Agnesian HealthCare Know & Go Showcase: Healthier Living in 2013Agnesian HealthCare
Dr. Heather Schmidt of Agnesian HealthCare presents on the benefits of living a healthier life this year. Fitness and proper nutrition are essential ingredients for good health.
Strengthening ncd surveillance in malaysia, asean ncd forum 2013Feisul Mustapha
Zainal Ariffin Omar and Feisul Idzwan Mustapha. Strengthening NCD Surveillance in Malaysia. 15 September 2013. Working paper presented at the ASEAN Regional Forum on NCDs. Manila, Philippines.
This webinar will discuss the prevalence of pre-diabetes and it’s contributing factors and the initial efforts to translate the National Diabetes Prevention Program to public health. We will also look at new approaches to providing interventions.
Learning objectives:
Scope and scale of pre-diabetes and what factors contribute to it.
Review initial efforts to translate the DPP to public health.
New approaches to providing interventions.
About The Presenter
Dr. Marrero received a B.A. (1974), M.A. (1978) and Ph.D. (1982) in Social Ecology from the University of California, Irvine. He joined the IU School of Medicine in 1984 and became the J.O. Ritchey Professor of Medicine in 2004. He was a member of the Diabetes Research & Training Center and served as Director of the Diabetes Prevention and Control Division. He is currently the Director of the Diabetes Translational Research Center. Dr. Marrero is an expert in the field of clinical trails in diabetes and translation research which moves scientific advances obtained in clinical trails into the public health sector. He helped design the Diabetes Prevention Program and the TRIAD study, which evaluated strategies to improve diabetes care delivery in managed care settings. His research interests include strategies for promoting diabetes prevention, care settings, improving diabetes care practices used by primary care providers, and the use of technology to facilitate care and education. Dr. Marrero was twice awarded the Allene Von Son Award for Diabetes Patient Education Tools by the American Association of Diabetes Educators, nominated to Who’s Who in Medicine and Health care in 2000, served as Associate Editor for Diabetes Care (1997-2002) and is currently the Associate Editor for Diabetes Forecast. He was selected as Alumni of the Year for University of California Irvine in 2006 and The Outstanding Educator in Diabetes in 2008 by the American Diabetes Association. He is the current President of the American Diabetes Association.
Agnesian HealthCare Know & Go Showcase: Healthier Living in 2013Agnesian HealthCare
Dr. Heather Schmidt of Agnesian HealthCare presents on the benefits of living a healthier life this year. Fitness and proper nutrition are essential ingredients for good health.
Strengthening ncd surveillance in malaysia, asean ncd forum 2013Feisul Mustapha
Zainal Ariffin Omar and Feisul Idzwan Mustapha. Strengthening NCD Surveillance in Malaysia. 15 September 2013. Working paper presented at the ASEAN Regional Forum on NCDs. Manila, Philippines.
This webinar will discuss the prevalence of pre-diabetes and it’s contributing factors and the initial efforts to translate the National Diabetes Prevention Program to public health. We will also look at new approaches to providing interventions.
Learning objectives:
Scope and scale of pre-diabetes and what factors contribute to it.
Review initial efforts to translate the DPP to public health.
New approaches to providing interventions.
About The Presenter
Dr. Marrero received a B.A. (1974), M.A. (1978) and Ph.D. (1982) in Social Ecology from the University of California, Irvine. He joined the IU School of Medicine in 1984 and became the J.O. Ritchey Professor of Medicine in 2004. He was a member of the Diabetes Research & Training Center and served as Director of the Diabetes Prevention and Control Division. He is currently the Director of the Diabetes Translational Research Center. Dr. Marrero is an expert in the field of clinical trails in diabetes and translation research which moves scientific advances obtained in clinical trails into the public health sector. He helped design the Diabetes Prevention Program and the TRIAD study, which evaluated strategies to improve diabetes care delivery in managed care settings. His research interests include strategies for promoting diabetes prevention, care settings, improving diabetes care practices used by primary care providers, and the use of technology to facilitate care and education. Dr. Marrero was twice awarded the Allene Von Son Award for Diabetes Patient Education Tools by the American Association of Diabetes Educators, nominated to Who’s Who in Medicine and Health care in 2000, served as Associate Editor for Diabetes Care (1997-2002) and is currently the Associate Editor for Diabetes Forecast. He was selected as Alumni of the Year for University of California Irvine in 2006 and The Outstanding Educator in Diabetes in 2008 by the American Diabetes Association. He is the current President of the American Diabetes Association.
