Posts Tagged ‘diabetes’

Infographic: The Data Behind Diabetes

July 22nd, 2016 by Melanie Matthews

The number of people living with diabetes has quadrupled since 1980, growing to more than 400 million. And with this rise in disease, sales of diabetes-related products have also climbed. In fact, in 2015, American consumers spent $592 million on such products, according to the World Health Organization.

Managing diabetes requires a proper balance of professional medical management, blood sugar control, and maintaining a healthy diet. So there is great value in understanding the diabetic patient and consumer journey through each step of the management process, all the way from the doctor’s office to the grocery aisles. And today, thanks to the power of data insights, healthcare providers and physicians, product manufacturers, and retailers can better tailor their offerings and experiences to aid diabetic patients and consumers in their path to healthy living.

A new infographic by Nielsen reflects key insights around the diabetic consumer.

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care ManagementReal-time remote management of high-risk populations curbed hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted self-management levels for nearly all remotely monitored patients, according to 2014 market data from the Healthcare Intelligence Network (HIN).

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation’s (NYCHHC) House Calls Telehealth Program that significantly lowered patients’ A1C blood glucose levels.

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Yale New Haven’s High-Risk Care Management Commences with Its Employees

January 14th, 2016 by Patricia Donovan

A care management pilot by YNHHS for employees and their dependents with diabetes was a template for future embedded care management efforts.

Disenchanted with vendors it engaged to provide care management for its workforce, Yale New Haven Health System (YNHHS) launched an initial care management pilot for its high-risk employee populations. The pilot went on to become a very robust program and served as a training ground for two more embedded on-site care management initiatives. Here, Amanda Skinner, YNHHS’s executive director for clinical integration and population health, provides details from on-site face-to-face care management for YNHHS employees and their dependents.

We have an RN care coordinator based on each of the four main hospital campuses of our health system: one in Greenwich, one in Bridgeport and two in New Haven. All of the RN care coordinators in this program are trained in motivational interviewing. The intent is for them to work with our high-risk, high-cost employees who have chronic diseases, and with their adult dependents that also fall into that population.

The care coordinators work with these employees across the entire system to help them access the care they need, identify their goals of care, get under the surface a little to determine barriers to their being as healthy as they can be, and manage them over time. We did create some incentives for employee participation in this program, including waived co-pays on a number of medications (for example, any oral anti-diabetics).

When we initially launched the program, we limited it to employees and dependents that had diabetes, because that was the population for which we had very robust data. We also knew that diabetes was generally a condition that lent itself well to the benefit of care coordination; that there were a lot of gaps in care. When we looked at our data, we saw that ED utilization was very high for this population; that their past trend was rising, that utilization of their primary care provider was actually below what you would expect. This meant that they were under-utilizing primary care, over-utilizing hospital services, and were not particularly compliant with care.

With that population, we saw a lot of opportunity that a care management program could help address. In general, diabetes is a condition that lends itself to accepting a helping hand, to help people understand their condition and address the medical and social issues so they can manage that condition more effectively.

The program has been tremendously successful. We expanded it this year to include wellness coaches based at all of our delivery networks’ main campuses as well. These coaches work with a lower risk population and are available to any health system employee that wants to work with a coach to set care goals and then meet with the coach monthly or quarterly to track improvements against those goals. This expansion is because we’ve seen such positive results from this program.

Source: 3 Embedded Care Coordination Models to Manage Diverse High-Risk, High-Cost Patients across the Continuum examines YNHHS’s three models of embedded care coordination that deliver value while managing care across time, across people, and across the entire continuum of care. In this 30-page resource, Amanda Skinner, executive director for clinical integration and population health at Yale New Haven Health System, and Dr. Vivian Argento, executive director for geriatric and palliative care services at Bridgeport Hospital, present a trio of on-site care models crafted by YNHHS to manage three distinct populations.

Infographic: Diabetes Drug Costs

August 17th, 2015 by Melanie Matthews

Primarily because of escalating drug costs, spending on insulin and other diabetes medications is expected to rise 8.3 percent over the next three years, according to a new infographic by the Alliance of Community Health Plans.

The infographic examines the percent increase of diabetes drug costs over the past five years and how this is impacting healthcare consumers, employers, healthcare providers and payors and the federal government.

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care ManagementReal-time remote management of high-risk populations curbed hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted self-management levels for nearly all remotely monitored patients, according to 2014 market data from the Healthcare Intelligence Network (HIN).

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation’s (NYCHHC) House Calls Telehealth Program that significantly lowered patients’ A1C blood glucose levels.

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ROI and 12 More Rewards from Stratifying High-Risk, High-Cost Patients

May 21st, 2015 by Patricia Donovan

Health risk stratification—for example, grouping diabetics in a single physician practice or drilling down to an ACO’s subset of medication non-adherent diabetics with elevated HbA1cs—followed by risk-appropriate interventions can significantly enhance a healthcare organization’s clinical and financial outlook.

For 9.4 percent of respondents to HIN’s 2014 Health Risk Stratification Survey, risk stratification resulted in program ROI of between 3:1 and 4:1, while 6.3 said return on investment was greater than 5:1.

Stratification and targeted interventions also generated a healthy drop in healthcare cost, nursing home stays, ER utilization and time off work while boosting quality ratings, patient engagement levels and care plan adherence.

Survey respondents further quantified successes achieved from health risk stratification in their own words:

  • “„„Decreased readmissions and decreased skilled nursing facility (SNF) utilization.”
  • “Improved treat-to-target for diabetes, blood pressure, and depression care.”
  • “Reduction in readmissions by 20+ percent.”
  • “Reducing heart failure, pneumonia, acute myocardial infarction (AMI) and chronic obstructive pulmonary disorder (COPD) Medicare readmissions.”
  • “Patient compliance to care plan.”
  • “Patient health outcomes, quality of life, and satisfaction with services.”
  • “Member satisfaction.”
  • “More referrals to patient-centered medical homes and fair retention with limited resources.”
  • “Decreased primary care-sensitive ED visits and increased quality metrics.”
  • “One-on-one interaction w/members to promote behavior change.”
  • “A reduction of costs in the range of 6 to 8 percent of target spend.”
  • “Lower readmission rates for those patients on AIM 2.0 program with home health and more compliance with meds. We meet with FQHCs every other month and discuss issues and case management.”

Source: 2014 Healthcare Benchmarks: Stratifying High-Risk Patients

http://hin.3dcartstores.com/2014-Healthcare-Benchmarks-Stratifying-High-Risk-Patients_p_4963.html

2014 Healthcare Benchmarks: Stratifying High-Risk Patients captures the tools and practices employed by dozens of organizations in this prerequisite for care management and jumping-off point for population health improvement — data analytics that will ultimately enhance quality ratings and improve reimbursement in the industry’s value-focused climate.

Yale Online Forum Helps Teens with Diabetes “Not Look Like a Jerk”

August 14th, 2014 by Cheryl Miller

Being a teenager is hard enough; when it’s complicated by a chronic disease like type 1 diabetes, it’s even harder.

Enter telehealth, in the form of a monitored discussion board for teens with the disease.

Margaret Grey, DrPH, RN, FAAN, Dean and Annie Goodrich Professor at the Yale School of Nursing, has spent the majority of her career helping patients and families manage chronic conditions, and helping kids — teenagers in particular — manage their diabetes through their teen years so they can reduce their risk of long-term complications.

“I’ve been studying these kids for 30 years,” says the pediatric nurse practitioner, who, prior to assuming the deanship in 2005, served as associate dean for scholarly affairs and was the founding director of the school’s doctoral program and the NIH-funded Center for Self and Family Management and a related pre- and post-doctoral training program. “Kids have black and white thinking — and have to manage how to ‘not look like a jerk’ by being given the skills to manage their disease, to think about it in a different way.”

Grey and other researchers conducted several clinical trials: an advanced diabetic education project and a life skills program, which showed that teens with diabetes’ overall health and quality of life were better after going through both programs. Results showed that intensive therapy and better metabolic control reduced the incidence and progression of microvascular and neuropathic complications from diabetes from 27 percent to 76 percent.

But how to maintain those results? According to researchers, “Metabolic control tends to deteriorate as a combined result of insulin resistance that accompanies the hormonal changes of adolescence and lower adherence to the treatment regimen often associated with the desire for autonomy.”

“So we took those interventions and developed an online program kids could do at their leisure,” Grey says. It incorporated a monitored discussion board that allowed kids to communicate with others like them. Teens with diabetes overcome their fear of being stigmatized by logging onto the Web site,­ called TeenCope, ­with other teens with diabetes and engaging in self-management exercises. The online program simulates situations teenagers with diabetes might encounter by using graphic novel animations that illustrate coping skills lessons from the animated characters. “As kids transition to adolescence, they require more effort and thought,” Grey says.

Peer support is an important component of maintaining a healthy lifestyle, as adolescents face pressures such as not wanting to reveal medical equipment in a social setting, or reveal their medical conditions in a social situation.

In addition, the program will also integrate an online educational program aimed at problem-solving for teens with diabetes. Adolescence is a time when patients neglect self-monitoring, dietary recommendations, and pharmacologic treatments — not because of a lack of knowledge, but due to the decision-making difficulties characteristic of this life stage. Studies show that poor metabolic control in the teen years correlates to reduced self-management in adulthood, making adolescence a key period for developing healthy behaviors. And once teenagers can get a handle on their diabetes, they improve not only their own health, but their families’ quality of life.

“This is a way to give them the skills to think about their condition in a different way,” Grey says.

5 Ideas to Improve ACO Performance Results

June 19th, 2014 by Cheryl Miller

One step John C. Lincoln network took to improve performance results at the end of its first year as a Medicare Shared Savings Program accountable care organization (MSSP ACO) was to focus on a relatively small number of patients, the top 5 percent of beneficiaries by claims volume who actually account for about 60 percent of medical spend, explains Heather Jelonek, CEO for ACOs at John C. Lincoln Network, who shares additional strategies here.

First, we decided to institute wellness visits across our health system. We’ve worked with several large third party payors here in the valley where they’re now recognizing the Medicare G-codes for wellness visits. We bring those patients in and get a full survey of what’s been going on with them.

Second, we’re engaging in regular population management. We now have our physicians talking about how often they want to see their patients with diabetes or hypertension or cancer.

Third, we’re also starting to focus on those individuals who are ‘aging in;’ those patients who are about 62½. We’re trying to get them in and get them into a routine, making sure they’ve got A1C scores every quarter and every six months, and have had their flu shots and colonoscopies. We’re hoping a healthier generation of individuals coming into the Medicare program improves the quality outcomes that we’ll see long-term.

Fourth, we’ve developed a standardization for our quality reporting. We’ve looked at the top 5 percent of our beneficiaries by claims volume, who actually account for about 60 percent of our medical spend. We’re hoping that by focusing on a relatively small number of patients, we’ll have a drastic impact on outcomes.

Next, we’re also leveraging our electronic medical record (EMR) to the fullest extent; we’re participating in a number of conversations and baseline studies with EPIC®. They are very interested in seeing what we’ve done with the tool and how we’re making it usable for our ACO reporting.

But the one thing that we will continue to struggle with and continue to dive deeply into is integration opportunities: talking to other communities, looking at health information exchanges (HIE’s) as we’re acquiring a new practice or signing a new community physician onto our ACO — bringing everybody to the table so that we’re all speaking the same language.

Excerpted from Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care.

Infographic: Diabetes on The Rise, Growing As Healthcare Concern

May 28th, 2014 by Jackie Lyons

The Center for Disease Control and Prevention predicts that one in three people will have diabetes by 2050. Furthermore, diabetes-related costs in 2012 totaled $245 billion, and the estimated cost of diabetes for 2020 is $500 billion, according to a new infographic from Tractivity.

This infographic also shows the causes of diabetes, number of affected people, the costs related to diabetes and ways to prevent the chronic disease.

You may also be interested in The Handbook of Health Behavior Change, 4th Edition. This resource contains chapters on lifestyle change and prevention and chronic disease management, with an intensive focus on specific behaviors (i.e. diet and nutrition, tobacco use) and chronic illness (i.e. diabetes, heart disease). It is organized around the specific behaviors and chronic illnesses with the most significant public health impacts in terms of morbidity and mortality.

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9 Things to Know About Patient and Disease Registries

February 19th, 2014 by Jessica Fornarotto

In the environment of accountable and value-based healthcare, registries are a straightforward tool for creating realistic views of clinical practices, patient outcomes, safety and comparative effectiveness and for supporting evidence-based medicine development and decision-making.

The Healthcare Intelligence Network’s most recent analysis of registries and their impact on healthcare quality, efficiency and cost, reveals that the management of chronic disease is a key driver in the use of registries.

E-survey responses provided by 105 healthcare organizations also found that one-third of existing registries are a component of an electronic health record (EHR); the top reason for not having implemented a registry is because respondents already use an alternative, such as an EHR.

Other survey highlights include:

  • A disease- or condition-specific registry is the most popular type of registry, say 17 percent of respondents.
  • Diabetes is the condition most frequently targeted by respondents’ registries (78 percent), followed by CHF and asthma (both reported at 59 percent).
  • The most popular reason for using a registry is to measure quality and performance on key health outcomes, followed by disease management and the identification of high-risk patients.
  • Almost two-thirds of respondents who are not using registries at this time say they will launch a registry within the next 12 months.
  • A third of respondents include 20 percent or more of their population in registries.
  • Chart audits are the most common sources from which registries draw data, say half of respondents.
  • Engaging staff in registry use is the greatest challenge of implementing a patient registry, according to 29 percent of respondents.

Excerpted from: 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care

Infographic: America, Land of the Obese

September 3rd, 2013 by Jackie Lyons

Obesity is officially an epidemic, and it costs the healthcare system approximately $90 billion per year, according to the surgeon general.

In the United States, one in three adults and one in six children are considered obese, according to a new infographic presented by PhentermineWars.com. This infographic also identifies factors and risks, health concerns and deaths associated with obesity, current obesity rates, the top 10 obese states and more.

America the Obese

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You may also be interested in this related resource: 2013 Healthcare Benchmarks: Health Coaching.

Infographic: Sick! Epidemic of Chronic Diseases

August 29th, 2013 by Jackie Lyons

Chronic diseases account for 70 percent of deaths every year, which translates to higher healthcare costs and utilization rates.

Heart disease has been the leading cause of mortality for Americans every year since 1920, costing an annual $108.9 billion in healthcare and lost productivity, according to a new infographic from Best Master of Science in Nursing Degrees. This infographic identifies the top chronic illnesses, their costs and possible preventative measures.

Sick! Epidemic of Chronic Diseases

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You may also be interested in this related resource: Chronic Care Professional Manual 5.0 .