Recent News

America is Catching on to Coordinated Care
January 18, 2008

The Center for Advanced Illness Coordinated Care (CAICC):

CAICC completed an evaluation of a Medicare demonstration, in collaboration with Hamot Medical Center in Erie Pennsylvania, studying the effects of improved care coordination with patients and family caregivers facing advancing Alzheimer’s disease. The results of this study have been accepted for publication in the peer review journal Home Healthcare Nurse, March, 2008.

CAICC, in partnership with The Garfield Foundation and Kaiser Permanente, recently completed the evaluation of a 4 site prospective trial studying the effects of Advanced
Illness Coordinated Care. This large study involved Medicare patients enrolled within Kaiser’s health system in San Diego and Oakland, California as well as Portland, Oregon and Denver, Colorado.

CAICC’s  focused activities on studying practical care coordination within populations facing serious chronic and advanced illness, as well as end of life care, continues to contribute relevant data to potential innovations in national public policy for care coordination. Significant findings in the studies mentioned above will be published in leading publications in 2008.

CAICC , in collaboration with Sesame Workshop, will proudly be releasing an educational DVD entitled, “Here For You: Helping Children Cope With Serious Illness” to national pediatric health care  and community providers in May 2008. CAICC and Sesame Street will be releasing the DVD at The Association of Pediatric Oncology Social Workers annual meeting in Bar Harbor Maine on May 14th. Plans are underway for CAICC to organize the “Helping Children Cope With Serious Illness Charitable Fund”. This fund will  donate a full time, hospital based, community focused nurse or social worker to provide continuous health counseling for families facing serious illness within 3 children’s hospitals in the first two years of operation.

Care Support of America:
Care Support of America continues to develop, market and evaluate a direct- to- consumer, affordable, proven, eldercare health counseling program called “Your Support Nurse” , (yoursupportnurse.com ) available nationwide.  Linking an experienced, specially trained Support Nurse on the telephone with local home care nurses providing home safety assessments, “Your Support Nurse” is gaining attention in the marketplace as well as in the healthcare arena.
An example of high engagement philanthropy on many levels, Care Support of America’s ”Your Support Nurse”  is making available to the public a proven product of care coordination and therapeutic health counseling by utilizing expert  marketing, advertising, sales, technology, and operational services. This RN health counseling program is contributing an operational knowledge base to the field of nursing and working in collaboration with physician practices and organizations as well as family caregiver, chaplain, homecare, private duty and other consumer groups nationwide.

Results are Proving Positive Impact on Palliative Care on ICU Length of Stay
December 13, 2007

The Surgical Intensive Care Unit (SICU) Study is being conducted at the Albany Medical Center to test a new model for improving the quality of care for patients, as well as their families, who are at the greatest risk for extended length of stays in the ICU. In addition, we hope that it will demonstrate that improved quality of care can be sustainable and cost effective.  The intervention will attempt to show that an intensive, focused family support in the SICU led by a Nurse Practitioner (NP) will help to better identify family needs and most importantly manage the often chaotic flow of complex medical information they receive. Our hypothesis is that if performed effectively, the intervention will allow the family to have less stress and more clarity about their loved one’s medical prognosis. As a result, they will be better able to effectively make medical decisions and come to closure more efficiently about goals of care for their loved one who often lacks capacity. There are two basic areas that the study will measure to determine the validity of this hypothesis: 1) family satisfaction with  quality of care, especially the nature of communication by the health care team, and 2) the cost of resource utilization. The former will show if the intervention is favored by the families over the prior baseline; the latter will show whether the intervention can help to reduce the total cost of resources enough to pay for the new NP position, appropriately titled the “Family Support Coordinator (FSC)” devoted fully to family assistance and comfort.

