Living Heart Foundation Executive Summary Providing: Health Risk Stratification with Early Lifestyle Intervention
February 2003 Executive Summary Dr. Archie Roberts Living Heart Foundation PO Box 294 Little Silver, NJ 07739 Tel. 732-842-5584 Fax. 732-530-6414 Prepared by: Robert P. Zurich, Ph.D.
Living Heart Foundation Executive Summary The Living Heart Foundation (LHF) is a nonprofit organization under IRS 501 (c)(3), funded in part by grants through the Edison Foundation, Pfizer and private donations. The LHF was established by Arthur J. Roberts, M.D. in April 2001 to combat sudden cardiac death and provide health risk stratification with early lifestyle intervention for cardiac, pulmonary, metabolic, nutritional, exercise, and behavioral conditions through on-site screening, tracking, and integrated health programs. The Foundation has been dedicated to providing these services to identified groups that traditionally have been overlooked, specifically high school and college students, with an initial Health Risk Stratification Page 1
emphasis on student athletes. The Foundation is planning to expand its services to commercial endeavors as well. The initial efforts began with a number of high schools in Massachusetts, followed by the Columbia football team. The Foundation has also extended its services to the rescue workers at the World Trade Center disaster following 9/11. MISSION STATEMENT The LHF s mission is twofold: (1) early detection, risk stratification, tracking, and lifestyle intervention through on-site screening services, physician mentoring, and an interactive web site, and (2) establishment of a national preventive wellness database for evaluation and health improvement. To date, data from the initial screening groups (students and rescue workers) is all but nonexistent. The results of early detection and intervention through the Foundation s integrated-preventative approach significantly decrease medical costs and increase compliance. State-of-the-art technology to deliver information and interactive programs can be customized for each individual group. SERVICES The Foundation provides multifactorial health risk analysis and early intervention through on-site medical screening including: On-site precautionary and post incident health screening to identify individuals at risk World-class medical experts for data review, consultation, and program development Filtered information for protocols and vital response data Page 2 Early Lifestyle Intervention
State-of-the-art technologic interactive delivery system tailored for the specific client base Pro-active health modules delivered on-site and through a variety of venues including CD-ROM, and the Internet Secure medical databases that can provide both specific individual information, and valuable group data analysis for statistical evaluation The range of health screenings offered include echocardiograms, electrocardiograms (ECGs), pulmonary function tests (PFTs), cholesterol profiles, cardiac risk scores, blood glucose, liver cell function, body fat and body mass index, blood pressure/pulse analysis, nutritional health, exercise status, and behavioral findings. OVERVIEW THE LHF Traditionally the high school and college athletes have been considered a healthy group, and are, therefore, generally ignored from health analysis. However, The LHF comprehensive approach examines a number of health issues, provides for life style intervention programs, and a controlled building of a health database. The LHF s initial studies have shown that as many as 40% of young adults already have one or more measured health abnormalities detected. The Foundation s Chairman of the Board and Chief Executive is Arthur J. Roberts, MD. Dr. Roberts is a Columbia College graduate and a retired cardiac surgeon, former Chairman of the Department of Cardiothoracic Surgery at Boston University Medical Center, and published author of over 110 scientific journal and book articles. As an ex NFL back-up Quarterback Health Risk Stratification Page 3
from 1965 through 1967 with the Cleveland Browns and the Miami Dolphins, Dr. Archie Roberts brings a unique perspective to the project. His father was a high school football coach and athletic director. STRATEGIC ALLIANCES Executive Medical Committee: Gary Huber, M.D., Medical Director for the Living Heart Foundation, Founder/Director Nutrition Institute, Tyler, TX Jeffrey Borer, M.D., Chief, Division of Cardiovascular Pathophysiology, NY Presbyterian Hospital, New York, NY Martin Goldman, M.D., Director of Echocardiography, Mt. Sinai Medical Center, New York, NY Rebecca Bascom, M.D., Chief of Pulmonary and Critical Care Medicine, Penn. State Medical School, Hershey, PA Robert McCunney, M.D., Director Occupational and Environmental Medicine, Massachusetts Institute of Technology, Boston, MA Medical Advisory Group: Robert Vogel, M.D., American Heart Association Lecturer (exercise and heart disease), Medical Director, Cardiac Network University of Maryland, Baltimore, MD Robert Pandina, Ph.D., Sports Psychology and Lifestyle Changes, Rutgers University, New Brunswick, NJ William Foran, President, National Conditioning Coaches Association, Miami, FL Alan Lewis, M.D., Director, Children s Lipid Clinic, University of Southern California, Los Angeles, CA Barry Maron, M.D., Director, Minneapolis Heart Institute Foundation, American Heart Association Lecturer (youth, sports, and sudden death), Minneapolis, Minnesota Page 4 Early Lifestyle Intervention
HOW WE STARTED, WHERE WE ARE HEADED: During the beginning of 2001 the Foundation took its screening program on the road to two high schools in Massachusetts. We limited the screenings to student athletes, and were surprised at the results 30% of these young subjects had one or more measured health abnormalities detected. These two programs were followed by a screening of the Columbia College football team, with similar results. After attending the National Athletic Trainers Association (NATA) annual conference in Dallas Texas, and speaking with a number of the coaches and trainers, we gained significant insight related to mechanisms contributing to the large proportion of abnormal health findings in athletes.. We realized that both high school and college athletes need guidance and lifestyle programs in order to become as proactive in their personal health as they are in their chosen sports participation. The Foundation began developing specific Health for Life Programs as a result of our initial experience. The Foundation is drawing upon its medical board to develop specific follow-up programs based upon the screening results. In addition, Dr. Gary Huber, LHF Medical Director and noted nutritionist, has created a unique library of over 500 articles promoting healthier living soon to be available through our web site. These health for life interventional programs will be delivered through a variety of venues including an interactive web site. Health Risk Stratification Page 5
