Patricia M. Doykos, PhD Director, Bristol-Myers Squibb Foundation patricia.doykos@bms.com 1
Bristol-Myers Squibb Foundation Mission: Reduce health disparities and improve the health outcomes of populations disproportionately affected by serious diseases and health conditions 2
BMS Foundation Strategy for Addressing Health Disparities Target funding and initiatives to improve health outcomes at the community level Healthcare worker training (professional / lay) Community mobilization and supportive services HIV in Africa, Hepatitis B/C in Asia, cancer in Central and Eastern Europe, Mental Illness and Type 2 Diabetes in the U.S. Foster innovation and sustainability Evaluate for impact on health outcomes, capacity, models and standards of care and health policy Advocate with partners Share lessons learned 3
Bristol-Myers Squibb Foundation Type 2 Diabetes and Mental Illness in the U.S. Cancer in Central and Eastern Europe Hepatitis and Type 2 Diabetes in Asia HIV/AIDS in Africa 4
Together on Diabetes Strategy $115M philanthropic initiative to reduce disparities and improve health outcomes for diagnosed and undiagnosed adults living with type 2 diabetes in the U.S. (2010), China (2012) and India (2012) Funding and partnership foci: Improve patient self management and care navigation for the course of their disease journey Expand and integrate community supportive services and community mobilization to fight type 2 diabetes Foster a radical rethink and test new ideas about how the diabetes response is approached, designed, implemented and measured for impact given the scale of the current and future epidemic and the duration of the disease experience 5
U.S. Partners American Pharmacist Association Foundation American Academy of Family Physicians Foundation/Peers for Progress American Association of Diabetes Educators Black Women's Health Imperative Camden Citywide Diabetes Coalition/Cooper Foundation Duke University/Durham County Department of Health East Carolina University Feeding America Harvard Law School (policy & advocacy) Marshall University/ARC/CDC Mississippi Public Health Institute National Council on Aging National Network of Public Health Institutes (learning collaborative) Riverview Medical Center Foundation United Hospital Fund University of Kansas (evaluation) United Neighborhood Health Services University of Virginia Sixteenth Street Community Health Center Whittier Street Health Center 6
U.S Partner and Project Sites Prevalence map from U.S. Centers for Disease Control
Early Achievements 21 grantees working in 27 states and over 50 communities $41.8 million committed to date for: Targeting high risk populations AA women, Native Americans, Appalachian people Bringing evidence based programs to communities of need Bending the curve of the diabetes burden at the population level Strengthen the impact and influence of the grants and projects through evaluation, policy and advocacy, dissemination and replication CMS Innovation Award of $9.7 million for three ToD grantees collaborative project for the Southeastern U.S. Co-investing with CDC and the Appalachian Regional Commission in Appalachian project with Marshall University First Grantee Summit with involvement of CDC and Office of the Surgeon General Presentations at National Minority Quality Forum, ADA Diabetes Disparities Forum (10 abstracts accepted), Joslin Diabetes Innovation Conference, Appalachian Regional Commission Governors Forum Active participation in Shaping NJ, NCOA Self Management Alliance and the Social Impact Exchange
High Risk Population example African American Women project U Virginia, East Carolina University, Whittier Street Health Center, United Neighborhood Health Center, Black Women s Health Imperative 4 month planning + 20 month interventions ranging from rural community health worker teams and small changes approach to texting support to Sister Circle adaptation 480 women living with diabetes enrolled in care and support programs to date High participation in diabetes self management education Clinical outcomes, self efficacy and behavior change data being collected
Evidence Based Practice example American Pharmacist Association Foundation Ashville model of a pharmacist coach improved clinical outcomes, patient knowledge and self management skills and standard of care and reduced healthcare costs Implemented as a benefit only by self insured employers Roll out and scale to 25 high need communities primarily through FQHCs and community pharmacies 81 pharmacists trained, 1907 patients in program Average Ha1c at baseline: 9.5 Average Ha1c at last 6 month assessment: 8.5
Population Level Impact example Duke Medical Center Partnering with Durham County DOH and U. Michigan Create a geospatial map of the diabetes problem and disease management assets in the county Develop, pilot and implement a series of coordinated community-based interventions to improve diabetes self-management, health outcomes and quality of life
Multi-sector collaboration for diabetes self management for seniors BMSF, National Council on Aging, Stanford, Wellpoint, OASIS, YMCA USA, Administration on Aging Over 25% of people in the US over 60 are living with diabetes Medicare benefit for the Diabetes Self Management Program is underutilized due to lack of physician awareness and referral, patient awareness, capacity to deliver programs and patient access to programs Develop and demonstrate a nationally scalable model delivery of DSMP: On-line program monitored by AADE In-person program delivered by CBOs (YMCA / OASIS) Target: 2500 participants in 2 metropolitan areas Real world experience by involving a major health plan, Wellpoint, in the demonstration to assist with patient recruitment, Triple Aim type evaluation and structuring reimbursement
U.S. Expert Advisory Council John Buse, MD Jo Ivey Boufford, MD Chair, CDC/NIH National Diabetes Education Program and Director, Diabetes Center, UNC President, New York Academy of Medicine Professor of Public Service, Health Policy and Management, Robert F. Wagner Graduate School of Public Service and Clinical Professor of Pediatrics, New York University School of Medicine Kate Lorig, RN, PhD Professor, Dept of Medicine and Director, Patient Education Research Center, Stanford University School of Medicine George Rust, MD, MPH Director, National Center for Primary Care, Morehouse School of Medicine Ken Thorpe, PhD Professor of Health Policy and Management, Rollins School of Public Health, Emory University James R. Gavin III, MD, PhD CEO & Chief Medical Officer of Healing Our Village, Inc. Clinical Professor of Medicine, Emory University School of Medicine Clinical Professor of Medicine, Indiana University School of Medicine Mildred Thompson Director, Health Equity and Place, PolicyLink and Co-Chair, Health Equity Committee, Institute of Medicine Lois Witkop, MBA Senior Vice President, STOP Diabetes, American Diabetes Association
China and India Partners Chinese Center for Disease Control and Prevention Shanghai Charity Foundation Mamta Health Institute for Mother and Child All India Institute of Diabetes and Research & Swasthya Diabetes Hospital Sanjivani Health and Relief Committee