8:30–9:15 a.m.

25 Years: The Biggest Changes in Health Care and What the Future May Hold, Alan Langnas, DO, Nebraska Medicine

Throughout the past quarter century, we have witnessed radical treatment advances such as the major developments in immunosuppression for organ transplantation; the public health and clinical benefits of statins; the impact of genomics on the entire field of medicine; the introduction of targeted biopharmaceuticals; the advent of oral antiviral agents for hepatitis C that are capable of cure; and the use of vaccines as cancer prevention. Additionally, the decrease of tobacco use has had a significant effect on prevention.

With cultural shifts, policy adjustments, the price of care and technological advances, the hospital industry has moved toward a more patient-empowered approach that prioritizes prevention, as it continues to evolve by streamlining and improving patient care.

Dr. Langnas will highlight the past 25 years of momentous advances and stunning innovations in health care that have ensued from the use of advanced technologies and life-saving approaches. He will also take a look down the road at what changes we may see in health care during the next decade and beyond.

Learning Objectives:

1. List the major advances and innovations in health care over the past 25 years.
2. State how the impact of technological innovations has fundamentally changed patient care.
3. Identify advances in health care that have influenced a more patient-empowered approach.
4. Explain how health care continues to evolve with the use of multidisciplinary teams and how this approach optimizes patient outcomes and quality of life.
5. List potential changes that may occur in health care with increased technological advances.

9:15–10:00 a.m.

A Cure for Diabetes? Innovations from Pancreas to Islet-Cell to Beta-Cell Transplantation, Dixon B. Kaufman, MD, PhD, FACS, University of Wisconsin School of Medicine and Public Health, University Hospital

The discovery of insulin transformed type 1 diabetes from a fatal disease to a manageable condition, but it remains a very serious chronic illness. Islet-cell or pancreatic transplantation can, in principle, cure type 1 diabetes, but lifelong immunosuppressive therapy is required and the lack of donor pancreas tissue has led to attempts to find alternative treatment of type 1 diabetes. This session will discuss the Clinical Islet Transplantation Consortium (CIT) study and the advances in pancreatic-islet-cell transplant and kidney/pancreas transplant. It will also explore the utility of stem-cell-derived beta cells for future treatment of diabetes and the challenges faced in developing beta-cell replacement therapies.

Learning Objectives:

1. Provide a brief overview of the history of pancreas transplantation for the treatment of type 1 diabetes.
2. Identify advances in the technical and immunologic aspects of islet transplantation that resulted in achieving long-lasting insulin independence.
3. Analyze the results of the Clinical Islet Transplantation Consortium (CIT) study through the National Institutes of Health (NIH) for allogeneic islet-cell transplantation for the treatment of diabetes.
4. Discuss the utility of stem-cell-derived beta cells for future treatment of diabetes and the challenges faced in developing beta-cell-replacement therapies.
5. Describe factors health care providers should consider when referring patients for pancreatic islet cell transplant and kidney/pancreas transplants.

10:15–11:15 a.m.

Developments and Advances in Medical Management of Diabetes, Anne Peters, MD, Keck School of Medicine of USC

Morbidity from diabetes involves both macrovascular (atherosclerosis) and microvascular (retinopathy, nephropathy, and neuropathy) diseases. Interventions can limit organ damage and, therefore, patients with diabetes require initial and ongoing evaluation for diabetes-related complications. Weight management and the prevention of cardiovascular morbidity is a major priority for patients with diabetes, especially type 2 diabetes mellitus (T2DM). This session will analyze why glycemic control is important in the long term to reduce the onset and severity of the complications of type 2 diabetes, as well as to reduce macrovascular risk. It will also discuss the significant metabolic benefit of medications that are used to aid in weight loss in the management of diabetes and review medical management approaches consistent with guidelines from the American Diabetes Association (ADA) for health maintenance in patients with diabetes.

Learning Objectives:

1. Review the mechanism of action and therapeutic utility of DPP-4 inhibitors and SGLT1 receptor agonists for the treatment of T2DM.
2. Explain how SGLT2 inhibitors could dramatically improve glycemic control in type 2 diabetes and how this new class of drugs may boost overall health by promoting weight loss.
3. Recognize why glycemic control is important in the long term to reduce the onset and severity of the complications of T2DM, as well as to reduce macrovascular risk.
4. List drugs that are used to aid weight loss in the management of diabetes, and state the significant metabolic benefits of these medications.
5. Discuss the increasing focus on a personalized approach in determining the degree of blood sugar control in this patient population.

12:45–1:30 p.m.

