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Daily monitoring helps patients keep control

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Daily monitoring helps patients keep

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HUNTINGTON -- If Wally Browning gains Marshall University three pounds or his blood pressure rises, the Marshall sports

Huntington Veterans Affairs Medical Center Local Sports

will know about the change without a phone National sports

call or a doctor's visit.
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The Huntington VA began daily monitoring
Nation / World news Browning's health statistics in February when
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he became the first local patient on the Your Life

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offered through VA.
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The program allows VA staff to monitor
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patients' health daily and will likely lead to Forum

Randy Snyder/The Herald-Dispatch more home monitoring efforts for a variety of Letters to the editor

chronic ailments, VA medical staff say. Submit a letter

Vietnam veteran Wally Browning, 62, of Extras

Huntington discusses a Healthy Buddy Communities

The program has expanded to more than 20 appliance he uses to monitor various vital Photo galleries patients with congestive heart failure or

signs on a daily basis to help treat his

congestive heart failure. Special reports

diabetes who are monitored through the local Web extras

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Through the use of a small computer, blood pressure, blood sugar levels and
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weight are recorded and sent to the local VA hospital so health professionals can Health Source

keep track of a patient's health on a daily basis and cut down on the number of
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Every morning, Browning, 63, of Huntington, inputs his vital information into a small Outdoors

machine with a monitor that sits quietly by his bedside. Travel & Attractions Dave Trippin'

The morning ritual reduces his doctor's visits in half to treat his congestive heart Customer Care

failure, a condition he has battled for two years, he said. It also provides peace of Links

mind, he said.
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"It is the best thing to come down the pike, in River Cities Printing

my opinion," Browning said. "When I get up in
the morning, I feel more confident I am good
for another day."

http://www.herald-dispatch.com/health/2005/May/HElist5.htm

6/27/2005

Daily monitoring helps patients keep control

As a congestive heart failure patient,
Browning constantly battles the threat of his
body filling with fluid, causing the need to
monitor weight

The program currently applies to only

diabetes and congestive heart failure patients but will soon expand to monitor patients with

other chronic health problems, said nurse Pondy Sreyder/The Herald-Dispatch Lillian Chaffin, care manager for the program.

The home monitoring program has taken hold Vietnam veteran Wally Browning. 62. of

at other VA areas in the country and became
Huntington demonstrates how he uses a available locally through a $1 million VA grant
Healthy Buddy appliance to monitor various endowed to the local VA district in 2004.
vital signs on a daily basis to help treat his
congestive heart failure. The appliance
records items like his weight and blood

The monitoring device asks the patient daily
pressure. The information is then sent to a
database in Arizona. It is then directed to his questions ranging from health trivia to their
health care worker at the VA Hospital in health signs, such as weight and blood
Huntington.

pressure.

The information travels into the VA system, where staff will keep tabs on the
patient's well being and call the patient if any problems arise.

The monitoring system doesn't replace doctor's visits, but does help medical staff
better gauge the effect of treatments and any burgeoning health problems, Chaffin
said.

"It is looking over the patient's shoulder to see if there is anything to add to their
treatment," Chaffin said.

The program will transfer the patient's information into a monthly medical chart for
all health care providers to access.

It can give insight into the lifestyles of the patients and help medical staff make
better recommendations, Chaffin said. The system showed one of the VA's
diabetic patients had something to eat that he shouldn't have, she said.

"Yesterday, a patient called in since his blood sugar was up." Chaffin said. "He had to go to the emergency room. It turned out he had ice cream."

Browning hasn't experienced any medical emergencies since he started on the
home monitoring program, but said he is now more mindful of his health.

Before he had the glowing contraption by his bedside asking about his health,
Browning said he would check his weight and blood pressure infrequently. Now he
doesn't miss a day without keeping tabs on his health, he said.

"I was in bad shape," Browning said. "If you have this, you have more of an urge to
watch your weight and see if your weight goes up."

In the future, the VA will distribute video telephones to patients with certain
problems so the doctor can visually see the person from home, Chaffin said.

By August, the local VA districts hopes to have 500 patients on the program with
85 patients per hospital in the local VA district, which includes 11 Kentucky
counties, two Ohio counties and 13 West Virginia counties, Chaffin said.

http://www.herald-dispatch.com/health/2005/Mav/HElists.htm

6/27/2005

Daily monitoring helps patients keep control

There are currently about 100 patients districtwide.

The monitors send the information via a telephone connection, making it necessary for the patient to have a touchtone phone. Patients are screened by the VA for their eligibility in the program.

