DERBY — The Griffin Hospital Cardiac Rehabilitation Department and Eunice Lisk, MS of Stratford will be honored with the Caring Heart Award at the ninth annual “Women and Heart Disease” program February 6 at Grassy Hill Lodge in Derby. The award recognizes individuals and groups that foster initiatives to promote and improve the general health and well-being of all. This is the sixth year that the award will conferred.

The event is hosted by Griffin Hospital’s Women and Heart Disease Committee, which consists of health-care professionals, heart patients and women from throughout the Valley communities. According to the American Heart Association, heart disease kills nearly twice as many women in the United States as all types of cancer.

Event registration and a silent auction will start at 5 p.m., followed at 6 p.m. by dinner and the awards program. Tickets for the dinner are $35 and the event is open to the public. Proceeds benefit the Women and Heart Disease Fund, which supports heart wellness programs for women in the Valley. Reservations are due January 30. To make a reservation or learn more, call 203-732-7584 or 203-732-1137.

 NEW HAVEN — A rare genetic mutation that disrupts production of histamine in the brain is a cause of the tics and other abnormalities of Tourette syndrome, according to new findings by Yale School of Medicine researchers.

The findings, reported January 8 in the journal Neuron, suggest that existing drugs that target histamine receptors in the brain might be useful in treating the disorder. Tourette syndrome afflicts up to one percent of children, as well as a smaller percentage of adults.

“These findings give us a new window into what’s going on in the brain in people with Tourette. That’s likely to lead us to new treatments,” said Christopher Pittenger, associate professor in the psychiatry and psychology departments and in the Yale Child Study Center, and senior author of the paper.

Histamine is commonly associated with allergy, but it also plays an important role as a signaling molecule in the brain. Interactions with this brain system explain why some allergy medications cause people to feel sleepy. 

Drug companies have developed medications that target brain-specific histamine receptors in an effort to treat schizophrenia and ADHD. While not approved for general use yet, those drugs or others that target histamine receptors should be tested to see whether they can treat symptoms of Tourette syndrome, Pittenger said.

 A new state Web page is intended to streamline resources to help families with insurance coverage and reimbursement for behavioral health and substance-abuse treatment.

The state Department of Insurance’s “Mental Health Parity” Web page is a compilation of free resources, publications and tools that consumers can access through the Insurance Department’s Web site. 

The new site includes the Insurance Department’s Behavioral Health Took Kit, a step-by-step plain-language template that families and providers can use to submit to insurance companies for preauthorization of medically necessary behavioral health services. The Tool Kit was launched in October, the same time the state announced it was dedicating $9 million in federal funds to address the needs of children in schools.

For more information on the new Web page visit the CID Web site, ct.gov/cid.

 BRIDGEPORT — On December 5, federal court Judge Stefan Underhill issued a decision granting members of the Fairfield County Medical Association and Hartford County Medical Association a preliminary injunction preventing UnitedHealthcare from unilaterally cutting hundreds of doctors from the insurer’s Medicare Advantage Network.

 

The two medical associations filed the legal challenge in early November seeking to block UnitedHealthcare from terminating as many as 2,250 physicians, or approximately 20 percent of its entire doctor network in Connecticut.  The associations estimated that as many as 20,000 to 30,000 Medicare patients could be impacted by UnitedHealthcare’s decision to eliminate a significant portion of its physicians in Connecticut.

 

The preliminary injunction order prohibits UnitedHealthcare from terminating any of the Associations’ members from the Medicare Advantage Network, notifying their Medicare Advantage customers/insured that certain providers will be terminated from Medicare Advantage Network as of February 1, 2014; and removing or failing to advertise/market the Association’s affected physicians in UnitedHealthcare’s 2014 directories for the Medicare Advantage Network.

 

“Both the Fairfield and Hartford County Medical Associations took this bold step for our patients and for our member physicians.  We won’t let UnitedHeathcare get away with interfering with the doctor-patient relationship. While this is one huge step in the right direction, the journey is far from over,” said Robin Oshman, MD, president of the Fairfield County Medical Association in response to the judge’s decision.