Online stakeholder survey results - IFPRI-NITI workshop "A Common Vision for Tackling Malnutrition in India: Building on Data, Evidence and Expert Opinion"- 29-30 March 2019
Non-Communicable Diseases: Malaysia in Global Public HealthFeisul Mustapha
Paper presented at a CME Session, held in conjunction with the NIH Research Week 2014, 26 November 2014 at the Institute for Health Management, Bangsar
Common vision outline of output maternal nutrition march 30 2019POSHAN
Maternal Nutrition group presentation - IFPRI-NITI workshop on "A Common Vision for Tackling Malnutrition in India: Building on Data, Evidence and Expert Opinion" - 29-30 March 2019
Critical appraisal of child health policies, programs, guidelines and their i...Mohammad Aslam Shaiekh
Critical Appraisal of Child Health Policies, Programs, Guidelines and Their Implementation Strategies and Review the Current Status of National Context
Η παθοφυσιολογία του ΣΔ Τύπου 2 και τα δυνητικά σημεία παρέμβασηςMedicalWeb.gr
Slides από την ομιλία του Κου Ιωαννίδη.
Ηλεκτρονικό μάθημα (webminar) από την Ελληνική Διαβητολογική Εταιρεία, με θέμα: "Η παθοφυσιολογία του ΣΔΤ2 και τα δυνητικά σημεία θεραπευτικής παρέμβασης"
Ομιλητές: Σ. Λιάτης, Ι. Ιωαννίδης
Ημερομηνία 13/2/2013
http://www.ede.gr
Online stakeholder survey results - IFPRI-NITI workshop "A Common Vision for Tackling Malnutrition in India: Building on Data, Evidence and Expert Opinion"- 29-30 March 2019
Non-Communicable Diseases: Malaysia in Global Public HealthFeisul Mustapha
Paper presented at a CME Session, held in conjunction with the NIH Research Week 2014, 26 November 2014 at the Institute for Health Management, Bangsar
Common vision outline of output maternal nutrition march 30 2019POSHAN
Maternal Nutrition group presentation - IFPRI-NITI workshop on "A Common Vision for Tackling Malnutrition in India: Building on Data, Evidence and Expert Opinion" - 29-30 March 2019
Critical appraisal of child health policies, programs, guidelines and their i...Mohammad Aslam Shaiekh
Critical Appraisal of Child Health Policies, Programs, Guidelines and Their Implementation Strategies and Review the Current Status of National Context
Η παθοφυσιολογία του ΣΔ Τύπου 2 και τα δυνητικά σημεία παρέμβασηςMedicalWeb.gr
Slides από την ομιλία του Κου Ιωαννίδη.
Ηλεκτρονικό μάθημα (webminar) από την Ελληνική Διαβητολογική Εταιρεία, με θέμα: "Η παθοφυσιολογία του ΣΔΤ2 και τα δυνητικά σημεία θεραπευτικής παρέμβασης"
Ομιλητές: Σ. Λιάτης, Ι. Ιωαννίδης
Ημερομηνία 13/2/2013
http://www.ede.gr
Symptoms of Pre-Diabetes and Diabetes Prevention TipsInovaHealth
Learn about pre-diabetes and how asses your risk and tips on preventing diabetes from Inova Medical Group physicians.
Learn more about Inova Medical Group at www.inovamedicalgroup.org.
