Michelle D. Stancil, RN, BSN, CDE

Blix M. Rice, MBA, CHFP

October 16, 2015

Putting a Diabetes Educator in Your Pocket: A Novel Approach to

Disease Management 

Introduction

GHS developed a Diabetes Self-Management Program with endocrinology treatment algorithms plus the addition of a wireless enabled glucometer• Pilot criteria:

– GHS insured employees – A1c equal to or greater than 8%– Diagnosis of diabetes (insulin pump excluded)– Age 18-75 – Target two GHS primary care physician practices– Goal:

• Primary - Reduce A1c by 15%• Secondary – Develop primary care workflow model• Improve diabetes understanding and self-management

Outcomes

• A1c improved, more than 15% reduction

• Provider and multidisciplinary collaboration strengthened, with increased referrals to titrate insulin

• DSMP utilization by employees increased

• Diabetes understanding and self-management improved, as measured by questionnaire

• Additional practices desired participation

• Co-worker support groups formed

Revisions

• Expand to all GHS physician practices

• Enroll additional 50 GHS insured employees and dependents

• Telehealth Diabetes Educator available Monday-Friday, 8:30-12:00

• PharmD, BC ADM (Board Certified-Advanced Diabetes Management) trial on telehealth team

• Expand medication algorithm to include insulin pump participants

• Pharmacy home delivery

Expansion

• Wireless meter for high risk populations

– Pediatric IRB in development

• Continuous glucose monitor cloud-based platform:  outpatient high risk, pediatric, pregnant, eventually inpatient populations

• MyChart – diabetes telehealth blood glucose evaluation and algorithm titration

• Cloud-based medical nutrition therapy coaching