Minnesota - June 2012 Archives

ROCHESTER, Minn. — June 4, 2012.  With the 2012 Summer Olympics fast approaching, two Mayo Clinic researchers have penned a timely and thought-provoking editorial in the June issue of Mayo Clinic Proceedings that explores genetic variation and how it plays out in professional athletic competition. The authors, Mayo Clinic's J. Michael Bostwick, M.D. and Michael Joyner, M.D., argue that fairness in athletic competition is not defined in terms of everyone being equal. The reality, they say, is that athletes need a great deal of practice and exercise, but also certain athletic endowments that make it possible to achieve at a high level. The editorial analyzes the recent case of Castor Semenya, a South African female runner disbarred from competition after she won the 800-meter race at the world championships in Berlin in 2009. Semenya was temporarily banned from competing because some argued she looked too much like a man, even though she had never identified as a man or been treated as one; she later was reinstated. "There really is no fast and hard definition of what constitutes a male and what constitutes a female," Dr. Bostwick says. "Nature is diverse, and there is variation of all kinds that can occur. It becomes a real challenge when we have an athletic system that is set up on a binary understanding of sex — you are either a man or a woman." Any advantage Semenya's physique gives her is no different from many other competitive athletes, Bostwick and Joyner say. A few examples: Swimmers with long arms, large feet and lax joints. Skiers who have a high oxygen-carrying capacity. Gymnasts who are small, limber and young.

ROCHESTER, Minn. — June 4, 2012.  An innovative model of diabetes care developed in southeastern Minnesota will be demonstrated at a national health forum this week in Washington, D.C. The new patient-centered approach uses a website that helps patients identify their most urgent needs — physical, emotional or financial — and then finds the most effective ways to address them. The goal is to use technology to improve the delivery and outcomes of diabetes care, while lowering the cost of managing this chronic condition. The new model of care was developed by the SE Minnesota Beacon Program, a collaboration of professional health groups including Mayo Clinic, Mayo Clinic Health System, Olmsted Medical Center, Winona Health, Allina Health and public health departments in 11 counties. The technology will be demonstrated June 5–6 at the third annual conference of the Health Data Initiative, a public-private collaboration started by the Institute of Medicine and the U.S. Department of Health and Human Services. "It is an honor to be asked to demonstrate our technology at this highly visible conference," says Lacey Hart, SE Minnesota Beacon Program director. "We hope that our success can help to provide better outcomes and more cost-effective treatment for people with diabetes throughout the country." Diabetes affects about 24 million Americans and is one of the biggest drivers of health costs. SE Minnesota Beacon's key innovation is to focus on patients' self-identified needs, or Patient Reported Outcomes (PRO). "We have compiled substantial evidence that PROs are indeed credible targets for diabetes assessment and intervention," says Jeff Sloan, Ph.D., a health sciences researcher at Mayo Clinic who led the team that developed the new diabetes care model. "In fact, we have shown that the scientific value of many PROs is actually superior to many commonly used laboratory and clinical outcome variables." In the Beacon model, PROs guide specific interventions aimed at improving patients' quality of life. The Diabetes PROQOL website, accessible by smartphones, first asks patients to identify their "single biggest concern right now." Ten options are offered, including not only monitoring health (measuring blood sugar, for example) but also personal relationships, emotional health and money. Once a category is chosen, the patient answers a few clarifying questions. For example, under money, patients are asked if they cut pills in half or skip doses of medication to save money. The questionnaire takes about a minute to complete.

ROCHESTER, Minn. — June 4, 2012.  The Minnesota Department of Human Services has entered into a two-year contract with Mayo Clinic to provide expert guidance to pediatricians and other primary care providers who prescribe psychotropic medications for children. The new service is referred to as "collaborative psychiatric consultation" and is based on pilot projects that improved care and saved money. A two-year, $1.7 million state and federal investment in the program is expected to be fully offset by reduced costs for inpatient hospitalizations and medications in the state Medical Assistance program. While all Minnesota physicians will be encouraged to use the service, it will be required for Medical Assistance fee-for-service payment for certain psychotropic medications for children. "We are pleased to join with Mayo Clinic to provide better mental health care to all Minnesota children, especially children served by the Medical Assistance program," says Lucinda Jesson, Human Services commissioner. "This new psychiatric consultation service holds the promise of improved access and quality of care as well as greater efficiency so resources can be focused on appropriate treatment." "For the first time in the state's history, this new program will enable child psychiatrists and social workers across leading health care systems to function as an integrated team," says Peter Jensen, M.D., a Mayo Clinic psychiatrist. "We're truly working together to help Minnesota's primary care physicians deliver quality health care to their children with mental health needs." The new service will also expand the capacity and strengthen the system of oversight and monitoring of psychotropic medication use among children in foster care; they are up to five times more likely to be on a psychotropic medication than other children on Medical Assistance, a concern in Minnesota and nationally. Mayo Clinic will partner with other health systems to ensure the new service is available statewide. Beginning in August, Mayo Clinic and its partners will operate a call center Monday through Friday from 7 a.m. to 7 p.m. A licensed social worker will answer calls and determine the most appropriate response. For example, when possible, callers will be connected with existing services in the caller's home community. If necessary, calls will be routed to on-call psychiatrists with qualifications specific to the request.