9:30 a.m. –3:30 p.m.

Facility Tour—University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital
Depart hotel at 9:30 a.m.; return 3:30 p.m.
Space is limited. Preregistration is required. More information.
Support for this tour is provided by University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital

7:00 a.m.

Registration and Continental Breakfast

8:30 a.m.

Welcome and Opening Remarks

9:00 a.m.

Keynote Address: I Am Not Sick, I Don’t Need Help! How to Partner With Patients, Xavier Amador, PhD, LEAP® Institute

Poor and partial adherence to treatment creates obstacles in recovery for any illness, but for people with serious mental illness, these roadblocks are staggering. Patients experience a poorer course of illness, increased involuntary hospitalizations, suicide, poorer subsequent response to treatment, and estrangement and discord with caregivers and providers. Some end up trapped in the criminal justice system. Relationships between health care providers (HCPs) and those with serious mental illness are often characterized by mutual distrust and loss of respect for the other person’s point of view. This stems from symptoms associated with schizophrenia, bipolar disorder and similar illnesses. It also stems from providers not having the communication tools needed to bridge the interpersonal chasms these symptoms create. The urgency to implement strategies that optimize adherence and recovery has never been greater.

Objectives:

• Define anosognosia and state how this term applies to people who live with serious mental illness.

• State an initial understanding of the LEAP communication tools that build alliances between health care providers/family caregivers and the patients who need their help and support.

10:00 a.m.

Break

10:15 a.m.

Early Intervention Is Prevention for Serious Mental Illness, Lisa Dixon, MD, MPH, New York State Psychiatric Institute

It is unfortunate that tragedies like school shootings become the spark for national discussion about the need for better access to mental health services. With extensive media coverage, some fear that these high-profile situations lead to greater misperceptions about people who live with mental illness, increasing the stigma that creates a roadblock to appropriate treatment. Biological and behavioral research suggests that early assessment, identification and intervention can possibly prevent serious mental illnesses. The National Institute of Mental Health states that the goal of treatment is not to merely reduce symptoms of mental illness, but to also promote recovery for this population, and make every effort to improve their quality of life. In this session, learn the challenges that patients and families face in seeking treatment, and the importance of early intervention.

Objectives:

• List three examples of behaviors that might be observed in adolescents or young adults who are experiencing psychotic symptoms.
• Recognize the importance of providing the right treatment at the right time for young people who are at risk of a psychotic episode.

11:15 a.m.

Unintentional Death: A Preventable Side-Effect of Chronic Pain Management, Nabarun Dasgupta, PhD, MPH, University of North Carolina at Chapel Hill

Opioid analgesics are the primary culprits in the vast majority of U.S. overdose deaths. An analysis conducted by investigators at the Centers for Disease Control and Prevention (CDC) in Atlanta, Ga., showed that 75.2 percent of pharmaceutical deaths involved opioids, either alone or in combination with other drugs.

“Data recently released by the National Center for Health Statistics show drug overdose deaths increased for the 11th consecutive year in 2010. Pharmaceuticals, especially opioid analgesics, have driven this increase. Other pharmaceuticals are involved in opioid overdose deaths, but their involvement is less well characterized,” according to the CDC. The data show that in 2010 there were 38,329 drug overdose deaths in the United States. Of the pharmaceutical-related overdose deaths, 74.3 percent (16,451) were unintentional, 17.1 percent (3,780) were suicides, and 8.4 percent (1,868) were of undetermined intent. This session will address the gap in chronic pain management that allows for unintentional death.

Objectives:

• List the population groups at highest risk for unintentional overdose.
• State the purpose behind state prescription drug monitoring programs, as recommended by the CDC.

12:00 p.m.

Luncheon Presentation, Mark Leenay, MD, Chief Medical Officer and Sr. Vice President, Optum Clinical Programs (nonaccredited/optional)

1:15 p.m.

Break

1:45 p.m.

Comprehensive Management of Sickle Cell Disease (SCD), Lanetta Jordan, MD, MPH, MSPH, University of Miami, Miller School of Medicine

According to the CDC, SCD is one of the most common genetic diseases in the United States. SCD is a group of inherited red-blood-cell disorders, wherein the red blood cells become hard and sticky C-shaped cells. These cells cause vaso-occlusive phenomena that result in painful episodes and a variety of serious organ system complications that can lead to lifelong disabilities and/or early death. Historically, the disease was considered fatal for infants and children, but with comprehensive care, immunizations, antibiotics, and more rapid treatment of complications, the disease has shifted from a fatal pediatric illness to a chronic disease associated with ongoing therapy and management.

