Real World Health Care Blog

Tag Archives: United States

Why We Give to HealthWell Foundation – and Why You Should Too

As the head of a communications strategy shop that helps clients in science, technology, and health care, I encounter a seemingly endless number of organizations that want to do good for society and the planet.  Why then have the WHITECOAT Strategies employees – who serve as editors of Real World Health Care (RWHC) Blog – decided that the HealthWell Foundation should be one of our two charter charities, as our firm becomes a social enterprise in 2014?

David Sheon

David Sheon

Before I answer that, just what is a social enterprise?

A social enterprise is an organization that applies business strategies to maximize improvements in human and environmental well-being, rather than maximizing profits for shareholders.

Social enterprises can be structured as for-profit or non-profit organizations, but their focus is using their proceeds to do good.

We decided that organizations seeking communications firms would like to know that revenue from their work is going to help society.  And our employees like to know that too.

When we made the decision to become a social enterprise, we thought about the impact of our work globally and locally.  And that’s how we arrived at helping CA Bikes, as well as the HealthWell Foundation.

CA Bikes is a nonprofit organization founded by Chris Ategeka, a native of Uganda. The oldest of five children, Chris became an orphan and head of his household at an early age after losing both his parents to HIV/AIDS. After years of poverty and laboring in the fields, a miracle happened, as Chris says, when a woman from the United States started an organization called Y.E.S. Uganda near his village, took him in, and supported him through school. Now, Chris holds a BS and an MS in Mechanical Engineering from the University of California, Berkeley.

Many people living in rural Africa have no access to emergency medical services, and given that the nearest health clinic or hospital is often miles away, this results in needless suffering and deaths. CA Bikes builds and distributes bicycle and motorcycle ambulances to rural African villages and trains partners in their maintenance and use to provide access to life-saving care during medical emergencies. For more information about CA Bikes and to help support their work, click here.

The WHITECOAT team is honored to help Chris fulfill the mission of CA Bikes.

WHITECOAT’s history with the HealthWell Foundation dates to a discussion one of my staff members and I had over three years ago.  She told me that her best friend from college had been diagnosed with a brain tumor. He had insurance through his job, which stuck with him through the medical emergency.  His wife had been laid off of her job a month before the diagnosis.  The emotional toll of the diagnosis was awful.  I knew the couple and their children would find their own way to deal with that and there was nothing we could do. But I felt that perhaps we could do something more to find them financial support.

One call to the HealthWell Foundation was all that was needed.  After reviewing financial records and evaluating the situation, the Foundation tapped a fund reserved for medical emergencies that reimbursed not only for the co-pays associated with medication, but also for the cost of the monthly health insurance premium and related medical expenses.  This program has now transformed into the Emergency Cancer Relief Fund, which WHITECOAT is proud to help launch for HealthWell.

HealthWell has awarded more than 265,000 grants to patients in over 40 disease categories, making a profound difference to over 165,000 people faced with difficult medical circumstances in the U.S.

I hope that at this time of giving, you’ll join me and the WHITECOAT staff by donating to the HealthWell Foundation.

Categories: Cost-Savings

Advocates Unite to Prevent Type 2 Diabetes During National Diabetes Awareness Month

One in three. That’s the number of people in the United States who will have diabetes by 2050 if current trends continue. Twenty-six million Americans – seven million of which are undiagnosed – now live with diabetes and another 79 million have pre-diabetes. To raise awareness and spotlight effective prevention strategies, patient advocates are mobilizing to promote National Diabetes Awareness Month and American Diabetes Month® this November.

Paul DeMiglio

Paul DeMiglio

As a disease that constitutes one of the leading causes of death and disability in the United States, diabetes is a disease in which glucose blood levels are elevated above their normal range. Those living with diabetes are also at higher risk of heart disease and stroke. According to the Centers for Disease Control and Prevention (CDC), the risk factors for type 2 diabetes include:

  • Being 45 years of age or older
  • Being overweight
  • Having a family history of Type 2 Diabetes
  • Engaging in physical activity fewer than three times per week
  • Giving birth to a baby that weighed more than 9 pounds
  • Having gestational diabetes (diabetes during pregnancy)