 

A spokesperson for UnitedHealthcare said the company intends to appeal the ruling.

“We believe the court’s ruling will create unnecessary and harmful confusion and disruption to Medicare beneficiaries in Connecticut,” said Jessica Pappas, a spokeswoman for UnitedHealthcare, in a statement.

 NEW HAVEN — Checking back into the hospital within 30 days of discharge is not only bad news for patients, but also for hospitals, which now face financial penalties for high readmissions. The key to reducing readmissions may be focusing on the whole patient, rather than the specific conditions that caused their hospitalizations, according to a new study by Yale School of Medicine researchers.

Published November 20 in the British Medical Journal, the researchers found that top-performing hospitals — those with the lowest 30-day readmission rates — had fewer readmissions from all diagnoses and time periods after discharge than lower performing hospitals with higher readmissions.

“Our findings suggest that hospitals may best achieve low rates of readmission by employing strategies that lower readmission risk globally rather than for specific diagnoses or time periods after hospitalization,” said lead author Kumar Dharmarajan, MD, a visiting scholar at the Center for Outcomes Research and Evaluation at the Yale School of Medicine and cardiology fellow at Columbia University Medical Center.

Despite the increased national focus on reducing hospital readmissions, Dharmarajan said it had not been clear whether hospitals with the lowest readmission rates have been particularly good at reducing readmissions from specific diagnoses and time periods after hospitalization, or have instead lowered readmissions more generally. To find out, Dharmarajan and colleagues studied more than 4,000 hospitals in the United States caring for older patients hospitalized with heart attacks, heart failure or pneumonia from 2007 through 2009. The authors examined more than 600,000 readmissions occurring within 30 days of hospitalization.

The Connecticut Foundation for Better Health (CFBH), New Haven’s newest nonprofit foundation, has awarded small-grant funding to nine recipients to facilitate disease prevention, health promotion and the integration of healthcare delivery at the local level.  

 

“The foundation will afford the health-care community broad opportunities to develop innovative solutions to health-care delivery for residents of the New Haven region,” said Fredric Finkelstein, MD, president of the CFBH board.

 

Start-up support for the foundation came from a generous donation made by the New Haven Community Medical Group in 2012. Foundation Treasurer Steve Wolfson, MD explained that the donation “was seen as an opportunity to give back and directly foster the health of the community, and represents our highest values.”

 PLAINVILLE — Triad, a musculoskeletal (MSK) specialty benefits management company, has been acquired by MedSolutions of Franklin, Tenn.

 

Triad specializes in programs that address pain management, spine surgery, joint surgery and physical medicine (PT, OT and chiropractic). When combined, these areas of medical care average 18 percent of commercial medical care payers’ costs and ten percent of Medicaid costs.

 

Originally announced September 5, the deal represents the first significant acquisition for MedSolutions and enables the company to broaden and deepen its existing services in this area of growing medical spend.

 

“MedSolutions’ now-expanded musculoskeletal offering is another important step in helping us fulfill our longtime mission of driving positive change in the healthcare system,” said Gregg Allen, MD, MedSolutions’ chief medical officer. “Together with Triad, we are expanding our ability to deliver proven, tailored products and services that measurably improve patient outcomes and reduce costs.”

 

Said Triad President Vince Coppola: “My team and I are thrilled to be working with MedSolutions because we see so much alignment in the services we provide. In creating a stronger, unified company, we are better able to serve our customers, patients and providers.”

 Dermatologist David Leffell has declared war on skin cancer

 

 

Three decades ago, some physicians began noticing unusual-looking skin lesions on a substantial number of male patients. David Leffell was one of those doctors.

 “In the early 1980s I was in New York, at [Memorial] Sloane-Kettering [Cancer Center],” Leffell recalls. “I was seeing men coming in with purple spots” — cancerous tumors that soon would become known beyond the medical community by their technical identification: Kaposi’s sarcoma.