Objectives:

• Differentiate sickle cell trait from SCD.
• List the complications associated with SCD.
• State the therapies included in the comprehensive care for SCD.

2:45 p.m.

Break

3:00 p.m.

The Role of Maintenance Therapy for Long-Term Cancer Management, Jonas de Souza, MD, The University of Chicago Medical Center

Maintenance therapy for cancer is defined as continued therapy offered for a tumor that has not become worse following the initial first-line chemotherapy. Historically, people were not treated further after initial therapy was complete, and symptoms were monitored through a period of watchful waiting to see if the tumor was again growing. Now, maintenance therapy is designed to improve survival time beyond that provided by initial therapy. Maintenance therapy is not without controversy, and side effects must be weighed against the benefit. Cost is also a consideration if the survival benefit is limited. In this session, learn more about the role of maintenance therapy in the fight against cancer.

Objectives:

• List the types of cancer wherein survival might be prolonged with the administration of maintenance therapy.
• Compare survival data that shows survival rates for those patients who choose to continue treatment with maintenance therapy.
• Discuss the costs versus benefits of long-term maintenance therapy for cancer management.

4:00–5:00 p.m.

Palliative Care: A Specialized Area of Practice, Drew A Rosielle MD, FAAHPM, University of Minnesota Medical Center, Fairview

Current research shows that palliative care improves the quality of life for both patients and their family members. This specialized care, given to patients who are experiencing a serious or life-threatening disease like cancer or transplantation, focuses on the physical and emotional symptoms of treatment, and complex chronic disease management. Palliative care is different from hospice care, although both share similar principles of comfort and support. Unlike hospice care, palliative care begins at diagnosis and continues throughout the course of treatment and beyond. This session is designed to increase awareness of the value of specialized palliative care in complex disease management, leading to better outcomes and better health care economics.

Objectives:

• State the primary goal of palliative care for solid organ transplant patients at each stage of the transplant process.
• Name the different types of health care professionals who are part of the specialized multidisciplinary palliative care team that addresses the physical, emotional, spiritual and social concerns arising during the course of oncology therapies.

5:00–7:00 p.m.

Welcome Reception and Exhibit Hall Grand Opening
Join us as we officially celebrate the opening of this year’s conference. Visit with exhibitors/supporters representing Centers of Excellence medical centers and industry organizations while networking with other attendees including Optum executives, clinicians, and staff. The Welcome Reception is THE place to be as you relax with great food and beverages before heading out for a night on the town!

7:00–11:30 a.m.

Wellness Screenings and Flu Vaccinations
Preventive health screenings and flu vaccinations are available at no cost to all conference attendees. Screenings take approximately 15–20 minutes. More information.
Support for this activity is provided by Optum Biometric Solutions.

7:20–8:15 a.m.

6th Annual Wellness Walk
Start your morning with a walk/run down the famed Nicollet Mall and along the historic Mississippi riverfront. More information.

8:00 a.m.

Registration and Continental Breakfast

9:00 a.m.

Opening Remarks

9:30 a.m.

Preventing the Long-Term Health Effects of Childhood Obesity, Colleen Buggs-Saxton, MD, PhD, Children’s Hospital of Michigan

Childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years. According to the Centers for Disease Control and Prevention (CDC), more than one-third of children and adolescents were overweight or obese in 2010. In the long term, obese children are likely to become obese adults. The fact is children’s lives may already be at risk for adult diseases. For example, in a population-based sample of 5- to 17-year-olds, 70 percent of obese youth had at least one risk factor for cardiovascular disease, such as high cholesterol or high blood pressure. In this session, learn how obesity predisposes children to adult diseases like type 2 diabetes and cardiovascular disease, and understand the impact on this young population. Our current health care system must find ways to address the long-term risk for adult diseases in children.

Objectives:

• List three adult health problems for which obese children might become at risk.
• Describe the physiologic impact that obesity has on a child’s growth and development.

10:30 a.m.

Pre-emptive Kidney Transplantation, Mark D. Stegall, MD, Mayo Clinic, Rochester

Pre-emptive renal transplantation is possibly the best option for renal replacement therapy (RRT) due to both clinical and quality-of-life (QOL) outcomes. The avoidance of dialysis morbidities, comorbidities and their associated costs are factors to consider. However, some ethical issues must be carefully considered with pre-emptive transplantation. This presentation will review the advantages of pre-emptive renal transplantation and discuss ethical issues, as well as the clinical and QOL outcomes when compared to other forms of RRT.

