When you think about giving back this holiday season, remember those persons serving as caregivers for the loved ones in your life.  Caregiving is one of life’s highest honors, but on the flip side it can also be physically and emotionally draining, especially during the holidays.  The added stress of having to balance holiday activities like shopping and visiting relatives and friends with caregiving responsibilities can be overwhelming, and may leave caregivers feeling frustrated, isolated, depressed and exhausted.

Caregiving today affects almost everyone – over 43 million adults in the United States have provided unpaid care to an adult or child in the past 12 months.

Bring a little joy to the world

There are a number of things you can do to help ease the burden for the caregivers in your life.  Here are some suggestions:

• Ask how you can help – This is the simplest approach. Begin by recognizing the caregiver’s role and ask about her or his concerns during the holiday season.  If you encounter resistance because the caregiver doesn’t feel that responsibilities can be set aside, make some suggestions about ways you can help without causing more stress.  For example, you could talk about family activities –are they able to attend, is the timing convenient, is there something you could do to help them prepare?
• Provide respite – Caregivers have their own holiday tasks to accomplish and more importantly, they need time to take care of themselves.  You could sit with a loved one for a few hours or help schedule in-home care for a period of time.  Perhaps spending time with the caregiver is the break they need.  Get together for coffee and companionship.
• Offer your services – With numerous responsibilities, there are bound to be a few things on the back burner that you could help a caregiver with.  Ask about needed home repairs, installing equipment to make their life easier or making a trip to the store or post office.  Could you assist with shopping or addressing holiday cards and getting them in the mail?
• Simplify traditions – Just because you’ve always done something doesn’t mean that the tradition must continue exactly as it was. Adapting activities to make them less stressful – and more enjoyable – is a win-win for everyone involved.  Plan ahead to ensure the space and timing is conducive. Something as easy as eating earlier in the day could benefit transportation arrangements, or keep caregiving needs on schedule.

Don’t limit recognition of the caregiver to the holidays.  The fact that you care enough to recognize the unique situation, the work performed, and to reach out may be enough to give the caregiver joy.  A burden shared is a burden lightened.

Keep up the good work

While holiday stress happens once a year, family caregivers are at an increased risk for burnout, depression, substance abuse, chronic illness and a host of other maladies year round.  In addition, there are a variety of caregiving situations that require special support, including long-distance caregiving and those caregivers in the sandwich generation who are caring for parents and their own children at the same time.

Check out the following tips and resources to see how you can support caregivers:

Long Distance Caregiving 

The Sandwich Generation

Finding and Choosing Respite Care Services

Caring for the Caregiver

10 Fast Facts About Caregivers

Ransomware, malware, distributed denial of service attacks, Mirai – bad actors in a scary sci-fi thriller targeting your personal computer (PC), tablet or gaming device? Cyber attacks look for vulnerabilities in any system, not just your PC. Many sectors including credit cards, banking, government, retail and social media are objects of cyber attacks. The healthcare ecosphere, particularly medical devices, are a prime target of cyber bugs. In fact, healthcare is the number one industry when it comes to breach of data and generally lacks specialized security controls. Moreover, personal health information is 50 times more valuable on the black market than a credit card.

Ransomware, which block access to a computer or network until money is paid, are on the rise with 88 percent of attacks occurring in healthcare. Earlier this year, a California hospital paid $17,000 to cyber intruders to regain control of its electronic health network. Just last year, Anthem’s database of about 80 million people was also hacked.

Internet-connected medical devices, hospital networks, and other devices fall in the realm of Internet of Things (loT). Like computers, these connected devices can be hacked, potentially affecting the safety and effectiveness of the device and compromising patient privacy and safety.