Clinical pathways implementing tools to accelerate performance in quality, ...Justin Campbell
Clinical Pathways are evidence-based clinical guidelines for patients with similar diagnoses that when applied aid in the coordination and delivery of high-quality care to improve patient outcomes while containing costs. Clinical Pathway tools and concepts incorporate patient centered best practices and protocols that are customized and locally defined. Join us as we share the considerations and practical steps leading to successful adoption for your organization.
Intended Audience: Multidisciplinary Roles - CMIO, CNIO, Medical Directors, Quality Department, Clinic Managers, Clinical Informatics Managers and Analysts
Learning Objectives:
-Summarize the fundamental concepts of standardized clinical process leading to improved patient care.
-Leadership approaches of cross-functional team collaboration.
-Recognize the technology role in sustained improved patient outcomes.
Team as Treatment: Driving Improvement in DiabetesCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: June 11, 2019 | 3 p.m. EST
This webinar will share evidence-based models that will provide a framework for health centers to optimize the team in primary care. Experts will describe how utilization of extended team members and technology can reduce gaps in care for prediabetics and diabetics. With a focus on lifestyle and community based projects, this webinar will highlight the strategies and resources to improve the health and behaviors of patients at risk for diabetes and manage uncontrolled diabetes. Through early detection and providing diabetes management through a team-based care, health centers can help patients’ live long, healthy lives.
Be There San Diego - Cardiovascular Disease Prevention, a Regional Quality Co...UCLA CTSI
2017 Southern California Dissemination, Implementation and Improvement (DII) Science Symposium
Be There San Diego: Improving Cardiovascular Disease Prevention through a Regional Quality Collaborative
Christine Thorne, MD, MPH - University of California, San Diego
Allen Fremont, MD, PhD - RAND Corporation; UCLA; VA Greater Los Angeles HealthCare System
For more information on DII, go to: https://ctsi.ucla.edu/patients-community/pages/dissemination_implementation_improvement
The National Diabetes Prevention Program (National DPP) encourages collaboration among federal agencies, community-based organizations, employers, insurers, health care professionals, academia, and other stakeholders to prevent or delay the onset of type 2 diabetes among people with prediabetes in the United States.
CDC will provide an overview of their WorkLife Wellness Office services and describe how they used the HealthLead accreditation process to provide a framework to assess the comprehensiveness of their new office and existing programs and processes. Also, how the scoring of framework identified strengths and weaknesses and how the assessment plan of action is used for future strategic planning to drive new connections, data sources, and programmatic gaps as they strive to achieve HealthLead Silver. CDC will share specific examples of what was required and shared as part of the HealthLead audit during the presentation.
The CMS Innovation Center held a Medicare Diabetes Prevention Program webinar on August 9, 2016 from 12:00 – 1:00p.m. EDT. This webinar provided an overview of the proposal in calendar year 2017 Medicare Physician Fee Schedule.
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CMS Innovation Center
http://innovation.cms.gov
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Similar to EDC Overview with Emphasis on DEEP (20)
Webinar: Medicare Diabetes Prevention Program - Overview
EDC Overview with Emphasis on DEEP
1. DEBORAH F. CHRISTIAN, PA-C
Diabetes Self-Management Education Program Manager
Health Services Advisory Group (HSAG)
Everyone with Diabetes Counts:
Diabetes Self-Management Education
2. HSAG: Your Partner in Healthcare Quality
• HSAG is the Medicare Quality Innovation
Network-Quality Improvement Organization
(QIN-QIO) for California, Arizona, Florida, Ohio,
and the U.S. Virgin Islands.
• QIN-QIOs in every state and territory are united in
a network administered by the Centers for
Medicare & Medicaid Services (CMS).
• The QIN-QIO program is the largest federal
program dedicated to improving health quality at
the community level.
2
3. HSAG’s QIN-QIO Responsibility
3
HSAG is the Medicare QIN-QIO for Arizona, California,
Florida, Ohio, and the U.S. Virgin Islands.
