Look Into Your Phone and Say “Aaahhh”

For those of us old enough to remember The Jetsons, their flying car was only one of the many futuristic perks imagined way back in 1962 by the show’s creative producers, Hanna-Barbera. The pioneering duo also foretold holographs, robot servants, talking computers . . . and tele-medicine!

Their version of remote diagnostic care was to have a family member stick their arm in a portal in the wall, which would “read” their symptoms and offer a diagnosis. As far-fetched as that might have seen back in the day, today it’s far closer to reality. Patients with congestive heart failure, diabetes and other ailments can step on automated scales in their homes, which measure their weight and send the data electronically to monitoring services. An appreciable weight loss or gain could indicate a problem – it’s flagged by the system, and a nurse then calls the patient to check in. People also can have their blood pressure, heart rate and sugar levels checked remotely using electronic sensors, communicate online with their physician’s offices, and access a wide variety of personal medical information and history via private electronic portals.

More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30 percent this year. And according to the American Academy of Family Physicians, 41 percent of family practice physicians use electronic portals for secure messaging, another 35 percent use them for patient education, and about one-third use them for prescribing medications and scheduling appointments.

For all the rapid growth, however, significant questions and challenges remain. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver in what forum. Complicating matters, rules defining and regulating telemedicine differ widely from state to state and are constantly evolving. In Connecticut, for instance, physicians cannot be compensated for services provided over the telephone, via fax or electronically, and are not allowed to prescribe controlled substances through tele-health services.

Another huge hurdle is physician compensation. Legislation today severely limits telemedicine. And without financial incentives to provide care electronically, physicians are reluctant to get onboard, especially since health insurance, which varies from plan to plan, covers only a narrow range of electronic services.

The future of telemedicine in the United States will depend on how regulators, providers, payers and patients can address these challenges, and the issue of quality versus convenience.  For example, there are a variety of on-line services now available where a patient can connect with a clinician for one-time phone, video or email visits on demand. These, typically, are for non-urgent-care issues such as colds, rashes and headaches. They cost far less than a trip to a physician’s office, or to an urgent care center or hospital.

Many large employers and their insurance providers are offering these services to the employees as a cost-saving alternative.  However, these services lack the bonds of trust and communication that are built over time between patient and caregiver, and can’t replace the value of a personal physician or health expert listening to your heart or lungs, peering into your throat, eyes or ears, drawing a culture sample or tapping other in-person diagnostic skills.

Over the past year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring as well as store-and-forward technologies (where patients and doctors send records, images and notes at different times), in addition to real-time phone or video interactions. Medicare, the federal health plan for the elderly, covers a small number of telemedicine services — only for beneficiaries in rural areas, and only when the services are received in a hospital, doctor’s office or clinic.

There are many additional challenges. Everyone is looking at how to manage state’s rights against national priorities and demands, never an easy task. Malpractice issues are complicated, and many physicians simply do not feel comfortable rendering services online or via a phone. Still, every day brings new technologies, legislation and efforts to respond to changing patient and physician needs.

When you look at emerging smart phone technology and the portable monitoring devices we now wear on our wrists to monitor steps, sleep, heart rate and more, it’s easy to imagine how quickly future generations of health monitoring tools will evolve. And it’s probably a safe bet that we’ll be using them to help manage our health long before we’re flying to work in our own personal aero-cars!


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Using Steroids Safely and Appropriately

The use of steroids and other natural and synthetic substances by professional athletes often is in the news.  Used primarily for building muscle mass and expanding strength and endurance, these drugs, many obtained illegally, give users an “edge” that is considered unfair.  Many Russian athletes were not allowed to compete in this summer’s Olympic Games in Rio due to their use of banned drugs, and controversy has swirled around famous baseball players, runners and biking legend Lance Armstrong over their use of steroids and other performance-enhancing supplements.  But there are many kinds of steroids, including those used by physicians to treat allergies, asthma, arthritis and many chronic illnesses.

Steroids, known medically as corticosteroids, can reduce inflammation associated with allergies, rashes or itching. They prevent and treat nasal stuffiness, sneezing, and runny nose due to seasonal or year-round allergies. They can also decrease inflammation and swelling from other types of reactions.

Systemic steroids are available in various forms as pills or liquids for serious allergies or asthma, locally acting nasal sprays for seasonal or year-round allergies, topical creams for skin allergies, or topical eye drops for allergic conjunctivitis.

Steroids are highly effective drugs for allergies, but they must be taken regularly, often daily, to be of benefit — even when you aren’t feeling allergy symptoms. In addition, it may take one to two weeks before the full effect of the medicine can be felt.

Steroids are used for reducing joint or bone inflammation and for battling osteoporosis. They also are known to increase recovery times in individuals dramatically. Cortisol is a hormone which is produced inside our body to help it handle stress. Cortisol is responsible for causing damage to muscle tissues and slowing down the time taken for a human body to recuperate. Steroids are known to regulate the production of this hormone when an individual’s body is stressed. This helps bodies to recover from sustained injuries a lot faster than normal and allows more stamina while an individual is exercising.

