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Letter from the Director:
This month’s newsletter highlights two early Regenstrief Center studies that are making a positive impact on how healthcare is delivered. These studies provide important contributions to the current dialogue about appropriate and cost-effective approaches to care delivery. One research team, led by Laura Sands, has examined the quality and cost-effectiveness of long-term care options for Medicaid patients with dementia, with the goals of improving patients’ quality of life and reducing costly hospital visits. Pam Whitten’s work in telemedicine similarly aims to provide quality monitoring and care services to patients with long-term medical conditions.
Findings from both projects are being reviewed by state Medicaid programs and one has already resulted in positive changes in reimbursement policies for telemedicine services. Through these and other studies, the Regenstrief Center is providing research findings to improve our healthcare system and healthcare policy to optimize quality, efficiency and effectiveness.
Steven M. Witz
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People
> Mary Schultz joins the Regenstrief Center on March 22 as the Center's administrative assistant. More.
> Pam Whitten, professor of communication at Purdue and a Regenstrief Center faculty member, believes there is great potential
for telemedicine to improve Indiana patients' quality of care and
reduce provider costs. More.
Projects
> Current long-term care options for Medicaid patients may not be
sufficient for those suffering from dementia. More.
Partners
> St. Vincent Health, a Regenstrief Center strategic partner, releases a
call for research abstracts for its 2006 Annual Research Symposium.
More.
Progress
> Purdue University hosted 244 industry leaders, faculty and students
for Delivering on Healthcare: 2006 Regenstrief Center Annual
Conference. More.
> Regenstrief Center Pioneers in Healthcare
“Operations Research in Healthcare: Who Let the Engineer into the Hospital?”
Michael Carter, Ph.D.; Mechanical and Industrial
Engineering, University of Toronto.
Thursday, April 20; 3:30 - 5:00 pm,
Stewart Center 314. More.
> Regenstrief Center Speaker Series
“Quality Issues in Healthcare.”
Jim Benneyan, Ph.D.; Industrial
Engineering; Northeastern University.
Monday, May 8; Time and
location TBA. More.
Publicity
> Report: Improved technologies and payments needed to expand
telehealth in Indiana. Executive Summary / White Paper. More.
> Purdue joins virtual national forum: “What is your health worth?”
More.
> Lower cost, portable surgical robots could be smooth operators.
More.
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Keynote speaker Marc E. Mattix.
At the 2006 Regenstrief Center
Annual Conference, he discussed the anatomy of the H5N1 avian flu virus and the lack of national
pandemic response plans around the world.
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Mary Schultz joins Regenstrief Center
Mary Schultz joined the Regenstrief Center on March 22 in the role of administrative assistant. Mary came to Purdue in 2002, and most recently worked as an administrative assistant in the School of Science. She has also been a member of the Administrative Professional Staff Advisory Committee (APSAC) and the Purdue Wellness Ambassadors committee. Previously she served for 16 years as a YMCA director and trainer, overseeing volunteer and front office staff.
Mary enjoys people and challenges on and off the job. She is actively involved in the volunteer board of the Tippecanoe County Public Library and the Jefferson High School parent advisory board, in addition to attending Purdue sporting events and playing with her children and grandson. The Regenstrief Center welcomes Mary to her new position.
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Pam Whitten brings telehealth expertise to Indiana
Technology is changing the face of doctor-patient interaction, and Pamela Whitten is on the front lines. A professor of communication at Purdue and a Regenstrief Center faculty member, Whitten believes there is great potential for telemedicine – healthcare that is delivered through communication technologies such as the telephone, Internet, or videoconferencing – to improve patients' quality of care and reduce provider costs.
“Our whole healthcare system and patients would benefit,” explains Whitten, who received her doctorate from the University of Kansas and started Kansas' telemedicine program through its medical center in 1995. “For example, the use of telemedicine services, such as reporting daily vitals, could help a home health patient stay out of a hospital emergency department.”
Whitten joined Purdue and the Regenstrief Center in the fall of 2005, applying her expertise to establish telemedicine in Indiana. She organized an interactive meeting with Indiana healthcare and business representatives in October 2005 to discuss the barriers to diffusing telemedicine in Indiana, including payment and reimbursement policies, liability and practice guidelines, and privacy and security issues. The conference resulted in a white paper of policy recommendations to advance telemedicine applications in the state (view Executive Summary and White Paper).
