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New Alliance Between Leaders in Health and Medicine to Address Healthcare Disparities Through Educational Initiative

August 7, 2008

In an effort to help reduce racial, ethnic and gender disparities in healthcare, leading professional organizations and academic medical institutions have joined forces in a unique collaborative alliance with the goal of creating a comprehensive educational initiative that aims to improve the quality of care and outcomes for traditionally underserved minority populations.

The collaboration between The American College of Cardiology, the Association of Black Cardiologists, the National Kidney Foundation, Joslin Diabetes Center, The Johns Hopkins University School of Medicine, and The Institute for Johns Hopkins Nursing will focus on cardiovascular disease, diabetes, obesity and chronic kidney disease (CKD) – conditions with consistently higher rates of morbidity and mortality among ethnic patients. The initiative will additionally examine multiple aspects of patient care including effectiveness of healthcare quality, patient safety, timeliness of and access to healthcare services and patient centeredness.

“The spectrum of clinical implications between hypertension, obesity, diabetes and chronic kidney disease has long been recognized by clinicians, but in recent years they have become a clear focus of considerable preventive and therapeutic attention,” according to Keith C. Ferdinand, M.D., FACC, Clinical Professor, Emory University and Chief Science Officer, Association of Black Cardiologists. “With this important clinical challenge facing us, however, ethnic disparities limit our ability to provide optimal care.”

“Despite extensive documentation of inequities in healthcare quality, little has been done to improve the delivery of services to ethnic populations,” states Jack Lewin, M.D., CEO, American College of Cardiology. “The resources and technology necessary to address disparities in health care exist today. If we can harness these tools and provide training in using them to physicians and their care teams, we will go a long way toward providing evidence-based quality care to all patients regardless of ethnicity.”

For example, statistics show that:

— Healthcare providers are 40 percent less likely to order sophisticated cardiac tests for African Americans with chest pain than for Caucasians with identical symptoms.

— African Americans, Native Americans, Hispanics and American Asians are, respectively, 4.5, 3.6, 2 and 1.6 times more likely to develop chronic kidney disease than are Caucasians, and ethnic patients have a rate of end-stage renal disease that is 2 to 4 times higher than Caucasians.

— Among patients diagnosed with diabetes, African-American patients are less likely (43.6 percent) than white patients (50.4 percent) to receive an eye exam, an established standard for diabetes care.

“As stakeholders in providing quality care to patients, we need to act aggressively to ensure that we address healthcare disparities among our patient populations,” states Enrique Caballero, M.D., Director of the Latino Diabetes Initiative, Joslin Diabetes Center. “Effective education and training for clinicians is the first step toward change.”

“This is an exciting opportunity to combine the expertise of our nation’s leading medical societies, associations and academic medical centers to provide the highest degree of educational value to an underserved and under recognized area of healthcare,” says Joseph Vassalotti, M.D., Chief Medical Officer, National Kidney Foundation.

Evidence shows that as patient populations grow and become more diverse, lack of cultural competence among providers will lead to an increasing gap in racial and ethnic disparities within the healthcare system. “This initiative will utilize several measures to assess the impact it will have on minimizing healthcare disparities,” said Todd Dorman, M.D., FCCM, Associate Dean and Director, Johns Hopkins CME. He outlined them in the following manner;

1. Provider Measures

— Did the initiative improve the provider’s knowledge/awareness

— Did the initiative change the provider’s behavior in relation to the process of care

2. Patient Measures

— Did the initiative result in better patient care and outcomes related to cardiovascular disease, obesity, diabetes and CKD

— Did the initiative improve the health status of patients through specific measures such as healthcare quality, timeliness of healthcare services, and patient centeredness

3. Healthcare Services and Utilization

— Did the initiative have an impact on patient safety and/or error reduction

— Did the initiative have an impact on diagnostic accuracy, appropriate therapy, and minimization of hospitalization rates

The curriculum-based, multi-year initiative aims to provide a series of educational interventions in multiple formats to various healthcare providers ranging from primary care and cardiovascular physicians to other specialists such as endocrinologists/diabetologists and nephrologists, as well as nurses, nurse practitioners, pharmacists, physician assistants, and dietitians.

A performance improvement (PI) system will be used in the curriculum to allow providers to apply quality measurement to their practices, and use the resulting data to take action specific to their practice for improved patient care.

Bringing this educational initiative to fruition demands a collaborative approach by healthcare organizations. “Our hope is that this initiative will empower healthcare providers in the U.S. to deliver the highest-quality care to every patient, regardless of race, ethnicity, gender, culture, or language proficiency,” said Dr. Dorman.

Gullapalli and Associates, LLC, a leading educational strategy firm, will facilitate the development and management of the initiative.

American College of Cardiology (ACC)

The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The ACC is a 34,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. For more information, visit www.acc.org.

Association of Black Cardiologists (ABC)

The Association of Black Cardiologists, Inc. (ABC) is the nation’s foremost advocate for the prevention and reduction of disparities in cardiovascular care and outcomes. Since its establishment in 1974, the ABC’s achievements have made it an important voice and the foremost advocate for the prevention and reduction of cardiovascular diseases in African Americans and other minorities. The ABC continues to promote its primary mission through education, research, health promotion and health policy advocacy. The ABC’s diverse membership consists of over 1,100 physicians, scientists, nurses, students and community health advocates. For more information, please call the Association of Black Cardiologists, Inc. at 1-800-753-9222 or visit www.abcardio.org.

Joslin Diabetes Center

Joslin Diabetes Center is the world’s preeminent diabetes clinic, diabetes research center and provider of diabetes education. Joslin is dedicated to ensuring people with diabetes live long, healthy lives and offers real hope and progress toward diabetes prevention and a cure for the disease. Founded in 1898 by Elliott P. Joslin, M.D., Joslin is an independent, nonprofit institution affiliated with Harvard Medical School. For more information about Joslin, call 1-800-JOSLIN-1 or visit http://www.joslin.org.

National Kidney Foundation/Kidney Learning System (NKF/KLS)

The National Kidney Foundation, Inc., a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. NKF’s KDOQI evidence-based practice guidelines are the leading resource in the treatment of chronic kidney disease (CKD). NKF’s KLS develops and implements comprehensive educational resources for public health, patients and families and medical professionals across all disciplines through a wide variety of learning formats, CME/CE programs, tools and resources. For more information please visit www.kidney.org.

The Johns Hopkins School of Medicine

In July 2008, U.S. News & World Report ranked The Johns Hopkins Hospital #1 among American hospitals for the 18th consecutive year. Johns Hopkins remains the nation’s leading medical school recipient of research funds from the National Institutes of Health. In 2006, the Johns Hopkins Office of CME received “Accreditation with Commendation”, the highest ranking issued by the Accreditation Council for Continuing Medical Education.

The Institute for Johns Hopkins Nursing

The Institute for Johns Hopkins Nursing designs and delivers leading-edge continuing education for nurses. The Institute accesses the expertise of faculty and nurses from both the Johns Hopkins University School of Nursing and Johns Hopkins Hospital, including over 2500 highly skilled clinicians in 10 clinical and countless subspecialty areas who are also world- renowned researchers and educators. For more information please visit www.ijhn.jhmi.edu

Gullapalli and Associates, LLC

Gullapalli & Associates (G&A) is an educational firm specializing in the facilitation of collaborative educational strategies with a variety of CME stakeholders, ensuring consistent educational strategy, goals and objectives. For more information, visit www.gullapalliandassoc.com




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