Diabetes

Nearly 26 million children and adults in the U.S. have diabetes, including 375,000 people in Minnesota. A quarter of those with the disease are unaware that they have it. Diabetes can affect anyone regardless of age, ethnicity, or social status. Recent estimates project that as many as one in three American adults will have diabetes by 2050.

Symptoms of type 2 diabetes often do not appear until it’s too late. If left untreated, diabetes can lead to deadly complications, including heart disease, stroke, kidney disease, blindness, and amputation. Over 150,000 Americans die each year from diabetes and its complications. For most people, many of these complications can be prevented or delayed with appropriate monitoring and treatment. However, studies in both fee-for-service and managed care settings indicate that care is sub-optimal.

Stratis Health has a history of partnering with a variety of Minnesota organizations to improve diabetes care and outcomes, promote best care practices related to diabetes, and eliminate health disparities in diabetes care.

Initiatives we are currently engaged in:

• Minnesota Diabetes Action Network. The charge of this network of diabetes and health care professionals is to work together to prevent diabetes and reduce the impact of diabetes in Minnesota by addressing the following areas through coordinated action: accessing care; linking health systems and communities; coordinating care; increasing community resources for high-risk populations; increasing diabetes self-management skills; promoting healthy behaviors among women of child-bearing age; supporting healthy eating in schools and child care programs; and increasing access to affordable, healthy food choices in underserved communities.
• Minnesota Diabetes and Heart Health Collaborative. A voluntary group working together to keep consumers and health care professionals informed about ways to prevent and manage diabetes and heart disease. The collaborative focuses on low literacy diabetes patient education tools and work to reduce health care disparities.
• We Can Prevent Diabetes Minnesota. A federally funded project to test the effects of incentives on participation and success in diabetes prevention activities for people enrolled in Minnesota’s Medicaid program. Authorized under the Affordable Care Act, the Office of the State Medicaid Director is collaborating with the Minnesota Department of Health to provide an opportunity for 3,200 Minnesota health care program enrollees to participate in a diabetes prevention program. The target population is MHCP enrollees between 18 and 75 years of age who have a diagnosis of pre-diabetes or have significant risk for developing type 2 diabetes. Rates of diabetes in this population are high, contributing to significant and growing health care costs. The project will operate in the 7-county Metropolitan area, where the largest and most racially and ethnically diverse population in the state is concentrated.

Initiatives we have been engaged in:

• Aligning Forces for Quality (AF4Q) Consumer Engagement Workgroup, chaired by Stratis Health President and CEO Jennifer P. Lundblad, PhD, MBA, focuses on The D5, diabetes tools for consumers and providers. AF4Q is a national Robert Wood Johnson Foundation program designed to help communities dramatically improve the quality of the health care they provide for chronic diseases in ambulatory settings.
• Diabetes Plan CENTRAL, the Collaborative Exchange Network to Raise Awareness & Learning is an online tool designed to serve as an interactive communication hub for the diabetes community in accomplishing the goals of the Minnesota Diabetes Plan 2010. It is supported by the Minnesota Department of Health and other Minnesota diabetes experts.
• Minnesota Health Reform Initiative and MN Quality Summit efforts to reform issues related to diabetes.

Reducing clinical disparities

Under a Centers for Medicare & Medicaid Services contract, Stratis Health led a quality improvement project focused on reducing the disparities in diabetes care for African Americans in Hennepin and Ramsey Counties. Multiple interventions were developed and implemented.

• Conducted academic detailing with targeted physicians and clinics serving significant African American populations, by having a respected African American physician provide unbiased medical information
• Mailed educational materials to physicians at clinics serving African American patients
• Facilitated community learning sessions for African American health care consumers focused on diet, exercise, emotional wellness, and community outreach
• Promoted awareness through media, fairs and festivals, and conference participation and presentations

Results: Decrease in the disparity in lipid testing for diabetes between African American and Caucasian Medicare consumers from 25.0 to 21.2 percent in Hennepin County and from 30.0 to 22.8 percent in Ramsey County.

Resources

The D5. This website that allows visitors to compare clinics in and around Minnesota using "The D5" to improve the care they provide, and better engage patients in high quality diabetes care. The D5 are a new set of communications tools to help clinicians, educators, health plans, and employers educate patients about diabetes treatment standards. D5 Goals:

1. Maintain blood pressure less than 130/80
2. Lower bad cholesterol (LDL) to less than 100 mg/dl
3. Control A1c to less than 7%
4. Don't smoke
5. Take a daily aspirin (for patients 40 years and older)

Minnesota Heart Disease and Stroke Prevention Initiative. A Minnesota Department of Health resource for health care professionals, with news, data, information, and other resources about heart disease and stroke.

American Academy of Ophthalmology (AAO). An educational resource for health care professionals, with newsletters and other publications on topics related to eye diseases.

American Association of Clinical Endocrinologists (AACE). Information and publications on clinical issues related to diabetes, endocrine disease, and glycemic control.

American Association of Diabetes Educators (AADE). An educational resource for consumers and health care professionals, with tips for living well with diabetes.

American Diabetes Association (ADA). Information for consumers, health care professionals, and scientists on diabetes related topics, including nutrition, fitness, lifestyle, prevention, community programs, events, news, and research summaries.

American Optometric Association (AOA). An educational resource for consumers, educators, health care professionals, with tips on identifying and addressing eye and vision problems.

Centers for Disease Control and Prevention's Diabetes and Public Health Resource. Information for consumers and health care professionals on treatment and control of diabetes, kidney disease, and cardiovascular diseases.

Diabetic Retinopathy Foundation. A collection of resources with information on symptoms, diagnosis, causes, treatment, research, and definition of retinopathy.

Institute for Clinical Systems Improvement. Clinical guidelines for diabetes diagnosis and management.

National Diabetes Education Initiative. Video vignettes, patient management tools, interactive case studies, and a variety of other resources on diabetes for consumers and health care professionals.

National Eye Institute (NEI). News, events, educational programs, research funding, and a variety of other diabetes resources for consumers and health care professionals.

National Guideline Clearinghouse (NGC). A public resource that offers syntheses of evidence-based clinical practice guidelines for selected topic areas, including diabetes management. Sponsored by the Agency for Healthcare Research and Quality, US Department of health and Human Services.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Conducts and supports basic and clinical research on many of the most serious diseases affecting public health. Provides information on campaigns and programs, clinical trials, educational tools, an image library.

Sight and Hearing Association/Preventing Blindness. Promotes the prevention of needless vision loss and hearing through effective screening, education, and research, with information on vision and hearing topics, as well as products and services.

Contact Stratis Health for assistance with your quality improvement and patient safety needs.

If your organization has projects it would like to work on, contact us to discuss how we can work together to support diabetes initiatives.

Mary Beth Dahl. program manager
952-853-8546