Phase I, baseline data collection began in the October of 2006 and ran through June of 2007. Phase II, the intervention phase, began in September of 2007 and is now in full operation. So far, based on both initial data from family surveys and from anecdotal evidence, the intervention is receiving rave reviews. Families are expressing their gratitude for having someone they know  available for them to always answer their questions and deal with any problem that might come up. Not only are families pleased, members of the care provider team are as well. The social worker can now focus more on dealing with the families’ psychosocial issues, and the nurses are less frustrated because the families have continuous updates on their patients’ progress. Furthermore, the physicians can breathe a sigh of relief to know that their medical plan is being accurately updated each day, and if and when the family has a question, the FSC will immediately let them know. As one physician said, “it saves me a lot of time to have the Family Support Coordinator there to keep the family informed.”

We have high hopes for this innovative study: To justify the need for a new role in the ICU that will not only improve the quality of care but also do so in a way that is cost effective. To be sure, our first priority is to improve the quality of care, especially end of life care. If families are less stressed and better informed to make decisions about value laden and complex treatment options, based on how they view the patient’s wishes and preferences and his or her best interests, this will be the gold standard for quality care in a complex environment. Lastly, because hospitals have not take taken the time to investigate the cost effectiveness of such patient and family centered care, we feel this is a unique and visionary opportunity to show the overlap between quality of care and cost effectiveness in a vitally important area of the healthcare system.

Antibacterial Lab Races the Clock
Albany Molecular sees a market for new treatments as bacteria grow increasingly resistant to existing drugs
June 9, 2006

Written for the Times Union by Eric Anderson

Albany-The company that helped ease allergy suffering is focusing on virulent infections that have outflanked existing antibacterial drugs.

Albany Molecular Research Inc. is seeking to develop new antibacterial drugs, a field that many major pharmaceutical companies "lost interest in," said Bruce J. Sargent, Albany Molecular's vice president for discovery research and development.

The Albany-based company, which holds the patents on the manufacturing process for the active ingredient in Allegra, has been exploring "natural product" drug candidates--substances that arise naturally--for five years, Sargent said. In the past two years, it has been focusing on antibacterial drugs.

The effort can't come soon enough, said George L. Drusano, co-director of the Ordway Research Institute, Inc. in Albany, and an expert in infectious diseases.

He said the pipeline of new drug candidates to battle infections that have developed resistance to current treatments is just about empty. That's in part because developing antibacterials just hasn't been all that lucrative for major drugmakers.

An antibacterial might yield sales of $200 million to $400 million a year, while a drug to treat high cholesterol or a chronic illness might yield $1 billion or more, Drusano said.

In part, that's because a drug to treat a chronic condition must be taken every day, while an infection is usually a temporary condition that can be cleared up within 10 days.

Many of the existing drugs have been around for decades, and are inexpensive. But increasingly, those drugs are running up against infections against which they have no effect.

Albany Molecular's laboratory in Seattle is working on screening compounds that seem to be effective against various bacteria. But the process has its challenges.

"You're sitting there trying to take this soup with 100,000 chemical entities, and you have to find out what it is and separate it from the other molecular entities," Drusano said. "The chemistry is difficult."

Previously, researchers would create synthetic drugs that seemed to work against the intended targets. But then the bacteria cell wall would prevent them from reaching their targets.

Both Drusano and Grant Carr, a researcher with Albany Molecular, says the instances of drug-resistant infections has been underreported. And more "multi-resistant" infections are emerging, which resist a range of treatments.

"This is why there's potentially a crisis out there," Sargent said.

Hospital settings have become fertile breeding grounds for many of these infections, with bacteria evolving rapidly--as many as 50 or 100 generations a day--and those that resist drugs surviving and multiplying.

That's why Albany Molecular expects a market where larger companies didn't see one.

"You might have thought, well, we'll be crazy to do this as well," Sargent said, "Our foresight is, this is going to change...The world is going to be in serious need of new antibacterial drugs in the not-too-distant future.

