DETROIT (WWJ) — The Southeast Michigan Beacon Community announced that it has achieved six of seven target measures in the care of patients with type 2 diabetes that are part of its “Clinical Transformation” efforts.
When it was activated in March of 2011, a primary goal of SEMBC was to use health information technology and clinical transformation strategies to achieve specific targets in high impact quality measures related to the care of patients with type 2 diabetes.
High impact measures that were targeted for a 5-percentage point increase include A1c testing, LDL testing, foot exams, blood pressure less than 140/90, A1c values less than 8.0, and eye exams.
Diabetic patients with A1c values greater than 9.0 or unknown were targeted for a 5 percentage point decrease.
Working with 46 SEMBC-affiliated private practice and Federally Qualified Health Center sites that collectively serve over 180,000 patients including over 18,500 patients with diabetes, clinical transformation and health information technology related tactics that were deployed include:
* increased use of Electronic Health Record (EHR) system clinical decision support prompts and reminders;
* practice workflow evaluation and modification;
* increased use of EHR and non-EHR patient educational materials;
* increased practice-level integration of health information technology;
* the use of Patient Health Navigators to assist patients with the social determinants of health;
and care quality and practice management report reviews, among other activities.
Using summary practice reports extracted from participating practices’ EHR system, baseline measures for each of the high impact measures were established during the latter half of 2011, with subsequent quarterly extraction through the second quarter of 2013.
Based on a comparison of baseline data to the most recent reports, the stated goals of a 5 percent improvement was achieved for each high impact measure with one exception, eye exams. The measure experiencing the greatest improvement (17 percent) was the proportion of patients having an A1c value that was greater than 9.0 or was unknown. Measures documenting patients having an A1c value of less than 8.0 and patients having blood pressure less than 140/90 also experienced greater than 10 percent improvement (16.6 and 10.9, respectively).
“We couldn’t be more pleased with the results and are extremely proud of the work that was done by our affiliated physicians and their staff,” said Terrisca Des Jardins, director of the Southeast Michigan Beacon Community, “Clinical transformation and the adoption of health information technology is hard work, but when you get practice level support like we have, it represents a powerful force in health care going forward.”
“We’re always looking for ways to improve the quality and efficiency of the care we deliver to our patients,” said Mark Wein, D.O., of Allenwood Family Health Care in Taylor, “This is clearly the direction for the future of health care, and this helps us use these strategies for all of the patients we see – not just patients with diabetes.”
The one measure in which the goal of a 5 percentage point increase was not achieved was eye exams among patients with diabetes. This measure typically requires the patient to see an ophthalmologist or optometrist who assesses the patient and reports results of these exams back to the primary care physician. To address this gap in care, SEMBC is working with three practices who are piloting on-site retinal eye exam technology that allows patients to receive their exam without leaving the office of their primary care provider.
According to the Michigan Department of Community Health, an estimated 758,300 Michigan adults have been diagnosed with diabetes, and another 250,200 have undiagnosed diabetes. This means more than 1 million adults in Michigan — more than 10 percent of the adult population – are directly affected by this ever-growing condition. This is particularly true in Wayne County, where estimates go as high as 16 percent of the adult population.
The Southeast Michigan Beacon Community is one of 17 Beacon Communities established by the United States Department of Health and Human Services and administered by the Office of the National Coordinator for Health Information Technology. The SEMBC’s job is building and strengthening local health IT infrastructure and testing innovative approaches to make measureable improvements in health, care and cost. For more information, visit http://www.sembc.org.