In October 2016, J&J reported the potential for hackers to exploit a security susceptibility in the Animas® One Touch Ping® insulin pump. This could force the pump to deliver unauthorized insulin injections, leading to a possible insulin overdose, which can be life threatening. In August 2016, there were denied allegations about a possible dangerous cyber bug with one manufacturer’s cardiac devices. Last year, the FDA issued a few warnings about potential cyber bugs with Hospira’s (now Pfizer) infusion pumps. Despite these reports, the FDA is not aware of any cases where hackers have exploited cyber vulnerabilities to harm a patient.

In January 2016, the FDA made medical device cybersecurity a priority by issuing draft guidance for manufacturers. It provides direction to monitor, identify, and address cybersecurity vulnerabilities throughout the medical device lifecycle. This is largely a voluntary framework to aid manufacturers in building a scaffolded approach to minimize and mitigate risk.

Cyber attacks on medical devices are expected to grow and become more sophisticated as hackers continue to hone their craft. Threatened connected devices range from security cameras to coffee makers and from the federal government to medical devices such as MRIs, infusion and insulin pumps, and the list goes on. There is a proliferation of wearables and medical devices with software and programmable logic. When factoring in the evolution of electronic medical records and telehealth, regulators, medical device manufacturers, and health networks need to get savvier in order to provide solid security against this new reality.

“Every citizen has gifts. A strong community knows it needs everyone to give their gifts.”

– John McKnight, Asset Based Community Development (ABCD) Institute

In supporting people with disabilities in our communities, it is important to shift from using a lens shaded by needs and wear one focused on seeing people’s strengths, talents and assets. This new lens reflects the potential of each person and helps to move the conversation from one marked by:

• listing the services a person may need, to one identifying the contributions an individual can make,
• seeing a consumer as a user of services, to one recognizing a citizen who can access shared resources and have valued roles in their community, and
• viewing programs with limited resources, to one recognizing relationships and connections to one’s community with endless possibilities.

The 2016 conference for TASH, an international advocacy organization, provides a unique opportunity for people with disabilities, their family members, other advocates, and people who work in the disability field to come together and learn about strategies that meet the objective of this year’s conference to “reignite their passion for an inclusive world.” I led an interactive session that engaged participants in using tools to clear the path to inclusion, employment and community connections. Attendees learned how to use strength-based strategies to expand and translate their interests, gifts and talents into real connections and a better quality of life.

These strategies, when applied to community inclusion for people with disabilities, are based on an exploration of an individual’s gifts of hand, heart, head and human connection. Gifts of the hand are the things we know how to do. These are our skills, habits or rituals that we learn or naturally possess. Gifts of the heart include our passion or things we care enough about to give of our time and effort. Gifts of the head are the things we know or want to learn about, such as an interest in a local sports team or in a hobby. Gifts of human connections are the people we know and who know us – often called our social capital.

For decades, we have kept those who are different from us, including people with disabilities, separated from the community or segregated in spaces society thinks they feel more comfortable and can live in more safely. While approaches to school inclusion and community living strategies have tried to address this, these efforts have often been more focused on meeting the needs of professionals or systems, as opposed to the needs of people. Far too many people living in their communities are segregated from typical experiences and do not have access to opportunities they deserve as citizens. However, when we support people to create connections to others in their communities based on their natural gifts and assets, opportunities for real inclusion develop.

Consumerization of products continues to drive new innovations across the marketplace. For example, you can use your smartphone as a GPS device, to request a car service directly to your house and to shop for a new car online, seeing the prices other people paid in real time. In banking, we’ve seen the transition from teller to the ATM to online banking, smartphone banking and now, using your smartphone as a smart pay device. Underscoring all of these innovations is the desire to make whatever experience the consumer is engaging in easier, simpler and more personalized.

Healthcare is no different. Across the healthcare continuum, companies like ours are finding new and innovative ways to enhance member engagement and participation in the healthcare journey, particularly through computerized or mobile devices. Think about how healthcare has changed over the past 50 years – house calls from doctors to office visits to telephone triage and now, computerized therapy and text therapy.

