1. Planning and Evaluating Outcomes for Wellness Programs: The ADSS Jeffrey A. Johnson School of Public Health University of Alberta

2. Diabetes in Alberta By the numbers…. Almost 206,000 people were living with diabetes in Alberta in 2009. Over 19,000 new cases were identified in 2009. Diabetes rates have almost doubled over the past decade. Each year, adults with diabetes see physicians 2-3 times more often and spend almost 3 more days in hospital compared to their non-diabetic counterparts. People with diabetes have mortality rates 2 times higher than people without diabetes.

3. CAHS Report 2010

4. Diabetes in Alberta By the numbers…. Albertas Diabetes Surveillance System Is a partnership between ACHORD/IHE/U of A and Alberta Health and Wellness; tracks the numbers and trends for diabetes in the province over time; is part of a national program run by the Public Health Agency of Canada; provides valuable information on the level of health services used by people living with diabetes.

5. 5 6/1/201402/17/2006 5 Goals for the National Diabetes Surveillance System Enhance capacity for Diabetes surveillance –Provincial / Territorial –Federal Create nationally comparable data: –Epidemiology –complications / co-morbities –health services utilization www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd

6. Health Care & Data Canadian Context Publically Funded, Privately Delivered Prescriber Amt Dispensed DIN Unique ID Mortality Health Services Demographic Data Unique ID PHN Unique ID PHN Unique ID PHN HospitalPhysician Insurance Registry Age Gender Location of Residence Status Aboriginal Co-Morbidities /Procedures DM Status Incident/Prev DM Status Incident/Prev Co-Morbidities /Procedures Drug ICD-9-CM or ICD-10CA ICD-9-CM Vital Statistics COD

7. 2 physician billing claims with a code of ICD-9 250 over 2 years OR 1 hospitalization with a discharge code of ICD-10, codes E10-E14 (ICD-9 prior to 2001/02) Note: Does not distinguish between T1DM and T2DM 2 physician billing claims with a code of ICD-9 250 over 2 years OR 1 hospitalization with a discharge code of ICD-10, codes E10-E14 (ICD-9 prior to 2001/02) Note: Does not distinguish between T1DM and T2DM NDSS Case Definition

8. NDSS Report www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd

9. Alberta Diabetes Atlas 2011 1. Background and Methods 2. Epidemiological Trends 3. Children and Adolescents 4. Health Care Utilization 5. Laboratory Testing 6. Cardiovascular Disease ACS, HF, Stroke and Hypertension 7. Foot Disease and LL Amputation 8. Kidney Disease 9. Eye Disease 10. Mental Health Disorders 11. Diabetes in the SA population 12. Gestational Diabetes 13. Key Findings and Policy Options

10. Number of Albertans Living with Diabetes 1995-2009

11. Newly Identified Cases of Diabetes 1995-2009

12. Rate of Diabetes in Alberta, 1995-2009

13. Alberta Diabetes Prevalence Provincial rate = 5.7%

14. Age-Specific Diabetes Rates, 2009

15. Death Rates in Alberta 1995 - 2009

16. ADSS – Monitoring Diabetes in Alberta Epidemiologic trends – incidence, prevalence & mortality Diabetes and related comorbidities Health care utilization Standardized reporting – time, age, geography Customizable queries for local planning

17. Diabetes and Heart Disease

18. Diabetes and Heart Disease (Cases)

19. Diabetes and Stroke

20. Diabetes and Hypertension

21. Diabetes and Depression

22. Diabetes and Health Care Utilization

26. Diabetes and Eye Disease Eye Examinations * Eye examinations by an Ophthalmologist

27. Diabetes and Laboratory Tests

29. A1c LDL

30. ADSS ACTIVE DISSEMINATION: Local Information, for Local Planning

31. ADSS Active Dissemination n Northern Lights Region (Wood Buffalo/Fort McMurray) Apr 08 n Peace Country Nov 08 n Aspen (Westlock ) June 08 n East Central Oct 08 n DTHR (Red Deer) Mar 08 n Lethbridge (Chinook) Aug 07 n Palliser Jan, Feb, Apr 08 n Capital Ongoing n Calgary Ongoing Local information, for local planning….

32. Prevalence Rates by Community Age-Adjusted (2006)

33. Incidence Rates by Community Age-Adjusted (2006)

34. Diabetes Prevalence Rates for Oyen, (Age-Adjusted) 1995-2006

35. Diabetes Prevalence Case Counts (2006)

36. Local Information for Local Planning… Diabetes crisis in Oyen Confirmation with ADSS numbers Case finding phenomenon Retired surgeon GP practice w/ DM focus Presentation to Regional Health Board & Executive Mobilized funding for diabetes outreach team MD, RN, RD, SW travelling DEC 2 monthly visits to Oyen in 2008 Ongoing shared client care model with local PCN Local DM registry Tele-health with Medicine Hat CDM team

37. www.albertadiabetes.ca

38. www.albertadiabetes.ca Interactive Website

39. https://www.interactiveadss.ualberta.ca You Tube tutorial

40. ADSS - Enhanced Surveillance & Program Evaluation P/T Admin data (ADSS) as a foundation Linkages with external datasets Lab data Risk factor surveillance (surveys) Clinical datasets/Patient registries Social datasets (e.g., school performance) Cross-walk with other CD surveillance systems (NDSS CCDSS)

41. Questions... ? jeff.johnson@ualberta.ca www.achord.ca www.albertadiabetes.ca