Fraer Mony
University of Lowa Carver College of Medicine, USA
Title: Ambulatory Intensive Management of Diabetes supports self-management care leading to better glycemic control, fewer ED visits and lower rate of hospitalizations
Biography
Biography: Fraer Mony
Abstract
Background
• Diabetes is a high cost chronic disease
• 42% of Iowans have prediabetes or diabetes
• Outcomes are determined by self-management activities occurring in the 5K annual waking hours outside of clinic visits
• In diabetes management, glucose measurement directly correlates to diabetes control
Purpose
Addressing the question;
Can
• addressing barriers to diabetes self-management
• remote monitoring &
• continuous decision support
Help:
• reach goals of care &
• reduce unnecessary health care expenditures
Strategy and Implementation
• Enrolled 41 patients over span of 6 months with Type 1 or Type 2 diabetes with the following criteria:
• 3 or more ED visits or hospitalizations over a 12 month period OR
• 1 ED or hospitalization over previous 12 months with a HgA1c > 9%
• Targeted patient education based on the following validated survey measurements to assess and understand barriers to self-management care
• PHQ9
• Patient Activation Measure (PAM) - 13™
• Morisky Medication Adherence Scale
• Michigan DTRC Brief Diabetes Knowledge Test
• Incorporated web-enabled blood glucose meter for ease of testing and remote monitoring
• Glucose reading is transmitted over HIPAA compliant FDA approved cloud to care team web portal allowing for real-time decision support
Key Findings
• Improvements in clinical measures and utilization
• Reduced cost of ED visits and admissions by $102K
• Improved efficiency & lower cost of clinical decision support
• Value from the patients’ perspective