At Magellan, we’ve invested in a unique type of computerized therapy – Computerized Cognitive Behavioral Therapy (CCBT) – to help individuals seek the therapy they need, in the comfort, convenience and privacy of their own home. Our CCBT programs were originally developed more than 20 years ago, for stand-alone personal computer use, but have since been developed for use on the internet and mobile devices, in both English and Spanish.

 The following five conditions make up more than 90 percent of behavioral health complaints in adults, and are present in more than 25 percent of adults:

• Insomnia
• Depression
• Anxiety
• Substance Abuse
• Obsessive Compulsive Disorder

Within each condition, studies have shown CCBT to be effective at reducing symptoms and severity. Importantly, our CCBT programs have undergone clinical trials involving more than 1,000 patients and have received endorsements and recognition from the American Academy of Sleep Medicine, the United Kingdom’s National Institute of Clinical Excellence, Accreditation Canada and the Substance Abuse and Mental Health Administration’s National Registry. Underscoring all of the studies and reviews, what can members expect? Sixty-nine percent of users show meaningful improvement within 30 days.

But CCBT isn’t just for members. We’ve found that providers can use a tool called Smart Screening to help screen individuals and triage them to the most appropriate levels of care on the CCBT platform, and in person, for the most serious cases. Various levels of screening can help direct individuals to CCBT, directly to an in-person counselor or a mix of both. Through this triage system, 90 percent of engaged participants rate this program as helpful and useful, and 75 percent of individuals actually prefer a non-medication care option when asked.

The most important thing about innovation in any industry – healthcare, banking or electronics – is refusing to rest on your laurels. There are new start-ups launched everyday whose mission it is to disrupt the status quo and provide new ways of doing things. As healthcare evolves, we plan to do the same.

Opioid addiction kills thousands of people every year. In 2014, for example:

• There were 18,893 overdose deaths related to prescription painkillers
• There were 10,574 overdose deaths related to heroin

Despite these shocking numbers, the problem continues to grow. (It quadrupled in the first decade of this century and continues to explode). In the past twelve months, the Drug Enforcement Administration (DEA) has been forced to issue new warnings on drugs such as fentanyl, a potent opioid more than 100 times more powerful than morphine and 30-50 times stronger than heroin. While fentanyl has killed thousands of people over the past few years, many only heard of it recently, when it was attributed to the death of the musician Prince.

Close to Home: Opioid Addiction from Prescription Sources

Given the dangerous nature of some of the most common prescription painkillers—not just from concerns about addiction but from accidental and intentional overdose (the leading cause of accidental death)—it may be surprising to find out just how common it is to find opioid medications in the home.

In 2012, the Centers for Disease Control (CDC) calculated that healthcare providers wrote 259 million prescriptions for opioid painkillers. That is enough for every American adult to receive a bottle of pills.

While there have been efforts to reduce the number of prescriptions written, the number of prescriptions remains very high and the volume of opioid medications already distributed is also alarming.

And this is a key contributor to the opioid addiction crisis. According to the CDC, most people who abuse prescription opioids get them for free from a friend or relative. Essentially, people give their old prescribed medications to friends or relatives. Or, alternatively, abusers take old prescription pills from friends and relatives without their knowledge.

Even among the people at the highest risk of overdose (using prescription opioids non-medically 200 or more days a year) a friend or relative’s medicine cabinet is a common source of finding opioid medications. Among that population:

• 27 percent use their own prescriptions;
• 26 percent get them for free from family or friends;
• 23 percent buy them from friends or relatives; and
• 15 percent buy them from drug dealers.

Cleaning Up: Reducing the Availability of Prescription Opioids

Since the early years of the decade, state and federal authorities have made a concerted effort to reduce the regularity by which opioid medications are being prescribed. In particular, there has been a focus on reducing the ability of abusers to use multiple prescribers to issue painkillers.

Several states have achieved various degrees of success. In New York, the number of patients seeing multiple prescribers for painkillers was reduced 75% percent between 2012 and 2013 after prescribers were required to check the state’s prescription drug monitoring program before issuing a prescription.