Although type 1 diabetes cannot be prevented because people are born with it, individuals can lower their risk of developing type 2 diabetes through a variety of practical strategies. The CDC’s National Diabetes Prevention Program is an evidence-based program for preventing type 2 diabetes. A public-private partnership of community organizations, private insurers, employers, health care organizations and government agencies, it teaches participants how they can incorporate physical activity into daily life and eat more healthfully, helping them to:

  • Cut their risk of developing type 2 diabetes in half
  • Lose 5-7 percent of body weight through modest changes in behavior
  • Reduce the risk of diabetes in people with pre-diabetes by 5 percent

The program pairs people with a lifestyle coach, in a group setting, to receive 16 core sessions and six post-core sessions over the course of a year. These lifestyle coaches work with the participants to identify emotions and situations that can sabotage their success. The group process encourages participants to share approaches for dealing with challenging situations.

Along with their National Diabetes Prevention program, the CDC also provides a Registry of Recognized Programs that lists contact information for community resources offering type 2 diabetes prevention programs. The registry was created to help health care providers more effectively refer their patients to the services they need, while also empowering patients to find and choose the programs that are right for them. For more information about diabetes and other diseases from CDC, you can sign up for e-mail updates here.

The National Diabetes Education Program (NDEP) is also committed to raising awareness and providing resources around issues such as diabetes risk, family support, and community support. The goal of their campaign – Control Your Diabetes. For Life is to increase awareness about the benefits of diabetes control through education materials, fact sheets, sample articles and PSAs for radio, print and television. A major part of their focus is also placed upon bringing diabetes information to community settings such as schools, worksites, senior centers and places of worship.

“Although the prevalence of diabetes has continued to rise due to the obesity epidemic, the aging of the U.S. population, and increasing numbers of people at high risk for diabetes, there are strong, encouraging indicators of progress in preventing and treating diabetes,” said Joanne Gallivan, M.S., R.D., Director of NDEP. “Today, there is much greater awareness that diabetes is a serious disease, a critical first step in changing outcomes. In 1997, only 8 percent of Americans believed diabetes was serious. In 2011, 84 percent of Americans understood that it is a serious disease.”

The American Diabetes Association (ADA), which works to “raise awareness of this ever growing disease,” leverages American Diabetes Month® to illustrate how diabetes impacts Americans. By asking people to submit photos that show “A Day in the Life of Diabetes,” the ADA plans to create a large mosaic that demonstrates how diabetes affects patients, families and communities nationwide from personal perspectives.

“Participating in ‘A Day in the Life of Diabetes’ for individuals living with diabetes lets them know that the American Diabetes Association is the one leading organization that continues to do research to ‘STOP Diabetes,’ advocate and promote ‘Healthy Lifestyle Management’ to avoid many of the health issues that people with diabetes die from, such as heart disease or stroke, kidney failure, blindness, and amputations,” said Lurelean B. Gaines, RN, MSN, President of Health Care and Education of the Association. “The campaign has grown this year and will continue to grow because every 17 seconds someone is diagnosed with diabetes.”

To learn more visit ADA’s website at www.diabetes.org and click on Diabetes Basics, Living With Diabetes, Food Fitness, Advocate, In My Community, or News & Research.  Information is available in English and Spanish. You can also “like” ADA on Facebook, follow them on Twitter (@AMDiabetesAssn) or call them at 1-800-Diabetes.

How can your community more effectively collaborate with stakeholders like ADA, CDC and NDEP to prevent diabetes and help those living with the disease?

Adherence Training Key to Improved Coordination of Care, Use of Specialty Drugs

I have been fortunate enough in my career to do humanitarian work in East Africa, and I have witnessed incredible health care service performed despite a paucity of resources. Conversely, one of the many health care tragedies in that part of the world is the downward therapeutic outcome spiral due to unattended simple maladies. An untreated toe could turn into a raging skin infection or worse. A simple break of a person’s leg improperly set could leave that person crippled for life.

Joel L. Zive

Joel L. Zive

In the United States, we have a different set of complex issues affecting our health care system. But there is a beacon of hope with some of the most vexing health care issues:  specialty drugs. Yes, they have annual costs that approach the length of phone numbers, but research and development costs must be taken into consideration.

Yet when one evaluates the pain and suffering these compounds alleviate – sometimes also saving money for our health care system in the areas of solid organ transplant rejection, HIV, Multiple Sclerosis and Cancer for example – real value emerges.

