Archive for January, 2007

Bridging the “Medical Home” Knowledge Gap

January 16th, 2007 by Melanie Matthews

The concept of "medical homes" -- establishing a medical point of contact through which each individual can receive comprehensive medical services -- is not a new one. Pediatricians have been on board with this idea since the 1960's, and national physicians groups embraced it in the 1990's. In two separate HIN 2006 audio conferences –— “Non-Urgent Emergency Room Usage: Proven Ways to Redirect Care to Appropriate Settings” and “Serving the Needs of the Medicaid Population in Disease Management Programs” — we heard industry thought leaders suggest that the establishment of medical homes could lead to more prudent use of healthcare resources, especially emergency departments.

That's why the results of a recent HIN survey were disturbing. Of the 230+ respondents who answered HIN's November 2006 online questionnaire on the subject, almost half — 46.3 percent — said they weren't familiar with the phrase “medical home.” Others erroneously associated it with remote monitoring of patients or a physical structure.

Granted, these results are not scientific –- just the responses from the hospitals, health plans and others that happened to hear about the survey. But it identifies a knowledge gap -- and an opportunity -- for healthcare organizations looking to improve care levels while holding down costs. A summary of the Medical Home survey results contains many online resources for researching this topic, including mention of a pediatric residency program in Hawaii that includes a “medical home” module in its training.

Now Congress is offering a financial incentive to make medical homes part of the healthcare landscape. Congressional action this past December strengthened the concept of a patient-centered medical home. The Medicare Medical Home Demonstration, authorized in the Tax Relief and Health Care Act of 2006, will be launched in eight states. This program demo will provide physicians who participate in the program with a "care coordination fee" for managing the care of patients with multiple chronic conditions as well as the ability to share in system-wide savings that may result.

We'll be watching this demo with interest.

Using Web Technologies in Consumer-Driven Healthcare for Transparency, Decision Support and Health Promotion

January 12th, 2007 by Melanie Matthews

With the growth of consumer-driven healthcare, the Internet is playing a large role in disseminating information due to its convenience and its ease of use. John Mills, director of product management with HIP Health Plans, and Kim Bellard, vice president of eMarketing with Highmark Inc. discussed the Web-based tools their companies have implemented to improve the healthcare experience for consumers. John Mills introduced some of the web-based initiatives his company has begun to use, and also discussed the impact of having easily accessible information available on the HIP Web site. Kim Bellard discussed how his company's use of technology helps consumers make informed decisions and their proactive approach to promoting the use of their Web site. Both speakers discussed the benefits as well as the possible challenges and pitfalls of these new ventures, as well as the role that consumer education plays in all arenas of information dissemination. Bellard and Mills examined how healthcare organizations are providing online tools to ensure that consumers have the information they need to not only take more responsibility for their health status, but also to get the right treatment at the right time at the right place during a January 25th audio conference, Using Web Technologies in Consumer-Driven Healthcare for Transparency Decision Support and Health Promotion.

Click here to listen to their comments.

Smoking Cessation Tips

January 3rd, 2007 by Melanie Matthews

As New Year's resolutions are still fresh, now is probably the best time for healthcare professionals to urge their patients and clients to do whatever they can to stick with their resolutions.

Smoking cessation is one of the biggest New Year's resolutions made each year, and Dr. Kevin Scott Ferentz, M.D., associate professor of family and community medicine at the University of Maryland School of Medicine, offers tips PCPs and other healthcare professionals can offer to help their clients quit.

  • Put it in writing. Write down your reasons for quitting on 3 X 5-inch index cards so you can refer to them when you are tempted to smoke.
  • Explore your motives for smoking. Keep a journal before you quit to document your feelings about your habit. You want to include details about where you smoke most often, when you smoke, with whom and why. Review your diary after four or five days to identify feelings and circumstances that trigger your cravings for nicotine.
  • Modify your behavior. Write down your "triggers" on the left side of a piece of paper and on the right side, jot down how you plan to either avoid or cope with those situations or feelings that send you reaching for nicotine.
  • Reduce the pleasure quotient. Most people have favorite brands of cigarettes. In the week or so leading up to your quit date, ditch your favorites for other, less-appealing varieties. For example, buy menthols if you normally don't smoke them. Buy low-tar filters or light versions of your favorite brand or try new, unusual brands that you've never smoked before.
  • Spread the news. Tell everyone you know you're quitting to develop a network of family members, co-workers and friends who can support your efforts.
  • Get rid of smoking paraphernalia. Throw out all of your ashtrays, matches and lighters.
  • Go cold turkey. Despite an urge to gradually cut back, stopping completely on your chosen quit date is the best approach to kicking the habit for good.
  • Reward yourself. Come up with reasons to celebrate your quitting at regular intervals. For example, a week after you quit, go to the movies or bowling. A month after quitting, go to a nice hotel for an evening or treat yourself to a shopping spree. A year after quitting, go on a nice vacation with the money you save from no longer buying packs of cigarettes.
  • If you relapse, don't panic. Identify what it was that triggered your desire to smoke again and come up with a way to cope with the trigger. The urge to smoke -- no matter how overwhelming -- will pass after a few minutes, whether or not you give into it.
  • Seek help. If you aren't able to quit on your own, try using aids such as nicotine gum or the nicotine patch. If you still aren't able to quit, see your doctor about other options. You may also want to join a support group. Whatever you do, don't give up!