Archive for February, 2008

Employee Health Promotion No Headache for this Manufacturer

February 29th, 2008 by Melanie Matthews

In a recent discussion about the importance of creating a workplace culture of health, David Sensibaugh, Eastman Chemical Company’s director of Integrated Health, described how his organization addressed the indirect impact of workers’ headaches and migraines on the safety of a manufacturing environment:

It is important to note that whenever we have accidents, like most manufacturing companies will tend to do on occasion, we review the cause, the results and the factors around the accident. We have found that in addition to unsafe behavior, health is a contributing factor to accidents on the job. Of the different types of health factors, a migraine is one of those.

We also participated in a health and productivity questionnaire survey that did much to help us understand the indirect cost of poor health within our population. A subset of that is the migraine element, which showed that about 28 percent of our employees suffered from migraines or headaches, and that the cost of that to our population is over $4 million annually.

That led us to participate in a headache education project. It was a joint effort between Eastman Integrated Health, HealthFitness and Johnson & Johnson Health Care. We had a company-wide marketing effort and employee information sessions, some which were held by an outside migraine expert from Vanderbilt Medical Center. The expert also held a physician dinner to help people in our community understand why this was an important issue and what we were trying to do with it here. Then we allowed people to voluntarily participate in this migraine study.

The study began with a pre-survey to help get an assessment of people’s headaches, their headache status, the severity of their headaches, their knowledge of headaches and headache treatment and so forth. Then we followed that up for period of about three months with educational materials provided by Johnson and Johnson. There was a small incentive to complete this study, a $25 gift card. After those three months of education and study there was a follow-up survey that was sent out, and then we had a headache severity survey that is currently being completed. Over 500 employees voluntarily participated in this study. The results of that will be forthcoming.

Childhood Obesity Increasing at Alarming Rates

February 28th, 2008 by Melanie Matthews

According to the American Heart Association, 9 million children and adolescents between 6 and 19 years old are considered overweight, and the prevalence of overweight among this age range has increased more than 10 percent between 1971 to 1974 and 2001 to 2004. If that isn’t enough, nearly 14 percent of preschool children are overweight as well. These statistics paint a grim picture for many children, as overweight adolescents have a 70 percent to 80 percent chance of becoming overweight adults. As of 2006, 142 million American adults are overweight or obese.

This week’s Disease Management Update looks at studies involving obesity in children as well as in adult males and the not-so-obvious side effects this condition can have.

Web 2.0 in a Nutshell: Learn, Find, Share.

February 27th, 2008 by Melanie Matthews

Blogs. Podcasts. Wikis.

MySpace. Facebook. YouTube.

New media is everywhere, and the healthcare industry is no exception. A growing number of healthcare organizations are using such Web 2.0 technologies to advertise their services and provide healthcare consumers with access to more interactive health education.

During this webinar, John Sharp, project manager for IT Web services with the Cleveland Clinic, sheds some light on Web 2.0 and all it encompasses — and what it means to healthcare.

“It’s about participation, usability and design. The core principles that define Web 2.0 are Web-based and easily accessible. One of the most important principles is that you control your own data, whereas in what is called Web 1.0, information was controlled by the Web site owner. Web 2.0 Web sites are open to complete participation by users.

Health 2.0 is a newer concept that takes the Web 2.0 technologies and imports them into healthcare. For instance, social networking is now available for patients, healthcare consumers or providers. Podcasts are available for medical and patient education and other uses in healthcare, wellness for instance. Wikis are available for medical references. Blogs are written by physicians and other medical experts. Tagging of medical topics, photos and videos is happening all over the Web.”

But even as a comparatively new form of media, Web 2.0 is already evolving into something bigger and better, says Dave Bennett, director of Web resource services at the Medical University of South Carolina (MUSC).

“A lot of people are talking about Web 2.0, and I am often asked when we are going to reach Web 3.0. We’re moving in that direction with many of the new technologies that we see online. With Web 2.0, we move away from static content to dynamic content in the forms of video and audio.”

University of Alabama Health System’s Internet Marketing Manager Susan Reid notes that engaging your audience is essential to Web 2.0 success.

“The difference between Web 2.0 [and Web 1.0] is now you have to engage the audience where they are. There are many ways to do that: email, social networks, blogs bulletin boards, Wikis, video and audio, RSS feeds, mobile phones. The key is going out and engaging them where they are.”

Baby Boomers Confused About Medicare

February 26th, 2008 by Melanie Matthews

According to new research from the National Association of Insurance Commissioners (NAIC), many baby boomers are confused about their post-retirement health insurance options, including their Medicare eligibility. The first waves of baby boomers turn 62 this year and begin claiming Social Security benefits.

  • Only 36 percent correctly knew that Medicare eligibility begins at age 65. Twenty-one percent thought Medicare coverage began at age 62; 9 percent said age 67; 6 percent said age 59½; and 28 percent said they were unsure of the age.
  • A large majority of baby boomers — 84 percent — said that access to health insurance was important when choosing a retirement date. However, only 43 percent said that Medicare eligibility was an important factor in determining when they would retire.

Depressed Teens Respond Well to Combination Therapy

February 26th, 2008 by Melanie Matthews

More than half of teenagers with the most debilitating forms of depression that do not respond to treatment with selective serotonin reuptake inhibitors (SSRIs) show improvement after switching to a different medication combined with cognitive behavioral therapy, researchers at UT Southwestern Medical Center and their colleagues in a multicenter study have found. The 334 study participants, ranging in age from 12 to 18 and coming from six sites across the country, suffered from depression on average for about two years. The teenagers, who were evaluated between 2000 and 2006, exhibited moderate to severe major depressive disorder, many with suicidal ideation.