Of note, potential side effects from oral steroids may include insomnia, increased appetite and weight gain, high blood pressure, lowered immune system resistance, stomach irritation and water retention.

Anabolic steroids were developed in the late 1930s primarily to treat hypogonadism, a condition in which the testes do not produce sufficient testosterone for normal growth, development, and sexual functioning. The primary medical uses of these compounds are to treat delayed puberty, some types of impotence, and wasting of the body caused by HIV infection, cancer or other diseases.

The dangers of steroid abuse

When we take small, prescribed doses of steroids for a short time in response to an inflammation or allergic reaction, our bodies eliminate or flush most of the residual compounds. However, people who abuse anabolic steroids usually take them orally or inject them into the muscles, where they remain for longer periods of time, and travel to our brains and other organs. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions. Steroids are also applied to the skin as a cream, gel, or patch.

Anabolic steroids do not have the same short-term effects on the brain as do other abused drugs. The most important difference is that steroids do not trigger rapid increases in the brain chemical dopamine, which causes the “high” that drives people to abuse other substances. However, long-term steroid abuse can act on some of the same brain pathways and chemicals — including dopamine, serotonin, and opioid systems — that are affected by other drugs. This may result in a significant effect on mood and behavior.

Abuse of anabolic steroids also may lead to mental problems, such as:

  • Paranoid (extreme, unreasonable) jealousy
  • Extreme irritability
  • Delusions (false beliefs or ideas)
  • Impaired judgment

Extreme mood swings can also occur, including “roid rage” — angry feelings and behavior that may lead to violence. Additionally, anabolic steroid abuse may lead to serious, even permanent, health problems such as:

  • Kidney problems or failure
  • Liver damage
  • Enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people

As with most medicines, supplements or drugs, steroids should be taken under the direction of a physician or medical professional. When used properly and as prescribed, they are incredibly effective and valuable. When abused or taken improperly, they can lead to a variety of negative side effects and behaviors with potentially long-term and life-threatening consequences.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

All the Dirt on Antibacterial Soaps, Colds, and the Flu

The long hot days of summer have blown by as if propelled by Hurricane Hermine’s winds. The sun sets earlier, sugar maples are starting to tinge, and the evenings already bear traces of autumn chill. September is upon us – the kids are back in school, pumpkins are showing up in the supermarkets, and the “Get your flu shot here” signs are appearing all around us. Sadly, colds, influenza, and throat, ear and sinus infections can’t be far behind.

With kids and adults in close proximity, poor hand-washing habits, and everyone sneezing around us, our natural immunities to bacterial and viral infections are taxed, leaving us more likely to contract a variety of illnesses. The late summer and early fall also bring a resurgence in seasonal allergies. Sometimes it’s hard to tell one malady from another  . . . with the aches and pains, runny noses, itchy throats and increased body temperature, we’re off to the doctor in search of an antibiotic, or searching at the drug store for magic pills to cure or, at the least, relieve us.

Many of the illnesses that wreak havoc in the autumn and winter are caused by bacteria or viruses, and it’s important to know the difference. Bacteria are single-celled organisms usually found all over the inside and outside of our bodies, except in the blood and spinal fluid. Many bacteria are not harmful. In fact, some are actually beneficial. However, disease-causing bacteria trigger illnesses such as strep throat and some ear infections. Viruses are even smaller than bacteria. A virus cannot survive outside the body’s cells. It causes illnesses by invading healthy cells and reproducing.

Antibiotics are our chosen line of offense against many types of infections, but they don’t work against all. For example, we should not treat viral infections such as colds, the flu, sore throats (unless caused by strep), most coughs, and some ear infections with antibiotics.

Antibiotics are drugs that fight infections caused by bacteria. After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases. The term “antibiotic” originally referred to a natural compound produced by a fungus or another microorganism that kills bacteria which cause disease in humans or animals. Although antibiotics have many beneficial effects, their use has contributed to the problem of antibiotic resistance, which is the ability of bacteria or other microbes to resist the effects of an antibiotic.

Antibiotic resistance occurs when bacteria change in some ways that reduce or eliminate the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates and co-workers, threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat.

According to the Centers for Disease Control (CDC), the single most important thing we can do to keep from getting sick and spreading illness to others is to clean our hands. As we touch people, surfaces, and objects throughout the day, we accumulate germs on our hands. In turn, we can infect ourselves with these germs by touching our eyes, nose, or mouth and food.

Although it’s impossible to keep our hands germ-free, washing hands frequently helps limit the transfer of bacteria, viruses, and other microbes. According to CDC research, some viruses and bacteria can live from 20 minutes up to two hours or more on surfaces like cafeteria tables, doorknobs, ATM machines and desks. So wash before and after using a restroom. Wash after visiting the supermarket, ride a bus or train, or using an ATM. When it isn’t easy to wash, use a hand sanitizer. Don’t use anyone else’s toothbrush, and avoid sharing food, drinks or eating off of one another’s plates. And in late-breaking news, stop using antibacterial soaps and products – they aren’t useful in protecting you, and are causing more damage than good.

