Page 13 - Christiana Care Health System Focus September 2018
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      What’s more, these same patients had a total of just one hospital visit in the 30 days following the program’s start. Thirty days before the program’s beginning, they had a total of 13 hospital visits. One of the main calls for help had nothing to do with the pill. Instead, callers wanted to know how toturnontheiPad.“Thatwasabitofa surprise for us,” Medaglio said.
There was another obstacle. States often have different policies regarding com- pounding (the creation of a personalized medication) and encapsulating (a tech- nique used to enclose medication in a
hard or soft capsule). To meet Delaware’s requirements and still include the chip with the medication, the pilot program had to locate an external mail-order pharmacy to encapsulate the two. Consequently, some patients had a co-pay.
“I see this as a clear example of what happens when the technology is ahead of policy,” Medaglio said. “Not every hot technology out there is ready to hit the ground running. There are still some significant barriers.”
Dr. Siegel returned to talk about the influence of “ZNA” on health care-related policies.
ZNA refers to your ZIP code, and like DNA,
it can affect your life expectancy. “There’s a tremendous variability in terms of life expec- tancy based on where you live,” Siegel said.
He displayed a 2014 map of the United States indicating the average life expec- tancy by county. There was about a 20-year gap between some areas, where the life expectancy averaged in the 60s, and others, where it was in the 80s.
Problematic areas included West Virginia, Kentucky and along the Mississippi Delta. These sections of the country also had a high cancer mortality rate.
However, there were variations when the criteria focused on lung cancer, pancreatic cancer and liver cancers — which by 2030 will be the leading causes of cancer deaths.
Risk factors for these cancers are related to behavior, he said. Consider the link between smoking and lung cancer.
Research has shown that many smokers have a low income and that there’s a high number of tobacco outlets in low-income neighborhoods.
“Where people spend their time has a huge impact on their behaviors,” Siegel said. “If there are more stores supplying tobacco, you have greater access.” He also noted that the price of cigarettes is frequently lower in these areas, and there are more marketing materials in store windows and at the register. In addition, smoking might be a
Psocial norm in the neighborhood.
olicymakers can use geospatial analytics to create intervention strategies, such as instituting tighter tobacco control measures
in ZIP codes with a high rate of lung cancer, promoting lung cancer screenings, providing smoking-cessation services and funding research focused on lung cancer treatments.
“I think this was a very informative event,” concluded Helen Stimson, president
and CEO of the Delaware BioScience Association, at the program’s close. “I know I learned a lot.”
Nancy J. Kovach, who attended the event, agreed. “I thought the technology about the digital pills was just fascinating,” said Kovach, vice president of Life Sciences Practice at the Salveson Stetson Group, an
“There’s a tremendous variability in terms of life expectancy based on where you live.”
Scott D. Siegel, Ph.D.
executive search firm. The cost of non- compliance for people with chronic medical conditions is staggering, she said.
Lisa Wolfington said the program was pow- erful and inspiring. “I really enjoyed seeing all the new technology and the advances in science and medicine that Christiana Care is involved in,” said Wolfington, director of Health System Marketing for Benchworks. “I was very impressed.”
Sponsors of the July 17 breakfast
included the Delaware IDeA Network of Biomedical Research Excellence (INBRE), the Pharmaceutical Research and Manufacturers of America (PhRMA) and VWR International, an American company involved in the distribution of research laboratory products. 
For more information on the Delaware BioScience Association, visit
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