Nearly 25 percent of the
nation’s Medicare beneficiaries
4. QIO Task Areas
4
Improve
Coordination
of Care
Improve
Medication
Safety
Improve
Nursing Home
Quality
Reduce
Hospital
Infections
Improve Health
Through Health
Information
Technology
Improve
Cardiac
Health
Prevent and
Manage
Diabetes
Patient is at the
center of care.
5. Everyone with Diabetes Counts (EDC)
• Diabetes was the seventh leading cause of death in the US
• Nearly 30 million Americans have diabetes.
• 8.1 million Americans are undiagnosed
• Upwards of 86 million Americans prediabetes
• Among the Older Adults
– More than 25 percent of Americans age 65 and older have diabetes.
– 51 percent are estimated to have pre-diabetes.
• 11th Scope of Work
– Reduce health disparities
– Initiative: Everyone with Diabetes Counts or EDC
– Economic burden $245 billion annually (2012)
Data Source: CDC National Diabetes Statistics Report, 2014, available at:
http://www.cdc.gov/diabetes/pdfs/data/2014-report-estimates-of-diabetes-and-its-burden-in-the-united-
states.pdf
5
6. The Burden of Diabetes in California
• Over 4 million Californians have diabetes (13.4% of adult
population)
• Over 11 million Californians have pre-diabetes (38% of
adult population)
• Diabetes costs an estimated $37.1 billion / year
– Direct medical expenses $27.6 billion in 2012
– Indirect cost $9.5 billion in 2012
6
Data Source: Centers for Disease Control & Prevention (CDC)
7. • African Americans
• Hispanics/Latinos
• American Indians/Native
Americans/Alaska Natives
• Asians/Pacific Islanders
• People living in rural
areas
• California Incidence
– AA & Hispanics: 14%
– Asian population
• Filipino: 15%
• South Asian: 16%
• Pacific Islanders: 18%
Disparities Exist in Diabetes Care
7
8. HSAG’s Role in EDC
• Increase adoption and implementation of diabetes
self-management education (DSME)
– Diabetes Self-Management Program, Stanford University
– Project Dulce, Scripps Health Whittier Diabetes Institute
– Diabetes Empowerment Education Program™ (DEEP),
University of Illinois at Chicago (UIC)
• Train organizations & individuals statewide to offer
DSME
• Provide assistance to organizations offering DSME
• Impact more than 7,000 Medicare beneficiaries with
diabetes or pre-diabetes
8
9. Goals and Target Population
Goals:
– Reduce diabetes care disparities
– Prevent and/or reduce adverse health outcomes
related to diabetes
– Reduce risk factors associated with diabetes
– Increase self-management skills
– Facilitate short- and long-term behavioral change
Special consideration for:
– Includes low-health literacy and low-literacy individuals
9
10. DEEP
Program Description
– Evidence-based program
– Six weekly workshops
– Each class is two hours long
– Taught by one certified DEEP Peer Educator
– Can be delivered in any language
– FUN
• Interactive, hands-on, group learning activities, and games,
including visual aids and demonstrations
10
11. DEEP Modules
• Diabetes risk factors and complications
• Nutrition
• Physical activity
• Use of the glucose meter
• Medications
• Building partnerships with diabetes healthcare team
• Psychosocial effects of illness
• Problem-solving strategies
• How to access community diabetes resources
11
12. “Tell me and I forget,
teach me and I may remember,
involve me and I learn.”
-Benjamin Franklin
12
13. Why DEEP Works
• Incorporates adult education,
empowerment principles, and
participatory techniques
• Speeds changes in knowledge and
behavioral and clinical indicators
• Meets the needs of
participants in real time
• Connects the dots in easy-to-
understand language
13
16. Visualizing Fats and Carbohydrates
16
Cheeseburger Cola Soda Fries
Total Fat 24 g = 6 teaspoons 0 g 29 g = 7 teaspoons
Total Sodium 897 mg = .16 teaspoons 15 mg = negligible 328 mg = .06 teaspoons
Total Carbs 39 g = 8 teaspoons 35 g = 7 teaspoons 63 g = 13 teaspoons
Total Fat, Salt, and Carbs
13 teaspoons of lard
½ teaspoon of sodium
28 teaspoons of sugar
17. • Certified peer educator/ workshop leader
• Only one leader required to lead workshop
• Allows for make-up sessions
Program Delivery Method
17
18. Training Requirements
• Attend a three-day, train-the-
trainer workshop, and receive
certification to facilitate DEEP
workshops as a peer educator.