Objectives:

• List the advantages of pre-emptive renal transplantation to include avoidance of dialysis morbidities, comorbidities and their associated costs.
• Discuss the ethical issues that should be considered with pre-emptive renal transplantation.
• Compare clinical and quality-of-life outcomes with different forms of renal replacement therapy.

11:30 a.m.

Lunch (provided)—Exhibit Hall

1:00 p.m.

A Philosophical Approach to Quality in the Light of Health Care Reform, Alan Langnas, DO, University of Nebraska Medical Center

The Patient Protection and Affordable Care Act passed in 2010 will result in dramatic expansion of publicly funded health insurance coverage for low-income individuals. It is estimated that of the 32 million newly insured, 16 million will obtain coverage through expansion of the Medicaid Program, and the remaining 16 million will purchase coverage through their employers or newly legislated insurance exchanges. While the Act contains numerous provisions to improve access to private insurance, the public sector coverage will be significantly affected. Transplant centers should be concerned about the impact of the reform on the financial aspects of transplantation. In addition, new “models” of health care delivery and expanded support for Comparative Effectiveness Research are in the works. Transplant providers, including transplant centers and physicians/surgeons need to lead this movement, drawing on our experience providing comprehensive multidisciplinary care under global budgets with publically reported outcomes.

Objectives:

• Outline the potential changes in the Affordable Care Act that may affect transplant centers.
• Describe proactive processes that transplant programs can implement to improve quality and meet the Centers for Medicare/Medicaid Services (CMS) requirements.
• Discuss the challenges providers and patients will face in light of health care reform and quality-improvement initiatives.

2:00 p.m.

Clinical and Ethical Considerations in Liver Transplantation, Joseph S. Galati, MD, Liver Specialists of Texas

In the evaluation of potential recipients for liver transplantation, patients’ history of alcohol abuse has been a long-standing debate amongst liver transplant team members. Standards held by physicians and payers appear to have validity but do not predict success. In this presentation, the moral and medical models of approaches to alcohol abuse will be compared and relevant ethical principles will be identified as they relate to transplantation.

Objectives:

• Review the current clinical approach to liver transplantation in patients with alcoholic liver disease.
• Discuss outcomes of liver transplantation for patients with a history of alcohol abuse.
• Distinguish moral from medical models of managing alcohol abuse.

3:00 p.m.

Break

3:15 p.m.

Special Considerations Unique to Recovering Pediatric Transplant Patients, Debra Lefkowitz, PsyD, The Children’s Hospital of Philadelphia

Transplantation in pediatric patients has become a common occurrence. Each year, more children receive solid organ transplants in the United States, and this number is expected to increase in the future. With this increase, management of recovering pediatric transplant patients has been a focus. Solid organ transplantation, similar to chronic illness, interrupts all aspects of normal development. This presentation will address the psychosocial, educational, and medical consequences of the underlying disease and transplant that needs to be addressed by pediatric care providers.

Objectives:

• Discuss the impact of transplantation on the physical and psychosocial development of the pediatric patient.
• Review the educational needs and school-related considerations of the pediatric patient post transplantation.

4:15–5:00 p.m.

Disease Management Options for Patients Living With Heart Failure, Eric Ernst, MD, FACC, University of Minnesota Physicians Heart

Currently, heart failure has no cure. According to the National Heart Lung and Blood Institute, about 5.8 million people in the United States have heart failure, and this number is growing. Fortunately, progress is being made in the treatment and management of heart failure. Disease management offers promise in reducing the need for hospitalization and improving QOL for heart failure patients. In this presentation, learn some strategies for disease management, as well as efforts providers and patients can make to prevent heart failure.

Objectives:

• List patient behavioral risk factors that can increase the incidence of heart failure.
• State disease management strategies to prevent recurrent hospitalizations and improve quality of life for patients with heart failure.

5:00–6:30 p.m.

Closing Reception—Exhibit Hall
Join us in the Exhibit Hall as we party with fabulous food and beverages as we wrap up the second day of the Annual National Conference.

8:30 a.m.

Continental Breakfast

9:00 a.m.