In the same time-frame, Tennessee saw a 36 percent reduction in the number of patients seeing multiple prescribers for painkillers when it instituted a program similar to New York’s.

Florida saw a 50 percent reduction in oxycodone overdose deaths between 2010 and 2012 after it regulated painkillers and stopped providers from issuing painkillers from their offices.

In addition to programs aimed at healthcare providers, the Federal government has directed resources towards educating consumers about disposing prescription opioids and other medications. The Food and Drug Administration provides information on the safe disposal of painkillers such as Fentanyl patches. The Drug Enforcement Administration is also providing information for the public regarding disposal as well as created a program to authorize and register drug disposal collectors.

A Pioneer in Substance Use Management

Magellan Health is a pioneer in offering integrated, comprehensive opioid risk and substance use management programs. We have an unyielding commitment to ending the current epidemic. And we are uniquely positioned to bring together behavioral, medical and pharmaceutical programs to positively impact overall population health and reduce cost.

Uncertainty is the name of the game for many industries today, including healthcare. With rapidly emerging technologies, regulations and changing consumer demands, companies must manage differently in order to keep up. Jeff Dyer, innovation visionary and co-author of the highly acclaimed, The Innovator’s DNA and its follow-on publication, The Innovator’s DNA: Mastering the Five Skills of Disruptive Innovators highlighted the threat to many companies today – predicting that 50 percent of the S&P 500 will be replaced over the next 10 years.

Human-Centered Innovation

As consumer experiences across nearly every industry become more personalized, on-demand and targeted, he encouraged pushing our thinking beyond meeting functional needs by looking at social and emotional ones as well. By doing so, companies are able to identify unmet needs that can be catalysts for more useful solutions that ultimately win in the market.

The GE Adventure Series Scanner, an MRI scanner designed for children to make scanning a less frightening experience, was a prime example shared of human-centered innovation. While advanced in functional features, what was discovered through observing young patients getting a scan was that the former machine was intimidating – the designer learning that as many as 80 percent of pediatric patients had to be sedated in order to sit still long enough for the scan.  Witnessing this, a new approach was taken, ultimately applying human-centered design methods to redesign the experience as a series of “adventures” for children, delighting and no longer scaring its young users.

The Big Picture in Quality Care

While human-centered innovation can be applied product by product and interaction by interaction, we heard another thought-provoking point from the day’s presentations – that it’s really hard to detect poor quality care through one interaction. The path to a poor outcome most likely includes bouncing from doctor to doctor and breakdowns in coordination and communication between interactions. Often, the big picture reveals the flaws.

The reality today is that many people still get prescriptions from multiple, independent physicians, and many hospital admissions come with undiagnosed behavioral health concerns. The healthcare system has an immense opportunity to come together around the whole patient and to better identify needs at a population level to deliver on value-based care that leads to healthier outcomes.

Physician Collaboration

Our physician panel sparked further ideas in how to collaborate with PCP’s, nurses and other care workers to better meet patients’ needs. Often at the front lines of the patient experience, creativity in finding unidentified needs was discussed as pivotal to creating an effective healthcare experience. While concepts of self-directed, consumer-focused healthcare and increasing consumer participation in healthcare decisions have become popular, the role of physicians is also being transformed. Their responsibility is increasingly to supplement and put into perspective available information, manage expectations, and instill confidence. The discussion thus encouraged leveraging physicians as “natural, trained problems solvers”, bringing them into the ideation for a better patient experience, and empowering them with action-oriented data and decision support along the way.

We thank all of our leaders, clients and partners for joining us in a memorable and energizing event. We look forward to our next gathering in January 2017.

The room at the inaugural Magellan Open Vision Exchange (MOVE) this past March was a sight to see. Filled with a buzz of energy and openness to think differently, Magellan executives, clients and partners gathered in shared pursuit of a better, more efficient healthcare experience of tomorrow. Collectively, the leaders in the room had impact over the healthcare experience for a significant portion of America. Yet, the focus of the conversation was clearly in how to pivot care to be more accessible and effective, one person at a time.

