Archive for September, 2008

Finding Alternatives to Alternative Medicine

September 25th, 2008 by Melanie Matthews

My 73-year-old dad has been struggling with a gastrointestinal disorder for the last few months. His gastroenterologist prescribed antibiotics and emphatically told him that diet would make no difference in his symptoms. During a particularly uncomfortable weekend, my dad's Web surfing turned up a practitioner of integrative medicine who offered consultations by telephone. Before the call ended, this "doctor" had recommended some herbal remedies.

(Yes, older adults ARE using the Internet to research health-related issues...and shop. My mother told me this weekend that she had Googled Wasilla Town Hall for details on the polar bear pin worn by Sarah Palin.)

By the time I talked to my dad last Monday, he was already getting some relief from the probiotics and slippery elm he had purchased from the health food store. I suggested we replace his virtual physician with a live one, and began my search for a local practitioner of integrative medicine. It wasn't easy. A survey by Health Forum, a subsidiary of the American Hospital Association, shows that more than one-third of responding hospitals are supplementing their clinical practices with complementary and alternative medicine (CAM), citing increased patient demand. While individual physicians may also be embracing CAM, it is less obvious from their Web presence that they are doing this.

I did finally locate a female trauma surgeon whose long-time interest in CAM led her to open an integrative medicine practice locally. At my request, her office sent my dad some paperwork to complete in advance of his appointment. That stopped the process dead in its tracks. He found many of the questions in the 20-page survey too invasive to answer. As anxious as he was for relief, he could not understand what his sleep patterns, sexual habits and mood had to do with his stomach problems. In the end, this septuagenarian was put off by the holistic approach to his medical troubles and the non-reimbursable nature of many of this doctor's services.

After additional research, we decided he should continue the antibiotics and probiotics but also experiment with some dietary changes. His decision to eliminate red meat, caffeine, alcohol and other "triggers" is at the same time heart-healthy (a co-morbidity) and friendly to my mom's type 1 diabetes. Last Sunday I served them both a lunch with all of the recommended "safe" foods and none of the dietary "triggers."

Armed with a "safe" foods list, he is doing much better, but his experience provided a glimpse into the world of integrative medicine and some of the resistance these practitioners must encounter, especially from older patients. Now that my dad has visited a health food store, however, I suspect that yoga, meditation and even acupuncture may be in his future.

No word yet on the polar bear pin, though.

Health System Shares Hand-washing Tools to Reduce MRSA

September 22nd, 2008 by Melanie Matthews

Novant Health has been hard at work for three years to reduce MRSA infection rates and clean up handwashing compliance issues among its hospital workers. And now that it's getting results (see related story), it's sharing the details and educational tools with others — for free — on the Internet. From a dedicated Web site, you can download many of their marketing materials for your organization's use. There's a computer screensaver and wallpaper, billboards, posters — even cafeteria tray liners.

Novant's success in changing its hospital culture is admirable; healthcare-associated infections claim 99,000 lives each year, by the most recent CDC estimates. But so is its decision to share its campaign tools. That's a great example, and a culture change that saves lives.

Stroke Recovery

September 18th, 2008 by Melanie Matthews

Every 40 seconds, a stroke occurs. That's just one startling statistic from the American Stroke Association. Others: Someone dies of stroke every three to four minutes; one of every 16 deaths each year is from stroke; and Americans will pay about $65.5 billion for stroke treatment in 2008. This week's Disease Management Update looks at what stroke patients are doing to better their health after surviving a stroke.

Chronic Pain Sufferers: Speak Up!

September 16th, 2008 by Melanie Matthews

chronic painIn pain? The Joint Commission is recommending that sufferers of chronic pain "speak up." The Joint Commission is launching a national campaign to help Americans work with their healthcare professionals to better manage pain. The new education campaign is part of The Joint Commission’s award-winning Speak Up™ program that helps patients become more informed and involved in their health care, and coincides with Pain Awareness Month in September:

The framework of the Speak Up™ program urges patients to:

  • Speak up if you have questions or concerns, and if you don't understand, ask again. It's your body and you have a right to know.
  • Pay attention to the care you are receiving. Make sure you're getting the right treatments by the right health care professionals. Don't assume anything.
  • Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.
  • Ask a trusted family member or friend to be your advocate.
  • Know what medications you take and why you take them. Medication errors are the most common health care errors.
  • Use a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards, such as that provided by The Joint Commission.
  • Participate in all decisions about your treatment. You are the center of the healthcare team.
  • Depression & Suicide Prevention

    September 11th, 2008 by Melanie Matthews

    Depression and suicide too often go hand-in-hand. Depression is the most common cause of suicide, with 80 percent of depression left untreated. According to the CDC's 2008 Report, over 32,000 suicides are reported each year, along with 395,000 treated cases of near-fatal self-inflicted wounds — making it the eleventh-highest cause of death in Americans. September 7th to 13th is National Suicide Prevention Week, and this week's Disease Management Update focuses on this tragic plight, as well as the disease of depression that is often behind it.

    Wellness Program Enrollment Rates Vary by Industry

    September 11th, 2008 by Melanie Matthews

    Enrollment rates in wellness and health coaching progarms vary significantly by industry, according to a nationwide study by Gordian Health Solutions, a leading personal health coaching company.

