AtlantaGA USA AmmanJordan Hebron Palestine July 12 2015 Omar M Lattouf MD PHD FACC FACS Professor of Surgery Emory University Conflict of Interest Statement Speaker has interest in developing new mobile technologies for selfrisk assessment vital signs reporting and clinical progress ID: 525510
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International Collaboration in Cardiovascular Disease Prevention; Atlanta-GA USA, Amman-JordanHebron-PalestineJuly 12, 2015
Omar M Lattouf MD PHD FACC FACS
Professor of Surgery
Emory UniversitySlide2
Conflict of Interest StatementSpeaker has interest in developing new mobile technologies for self-risk assessment, vital signs reporting, and clinical progress post clinic or hospital discharge. Slide3
What are Chronic Diseases ? Long-lasting conditions that can be controlled but not cured. CD affect populations worldwide
and are leading causes of death and disability . Slide4
Georgia Wellness Leadership WorkshopFebruary 27, 2014
Omar M Lattouf
Brenda Fitzgerald
Michael Johns
Heval Kelli
Brent Keeling
John Sweeney
Jean O’Connor
Jag D
Sheth
Larry Sperling
Dave Cantin
Michael StaufackerSlide5
Case 1: 36 Yrs. old F, 36 Weeks GravidSlide6
Aortic Dissection During PregnancySlide7
Case presentation #2:A 21-year old female patient, 26 weeks gravid with twins, presented with back pain and shortness of breath. Past medical history was significant for paraplegia afte motor vehicle accident 6 years earlier.
Embolus – in - transit
Embolus, surgically removedSlide8
Metabolic
Syndrome
Obesity
Impaired blood glucose
Hypertension
Elevated lipids
Heart disease
Diabetes
Stroke
Cancer
Kidney
disease
& moreSlide9
CMS: A Disease at Epidemic Proportion
(Grundy 2005
)
34%
USA
4.2%
among US adolescents
37%
Brazil
37% Gulf Countries
29% M / 40% W Jordan
25%
Europe
22-39%
India
20.7-37.2%
MENA
17%
China
2-fold
risk of CVD
5-fold
risk of DM-II3-fold risk of dying from colon cancer1.9-2.6 risk ratio for breast cancer3.38 odd ratio for chronic kidney diseaseAssociated with liver disease, sleep apnea and erectile dysfunction. Slide10
The Economist May 30 2015In the United States of America 1% of Patients Account for 22.7% of Healthcare SpendingSlide11
Cardiometabolic Syndrome (CMS) and Disease (CMD)Key Metrics
34%
1
of adults have
Cardiometabolic Syndrome
7out of 10 patients discharged
have CMS conditions
2
$3T
*
U.S.
Health
Care
$2T
Chronic
Disease
$1T
CMS-Related
~$500B
CardioMetabolic Disease
* 2013 projected costs
1
American
Heart Association (2013
)
2
CDC (2013)Slide12
Cardiometabolic – U.S. Direct Cost
Overview Summary
Cardiovascular
Disease
2
Chronic Kidney Disease
3
CM Disease
$446B
Type-2
Diabetes
1
4
of Top 5 most common chronic conditions
in Medicare
are
Cardiometabolic
4
High
blood pressure (58%)
High cholesterol (45%)
Heart disease (31%)
Arthritis (29%)
Diabetes (28%)
Source:
1
American Diabetes Association (2012
)
2
American
Heart Association (
2013)
3
Journal of
the American Society of Nephrology (2013) 4 CHRONIC CONDITIONS AMONG MEDICARE BENEFICIARIES, CHARTBOOK: 2012 EDITION 47% of CMD or $210B are hospital costsSlide13
Projected Direct & Indirect Cost of All CVD in USASlide14
Lloyd-Jones et al Defining and Setting National Goals for Cardiovascular Health Promotion and Disease ReductionThe American Heart Association’s Strategic Impact Goal Through 2020 and Beyond .
Circulation
February 2, 2010 Slide15
Million Hearts® national initiative to prevent 1 million heart attacks and strokes by 2017, brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke.Slide16
Colorado Kaiser Permanente Heart360 and Blood Pressure Control Slide17Slide18Slide19
Effectiveness of BP ControlSlide20
Levels of BP Drop in Control vs. Rx GroupsSlide21
Level of Satisfaction with CareSlide22
Better Care is Cost EffectiveSlide23
Patient – self-empowerment, self-diagnosisPhysician – improved utilization of data at point of careHospital – patient tracking, prevention of costly re-admissionsThree-pronged ApproachSlide24
Self-Analysis toolCardio Metabolic Syndrome “Bulls Eye”Simple, visual model to show where one stands in terms of ideal Cardio Metabolic healthWhat
areas
to improve.
PatientSlide25
From Cardiovascular Disease to Cardiovascular Health A Quiet Revolution? Darwin R. Labarthe
, MD, MPH, PhD
(
Circ
Cardiovasc
Qual
Outcomes.