In partnership with St. Vincent Health Systems of Indiana, Dr. Whitten is now working to develop, implement, and evaluate telehome care services for patients diagnosed with heart failure. According to the National Heart, Lung and Blood Institute, 550,000 new cases each year are added to the 5 million individuals currently suffering from heart failure in the U.S. Heart failure is a difficult condition to manage, and often translates into repeat hospital visits and significant provider costs.
This project aims to improve quality of care and reduce length of stay and re-admission for St.Vincent's heart failure patients by providing at-home monitoring and communication devices. This technology will increase “face time” between patients and home-health providers, helping to ensure compliance and reduce the need for re-admission.
St. Vincent recently added $50,000 to the project to broaden its scope – allowing for additional equipment and more patients in the study sample. Expected outcomes include a business case for developing telehome care in a variety of healthcare settings throughout the state.
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| Long-term care options for Medicaid patients with dementia
Home-based long-term care is often cited as less expensive than nursing home care, and is preferred by two-thirds of older adults. However, a recent study led by Laura P. Sands, professor of Nursing and RCHE-affiliated faculty member suggests that the type and amount of home based care that is currently being delivered may not be sufficient to meet the complex caregiving needs associated with dementia, leading to higher rates of hospitalization and use of outpatient services.
Long-term care is already an enormous healthcare cost in the United States. More than $130 billion is spent on long-term care each year, with half of that total paid by taxpayers through programs such as Medicaid. Long-term care alone consumes nearly one third of states' Medicaid budgets.
The research team, including Sands, Purdue University professors Joseph Thomas and Bruce Craig, graduate student Huiping Xu and IU faculty Drs. Michael Weiner and Marc Rosenman collaborated with the Indiana Family and Social Services Administration to examine Indiana Medicaid eligibility and claims data for patients with at least two medical claims with the diagnosis of dementia. Results indicated that the probability of hospital use for patients receiving at-home care rose significantly over 12 months; they were 2.8 times more likely to use a hospital after 12 months. Rates of hospital use among nursing home patients stayed relatively steady over the twelve month period. The cost of at-home care also increased over time, rising 30 percent over 12 months. Nursing home expenses, while higher overall, remained stable.
Increases in hospitalization and expenditures may reflect deterioration in clinical status that was not directly addressed by home-based long-term care services. “It's likely that more home-based care services are needed to meet the entire set of needs because of the complexity of dementia.” Sands said. “It is also important to note that much of home-based care is donated by families and is often accompanied by significant personal and financial strains, even with professional in-home assistance.”
The collaboration between Indiana Family and Social Services and RCHE investigators Laura Sands and Joseph Thomas has resulted in four manuscripts, a grant proposal to the Alzheimer's Association, and other project opportunities to determine how to deliver care to frail and demented elders that meets their complex needs and makes the most efficient use of public dollars.
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St. Vincent Hospitals and Health Services call for Research Abstracts
The St. Vincent Hospital Research Department invites individuals and groups to submit abstracts for presentation during the 2006 Annual Research Symposium on June 7 on its Indianapolis campus. Submission deadline is Friday, May 19. Call for Abstracts / Poster Guidelines
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Keynote speaker Marc E. Mattix |
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2006 Regenstrief Center Annual Conference
On March 20-21, Purdue University hosted 244 industry leaders, faculty and students for the Regenstrief Center Annual Conference, held in conjunction with the Purdue Homeland Security Institute. The Monday morning keynote address by Marc E. Mattix, American College of Veterinary Pathologists, focused on the anatomy of the H5N1 avian flu virus and the lack of national pandemic response plans around the world. According to Mattix, the most significant threat to the United States is the lack of healthcare resources to accommodate surges in patient load. A subsequent panel included perspectives from Linda Chezem, state judge; Dr. Robert Kolodner, chief health informatics officer from the Department of Veterans Affairs; David Sanders, Purdue professor of biological sciences; Jim Westman, director of Purdue student health, and James D. McGlothlin, Purdue professor of health sciences and a former public health official. Panelists agreed that while the U.S. may have more resources than most countries, the current state of its healthcare system, military, and justice system and military has the potential to impede rapid mobilization of resources in the event of a pandemic outbreak.