Despite their high expense, there are organizations, including the HealthWell Foundation, that help patients pay for access to these medications. And do not forget social workers, case managers and an army of master insurance billers in doctor’s offices and pharmacies across the country.

Yet these drugs carry with them a promise and a peril: A promise if their regimens, with high pill burden, are adhered to and the side-effects are understood. And a peril to the patient and unnecessary high cost to our health care system.

What person who deals in specialty drugs has not been brought to the brink of tears due to the frustration of non-adherence? Of a transplant patient who never told their pharmacist or transplant coordinator that he stopped taking their immunosuppressive medications and lost their transplanted organ? The efforts of the pharmacists, nurses, prescribers, surgeons, transplant coordinators, social workers that were wasted along with precious time and money are horrifying.

On the other hand, you have a patient newly transplanted or newly diagnosed with a complex disease. Frightened, scared — even angry — wondering whether they can afford medications to stave off dialysis or stay alive. In my career, I have seen first-hand examples of turnarounds in patients’ attitudes and quality of life due to these medications and adherence training:

  • A kidney transplant patient who was on dialysis for years who saw other patients go into dialysis walking, then in a wheelchair, then on a gurney before expiring.
  • Another patient at the dialysis center who announced one day, “I give up.” This individual had sufficient motivation but still needed guidance and assurance he would get his medications in a timely manner. Now, this person is rebuilding a life for himself and his family.
  • A woman tired, frail and scared lying in a hospital bed post-transplant wondering how she will live the rest of her life. With encouragement and adherence training she is now flying cross-country to see her relatives.
  • Another patient was diagnosed with relapsing remitting Multiple Sclerosis in the prime of his life. Yes, he had difficulty dealing with his insurance company and their specialty pharmacy.  But he had help and encouragement from an outside specialty pharmacy. And with patience and persistence from others he is now in graduate school.

What do these examples underscore? That although the United States enjoys an abundance of health care resources compared to Africa, what we’re missing is the coordination of care. Sometimes this is due to the health care system and sometimes this is because of the patient.

There are a couple of strategies providers can employ to improve this situation:

  • This scenario I saw first-hand in Rwanda.  If a pharmacist senses there is something not right mentally with the patient, he can contact a social worker in the clinic for further workup.
  • Another approach includes an agreement among the multidisciplinary team about what the adherence goals  should be. If the goals seem to be remiss, then the pharmacist could be notified, and he could handle the issue or direct it to the appropriate provider.

In both cases, there is feedback among the health care team. In the area of specialty drugs, adherence training can fill and highlight these gaps to the patient’s benefit.  As my colleagues in East Africa have told me, “We admire your health care system.”

We have many issues to be worked out and negotiated in the weeks, months and years ahead.  But let’s use adherence training to give my colleagues overseas something they can aspire toward and emulate.

What other strategies can providers employ to improve coordination of care? How can hospitals, government and health care industry stakeholders coordinate to become part of the solution when it comes to more effective adherence training?

Are You Ready to Show Your Purple to Stop Alzheimer’s?

Advocates nationwide are gearing up to participate in activities around Alzheimer’s Action Day on September 21, a pre-event to World Alzheimer’s Awareness Month in November. As the facts demonstrate, the need for education and action around this disease is great. A form of progressive dementia that adversely impacts memory, thinking and behavior, Alzheimer’s is the sixth leading cause of death in the United States and there is no cure.

Paul DeMiglio

Paul DeMiglio

To build support and increase visibility, the Alzheimer’s Association leverages Alzheimer’s Action Day to educate the public and fund research for Alzheimer’s, urging individuals to “Go Purple to End Alzheimer’s.” The association empowers supporters to raise money for Alzheimer’s research with the following creative ideas that can be used in the workplace, at school or at home:

  • Go purple at your office or campus by encouraging your co-workers or your peers to wear purple.
  • Decorate common areas at your workplace or school with purple. Share the latest stats and trends about the disease, like the 10 warning signs of Alzheimer’s. Call (800) 272-3900 to request fact sheets.
  • Go “Casual for the Cause” at work. Order $5 stickers from the association that you can then sell in your office to raise funds. Download a flier here and e-mail Kaarmin Ford at kaarmin.ford@alz.org for stickers.
  • Host a dinner party at your home and ask each attendee to donate what they would have spent going out. Click here to download meal ideas that can be used at home or in the cafeteria.
  • Invite your friends to Tailgate to Tackle Alzheimer’s starting this month. Supporters who host these purple-themed tailgates can ask participants to donate $5 to help the 5 million Americans living with Alzheimer’s.