Program progress and results will be trackable per individual, and compiled group data will also be available for further analysis. WTC 911 INTERRUPTS OUR PLANS As all Americans we were devastated by the attacks on the World Trade Center and the Pentagon, and the downed plane in Pennsylvania. Since we had gained significant insight regarding the value of health screening, we mobilized our organization and moved to Ground Zero. With the collapse of building seven, we were moved along with the New York City command center up to the Police Academy on 23 rd street. We quickly established an emergency screening clinic, and processed 1785 rescue workers in only fourteen days. Within a month of 9/11 we were able to organize and complete this initial in-depth health screening. Our goal was to identify specific health abnormalities, refer identified individuals for definitive diagnosis/treatment, and counsel these brave people. Because there was little time for planning, we had to establish procedures and protocols as we progressed day by day with our screenings. We had a volunteer staff of 200 people ranging from medical doctors, nurses, technicians, and students to lay responders. Our program included health questionnaires, consent forms, ECGs, PFTs, echocardiograms, blood pressure analysis, cardiac risk assessment, and blood tests for blood sugar, cholesterol and lipid profiles. Each person also had an exit consultation with a physician who had the preliminary results in hand at that time. The ECGs, PFTs, and the echocardiograms on each subject were subsequently read by various medical doctors selected by the Page 6 Early Lifestyle Intervention
LHF medical advisory group, and complete reports were mailed to each participant in the following months. The intensity of this program provided us with literally years of experience within a two-week period. We were able to evaluate our entire process from concept through delivery and subsequent data analysis. The structure of our current program protocols, delivery, and content is based on this uniquely demanding experience. Furthermore, beginning in late 2002, the LHF and Penn. State Medical School have partnered to examine the early and longterm health effects on rescue workers related to the 9/11 terrorist disaster at Ground Zero. THE NEXT STEPS After the experience of 9/11, we were further convinced of the value of health screening, and surprised at the high percentage of acute and chronic abnormal findings among the NYC professionals. We then began evaluating the possibility of bringing our program to Team Texas (a community AAU basketball youth training league). We have had several meetings in Dallas, and concluded that our approach would be to establish a health for life program including a control group of youngsters so we could evaluate the efficacy of our health for life programs. This program is currently under development in conjunction with our regional Texas Physicians, and we are in the process of seeking funding with an anticipated start date in late 2003. Health Risk Stratification Page 7
OUR STRUCTURE Medical The Living Heart Foundation is a medically based organization. Its founder and director Archie Roberts, MD and the majority of its board and advisors are medical doctors. In addition, the Foundation relies heavily upon scholastic and commercial medical manufacturing and research organizations. However, the Foundation does not practice medicine. It provides early identification of health abnormalities, and health risk stratification with early lifestyle intervention for cardiac, pulmonary, metabolic, nutritional, performance, exercise, and behavioral conditions through on-site screening and integrated health programs. The Foundation has also established a regional network of physicians to oversee the quality of future health screenings, and to provide optional referral resources for any at risk individual identified and desirous of further examination, diagnosis, and treatment. Administrative Our administrative offices and training center are located at Monmouth University, Long Branch, NJ. Pennsylvania State Medical School is our primary academic partner and our center for health database and scientific analysis. Policies, Procedures, Protocols All of the data collected through our screening process is considered a subject/patient s confidential medical record, and is treated as such. No one is granted access to any information without the subject/patient s written consent. Each individual who participates voluntarily in a health screening first signs a Page 8 Early Lifestyle Intervention
consent form for health screening. Depending upon the particular screening assignment, the Foundation may seek to compile group data on the subjects examined. In that case, each subject/ patient is presented with a written consent form prior to screening providing authorization for anonymous group data evaluation. In those cases, all procedures and data adhere to strict institutional review board (IRB) requirements, and any and all subject/patient identification is removed from the records prior to analysis. If the sponsoring organization wishes data review and analysis on its group, this also requires a signed release from each subject/ patient. No individual subject/patient specific data is released to the sponsoring organization at any time. Each participant, however, is provided with a complete report. All screening protocols are medically established in accordance with accepted procedure and equipment manufacturer s guidelines. When indicated, the technicians are nationally certified in their specific field, such as our echocardiographic and respiratory technicians. With the exception of administrative personnel, all on-site staff members are certified healthcare professionals and technicians. The Foundation s screening program is modular by design to fit the client organization s specific needs. Currently, we provide health screening and evaluation for blood sugar, cholesterol and other lipid levels, echocardiograms, pulmonary function tests, ECGs, body mass index, body fat content, nutrition, blood pressure and cardiac risk evaluation. Additional screenings may be added upon request. Although we have screened over 200 subjects per day, ideally, we would like to keep our volume from 20 to 80 individuals per day. Health Risk Stratification Page 9