Antibacterial soaps aren’t good for us

The Food and Drug Administration (FDA) recently banned the sale of soaps containing certain antibacterial chemicals, saying industry had failed to prove they were safe to use over the long term or more effective than using ordinary soap and water.

In all the FDA took action against 19 different chemicals and has given industry a year to take them out of their products. About 40 percent of soaps – including liquid hand soap and bar soap – contain the chemicals. Triclosan, mostly used in liquid soap, and triclocarban, in bar soaps, are by far the most common.

The rule applies only to consumer hand washes and soaps. Other products may still contain the chemicals. The agency is also studying the safety and efficacy of hand sanitizers and wipes, and has asked companies for data on three active ingredients – alcohol (ethanol or ethyl alcohol), isopropyl alcohol and benzalkonium chloride – before issuing a final rule on them.

This decision comes after years of mounting concerns that the antibacterial chemicals that go into everyday products are doing more harm than good. Health experts have pushed the agency to regulate antimicrobial chemicals, warning that they risk damaging hormones in children and promote drug-resistant infections. Additionally, studies in animals have shown that triclosan and triclocarban can disrupt the normal development of the reproductive system and metabolism, and health experts warn that their effects could be the same in humans.

The chemicals were originally used by surgeons to wash their hands before operations. Their use has expanded significantly in recent years as manufacturers added them to a variety of products, including mouthwash, laundry detergent, fabrics and baby pacifiers. The CDC reports the chemicals from antibiotic soaps are found in the urine of three-quarters of Americans, one of the many factors they considered in issuing the ban.

The surest bet for a healthy fall and winter is to be vigilant about hand washing, and to take reasonable precautions such as getting flu shots (note that the CDC is questioning the effectiveness of the nasal spray version of the flu vaccine for the 2016/2017 flu season) and avoiding people who are coughing, feverish or obviously ill. When sick, try to stay home from work or school to avoid spreading the joy, and seek medical care if you feel you may require antibiotics or other medicinal remedies. You also can speak with your physician about antibiotic resistance, or take the time to learn more about this important subject by visiting reliable websites such as www.cdc.gov.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

It’s Not the Size That Matters

As summer wraps up and we get into the autumn months, most of us are coming off of a cycle of outdoor activity and recreation that diminishes with the shorter and colder days. The holidays will be upon us before we know it, as well as the requisite excess eating and drinking that accompany the season. But with a few months left in the year, it’s also a good time to take stock of your health and wellness activities, and to consider what’s worked well, what hasn’t worked, and what you might do differently or better next year.

There are numerous national studies documenting the value and benefits of having a formal employee wellness program. Companies that implement wide-ranging programs reap benefits in improved employee satisfaction, productivity and morale. Sick days and absenteeism diminish, and participation in the programs increases.

For large companies, the return on investment is clear. But even for smaller companies, the impact can still be dramatic, especially in terms of personal health and attitude, in teamwork, and in respect for the employer.

Regardless of the size of the company, there are certain aspects of implementing health and wellness efforts that are consistent and proven. Here, for example, are key facilitators common to all organizations that have successfully implemented a health and wellness program:

  • Broad outreach and clear messaging from organizational/company leaders.
  • Making wellness activities convenient and accessible for all employees.
  • Making wellness an organizational priority among senior leaders, middle managers and supervisors.
  • Leveraging existing resources and building relationships with health plans to expand offerings at little to no cost.
  • Approaching wellness with a continuous quality-improvement attitude; and
  • Soliciting regular feedback from employees to improve programs and participation.

There are other constants, as well. For companies that implement and promote the use of online health-assessment tools, researchers find statistically significant and clinically meaningful improvements among program participants, especially in exercise frequency, smoking behavior and weight control. Additionally, participation in a wellness program over five years is associated with lower health care costs and decreasing health care use. And outreach to employees works more effectively when a company appoints a wellness champion who can help coordinate activities, approach management, share educational information and solicit candid feedback more easily.

Approximately half of U.S. employers offer wellness promotion initiatives, and larger employers are more likely to have more complex programs. Programs often include wellness screening activities to identify health risks, and interventions to reduce risks and promote healthy lifestyles.

For smaller companies, implementing formal smoking-cessation, nutrition and exercise programs isn’t as easy – but encouraging employees to establish and pursue personal goals, recognizing their efforts and rewarding them for their commitment and success is not difficult. Often, smoking-cessation and exercise programs are available through local chapters of national organizations, or through local fitness and nutrition centers. It just takes support and commitment.

Healthy employees are more productive and happy employees, and statistically, they tend to remain with employers longer when their interest in a healthier lifestyle is encouraged and supported. The most successful small-company wellness programs may start out simply and evolve, but the trick is getting started and building momentum . . .  the rest will follow!


If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!