Current Issues in HIV: Successes, Challenges and Epidemic Trends, Timothy Schacker, MD, University of Minnesota

The first benchmark along the continuum of human immunodeficiency virus (HIV) care is diagnosis. At the time of HIV diagnosis, patients should be evaluated to assess the stage of the disease and establish a baseline to help determine management plans and goals. Timely linkage to care following diagnosis is the next step, and the more quickly newly diagnosed individuals enter HIV care, the better their health outcomes. Antiretroviral therapy (ART) may be initiated more promptly, with a subsequent reduction in viral load, which leads to improved health outcomes and a reduction in HIV transmission. To achieve optimal clinical outcomes and to realize the potential public health benefit of treatment as prevention, attention to each step in the treatment cascade is critical. Given the many available assessment strategies and interventions, the challenge for the treatment team is to select the techniques that best fit each patient and patient population. This session will discuss how interdisciplinary teams of health care providers can address the timeliness of treatment and encourage adherence to ART, including programs in place through local and state health departments.

Learning Objectives:

1. Explore the concern that, although treatment approaches continue to evolve, HIV continues to represent a significant public health issue.
2. Describe barriers to care among different patient populations, including marginalized patients and older adults.
3. State ways in which interdisciplinary teams of health care providers can improve the timeliness of treatment and encourage adherence to ART, including programs in place through local and state health departments.
4. Identify important research being performed by scientists at the Centers for Disease Control (CDC), focusing on the continuum of care for individuals diagnosed with HIV.

1:30–2:15 p.m.

Relationship Between Physical and Mental Health in Children and Adolescents, Barry Sarvet, MD, The University of Massachusetts Medical School at Baystate

Medical science increasingly recognizes the vital link between physical and mental health. Consequences of adverse experiences are major risk factors for the leading causes of psychological and physical illness in children and adolescents. Adolescent psychological problems are often accompanied by physical symptoms. A prevalent mental disorder experienced among adolescents is depression, and a disturbing potential consequence of adolescent mental health disorders is the incidence of suicide. Prevention requires a comprehensive approach that influences all levels of the social ecology, including community involvement, relationships among families and neighbors, and individual behaviors. This session will identify the relationship between physical and mental health and its impact on children and adolescents.

Learning Objectives:

1. State the relationship between physical and mental health and its impact on children and adolescents.
2. Discuss how adverse experiences in childhood can lead to causes of psychological and physical illness in children and adolescents.
3. Explore the influence of depression on outcomes and costs of chronic diseases in the pediatric and adolescent populations.
4. Describe the impact of mental health disorders on the incidence of suicide in adolescents.

3:00–4:00 p.m.

Reducing the Burden of Heart Failure: Patient-Centered Care and Process Improvement, Michael Petty, PhD, RN, CCNS, ACNS-BC, University of Minnesota Health

According to the CDC, 5.1 million Americans are currently diagnosed with congestive heart failure (CHF) at a cost of $32 billion dollars per year. Half of these patients will die within five years of diagnosis. Despite the seriousness of this condition, health care providers struggle with how to diagnose, treat, and manage complications in patients with heart failure. During this session, Dr. Petty will review the importance of interdisciplinary teams of health care providers to effectively communicate with marginalized populations — including older adults, patients with advanced heart failure, and long-term care residents — about their prognosis, emergency situations, and advanced-care planning as forms of patient-centered care for heart failure. Treatment options for optimal management of heart failure will also be reviewed.

Learning Objectives:

1. Discuss the pharmacologic and nonpharmacologic treatments for managing heart failure.
2. As members of an interdisciplinary team, review effective communication strategies for establishing rapport and creating treatment plans with vulnerable patient populations.

4:00–5:00 p.m.

Hematopoietic Cell Transplant (HCT): Moving Beyond Survival — The Patient’s Perspective, Linda Burns, MD, National Marrow Donor Program (NMDP)/Be The Match; Jan Perske, Bone Marrow Transplant Recipient Mom and Caregiver; Greta Perske Hokanson, Bone Marrow Transplant Recipient; Ed Plass, Double Cord Blood Transplant Recipient; and Kate Plass, Transplant Recipient Spouse and Caregiver

HCT is a complex and costly treatment that is often the only potentially curative therapy available for patients with hematologic malignancies and genetic/immune disorders. Transplant recipients and their caregivers often experience new physical, emotional, social and financial challenges posttransplant. NMDP/Be The Match is partnering with the transplant community to better understand what matters most to recipients and caregivers and to develop a patient-reported-outcomes HCT research agenda. This unique panel session of transplant recipients and their caregivers will provide you with a very personal view into the triumphs and challenges of receiving this life-saving treatment.

Learning Objectives:

1. Identify transplant recipient- and caregiver-reported challenges with regard to HCT treatment and coordination of care.
2. Describe the systemic barriers related to these identified challenges.
3. State the importance of measuring value and outcomes in addition to survival rates.
4. Discuss the aims of the Patient-Centered Outcomes Research Institute- (PCORI-) funded project, Engaging Patients in Developing a Patient-Centered Hematopoietic Cell Transplant Research, led by NMDP/Be The Match.