  • Nearly 55 percent of teenagers who failed to respond to a class of antidepressant medications known as SSRIs, responded when they switched to a different antidepressant and participated in cognitive behavioral therapy, which examines thinking patterns to modify behavior.
  • About 41 percent of participants responded after switching to either a different SSRI or to venlafaxine, a different kind of depression medication.

Physician Practices Face Multiple Demands

February 25th, 2008 by Melanie Matthews

In recent weeks a clearer picture has emerged of the challenges facing physician practices — from electronic health records use to medical home adoption to quality data reporting. As physicians attest in two different stories this week, adapting practice work flow to embrace these trends can be daunting. Fortunately, public and private pilot programs do offer willing practices the chance to get their feet wet before participation is mandated. And to echo Dr. Bruce Bagley’s question, if there is an opportunity to increase revenue and improve patient care, why wouldn’t a practice participate?

Click here to read this week’s Healthcare Business Weekly Update in its entirety.

Retail Clinic Voices of Experience Say Members and Patients Vote with Their Feet

February 22nd, 2008 by Melanie Matthews

Like electronic health records, quality data reporting and emerging primary care models, retail clinics are here to stay. Physician practices, health plans and even hospital emergency departments must decide whether to compete or coexist. This week, Humana and Sutter Health — a payor and provider in the retail clinic space — gave us food for thought, sharing their experiences with reimbursing for and running retail clinics.

Dr. Steven Goldberg, corporate medical director at Humana, which includes MinuteClinic in its provider network, describes the very early feedback his organization has received:

Are retail clinics a good thing? Well, that depends on your vantage point. A couple things: the rate of clinic visits has dramatically increased over the past years. I believe recent published literature shows about 1,000 such clinics now, and hundreds of thousands of visits. In general, the consumer experience has been very good, and that’s a very positive thing. For the narrow scope of services, the experience has overall been consistently reported in sources as very, very positive. As a payor, we really look at this in the context of a range of approaches for these types of problems and settings. How does a retail clinic stack up for issues versus self management, versus urgent care, versus primary care, versus ER care? The public domain literature is very limited. Our findings are early. As far as quality, the general experience for the scope of services is very positive, and people in general seem to be pleased with cost. Frankly, they are walking with their feet and walking more and more every day. As far as continuity, that remains something that we have to follow more.

Offering the provider perspective was Dr. Thomas N. Atkins, medical director of Sutter Express Care, six drugstore-based medical clinics that are part of Sutter Health’s network of hospitals and doctors serving Northern California. There were enormous administrative and regulatory hurdles to overcome in the establishment of the clinics, Dr. Atkins said.

On clinics’ critical success factors:

It’s important if you want to be as successful as you can that you be first to market. I think it’s much more difficult to try and establish these behind another provider that puts these in in a community.

On fears voiced by health plans:

There’s some evidence that in some areas or for some conditions, patients will see someone in these retail clinics and then go see their doctor anyways, and that’s the kind of thing that increases utilization that is disturbing to the health plans. And the one health plan that didn’t contract with us, felt that that was what was going to happen. Now, their patients were really upset because we had that contract last year, we didn’t this year, and these patients have been coming in and being patronizing for us, and they were just, they were really upset about not being able to have this service covered for them. The patients to the clinics are quite loyal.

On why typical hospital marketing does not work for this kind of a project:

The nurse practitioner or the physician assistant is of course the patient care giver, educator, counselor, customer service rep. This piece here is really important. These people need to for the most part be extroverts; we really encourage them to walk around in the aisles and wear their clinic coat to Starbucks when they take a break. They have to take on a marketing role to help sell the clinics to their community. They often will go visit local stores and employers as well. …They are the face of Sutter Express Care.

Retention of Local Public Health Workforce Continues to Pose Major Challenge

February 21st, 2008 by Melanie Matthews

The local public health workforce in New York State is older than the average age of the U.S. civilian workforce, and nearly one in five public health workers plans to retire within five years, according to a study by the Center for Health Workforce Studies at the University at Albany’s School of Public Health. The survey was conducted in 32 of the 57 county health departments across the state, not including New York City.

  • Not only are large numbers of older employees planning on retiring soon, but 20 percent of public health workers under 35 plan to leave the field within the next five years.
  • The median age of a local public health worker is 49, compared to the median age of a U.S. civilian worker of 40. Sixty-two percent of local public health workers are between ages 45 and 64.

Disparities in Healthcare Among Racial and Ethnic Minorities

February 21st, 2008 by Melanie Matthews

Disparities — whether they are due to race, income, age or other factors — are a serious problem in healthcare. An average of 84,000 deaths occurred in the United States alone due to healthcare disparities, and studies show that racial and ethnic minorities receive lower-quality healthcare than non-minorities, even when insurance status, income, age and severity of conditions are comparable.

This week’s Disease Management Update features one study about disparities that minority children face, while another study deals with disparities in health coverage and cancer diagnoses.

Late-Stage Diagnosis More Likely Among Uninsured

February 18th, 2008 by Melanie Matthews

Uninsured or Medicaid-insured patients are far more likely to be diagnosed with an advanced stage cancer than those with private insurance, according to a new American Cancer Society study of 3.5 million cancer patients with 12 of the most common cancer types. Previous studies have shown that insurance status is an important factor in ensuring timely diagnosis and care, but they were comprised of smaller patient groups, conducted in specific regions of the country, or looked only at specific cancer types (for example, breast or oropharyngeal cancer). This is the first large-scale national study to definitively link a late-stage cancer diagnosis with insurance status across a broad range of cancer types.

  • Uninsured and Medicaid-insured patients showed a significantly increased risk of having an advanced-stage cancer compared with their privately insured counterparts.
  • Uninsured and Medicaid-insured patients were also more likely to be diagnosed with late-stage breast and colorectal cancer, two cancers that can be detected at an early stage by screening.