Michelle D. Stancil, RN, BSN, CDE Blix M. Rice, MBA, CHFP October 16, 2015 Putting a Diabetes Educator in Your Pocket: A Novel Approach to Disease Management

Introduction GHS developed a Diabetes Self-Management Program with endocrinology treatment algorithms plus the addition of a wireless enabled glucometer Pilot criteria: –GHS insured employees –A1c equal to or greater than 8% –Diagnosis of diabetes (insulin pump excluded) –Age –Target two GHS primary care physician practices –Goal: Primary - Reduce A1c by 15% Secondary – Develop primary care workflow model Improve diabetes understanding and self-management

Outcomes A1c improved, more than 15% reduction Provider and multidisciplinary collaboration strengthened, with increased referrals to titrate insulin DSMP utilization by employees increased Diabetes understanding and self- management improved, as measured by questionnaire Additional practices desired participation Co-worker support groups formed

Revisions Expand to all GHS physician practices Enroll additional 50 GHS insured employees and dependents Telehealth Diabetes Educator available Monday- Friday, 8:30-12:00 PharmD, BC ADM (Board Certified-Advanced Diabetes Management) trial on telehealth team Expand medication algorithm to include insulin pump participants Pharmacy home delivery

Expansion Wireless meter for high risk populations –Pediatric IRB in development Continuous glucose monitor cloud-based platform: outpatient high risk, pediatric, pregnant, eventually inpatient populations MyChart – diabetes telehealth blood glucose evaluation and algorithm titration Cloud-based medical nutrition therapy coaching