GE Healthcare Camden Group Insights Blog

Build a Field-Tested Diabetic Management Program

Posted by Matthew Smith on Feb 25, 2013 11:10:00 AM
Diabetes management, IAFP, Family PhysiciansThis presentation provides an up-to-date analysis of the status of diabetic care in the United States and its likely future, including the growing incidence of both Type I and Type II diabetes. Specific reference is made to quality of life issues pertaining to diabetic patients as well as to the avoidable problems, complications and ER or hospital admissions and their attendant costs which follow upon less-than-adequate management of diabetics.

Specific slides include:

  1. Resources for tracking patient care outcomes
  2. Diabetic care measure crosswalk table
  3. Diabetic care approach: Protocols, Models, Tools
  4. Sample measures by domain
  5. Comprehensive diabetic care outcomes: HEDIS 2012

Following this introduction, the presentation turns to an examination of the benefits of the family practice's conduct of a comprehensive diabetic management program for its patients. Such benefits include:

  • the improvement of a patient's overall health and longevity,
  • cost savings coming from reduction of unnecessary complications of care,
  • occasions to advance clinical integration,
  • and opportunities for physicians to expand the volume of their practices and incomes.

Next, the presentation turns to an extensive and detailed description of a model comprehensive diabetic management program. This description includes topics as its organization and operation; patient identification, contact, induction and orientation; and patient assessment, education, counseling and monitoring. 

The presentation concludes with a brief listing of a practical, "field-tested" procedures and techniques which can strengthen patient commitment to and compliance with the management programs expectations and requirements, thereby enhancing the prospect of achieving the program's main objective: the improvement of the diabetic patient's management and care. 

Health Directions' role within the diabetic management program:

To help physician practices:
  • Achieve CMS EHR “meaningful use” or NCQA PCMH recognition
  • Leverage “reportable” quality of care and outcomes for better reimbursement
  • Participate in pilot programs with local payers
  • Partner with local health systems to create electronic linkages
  • Increase patient satisfaction
  • Improve practice profitability
  • Strategically position themselves for the future 

Topics: EHR, Meaningful Use, Practice Management, Family Physicians, Diabetic Management Program, Physicians, Diabetes, Diabetic Cohort

Boston Children's Study Uses Bi-Directional Social Media Approach

Posted by Matthew Smith on Feb 15, 2013 3:24:00 PM

children's hospital bostonResearchers in Boston Children's Hospital's Informatics Program (CHIP) have published a study that utilizes social media to both augment traditional surveillance methods and encourage bi-directional conversation to encourage healthier behaviors among participants.

The study, which investigated the effects of hypoglycemia in a diabetic cohort, was published online on Feb. 11 in the journal JAMA Internal Medicine.

The study team was led by Elissa Weitzman and Kenneth Mandl, M.D.

In a statement accompanying the study's publication, Weitzman said the methodology demonstrated an effort to expand knowledge of complications of diabetes beyond the limitations of traditional data collection methods such as emergency room visit data and clinical trial reports.

"We don't know much about how populations with diabetes in general experience insulin effects and complications like hypoglycemia," Weitzman said. "Insulin is widely used, but we don't have a grasp of how many patients experience hypoglycemic episodes that are not severe enough to merit emergency treatment. Learning more about hypoglycemia requires engaging a broad pool of patients as collaborators in ― a model enabled by social media."

Diabetic Cohort

Weitzman and Mandl turned to a cohort of people with diabetes recruited through the online social network They had previously worked with the organization to develop and launch a social networking app called TuAnalyze and engage TuDiabetes members in real time, participatory surveillance of hemoglobin A1c levels, feeding back data to participants using maps and graphs. TuAnalyze is based on CHIP's Indivo personally controlled health record platform and implements controls that let users preserve the privacy of their personal health information.

Research Through Social Media

For this study, the researchers asked TuDiabetes members to use TuAnalyze to share information about the frequency with which they experience episodes of hypoglycemia. They also asked members reporting recent or severe hypoglycemic episodes for details about their lifetime experiences of significant impacts or harms, such as vehicle crashes or withdrawal from daily activities in order to avoid hypoglycemia, caused by the complication.

Of the 613 TuAnalyze users who offered up data for the study (representing about a quarter of all TuAnalyze users), nearly half reported more than four episodes of "going low" in the previous two weeks and about 30 percent reported at least one severe hypoglycemic episode ― one resulting in unconsciousness or seizure, or one which required glucagon, medical treatment and/or help from another person ― within the last year. More than half of the respondents reported experiencing more than one impact or harm related to hypoglycemia, including avoiding exercise, daily debilitating worry, and accidents or injuries.

Community Engagement

Measures of engagement on the part of the cohort showed that the participants both exhibited great interest in the study's findings and acted quickly on them.

"People in the community picked up on the data and started talking about how to better manage their diabetes day to day," Weitzman said. "Seeing that conversation, we could make midstream corrections in how we presented the data to the community so as to increase the health impact and keep them more aware of what was going on.

"With this participatory approach, we're taking a platform developed for a research purpose and turning it into a way to help promote and manage care," she continued. "People are talking about how the results and the discussion online around them make them think about their health behaviors and care. The burden is now on us as researchers and public health practitioners to devise strategies to encourage these conversations and build tools that are impactful and effective for promoting better health outcomes."

The study was supported by the U.S. Centers for Disease Control and Prevention, the National Library of Medicine, and the National Center for Research Resources.


Source: Boston Children's Hospital

Topics: Social media, CDC, Diabetes, health information, Diabetic Cohort

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