Interview: Sharon K. Aureli, RN, MSN, SCRN, CNOR, RNFA, CNL
July 30, 2019
Sharon K. Aureli, RN, MSN, SCRN, CNOR, RNFA, CNL
Clinical Quality Manager
Baptist Health Physician Partners
State: Arkansas (AR)
In efforts to communicate how federal and state government organizations continue helping those living with diabetes, I’ve had the pleasure of speaking with several department of health and medical executives nationwide. I caught up with Baptist Health Physician Partners Clinical Quality Manager and Health Hero, Sharon Aureli, to learn more about Baptist’s recent signing with dMeetings to provide an online Diabetes Self-Management Education and Support (DSMES) series to Arkansans. Upon partnering with Arkansas Department of Health for DSMES curriculum, Aureli was immediately convinced, knowing dMeetings would continue being a positive solution for the state of Arkansas and the populations she and her team are mainly supporting. She was eager to share about the current state of diabetes in Arkansas, where it’s headed, and how online diabetes patient education is helping change its trajectory.
Ravyn Towns: Sharon, share with me the origin of Baptist’s partnership with dMeetings, your role with Baptist, and Baptist’s main goal for signing on with dMeetings.
Sharon Aureli: I joined the Arkansas diabetic council meeting that occurs every other month and attended regularly. One of my roles as clinical quality manager is looking at population health. Here at Baptist Health Physician Partners we’re a clinically integrated network serving over 1,500 providers, 11 associated hospitals, and over 275 clinics across 40 cities and towns in Arkansas. Diabetes is our biggest population health problem; so that’s been my biggest focus for a while. Working with as many clinics and physicians as we do, I know about the burden of diabetes on our state all too well. In AR alone, 14.8% of Arkansans have diabetes with 75,000 of them being undiagnosed. That is a lot of people that don’t even know they have diabetes. An estimated $3.1 billion is spent annually for diabetes and pre-diabetes in the state. So, to answer your last question, our main goal for using dMeetings is to save money and reach more people so that diabetes-related expenses will lessen.
RT: What recent data, from your department, attributes to the issue you just described?
SA: I recently conducted an opportunity assessment here, within our clinically integrated network, and we’re just a little bit above the benchmark on per member per month cost on drugs, visits, and admissions related to diabetes. We also looked at our overall disparities in diabetes in Arkansas. Our African American (black) population is higher for cause of death, so we really have a focus in that area as well. We’re constantly trying to ensure we’re helping and reaching our population.
RT: Was onboarding online DSMES a “no brainer” for your team?
SA: In a sense, ABSOLUTELY.
SA: A lot of people around the state just can’t get to diabetes education classes, for obvious reasons. Because of this, we were definitely attracted to the online format. We all examined the components and went through several of the sessions. We thought the webinars were very well organized and presented.
RT: What phase are you in (in the deploying process)?
SA: Currently, we are still at the promotion stage and actually making physicians and patients aware of these new resources available to them. We have the website available and just added the risk score for prediabetes recently. We’re about to add on all of the locations throughout the state that offer diabetic education, including both DPP and DSMES. It’s important to have all of that information online and readily available.
RT: Who was notified about the availability of dMeetings in your network?
SA: We sent it out to all of our physicians in our clinically integrated network and informed them of how to register patients.
RT: What did your announcement include?
SA: It included a link and a code to ensure that the process was understandable and easy to do. We’re hopeful that as word gets out, we’ll see usage of the program expand and more people signing up.
RT: What are some other strategies you’re using to increase participation?
SA: Many of our physicians are providing dMeetings within their clinic. So, patients will not only be able to sign up for dMeetings at their clinic and use it there as well but also for patient and caretaker use at home. Also, we’re excited that reimbursement is a possibility with Medicare, if the patient meets certain criteria. In addition to emailing the flyer, we also visited numerous clinics handed out copies of the flyer there too.
RT: Will there be additional marketing to encourage patient use?
SA: Yes. We’re actually trying to design a campaign that includes an incentive for both physicians and patients. It will help greatly for the physician to encourage their patients to sign up.
RT: Tell me how you and the Arkansas Department of Health have worked together to support AR’s diabetes population?
SA: Thankfully, I already had a relationship with ADH because I developed their stroke programming for 5 years in my role as Stroke Coordinator; diabetes and stroke are extremely relative. Because I was already aware of the opportunities for me to learn more, I began attending meetings with ADH’s Diabetes Section Chief, Rachel Johnson. This led to a one-on-one meeting with Rachel about changing the trajectory of diabetes in the state and she quickly offered dMeetings and its resource.
RT: What support have you received from dMeetings before and during this process?
SA: I actually met dMeetings Chief Operating Officer, Mike Caira, at the huge Centers for Disease Control and Prevention’s health department meeting and that was nice. I could tell how helpful and supportive he was upon our initial meeting. Since signing on with dMeetings, Caira is still genuine and readily available if I need help with anything.
RT: What are your main expectations with rolling out this pilot to your clinics and providers?
SA: Our main expectation is to reach rural and underserved diabetes populations and the sites that may not have diabetes educators present to educate about managing the disease. Our largest populations are those that are rural and underserved. A big part of helping them avoid additional health problems related to diabetes is through valuable education. dMeetings IS not only valuable education but it’s by far, the most affordable and available, as well.
RT: What are you looking forward to as a result of this pilot?
SA: I look forward to continuing the expansion of dMeetings throughout the state because I know it will allow patients to reach the outcomes I expect.
The CDC continues supporting the United States and the District of Columbia in their efforts to address serious national health problems with diabetes remaining a top priority. As Aureli noted about Arkansas, some states are 100% funded by the CDC’s Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke grant. This funding continues supporting Arkansas’ efforts to prevent and delay the development of type 2 diabetes in people at high risk and improve the health of the diagnosed population. In September 2018, Arkansas was awarded $906,189 for diabetes related tasks, initiatives, and programs. This award, distributed under a 5-year cooperative agreement, supports all state health departments efforts toward type 2 diabetes prevention and diabetes management. In regard to type 2 diabetes prevention, it will increase access to, coverage for, and enrollment and retention of people with prediabetes in the National Diabetes Prevention Program’s (National DPP) lifestyle change program.
It will also allow state health departments to work with health care organizations to identify people with prediabetes and refer them to CDC-recognized organizations offering the National DPP lifestyle change program. In regard to diabetes management, it will increase access to, coverage for, and participation of people with diabetes in diabetes self-management education and support Diabetes Self-Management Education (DSMES) and Support programs recognized by the American Diabetes Association (ADA) or accredited by the American Association of Diabetes Educators (AADE). Lastly, it will support the increase in the use of pharmacists in providing DSMES and in helping people with diabetes manage their medications. As Ravyn Towns continues chronic disease research across the nation, these findings will be published in a series of case studies, articles, and interviews.