Monday afternoon featured the Regenstrief Center's research advances in Indiana and with its strategic partner, Ascension Health. Projects included statistical analysis of nurse movement and functions, the development of delivery infrastructures for pandemic response plans, and the application of evidenced-based design principles to increase safety, efficacy and satisfaction.
Tuesday morning's panel discussion focused on the communication vulnerabilities revealed during and after Hurricane Katrina. Participants included Gail Belles, Office of Information security advisor from the department of Veterans Affairs; Eugene Spafford, director of Purdue's Center for Education and Research in Information Assurance and Security; J. Eric Dietz, executive director of the Indiana Department of Homeland Security; and Roger L. Lehman, Evansville Vanderburgh County Building Commissioner. The panel was followed by a keynote address on the Federal government's progress in developing nationwide strategies for healthcare information technology by Dr. John W. Loonsk, director of interoperability and standards in the U.S. Department of Health and Human Services.
Final conference sessions included a panel discussion on the technological and utilization trends of telemedicine from Purdue, University of Kansas Medical Center and Marquette General Health System in Michigan. Panelists identified the busyness of health practitioners as a significant barrier to implementing telemedicine systems.
The conference ended with a review of research progress in government-based healthcare, including developments in patient safety centers, Medicaid options for long-term care, and Veterans Affairs' research in health information technology. Conference presentations will be posted on the Regenstrief Center website (http://www.purdue.edu/rche) in the next month.
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Regenstrief Center Pioneers in Healthcare
“Operations Research in Health Care: Who Let the Engineer into the Hospital?”
Michael Carter, Ph.D.; Mechanical and Industrial Engineering, University of Toronto
Thursday, April 20; 3:30-5:00 p.m.; Stewart Center 314
Carter is currently pursuing research in healthcare resource modeling with a variety of projects in several hospitals, home care and mental health institutions. The 90-minute lecture is free and open to the public.
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Regenstrief Center Speaker Series
"Quality Issues in Healthcare"
Jim Benneyan, Ph.D.; Industrial Engineering, Northeastern University
Monday, May 8; Time and Location TBA
Benneyan's expertise includes quality engineering, statistical quality control, inspection error models, computer simulation, industrial experiments, and applications in manufacturing and healthcare, including semiconductor fabrication and cancer screening. The one-hour lecture is free and open to the public. back to top
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Report: Improved technologies, payments needed for telehealth
The Indiana Telehealth Policy Working Group, led by Regenstrief Center faculty member Pamela Whitten, released its report of policy recommendations to promote telehealth in the state of Indiana. The white paper, a result of the telehealth policy conference held in October 2005, focuses on challenges for telemedicine, such as privacy and confidentiality, licensure and credentialing, reimbursement for services, and the necessary infrastructure for technology. The Regenstrief Center will facilitate partnerships to improve and promote the services. News Release.
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Purdue joins virtual national forum: 'What is your health worth?'
Nearly 70 Purdue students, faculty and community members joined other Big Ten universities and schools of public health in a virtual discussion about potential solutions to current healthcare challenges, including access, cost, and quality. This public forum, organized by the President's Office and the Regenstrief Center, was one of more than 25 community meetings nationwide commissioned by Congress through the Citizens' Health Care Working Group.
According to surveys completed at the public forum, nearly all Purdue participants agreed that it should be public policy that all Americans have affordable healthcare insurance or other coverage (95 percent). In addition, a large majority indicated that some people should be responsible for paying more than others, based on their health behaviors (59 percent) and income level (52 percent). Opinions varied about potential solutions to address rising costs, but 91 percent of participants agreed that health plans/insurers should use financial incentives to encourage consumers to pursue healthy lifestyles and prevention. Information from these meetings will be submitted to Congress and President Bush in a national report. Additional surveys and discussion forums are available at http://www.citizenshealthcare.gov. News Release.
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Lower cost, portable surgical robots could be smooth operators
Dr. William Peine, assistant professor of mechanical engineering and a Regenstrief Center faculty member, is teaming up with medical doctors in research to develop less expensive, portable and versatile surgical robots that could become more common in operating rooms. Peine believes that surgical robots have the potential to improve the quality, efficiency and safety of healthcare. “Our work to create high quality, affordable robots would make the technology available to more hospitals,” Peine said. “In addition, the quality and safety of care would improve by including a computer in the loop with the surgeon." News Release.
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