 1 percent, and organizations focusing on multiple or all races/ethnicities accounting for 4 percent.
The CDC supports HIV prevention at national, state, local, territorial and tribal levels, and this award represents just one of many efforts that are a part of CDC's $728 million funding for domestic HIV prevention. The CDC funds HIV prevention efforts throughout the nation, with the bulk of funding each year going to state and local health departments to implement HIV prevention among those at greatest need. The CDC also works on a number of fronts to combat the HIV epidemic, including: increasing access to HIV prevention and testing services, conducting surveillance, researching new prevention approaches, and using new technology and communication tools to combat complacency regarding the HIV epidemic in the U.S.

To learn more about this research, please visit:
http://www.cdc.gov/nchhstp/newsroom/cboaward.html

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Health Coaching in 2010

Health coaching's domain has moved beyond traditional disease management to encompass care transitions coaching, medication adherence, and more. Join the more than 70 organizations that have taken HIN's third annual Health Coaching survey to find out how healthcare organizations are implementing health coaching as well as the financial and clinical outcomes that result. Complete the survey 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/s/healthcoaches

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