The new patient-centered approach uses a website that helps patients identify their most urgent needs — physical, emotional or financial — and then finds the most effective ways to address them. The goal is to use technology to improve the delivery and outcomes of diabetes care, while lowering the cost of managing this chronic condition.
The new model of care was developed by the SE Minnesota Beacon Program, a collaboration of professional health groups including Mayo Clinic, Mayo Clinic Health System, Olmsted Medical Center, Winona Health, Allina Health and public health departments in 11 counties. The technology will be demonstrated June 5–6 at the third annual conference of the Health Data Initiative, a public-private collaboration started by the Institute of Medicine and the U.S. Department of Health and Human Services.
“It is an honor to be asked to demonstrate our technology at this highly visible conference,” says Lacey Hart, SE Minnesota Beacon Program director. “We hope that our success can help to provide better outcomes and more cost-effective treatment for people with diabetes throughout the country.”
Diabetes affects about 24 million Americans and is one of the biggest drivers of health costs. SE Minnesota Beacon’s key innovation is to focus on patients’ self-identified needs, or Patient Reported Outcomes (PRO).
“We have compiled substantial evidence that PROs are indeed credible targets for diabetes assessment and intervention,” says Jeff Sloan, Ph.D., a health sciences researcher at Mayo Clinic who led the team that developed the new diabetes care model. “In fact, we have shown that the scientific value of many PROs is actually superior to many commonly used laboratory and clinical outcome variables.”
In the Beacon model, PROs guide specific interventions aimed at improving patients’ quality of life. The Diabetes PROQOL website, accessible by smartphones, first asks patients to identify their “single biggest concern right now.” Ten options are offered, including not only monitoring health (measuring blood sugar, for example) but also personal relationships, emotional health and money. Once a category is chosen, the patient answers a few clarifying questions. For example, under money, patients are asked if they cut pills in half or skip doses of medication to save money. The questionnaire takes about a minute to complete.
The responses are shared electronically with the patient’s care providers so that appropriate referral and supportive services can be engaged. In the example above, the patient’s medication list would be reviewed to see if a less-expensive option could be substituted. The data also are placed in patients’ electronic health records to provide continuity of care. County health departments have access to these records, allowing public health nurses to follow up with patients on home visits.
The initial response from patients who have used Diabetes PROQOL is positive. “It is about time we were asked about these things beyond just glucose levels,” says one patient who has had Type 1 diabetes for more than 30 years.
The Beacon Community Program was created by HHS to better harness the power of technology within health care. Part of the Office of the National Coordinator for Health Information Technology, the program aims to fund projects that use technology to improve coordination and delivery of health care while lowering costs. Southeast Minnesota was one of 17 areas across the U.S. to receive a Beacon award. Participating counties are Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha and Winona.
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