For more information about the program, call Chaffin at (800) 827-8244 ext. 3262.
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6/27/2005

Senator Kohl. Thank you for being here, Mr. Brown. Mr. Woolf? STATEMENT OF MR. STEVEN H. WOOLF, PROFESSOR, DEPARTMENTS OF FAMILY MEDICINE, EPIDEMIOLOGY AND COMMUNITY HEALTH, VIRGINIA COMMONWEALTH UNIVERSITY, FAIRFAX, VA

Dr. WOOLF. Thank you, Senator Kohl, Senator Smith, other members of the Committee.

My name is Steven Woolf. I am a family physician and a specialist in preventive medicine and public health. I serve as professor of Family Medicine, Epidemiology and Community Health at Virginia Commonwealth University.

I am pleased to talk with you this morning about prevention and seniors.

The prevention of disease is the cornerstone of healthy aging. The underlying logic is obvious. The major diseases that claim the lives of seniors and account for the rising cost of health care are caused largely by our health habits, such as smoking, lack of exercise, and poor diet. These behaviors account for one out of three deaths in the United States.

We spend great sums on treating the complications of disease, and far too little on helping the public avoid getting sick in the first place. As Arkansas Governor Mike Huckabee has said, rather than building a fence at the top of a cliff, our health care system keeps sending ambulances to the bottom. Paying for prevention is a smarter use of scarce resources.

Many seniors wrongly believe they are too old to benefit from a change in health habits, but the facts are that seniors live longer and live healthier if they abandon unhealthy behaviors, obtain recommended vaccines and receive certain screening tests that catch diseases early. Prevention can improve function and postpone disabilities, as we have just heard.

Healthy again ought to begin early in life when it is more effective, but reducing risks for disease pays off at any age.

Prevention has always been important, but is taking on greater urgency now when more Americans are growing older and the costs of health care loom large.

At a time when we worry about how Medicare will afford these costs, it is a mistake to ignore the business case for prevention.

In the face of these benefits, it is concerning that so many older adults in our country engage in health habits that increase their risk. In an average group of 100 Americans who are age 65 and older, 25 of the 100 are obese; 25 get no exercise; and 10 smoke cigarettes.

Altogether, five million seniors in this country smoke cigarettes. Obesity rates are climbing, and the averages I am quoting for America's seniors obscure higher rates of risk factors among subgroups, such as African Americans, Hispanics, and Native Ameri

Millions of seniors have not received recommended vaccines. For example, one out of three have not received the pneumococcal vaccine, which helps prevent deaths from pneumonia. Congress has worked for many years now to expand coverage for preventive serv

cans.

ices under Medicare, thereby, removing a major barrier to access. The Medicare Modernization Act in 2003 introduced the Welcome to Medicare visit and expanded coverage for cardiovascular and diabetes screening. Yet, we see that Medicare coverage by itself does not make it happen.

The GAO found that only 10 percent of beneficiaries had received five cancer tests and immunizations that are covered under Medicare.

The problem is worse among beneficiaries who are poor or among minorities. For example, whereas the proportion of Medicare beneficiaries who have received a recent flu shot is 67 percent for Whites, it is 53 percent for Hispanics, and 43 percent for African Americans. This is among Medicare beneficiaries.

This Committee already knows that life expectancy is lower among minorities, but the scope of the problem is less well known.

People aged 65 to 74 are almost 50 percent more likely to die in the next year if they are African American than if they are white.

We spend billions of dollars in this country to make better drugs and medical devices, thinking this will save lives, and indeed it does. But_far more lives could be saved by correcting health disparities. For every life saved by medical advances, five would be saved if African Americans had the same death rate as Whites.

Congress has enacted legislation to address disparities, but that investment is actually a small fraction of the billions we spend on research. Most of those billions are in the pursuit of medical advances, a worthy aim, but if correcting disparities saves more lives than medical advances, do we have our proportions right?

Certainly, we must continue to invest heavily in new drugs and technology, but perhaps we should tip the scales a bit and make more substantive investment in removing barriers to receiving those treatments.

Enabling all Americans to enjoy aging is not only ethical, it will save more lives and will go further to control the costs of medical care.

With that background, let me devote my remaining minutes to some policy options for promoting prevention among seniors.

I offer seven examples, but I urge the Committee to gather broader input from other experts, assemble a longer list of policy options, and choose from the best.

We owe it to America's seniors to pursue the most innovative and effective strategies to promote healthy aging. My written testimony elaborates on the following seven suggestions.

No. 1, Congress should use its visibility with the public and the media to launch a public education campaign aimed at America's seniors to emphasize prevention. Getting the message out that prevention is important to the health of seniors is the first step toward changing public attitudes and creating a new culture for healthy aging.

No. 2, Congress should encourage the Centers for Medicare and Medicaid Services, CMS, to become more proactive in encouraging Medicare beneficiaries to adopt healthy lifestyles. My written testimony explains that existing CMS initiatives concentrate on making beneficiaries aware of expanded coverage benefits, but they tread lightly on giving health advice. Congress should encourage CMS to

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