"At some point, pharma companies will be crying out for this," he said

Unavoidable Shift in Health Care
Foundation shares insight on rising health care concerns with Commission on Health Care Facilities in the 21st Century
February 7, 2006

VIA FACSIMILE (518) 474-4669

Carla Cocca
Commission on Health Care Facilities in the 21st Century
Corning Tower, Room 2580
Albany, NY 12237

Dear Ms. Cocca:

We welcome the opportunity to express our concerns regarding the misalignment between the supply of health care services and the needs of the community. Charitable Leadership Foundation (CLF) has a real interest in the Capital Region’s medical affairs since it is part of our mission. Therefore, we feel it might be useful to provide the Commission on Health Care Facilities in the 21st Century with the knowledge that we have gained either through the conduct of medical research, the experience gained working within the community or the research on medical affairs that is currently being conducted. The evidence of recent medical research and the continuous push towards the advancement of medical technology demonstrates that a significant shift in health care worker requirements, health care policy, and health care facilities is both imperative and unavoidable.

Currently, all health care facilities are faced with health care worker shortages with respect to nurses and technicians. As medical technology and research continue to advance, the need for highly trained, more specialized health care workers will increase in unison. Likewise, there will be a significant push for health care facilities to purchase the most up to date equipment that correspond with the advances of technology, thereby creating an additional need for well-educated health care workers to operate such equipment.

Community/local hospitals are or will be technologically unequipped and inappropriately staffed with the expertise and/or specialized training that will be required to handle an increased level of patient severity. Although current advances in medical research are expected to alleviate or lessen the patient population effected by non-severe ailments, we do not expect that the number of severe/intense patient cases to decrease immediately. Ultimately, community hospitals will be faced with the difficult decision of either employing more highly skilled/specialized staff and purchasing the latest technology (increasing expenditures) or transporting more and more of their health intensive patients to a larger medical facility similar to that of Albany Medical Center Hospital or St. Peters Hospital (decreasing revenues). While this will be very difficult for the community hospitals and the population that it serves to accept, the community hospitals will inevitably begin to realize that they will have a significant gap between their revenue and expenditures. This financial gap will create an unbearable burden for community/local hospitals that will likely force many community hospitals to close.

As community hospitals begin to close, it will require the larger, financially stable, and medically advanced hospitals to accommodate an increase in patient enrollment that will require necessary changes to health care policy and regulations. Currently, the Department of Health (DOH) regulations include restrictions on the quantity of beds that each hospital is licensed and regulations on how the beds are to be utilized. Additionally, hospitals are expected to house patients that are not well enough to be discharged, but are not sick enough to stay in the hospital. With this shift in health care, larger hospitals will need to be afforded the flexibility as it relates to the number of licensed beds and restrictions on how the beds are utilized in order to appropriately accommodate an increase of patient enrollment/severity. Likewise, DOH will need to modify the regulations of wellness/rehabilitation centers to provide care for the patients that are not considered severe/intensive, but are not well enough to be discharged to home. This will allow hospitals to meet the needs of more severe/intensive patients by providing beds that would have otherwise been occupied.

Advances in medical technology and research indicate that community hospitals or the average physician’s offices will not have the means, technology and/or expertise to take advantage of this shift in health care. However, it is critical to have access to electronic records for the organizations that are able to overcome the financial impact and/or comply with the requirements of the medical advances. Such records should be maintained on a platform that would require significant security, but ease of access for hospitals, rehabilitation centers, and doctor’s offices alike. This system would provide constant and immediate communication between all health care facilities/organizations. Likewise, it would provide hospitals with the patient’s medical history within minutes and would also allow the primary physician to be immediately informed of their patient’s medical status.

In summary, as community hospitals begin to close we will be faced with the rising need for the larger hospitals to:

• obtain highly trained, well-educated health care workers;
• locate public transportation for the populations formerly serviced by community hospitals;
• implement a secure, multi-purpose, easily accessible electronic record keeping system;
• adjust the number of beds allowed/licensed per facility;
• obtain flexibility in how the beds are used; and
• collaborate with wellness/rehabilitation centers to house patients that are not well enough to
  recover at home, but not sick enough to remain in the hospital (a means to free up beds for
  additional patients with severe ailments 

We expect the advances in medical technology and research to have a significant impact on the financial conditions of health care facilities and to occur sooner rather than later. We hope that our comments are both beneficial and informative. Please feel free to contact me directly at (518) 877-6701 x302 or via e-mail at jcornell@charitableleadership.org, for additional information.

Sincerely,
Jennifer L. Cornell
Senior Program Officer - Medical Affairs