2012;5:e86-e92.)
Trust for America’s Health reported that:
I
nvestment
of $10 per person per year
in
programs
to increase physical
activity
, improve nutrition, and prevent smoking
could
save
than $16 billion annually
within 5
years; a return of $5.60 for every $1 invested.”
Investing in disease prevention is the most effective, common-sense way to improve health, spare millions of Americans from developing prevent- able illnesses, reduce health care costs, and improve the productivity. ORB
uild super expensive monuments for the treatment of sick individuals, eg, a $7 billion 5-year construction in 1 medical center alone.Slide26
Differences in prevalence of selected risk factors and diseases, by socioeconomic status: Australian Bureau of Statistics (ABS). Australian Health Survey: First Results, 2011–12. (unpublished data). Canberra: ABS, 2012 Slide27
Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: Preliminary Data for 2009. National vital statistics reports; vol 59 no 4. Hyattsville, MD: National Centers for Health Statistics, 2011.Slide28
In the Middle East and North Africa, the leading causes of premature death and disability and their percentage changes between 1990 and 2010 were:Ischemic heart disease: 44% increaseLower respiratory infections: 47% decrease
Stroke: 35% increase
Low back pain: 77% increase
Major depressive disorder: 58% increase
Preterm birth complications: 23% decrease
Congenital anomalies: 36% decrease
Road injuries: 46% increase
Diabetes: 87% increase
Diarrheal diseases: 69% decrease
Published by the World Bank and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. September 4,2013 Slide29
In Jordan The cost of CV care increased from 645 million in 2004 to 1 billion 200 million in 2010.
Petra – Jordan news agency.
28-9-2013 .Slide30
In the Middle East and North Africa, the top 10 risk factors for premature death and disability and their percentage changes between 1990 and 2010 were:Dietary risks: 64% increaseHigh blood pressure: 59% increase
High body mass index: 138% increase
Smoking: 10% increase
High fasting plasma glucose: 66% increase
Physical inactivity: percentage change unavailable due to lack of data
Ambient particulate matter air pollution: 4% increase
Occupational risks: 38% increase
Iron deficiency: 7% increase
High total cholesterol: 51% increase
Published by the World Bank and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. September 4,2013 Slide31
In gulf countrieschronic diseases cost about 36 billion in 2013 and may reach 68 billion in 2022 .every 10% increase in the chronic diseases the yearly income for each country will decrease by .5% .
Aleqtisadiah
news.
22-1-2013.Slide32
Death rates from cardiovascular disease in selected countries in Africa and the Middle EastDrawn from data presented by the World Health Organization. Wael Almahmeed,
1
Mohamad
Samir
Arnaout
,
2
Rafik
Chettaoui
,
3
Mohsen
Ibrahim
,
4
Mohamed Ibrahim Kurdi,5
Mohamed Awad Taher,6 and Giuseppe Mancia7, Coronary artery disease in Africa and the Middle East,2012 Feb.Slide33
The UAE spends $272 million on diabetes treatment annually. A study by Abu Dhabi health authority estimated the overall social costs of the disease at about $1.9 billion.As mentioned in Reuters.
4-7-2012.
While
Saudi Arabia
spend around $3 billion annually on treating
diabetes and high blood
pressure diseases.
Published in news-bank.net
Slide34
For the Arab region it was expected to spend USD 8.7 billion as expenditure for diabetes in 2011.Abdesslam
Boutayeb
,
Mohamed E. N.
Lamlili
,
Wiam
Boutayeb
,
Abdellatif
Maamri
,
Abderrahim
Ziyyat
,
Noureddine
Ramdani.The rise of diabetes prevalence in the Arab region .Open journal of epidemiology .Published 26-4-2012.Slide35
Saudi Arabia could be spending over $800 million by 2020 on renal failure.Alriyadh news.29-1-2015.Slide36
Diabetes in adults 20 years or older member countries of World Health Organization Eastern Mediterranean Region. (Blood Sugar ≥7 mmol/L) Rajiv Khandekar,Screening and public health strategies for diabetic retinopathy in the Eastern Mediterranean Region,2012Slide37
Cholesterol in HispanicsNearly Half Of Hispanic Individuals Who Have High Cholesterol Are Not Aware That They Have It. Only 29.5 percent who did know about it received treatment.ACC CV News Digest June 25, 2015 Slide38
The Solution:Technological Wellness: Using Point-of-Care Analysis to Improve Patient Cardiometabolic HealthSlide39
As of January 2014:91% of American adults have a cell phone55% of American adults have a smartphone32% of American adults own an e-reader42% of American adults own a tablet computer
http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/
Technology in the US Slide40
PatientSlide41
http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/
Point-of-Care Analysis Slide42
The APPSlide43
The APPSlide44
The APPSlide45
Mobile Patient Screening and TrackingSlide46
Mobile Patient Screening and Tracking