Diabetes Management and Prevention Through the Integration of Information Systems and Technology
Using Information Systems and Technology to Enhance Diabetes Care
Bay Area Community Health Center (BACHC) in Fremont, California established a panel to produce better processes and results that have enhanced diabetes care among their patient population. This is managed by the health center’s wellness department with case managers, Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Medical Assistants (MAs) that help coach all diabetes patients at BACHC. With the use of the panel, BACHC has been able to follow up with their patients daily and set up time frames on when their case managers will follow up with patients depending on their A1C levels.
La Maestra Community Health Centers (LMHC) has established the use of clinical pharmacists that provide support with adjusting medications as needed for their patients in conjunction with their treating providers. LMHC has also implemented after-hour group classes to accommodate patients with their schedules and has been shown to be successful. LMHC established cohorts of 20 patients for the after-hour group classes, and in each cohort, there was a compliance rate of about 85%. Successes that were seen as part of the after-hour group classes include weight loss of five pounds in four weeks in some patients.
Diabetes Management and Prevention by Implementing Medical Nutrition Therapy (MNT)
The Impact of Nutrition on Diabetes Prevention and Diabetes Management
MNT is a comprehensive therapy where patients follow a plan based on established goals between the registered dietitian and the patient. MNT is as service that is a Medicare covered benefit, that is cost effective and that has shown to improve A1C levels with an absolute decrease of up to 2.0% among patients with Type 2 Diabetes and up to 1.9% among patients with Type 1 Diabetes within a three-to-six-month period. The implementation of such therapy by health centers may help improve the health outcomes for patients by helping manage and prevent diabetes.
Diabetes Management and Prevention Through Health Literacy Improvement Strategies
Association of Health Literacy With Poor Diabetes Outcomes
The Improving Adherence-Tool & Brown Bag/Medication Management is a tool developed at Zufall Health Center in collaboration with health center pharmacists to help improve health literacy among health center patients at Zufall Health Center. The purpose of this tool was to serve as part of the “Teach Back” method, as a personal medication record, a medication plan, and evaluate how high the health literacy of patients was by engaging them into medication plan conversations.
Diabetes Prevention and Management Through the Use of Data and Community Health Aides Program (CHAP)
CHWs of the Future – Virtual Visits and Technology
Southcentral Foundation (SCF) uses “the Using Data approach” to create a diabetes registry and action list that help identify elements that contribute to patient care, risk factors, co-morbidity conditions, test results and more. The CHAP approach focuses on the use of high-school graduates that have unique training and responsibilities to provide diabetes care to patients in hard-to-access areas of Alaskan communities. The aides receive training to provide remote care to patients such as diabetes management, they also live and work in the remote areas where they provide their services. The aides also connect patients with specialty services with the use of telehealth and help coordinate health educator visits to remote sites. In addition to serving as aides that bridge the gap between patients and diabetes health care services, they also encourage people to use an app called My Alaska Wellness app that facilitates the communication between health care providers and patients, and where they can access their own medical records and keep track of their diabetes management.
Diabetes Prevention and Management Through the Adoption of the Seek, Help, Assess, Reach, Evaluate (SHARE) Approach
The Impact of Health Literacy on Diabetes Mellitus
The Seek, Help, Assess, Reach, Evaluate (SHARE) Approach is a process of five-steps developed by the Agency for Healthcare Research and Quality (AHRQ). The SHARE Approach may be adapted by health centers to help improve health literacy for patients with diabetes and increase their knowledge about diabetes, self-efficacy, self-care behaviors and how to control their glycemic levels. This approach has been well-received by educators and patients in past trainings that have focused on medication adhesion.