The Impact on Liver Transplantation by Aging Baby Boomers With Hepatitis C Virus (HCV), Scott W. Biggins, MD, MAS, University of Colorado Denver

An aging population of adults with HCV is behind an increasing demand for liver transplantation in the United States. The disease can cause serious health problems including liver damage, cirrhosis and even liver cancer. Hepatitis C is a leading cause of liver cancer and the leading reason for liver transplants. People born between 1941 and 1960 accounted for 81 percent of all new liver transplant registrants infected with the virus. This presentation will discuss the increased demand for transplantation that is driven by the development of liver cancer in baby boomers with HCV.

Objectives:

• Describe the impact of hepatitis C on liver transplantation.
• Discuss the increased demand for transplantation that is driven by the development of liver cancer in baby boomers with HCV.
• Review effective therapeutic approaches for treating HCV-reinfection after liver transplant.

10:00 a.m.

Break—Please use this extended break for hotel check out, if necessary.

10:30 a.m.

Using Integrative Nurse Coaching to Enhance Healthy Lifestyle Change, Mary Elaine Southard, MSN, RN, Integrative Health Consulting and Coaching, LLC

The practice of integrative nurse coaching is all about interaction with clients in a skilled, purposeful and results-oriented way. This structured relationship between a patient and a nurse coach in this specialized nursing role promotes the achievement of client goals. Nurses are assuming positions as nurse coaches in hospitals, clinics, communities and in private professional nurse practices. The role as coach is grounded on the principles and core values of professional nursing.

Objectives:

• Name a clinical situation where the role of an integrative nurse coach might improve the outcomes of a particular patient.
• List two nurse coaching skills that facilitate lifestyle changes that might impact wellness oriented patient behavior.

11:30 a.m.

Management of Neuroendocrine Tumors (NETs), Edward M. Wolin, MD, Cedars-Sinai Medical Center

NETs often present a diagnostic and therapeutic challenge. They can arise almost anywhere in the body and are therefore associated with a board range of local symptoms. Improved diagnostic techniques, increased recognition of neuroendocrine tumor subtypes, and new therapeutic modalities have enhanced the ability to detect and appropriately treat these unique malignancies. This presentation will discuss the treatment options and clinical benefits of advances in targeted therapy for NETs, along with the importance of a multidisciplinary team for optimal outcomes.

Objectives:

• Define NETs and the challenges in diagnosing them.
• Discuss the treatment options for NETs and the clinical benefit of advances in targeted therapy when appropriate.
• Review the benefits of receiving treatment recommendations from a multidisciplinary team at a cancer center prior to receiving treatment in a community practice.

12:30 p.m.

Lunch (provided)

1:30 p.m.

Myelodysplastic Syndrome (MDS): Diagnosis and Treatment, Aaron T. Gerds, MD, MS, Cleveland Clinic Taussig Cancer Institute
Allogeneic hematopoietic cell transplantation (HCT) is the only treatment for MDS with the potential for cure, but its use has been limited by donor availability and the advanced age of most patients with this disorder. However, the advent of reduced-intensity HCT has extended the applicability of HCT to patients in their 60s and even early 70s. Such intensive therapies are preferred in this patient group because of a low expected median survival and high rate of transformation to acute myeloid leukemia when these patients are treated with supportive care alone. This presentation will describe common presentations of MDS, optimal diagnostic approaches, and the role of HCT for MDS and its survival outcomes.

Objectives:

• Compare the difference between high- and low-risk MDS and the treatment guidelines for these patients.
• Discuss therapy related MDS.
• Explain the role of hematopoietic cell transplantation for MDS and its survival outcomes.

2:30 p.m.

Postpartum Depression (PPD): Prevention and Recovery, Susan Killenberg, MD, University of North Carolina Women's Mood Disorders Program

According to the American College of Obstetricians and Gynecologists (ACOG), PPD may occur at any time after childbirth, but most frequently starts within one to three weeks after delivery. At a time when most new mothers are filled with joy, a mother who experiences PPD develops such strong feelings of sadness, anxiety or despair that coping with the daily tasks of life becomes extremely difficult. Untreated PPD may result in a mother not being able to care for herself or the baby. A few of these mothers develop a more severe mental illness called postpartum psychosis. What are the contributing factors of PPD? Does treatment lead to full recovery? In this session, learn the frequency of PPD, the signs or symptoms, and the necessary interventions to ensure recovery.

Objectives:

• List three symptoms of PPD.
• Define the difference between “Baby Blues” and PPD.

3:30 p.m.

Adjourn