Arkansas Department of Health Partners with Health Providers to Extend Diabetes Patient Education

Background

According to the Arkansas Department of Health, diabetes remains a top health challenge for the state, with diabetes and prediabetes costing Arkansas an estimated 3.1 billion dollars a year (American Diabetes Association, 2019). Additionally, 797,000 people in AR, or 36.4% of the adult population, has prediabetes with blood glucose levels higher than normal but not yet high enough to be diagnosed as diabetes. Statewide, the diabetes population is managed by the Arkansas Department of Health with their overall goal to reduce the incidence of diabetes, diabetes-related health complications, and costs related to diabetes. One of their main objectives to achieve these goals is to provide online diabetes self-management education in an effort to support the diabetes population through partnerships throughout the state. These partnerships include health systems, employers, pharmacies and state managed clinics. By extending online DSMES to health providers statewide, diabetes education will reach a substantial number of educators, physicians, and ultimately diabetes patients in Arkansas.

Diabetes Self-Management Education and Support (DSMES) programs help both patients and their healthcare teams prevent or delay diabetes complications. Because Arkansas’s diabetes population faces numerous barriers to receiving in-person DSMES, the ADH is addressing these barriers by deploying online DSMES on a broad scale. This will result in increased distribution of quality diabetes patient education, the reduction of healthcare costs, and minimizing the complications of diabetes and its related conditions including heart disease and stroke. With a large segment of the population confronted with transportation as a barrier, online diabetes education will reach residents who live in rural areas along with residents who are simply unable to attend in-person sessions. This case study documents Arkansas implementation of a new, online solution and projected outcomes.

The Challenge

In Arkansas, a significant portion of the population has both undiagnosed and diagnosed diabetes and pre-diabetes. Due to several constraints, including money, time, and transportation, AR’s diabetes population lacks easy access to diabetes management and support solutions. With the ADH combatting these barriers on a large scale, they are seeding an initiative utilizing online DSMES solutions for Arkansas. The ADH has sought to better inform patients about the initiative and extend patient education to their residents, but due to lack of staffing and funding, this has been a significant challenge. Because of this, the ADH has partnered with organizations statewide to meet objectives and achieve outcomes by taking an in-person approach. The ADH hit the ground running to visit their diabetes population in person, to not only listen to their needs, but to respond with action. By using partners to extend the reach of the Department, the ADH will be better positioned to implement diabetes education and have greater success in meeting their strategic goals and objectives. As the Arkansas diabetes population succeeds, everyone succeeds in this effort. Not only do patients benefit but partners also benefit by beginning their journey to becoming an accredited diabetes patient education program moving forward. The ongoing challenge to launch this plan to effectively meet not only patients but to also achieve program strategies and objectives on a large scale will directly address the challenges facing Arkansas diabetes population.

The Solution – Online Patient Education

Evidence has shown, better diabetes management helps people living with diabetes live longer, more productive and healthier lives. To eliminate the barriers plaguing Arkansas’s rural diabetes population and residents with both travel and scheduling conflicts, the Arkansas Department of Health sought dMeetings as the best method to address these issues and began working with partners in the state to maximize their reach and achieve goals on a larger scale. dMeetings is an online DSMES curriculum that, in conjunction with health coaching and oversight, leverages online education to help patients better manage their diabetes. Patients, and healthcare payers, who manage diabetes effectively benefit by having lower healthcare costs and improved quality of life.

The dMeetings model consists of 10 online sessions derived from the AADE’s 7 core behaviors of managing diabetes. Each session is about 30 minutes in length and is accompanied by a quiz and self-study resources. The Learning Management System (LMS) allows health coaches and administrators the ability to track progress and measure learner comprehension throughout the series. This information is particularly relevant as coaches work with patients in follow-up and/or conduct telemedicine sessions to help the patient apply concepts learned. At the successful conclusion of the training, a certificate of completion is awarded that the patient can leverage in a variety of ways including in health and wellness and reimbursement programs.

Currently, Baptist Health Physician Partners has taken full advantage of the opportunity to partner with the Arkansas Department of Health. Through partnerships like Baptist, rural health clinics, large employers, and state pharmacy associations, the ADH will reach a broad spectrum of hospitals, clinics, physicians, and ultimately, patients through Baptist’s direct contact, and ability to identify and connect with audiences. In addition to identifying target audiences, partners like Baptist are able to identify and understand their needs, thus ensuring everyone is receiving accurate information, education and support.

Expectations

Overall, the Arkansas Department of Health is anticipating positive outcomes for their diabetes population with three at the top of their list, including:

· Fewer or less severe diabetes-related complications

· Decreased diabetes-related, health care costs, including fewer hospital admissions and readmissions

· Empowering health partners and pharmacies to utilize dMeetings through their Community Pharmacy Extended Services Network

Since deploying dMeetings, Arkansas has experienced exponential growth in eliminating barriers for diabetes self-management education to Arkansans. Officials expect to triple this growth with its provision through additional partnerships. With Baptist Health Physician Partners as the largest clinical integration program in Arkansas, it is inevitable the presence of online DSMES in Arkansas will continue growing. The ADH, Baptist Health Physician Partners, and other partnering organizations and state managed clinics all share the common goal of providing quality care and lowering the cost of that care for all Arkansans. Arkansas next step is to work with pharmacies, employers and other providers to utilize dMeetings to not only support patients, but to support diabetes educators and programs as well.