    Over a two-year course, the study looked at enrollment rates in Gordian’s programs by examining nearly 1.3 million employees at more than 125 organizations and businesses. The study showed industry-specific enrollment rates relative to the study population
    average.

    “The study results show a significant difference in rate of health coaching engagement by industry sector. One take-away is that organizations considering implementing or revamping a wellness initiative should look at best practices within their respective industry sector to see what worked and what didn’t work,” said Adam Long, Ph.D., vice president of research and informatics for Gordian.

    The listing of industry sectors included in the study and their relative rates of enrollment is as follows:

  • 1. Healthcare and Social Assistance: 157 percent of the average
  • 2. Food Manufacturing: 151 percent
  • 3. Other Manufacturing: 104 percent
  • 4. Professional/Scientific/Technical: 97 percent
  • 5. Finance and Insurance: 92 percent
  • 6. Retail Trade: 62 percent
  • 7. Educational Services: 60 percent
  • 8. Information: 47 percent
  • 9. Construction: 44 percent
  • 10. Utilities: 22 percent
  • Medical Homes Reduce Hospital Admissions, But Primary Care Ill-Equipped to Build Them

    September 10th, 2008 by Melanie Matthews

    Some concrete ROI on the impact of medical homes today, as Reuters reports that the establishment of medical homes by Geisinger Health System in Pennsylvania has cut hospital admissions by 20 percent and healthcare costs by 7 percent.

    The program could serve as a model for U.S. healthcare reform, researchers reported in the journal Health Affairs.

    However, another study released today indicates that before that can occur, primary care practices must equip themselves with the essential tools to transform themselves into medical homes. The study, by researchers at the University of California at San Francisco (UCSF), UC Berkeley, and the University of Chicago,appears in the September/October issue of Health Affairs.

    When researchers examined large medical groups with at least 20 physicians, they found that these physician practices are lagging on key measures of what it takes to create a “medical home,” a model of healthcare delivery that emphasizes comprehensive primary care to ensure the best outcomes for patients:

  • Whether physicians work closely with other healthcare providers in patient care “teams”;
  • How well care is coordinated and integrated;
  • Whether care is delivered in ways that maximize quality and safety;
  • Whether patients can reach physicians in nontraditional ways, such as by e-mail. Researchers also looked at physicians’ use of electronic medical records, disease registries, patient reminders, and performance feedback as well as their distribution of educational materials to patients.
  • The medical home model is now widely recognized by healthcare providers, large employers such as IBM, and increasingly patients as a promising blueprint for delivering comprehensive care over a patient’s lifespan.

    Results of a similar study of practices with less than 20 physicians will be released next year.

    The privately held Geisinger Health System is a network of network of hospitals and clinics that works with private insurers and caters directly to 2.5 million people in Pennsylvania.

    Injecting Web 2.0 into Healthcare

    September 9th, 2008 by Melanie Matthews

    For many of us, back-to-school also means lessons in computer literacy to access our children's online textbooks, e-mailed status reports and teachers' Web sites. Web 2.0 is everywhere — co-workers and children are friending, tweeting and texting away as these social networking tools become de facto communication modes. The healthcare industry isn't immune. A featured story this week chronicles how blogs, podcasts and wikis are changing the face of information exchange at the Cleveland Clinic.

    We're no strangers to user-generated content (UGC) ourselves. HIN ventured into the Web video realm earlier this year, and this month are raising our virtual profile even higher. You can now friend HIN VP and COO Melanie Matthews on Facebook and join the Healthcare Intelligence Network group.

    You can also follow HIN on Twitter.

    Join us there, and we'll figure out together whether Health 2.0 is helping or hindering our industry's information flow. And share your Web 2.0 experiences at the HIN blog.

    We also offer you one final way to communicate — by taking our fourth annual Healthcare Trends survey. Tell us about your year in healthcare and what's ahead for your organization in 2009, and we'll send you an e-summary of the results at the conclusion of the survey.

    Health Costs and Insurance Claims Less for Morbidly Obese after Bariatric Surgery

    September 8th, 2008 by Melanie Matthews

    Insurers recover their costs for bariatric surgery in two to four years depending on the type of surgery that is performed, according to a new study published in The American Journal of Managed Care (AJMC), a peer-reviewed journal on health outcomes research. The study found healthcare costs for patients who were morbidly obese and had bariatric surgery dropped while costs for morbidly obese patients who did not have surgery continued to rise. The analysis covered six months of pre-surgical evaluation and care, the surgery itself, and up to five years of post-surgical care, including any costs incurred for complications from surgery. Costs and claims were monitored for morbidly obese patients who did not have bariatric surgery over the same period. The study compared actual insurance claims filed by 3,651 bariatric surgery patients to actual claims filed by an equal number of morbidly obese patients who did not have surgery.


  • Insurers fully recovered the costs of laparoscopic bariatric surgery in about two years and in about four years for traditional, open bariatric surgery.
  • Reductions in costs associated with prescription drugs, physician visits and hospital services offset the $17,000 average cost of laparoscopic surgery and the $26,000 average cost of traditional, open bariatric surgery.
  • Video: Health Coaching Scores Big Gains in Disease Management, Behavior Change

    September 5th, 2008 by Melanie Matthews

    Learn how health coaching for chronic illness helps employers and health plans save millions in healthcare costs and motivates individuals to change unhealthy behaviors in this new video from HIN: