Vt. health reform: manage chronically ill patients - washingtonpost.com

By WILSON RING, The Associated Press

What could play a central role reforming the nation's health care system happens in a small conference room of the Aesculapius Medical Center - two patients learning the basics of managing their diabetes.

The pilot program begun in 2003 aims to reach patients with chronic conditions, keep them healthier and, ultimately, save money by heading off expensive hospitalizations and procedures. Already, emergency room visits are down.
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Urban Institute: Estimating the Cost of Racial and Ethnic Health Disparities

This analysis estimates cost burdens of racial and ethnic disparities in a select set of preventable diseases including diabetes, hypertension and stroke. Excess rates of these diseases among African Americans and Latinos relative to whites will cost the health care system $23.9 billion dollars in 2009. Medicare alone will spend an extra $15.6 billion, and private insurers will spend an extra $5.1 billion. Over the next decade, the total cost is approximately $337 billion. Left unchecked, these annual costs will more than double by 2050 as the representation of Latinos and African Americans among the elderly increases.

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Wheat Consumption May Contribute to Diabetes - Forbes.com

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(HealthDay News) -- An abnormal immune response to wheat proteins may contribute to type 1 diabetes, Canadian researchers say.

Their study of 42 people with type 1 diabetes found that nearly half had immune system T-cells that overreacted to wheat. The researchers also identified genes associated with this abnormal immune response.
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impacts-of-incontinence.pdf (application/pdf Object)

The following policy brief has been commissioned by The Canadian Continence Foundation (TCCF) to help government address the unmet needs of Canadians living with incontinence. Incontinence is a chronic condition that continues to carry an enormous stigma. Incontinence can impact all parts of a persons’ life: social interactions, sex life, ability to work, travel, play sports, and participate in community life. An extremely conservative estimate of the prevalence of incontinence in Canada indicates that 7% of Canadian women and 3.5% of Canadian men experience moderate to severe incontinence on a daily basis. Many studies suggest that the prevalence is significantly higher. Incontinence takes a serious emotional toll on those living with the condition. Women living with incontinence are more likely to suffer from depression than their continent peers. In one study, urinary incontinence, Alzheimer’s disease and stroke were the three chronic conditions found to most adversely affect an individuals’ health-related quality of life. Read More: impacts-of-incontinence.pdf (application/pdf Object)

NIH: Women's Health Initiative Observational Study

This study will be used by the NIH to evaluate risk factors for chronic disease among older women by developing and following a large cohort of postmenopausal women and relating subsequent disease development to baseline assessments of historical, physical, psychosocial, and physiologic characteristics. In addition, the observational study will complement the clinical trial (which has received clinical exemption) and provide additional information on the common causes of frailty, disability and death for postmenopausal women, namely, coronary heart disease, breast and colorectal cancer, and osteoporotic fractures. Continuation of follow-up for ascertainment of medical history update forms will provide essential data for outcomes assessment for this population of aging women.

Barriers and Drivers of Health Information Technology Use for the Elderly, Chronically Ill, and Underserved

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD.

Researchers reviewed the evidence on the barriers and drivers to the use of interactive consumer health information technology (IT) by specific populations, namely the elderly, those with chronic conditions or disabilities, and the underserved.

Interactive consumer health information technology (health IT) promises to engage consumers and promote their active participation in improving their health. Interactive technologies provide health information and tools that are patient-centered, offering care and support that integrates individual needs and preferences into clinical information systems. Such technologies, by tailoring health information and delivering targeted care, have significant potential to foster patient self-care monitoring and management. As the evidence on health IT interventions increases, it is important to understand how specific target groups such as the elderly, those with chronic conditions or disabilities, and underserved populations are able to access, use, and benefit from these applications.

Continuous Innovation in Health Care: Implications of the Geisinger Experience

Through innovations like patient-centered medical homes, chronic disease management, and bundled payment of acute-care episodes, Geisinger Health System in Pennsylvania is improving its quality of care and achieving better outcomes for patients, while at the same time lowering costs and increasing value.

Health Implications of Targeted Food and Beverage Marketing to African Americans

September 2008, Vol 98, No. 9 American Journal of Public Health 1616-1629 Targeted marketing of high-calorie foods and beverages to ethnic minority populations, relative to more healthful foods, may contribute to ethnic disparities in obesity and other diet-related chronic conditions.

American Health Information Community Workgroup Meetings

All meetings below are available via web cast.

Quality Workgroup

DATES: September 5, 2008, from 2 p.m. to 4 p.m.

The Workgroup will continue its discussion on how health information technology can provide the data needed for the development of quality measures that are useful to patients and others in the health care industry, automate the measurement and reporting of a comprehensive current and future set of quality measures, and accelerate the use of clinical decision support that can improve performance on those quality measures.

Chronic Care Workgroup

DATES: September 8, 2008, from 1 p.m. to 4 p.m. The Workgroup will discuss progress made to date and future steps regarding secure messaging and remote care as it relates to the transition to the new AHIC.

Electronic Health Records Workgroup

DATES: September 10, 2008, from 1 p.m. to 4 p.m.

The Workgroup will continue its discussion on ways to achieve widespread adoption of certified EHRs, minimizing gaps in adoption among providers.

Confidentiality, Privacy, & Security Workgroup DATES: September 11, 2008, from 1 p.m. to 5 p.m. The Workgroup Members will continue discussing and evaluating the confidentiality, privacy, and security protections and requirements for participants in electronic health information exchange environments. Community Consumer Empowerment Workgroup DATES: September 16, 2008, from 1 p.m. to 4 p.m. The Workgroup will continue its discussion on how to encourage the widespread adoption of a personal health record that is easy-to-use, portable, longitudinal, affordable, and consumer-centered. Population Health and Clinical Care Connections Workgroup DATES: September 17, 2008, from 2 p.m. to 5 p.m. The Workgroup will continue its discussion on how to facilitate the flow of reliable health information among population health and clinical care systems necessary to protect and improve the public's health.

E-Patients: Chronically Ill Seek Health Information Online

from article in News@pewresearch eNewsletter by Susannah Fox, Associate Director, Pew Internet & American Life ProjectAugust 26, 2008 This latest survey confirms that information gathering has become a habit for many Americans, particularly those in the 55% of households with broadband connections. Home broadband has now joined educational attainment, household income and age as the strongest predictors of internet activity. For example, 78% of home broadband users look online for health information, compared with 70% of home dial-up users. Home broadband users are twice as likely as home dial-up users to do health research on a typical day -- 12% vs. 6%.

Internet users living with a disability or chronic disease are more likely than other internet users to be wide-ranging online health researchers and to report significant impacts from those searches. For example, 75% of e-patients with a chronic condition say their last health search affected a decision about how to treat an illness or condition, compared with 55% of other e-patients.

Millions With Chronic Disease Get Little to No Treatment

By REED ABELSON Published: August 5, 2008, New York Times A study estimates that about one of every three working-age adults without insurance in the U.S. has received a diagnosis of a chronic illness and is not getting adequate treatment.