Help One, Help Many

The event kicked off with stories from Mick Ebeling, CEO of Not Impossible Labs, whose commitment to changing the lives of a few individuals has sparked a few of the most impactful innovations in healthcare. From his entrée into healthcare innovation with the eyewriter, helping a graffiti artist paralyzed by ALS to create art again using his eyes, to Project Daniel, a 3D prosthetic printing process that started with the goal of creating an arm for a Sudanese boy, he challenged the group to “recognize an absurdity” and then to “just commit to figuring it out.”

Neither an engineer nor a healthcare expert, his “open source” method for creating healthcare inventions turned heads. He demonstrated a commitment to designing a solution through the eyes of the individual suffering, which made all the difference in his ability to impact lives. He reminded us that he did not have all of the answers -far from it. But asserted that a key point to breaking the mold was to think of challenges as “not impossible.” He reminded us that it would be very difficult to name something that is possible today that wasn’t at one point thought of as impossible.

Healthcare as an Experience

Our client presentations continued to emphasize applications of human-centered innovation in healthcare, sharing approaches grounded in first understanding the behaviors that drive and influence healthcare experience. Key takeways included:

• Remembering that the most common reasons for a hospital stay are the more common ailments of mankind, from childbirth to respiratory and circulatory conditions, musculoskeletal conditions and mood disorders. While emphasis is often placed on advancement in rarer, more specialized conditions, a significant portion of patients can be impacted by anticipating the needs for more routine healthcare experiences.
• Listening to what’s working, and what’s not, disease state by disease state. From crowdsourcing feedback from patients to understand what helped them get better, to creating focused innovation platforms within organizations to spawn creative solutions unencumbered by traditional perceived barriers, we learned of many approaches to closing gaps in the system.
• Speaking to people successfully living with their conditions provides tremendous perspective for recovery and chronic condition management programs. When the formula isn’t as simple as issue identification + treatment = healthy, concepts like peer support become an opportunity to support living well with a physical, mental or emotional challenge by empowering the patient to learn to thrive through peer experience.
• Re-positioning healthcare leaders as “chief experimenters.” It was underscored that healthcare leaders today can’t simply focus on making decisions, they must design and enable experiments to truly push the healthcare experience forward.

Stay tuned for Part 2 of our event recap.

Looking for more information about MOVE, our gathering of healthcare innovators and thought leaders? View media and request an invitation to our January 2017 event. For questions, contact mediarelations@magellanhealth.com.

Opioid addiction has grown over the past fifteen years from a personal issue to a national emergency. A new infographic from Magellan Healthcare reveals the devastation that this epidemic is causing.

• In 2014, there were 18,893 overdose deaths related to prescription pain relievers
• There was a 3,203% rise insurance claims for opioid dependence diagnosis from 2007-2014
• Prescription opioid abuse is costing employers $25,000,0000 a year

The opioid addiction crisis is causing such an unprecedented amount of harm precisely because it is such a complex, multi-faceted issue. Those looking for answers as to how such an epidemic could have happened, will need to examine a swath of individual problems, including:

• The enormous quantity of prescription opiates
• The limited patient knowledge of opiate risk
• That diversion of opiates to family and friends is so common that only 20% of those with opioid abuse problems are actually using opioids prescribed to them
• The struggle to adequately assess patient’s substance use history and risk of addiction when prescribing opiates
• The lack of clear guidance as to who should receive opiates and for how long
• The difficulty in maintaining patient adherence to withdrawal management treatment plans.

New solutions are needed to tackle each of these individual issues. At Magellan Health, we intend to do precisely that. The opioid addiction crisis has already taken a huge toll and it grows worse every day. It is manifesting itself in myriad ways among thousands of communities across the nation. At Magellan Health, we have an unyielding commitment to ending this epidemic.