 “They were people with HIV,” explains Leffell, who conducted research on what would become a major medical focus. “It was clear to me that was an exciting new area.”

 That experience is what sparked Leffell’s interest in dermatology. Currently one of the most renowned physicians in his field, his work revolves around prevention, treatment and diagnosis of skin cancer.

 Today Leffell is deputy dean for clinical affairs at the Yale School of Medicine, and for the past 15 years he’s headed the Yale Medical Group — one of the largest faculty practices in the country. The organization offers care in more than 100 specialties.

 “The purpose is to oversee strategies for the state. That’s been my big role for 15 years,” says Leffell, whose tenure concluded last year.

 When he first took the position he sought to make the group better.

 “At that time Yale was primarily a research medical school. I wanted to make it more patient [oriented].” Among initiatives instituted under Leffell’s watch were patient-satisfaction ratings. “We had a great deal of success,” he notes.

 For example, patients noted less than total satisfaction with something so fundamental it could easily be overlooked by quality-assurance personnel: the telephone system.

 “There’s always been a problem with people getting through by phone. [So] we implemented a monitoring system,” says Leffell.

 For inpatients, a common source of dissatisfaction is food, and for office-based practices, “The No. 1 complaint is parking,” Leffell notes. Such information might not be known — and improvements made — without the patient-satisfaction ratings.

 “So we’ve made great strides,” Leffell says.

 “Transition is essential to stay alive,” he adds, and the time has come for “new blood” to head the group. He still has ideas about the course of the group’s future, however.

 As a new CEO of the Yale Medical Group begins to assess needs and devise ways of addressing those needs, Leffell says he’d like to “see a new strategy laid out. I’d like to see physicians and other providers, such as nurse practitioners, take more of a leadership role in health care.”

 Leffell also has helped to advance the field of dermatology through research and invention. He was instrumental in the discovery of the skin cancer gene PTCH and the protein it is involved in coding, and holds joint patents for that discovery. He also holds a patent for a medical instrument that measures aging of the skin. In addition, Leffell has developed a streamlined method for treating vitiligo surgically.

 Leffell is also a prolific author, having written or co-written more than 120 published works. Among them is Manual of Skin Surgery, and Fitzpatrick’s Dermatology in General Medicine, a leading dermatology textbook which Leffell edited. Leffell’s book Total Skin: The Definitive Guide to Whole Skin Care for Life was published in 2000. Refreshingly absent of medical jargon, it was written as a handy education tool about skin health for the general public. It has been widely used by laypersons as a reader-friendly reference book.

 Born and raised in Montreal, Leffell came to the United States for undergraduate study at Yale. He returned to Canada to earn his medical degree at McGill University in Montreal. He came back to Yale in 1988 to join the School of Medicine faculty as an assistant professor.

 Leffell and his family (he is a married father of two) have residences in New Haven and the Litchfield County town of Norfolk. Active in the local community, he extends himself beyond the medical field. He is, for example, a board member of New Haven’s Artspace and of Connecticut Public Television, and is also a Hopkins School trustee.

 Leffell has even ventured into photography. A 2011 coffee table book, Connecticut Pastoral, designed by Leffell’s niece, Rebecca Leffell, features his striking scenic photographs of locations across the state.

 “One of my pastimes is photography,” says Leffell. He gives the book to people who make charitable donations to special causes.

 Among causes about which Leffell is most adamant is the dermatological harm that can be caused by tanning salons.

 “Far and away the most important cause of skin cancer is ultraviolet radiation,” he notes.

 Leffell has fought vigorously for legislation that would require parental consent for minors to utilize tanning facilities. However, his advocacy has been met with resistance from some politicians and others set squarely against such legislation.

 “So that was my introduction to politics,” say Leffell, who maintains such legislation is needed.

 “We are ignoring, damaging and hurting our children” without it, he says, “and I’m the one who sees the end result. I’m the one who has to operate on them.”