Rethinking the Delivery of Diabetes Care

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Rethinking the Delivery of Diabetes Care

• Joseph Prendergast M.D., FACP, FACE
• Abraham Silvers Ph.D, B.S., Fellow A.S.A
• Penelope Ann Mayes R.N., B.S.N., P.H.N.

ACR 114 Task Force October 8, 2008
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Crisis in Diabetes Care

• Diabetes Epidemic
• Shortage of Endocrinologists
• Shortage of Primary Care Physicians

• 37 increase in diagnosed diabetes since 2002
• Predicted 25 to 35 shortage of endocrinologists
  by 2020
• Need 39 more primary care physicians in next 14
  years

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An Integrated Community Based, Telecommunication
Model
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Subject Values at Initial Visit
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Changes in HbA1c from Last Value to First Value
and Slope of Repeated Measures Mean HbA1c Change
-2.4, p.001
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It is difficult to keep in touch with the poor

• New Technologies called Social Media is
  penetrating health care
• The use of social software and its ability to
  promote collaboration between patients, their
  caregivers, medical professionals, and other
  stakeholders in health.
• their stories with each other, not just for
  emotional support, but for the clinical knowledge
  they gain from participating with patients like
  me.

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Conclusions

• Chronic health delivery approach that worked
• Promotes follow-up that can prevent complications
• Saves on costs