Everyone with Diabetes Counts Sophia Cherry, RPh, MPH Quality Improvement Specialist May 13, 2015
Overview Diabetes in the United States and Florida Everyone with Diabetes Counts (EDC) Benefits of EDC Participation Training Requirements Diabetes Education and Clinical Outcomes by County Success Stories 2
The State of Diabetes in the United States 3
The State of Diabetes in Florida Adults who have ever been told they had diabetes, Overall 2013 CAH Counties Diabetes Rate Bradford 13.6 Calhoun 13.1 Franklin 12.1 Hardee 19.2 Hendry 21.9 Holmes 14.4 Jackson 12.4 Madison 17.2 Monroe 6.6 Suwanee 16.1 Union 17.8 Washington 12.8 4
Why the Concern about Diabetes? The most common cause of blindness, kidney failure, and amputations in adults A leading cause of heart disease and stroke People with diabetes spend 2.3 times more on health care costs than others without the disease The total costs of diagnosed diabetes have increased 41% over a 5-year period In 2007, the total cost was $174 billion In 2012, the total cost was $245 billion 5 Sources: National Institutes of Health and the Centers for Disease Control and Prevention, American Diabetes Association
The Centers for Medicare & Medicaid Services (CMS) Reducing Disparities in Diabetes Care: Everyone with Diabetes Counts
EDC Goals Improve health literacy of Medicare and dual-eligible beneficiaries with diabetes and prediabetes by referring them to no-cost diabetes self-management education (DSME) classes Improve clinical outcomes (HbA1c, lipids, blood pressure, eye exam, and weight control) Decrease the number of patients who require lower extremity amputation due to complications from poorly controlled diabetes 7
EDC Goals (cont.) Increase the number of DSME sites, classes, and trainers/peer educators in the community Collaborate with providers and organizations to develop a sustainability plan to ensure continuation of DSME 8
DSME Curriculum Diabetes Empowerment Education Program (DEEP) An educational curriculum designed to engage participants in self-management practices for the control of diabetes and the prevention of its complications. Part of the Midwest Latino Health Research Training Policy Center at the University of Illinois-Chicago (UIC) Based on national medical care and diabetes selfeducation guidelines and recommendations CMS-approved curriculum (English and Spanish) 9
EDC Classes Six weekly classes. Each class is two hours. No cost to participate Covers eight DEEP modules Understanding the Human Body Understanding Risk Factors for Diabetes Monitoring Your Body Get Up & Move! Diabetes & Physical Activity Management of Diabetes through Meal Planning Diabetes Complications: Identification and Prevention Learning about Medications & Medical Care Living with Diabetes: Mobilizing Your Family and Friends Pre-survey, post-survey, demographics form 10
Patient Engagement DSME classes will be offered: Within the facility or organization In the community where patients live Senior centers Senior living sites Health fairs Churches 11
Why Participate? What are the Benefits? Become part of a national focus on reducing disparities among underserved populations with diabetes Benefits and opportunities include: Training on evidence-based diabetes curriculum Education materials, tools, and program resources Marketing of the DSME program and services Support for existing community resources and relationships Assistance with data collection and analysis Assistance with obtaining accreditation for your diabetes program in order to bill payers 12
To Become a DEEP Trainer Be affiliated with an organization that has purchased a license from UIC to use DEEP Lead Trainer Attend a 24-hour Lead Trainer workshop Be recommended for certification by the Senior Trainer Peer Educator Attend a 20-hour Peer Educator workshop Be recommended for certification by the Senior Trainer or Lead Trainer 13
Diabetes Education vs. DSME Diabetes Education Inpatient and outpatient settings Diabetes Survival Instruction (bedside) Handouts Combination of individual and group sessions; more focus on individual sessions 1-2 day, 8-hour session Diabetes Self-Management Education (DSME) Outpatient setting Focuses on AADE7 Curriculum focuses on behavioral changes Combination of individual and group sessions 4-8 sessions offered during a 1-2 month period of time 14
Barriers Patient Medical Personnel Fatalistic attitude Anger/Denial Religious reasons Access to nutritious food Transportation availability Access to quality health care Minimal or lack of support from the medical community Misunderstanding of what DSME is about Understanding the benefits of behavioral change How to refer a patient to a class Obtaining correct information to give to patients 15
DSME Workshop Diabetes Self-Management Education Workshop by HSAG 16
Diabetes Classes Offered in Florida CAH Counties County CAH CAH Diabetes Classes Health Centers Diabetes Classes Health Department Diabetes Classes Bradford Shands Starke No Yes No Calhoun Calhoun - Liberty No No No Franklin George E. Weems Yes (IP/OP) No No Hardee Florida Hospital Yes (IP/OP) No No Hendry Hendry Regional Yes ( IP/OP) No No Holmes Doctor's Memorial No No Yes Jackson Campbellton-Graceville Yes (IP/OP) N/A Yes Madison Madison County No Yes No Monroe Mariners Yes (IP/OP) No No Monroe Fisherman's Yes No No Suwanee Shands Live Oak Yes (IP) Yes No Union Lake Butler Yes ( IP/OP) No No Washington Northwest Florida No No No 17 IP: Inpatient OP: Outpatient
Clinical Outcomes by CAH County: A1c, Eye Exam, and Foot Exam (2013) County % of Adults with Diabetes who had two A1C tests in the Past Year % of Adults with Diabetes who had an Annual Eye Exam % of Adults with Diabetes who had an Annual Foot Exam Bradford 71.1 78.5 58.5 Calhoun 69.1 67.7 63.3 Franklin 74.7 42.8 57.2 Hardee 64.9 63.2 75.1 Hendry 90.3 44.8 64.1 Holmes 86.1 56.7 59.8 Jackson 89.0 67.7 73.3 Madison 72.1 64.6 70.9 Monroe 77.4 74.6 54.9 Suwanee 77.8 67.4 63.5 Union 50.9 73.8 83.5 Washington 76.1 51.2 72.3 18
Success Stories Cooking Meals with Food Bank Ingredients Rural Doctors and Patients Overcome Challenges to Diabetes Care 19
Additional Areas of Focus for HSAG 20
HSAG Your Go-To Resource For Meaningful Use Participate and receive assistance to use your electronic health record to advance through the stages of meaningful use. Contact Diane Chronis, Project Director IHPC@hsag.com or call 813.865.3170 21
Thank you! Sophia Cherry, RPh, MPH Quality Improvement Specialist 813.865.3197 SCherry@hsag.com
This material was prepared by Health Services Advisory Group, Inc., the Medicare Quality Improvement Organization for Florida, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. FL-11SOW-B.2-05072015-01