Over the past decade, Alzheimer’s has become an even more urgent public health crisis, demanding greater attention from both a patient care and cost-savings standpoint:

  • Five million Americans and one in three seniors live with Alzheimer’s.
  • Since 2000, the number of deaths attributed to Alzheimer’s has increased by 68 percent.
  • The disease accounts for 50-80 percent of all dementia cases.
  • Alzheimer’s will cost the nation an estimated $203 billion this year.
  • Costs are expected to increase by 500 percent by the year 2050, meaning that the annual cost will swell to $1.2 trillion.

The Alzheimer’s Association is collaborating with partners from around the country to help communities “Go Purple.” These include the Las Vegas CME – Medical and Health Education for All, the California Association of School Health Educators (CASHE) and Cox 11, a community station in Hampton Roads, VA, which are all spreading the word about ways to get involved at the local level. Ruby Tuesday will also raise awareness for Alzheimer’s Action Day at select locations, giving 20 percent of purchases to the Walk to End Alzheimer’s when customers present a flyer to their server on September 21.

“Supporting Alzheimer’s Association specifically on Alzheimer’s Action Day will help generate much needed awareness about this disease and what we can do as a community to support families with this disease on a daily basis,” a Ruby Tuesday spokeswoman said. “With the GiveBack Program specifically, we hope to raise funds within the communities of our restaurant that will directly contribute to research and ultimately find a cure for Alzheimer’s.”

What are you doing in your community to educate colleagues, peers, family and others about this disease? How can other stakeholders – including health systems and government – get more involved and join in efforts to raise awareness around the impact of Alzheimer’s year-round?

Categories: Access to Care

More Patients DASH to New Solution to Reduce High Blood Pressure: Part I

Shawn_J_Green

Shawn J. Green

What’s the solution to reversing the tide of hypertension, the most commonly diagnosed condition in the United States?  More evidence indicates that the answer begins with the food choices we make every day.

An underlying cause of heart attacks, strokes and kidney disease, one in three American adults now experiences high blood pressure – the single-largest contributor to death worldwide. It is also becoming more resistant to the pharmaceutical drugs used to lower it. In fact, blood pressure remains elevated in nearly one-third of all treated hypertensive patients on pharmaceutical drugs.

Instead of relying on prescriptions, more patients are turning to a healthier eating approach: Keeping sodium intake low and making consumption of nitric oxide-rich vegetables and leafy greens high. This cardio-protective daily diet, known as the DASH (Dietary Approach to Stop Hypertension) Eating Plan, is emerging as an effective way to delay or prevent high blood pressure altogether.

The value of nitric oxide was spotlighted when the Nobel Prize was awarded in 1998 for discovery of this naturally produced cardio-protective factor. A string of clinical studies underscored that vegetables (like red beet roots) and leafy greens (such as spinach and arugula) are replete with nitric oxide.

Diets known for promoting heart health and lowering rates of diabetes and obesity – like Japanese diets, Mediterranean diets and plant-based diets, such as DASH, among others including TLC, Ornish, and Pritikin – incorporate these natural whole foods. The need to consume more nitric oxide-potent vegetables and leafy greens becomes even more critical as we age because our bodies are less able to synthesize this natural hypertensive-fighting factor.

Reducing hypertension would not only improve health outcomes for individual patients, but would also benefit the health system as a whole. Although the percentage of resistance to antihypertensive drugs is relatively lower in the U.S., elevated blood pressure among a rapidly growing number of baby boomers will mean more challenges for health care in the long run unless we identify tools that work and make them as accessible and user-friendly to the public as possible.

DASH holds great promise to fuel compliance – a critical driver to prevent elevated blood pressure – among those living with hypertension. But a healthful eating strategy alone will not mean better outcomes for patients without a model to help them break bad habits and support dietary changes on a personal level, one day at a time.

So how do we get there?

Join us here next Thursday for the second post in our two-part series. Discover what innovative tools can empower patients to make the DASH Diet a part of their arsenal in the fight against hypertension.