• Peer educator training is taught
by lead trainers.
• Lead trainer training is taught by
senior trainers.
• No-cost training offered.
18
19. Goals are Outcomes-Based and Data-Driven
• HSAG will help track and analyze data.
• HSAG tracks pre- and post-activation measures.
• HSAG tracks clinical outcomes for 10 percent of
participants:
– HbA1c
– Lipids
– Blood pressure
– Weight
– Foot exams
– Eye exams
19
20. • 1,124 Medicare beneficiaries with diabetes or pre-diabetes
graduated from a DSME workshop.
• 470 Medicare beneficiaries completed both the Pre- and
Post-Patient Activation Surveys.
• Gender
– Male: 27 percent
– Female: 73 percent
• Average age: 72
• Reported Health Conditions
– High Blood Pressure: 61 percent
– High Cholesterol: 52 percent
– Arthritis: 35 percent
– Eye Disease: 18 percent
– Heart Disease: 14 percent
– Lung Disease: 5 percent
20
California Demographics
(January 2015 to April 2016)
22. Pre- and Post-Patient Activation Survey
• 14 total questions
– 4 questions: Diabetes knowledge
– 5 questions: Coping with diabetes
– 5 questions: Self-care methods
• Administered during first week and then again at
sixth week
22
23. Diabetes Knowledge
78%
64%
80%
71%
97% 94% 92% 90%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
How exercise
affects blood sugar
How to take care of
feet
What is a retinal
exam?
How carbohydrates
break down in body
Pre-PAS Post-PAS23
27. Program Costs
• Organizational License: $600/five-year license
• Peer Educator Certification: $100/three-year certification
• Training Cost (for UIC):
– Peer educator training fee: $800 per person
– Off-site training fee: $10,500, plus travel expenses
• Training Cost (for HSAG): None
• Participant Cost: None
27
28. Program Costs (cont.)
For a limited time, HSAG will provide:
• Leader training at no charge to organizations committed
to offering this program in their community.
• Materials for conducting workshops.
• Licensing and certification fees may also be provided.
• $40 per DSME completer who meets
contract requirements:
– Medicare beneficiary (65+) and
– Has diabetes or pre-diabetes and
– Completes five of six classes
28
29. Will You Join Us?
• Offer DEEP internally
• Outsource DEEP to partnering organizations
• HSAG will provide training
and assistance to your
organization and your
community partners.
29
31. This material was prepared by Health Services Advisory Group, the Medicare Quality
Improvement Organization for California, under contract with the Centers for
Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and
Human Services. The contents presented do not necessarily reflect CMS policy.
Publication No. CA-11SOW-B.2-08162016-01
CMS Disclaimer
Editor's Notes
Committed to improving quality of healthcare for more than 35 years
Provides quality expertise to those who deliver care and those who receive care
Engages healthcare providers, stakeholders, Medicare patients, families, and caregivers
Provides technical assistance, convenes learning and action networks, and analyzes data for improvement
Drives quality by providing technical assistance, convening LANs, collecting and analyzing data for improvement
Works on initiatives to improve patient safety, reduce harm, improve clinical care
Engages healthcare providers, stakeholders, and beneficiaries to improve health quality, efficiency, and value.
We Serve…
25 percent of our nation’s Medicare population.
45 percent of our nation’s Medicaid population.
19 percent of our nation's dialysis population.
Reworking prescription labels; understanding food labels; lard/sugar example involves literacy, numeracy and nutrition literacy (carb/sugar/salt- one of the hardest for people to learn; teach how we teach it. how we try to meet the person where they are