Sharon A Watts1, Laura Roush2, Mary Julius3, Ajay Sood4. 1. Endocrinology Section, Louis Stokes Cleveland VA Medical Center, USA Sharon.Watts@va.gov. 2. Psychology Section, Louis Stokes Cleveland VA Medical Center, USA. 3. Nutrition and Food Section, Louis Stokes Cleveland VA Medical Center, USA. 4. Endocrinology Section, Louis Stokes VA Medical Center, USA Case Western Reserve University, USA.
Abstract
INTRODUCTION: An increasing number of patients with diabetes mellitus has created a need for innovative delivery of specialized care not only by diabetes specialists but also by primary care providers (PCPs) as well. A potential avenue to address this need is training of PCPs by specialists via telehealth. The Veteran Affairs (VA) Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) program includes education and case-based learning for PCPs by a multidisciplinary specialty team utilizing videoconferencing technology. METHODS: Two PCPs completed a year of SCAN-ECHO diabetes training. These two PCPs set up "diabetes mini-clinics" to treat difficult-to-control high-risk patients with diabetes mellitus from their own panel and from their colleagues in the same community-based outpatient clinic (CBOC). We utilized a retrospective program evaluation by t-test using pre/post glycated hemoglobin (HbA1c) lab values after being seen by the two PCPs. RESULTS: A total of 39 patients, all with HbA1c > 9.0%, were seen in the two PCP mini-clinics over 15 months. The mean HbA1c improved from 10.2 ± 1.4% to 8.4 ± 1.8% (p < 0.001) over the average follow-up period of five months. This was not explained by system-wide changes or improvements. DISCUSSION: Care of veteran patients with poorly controlled diabetes by PCPs who participated in SCAN-ECHO program leads to improvement in glycemic control. This model of health care delivery can be effective in remote or rural areas with limited availability of specialists.
INTRODUCTION: An increasing number of patients with diabetes mellitus has created a need for innovative delivery of specialized care not only by diabetes specialists but also by primary care providers (PCPs) as well. A potential avenue to address this need is training of PCPs by specialists via telehealth. The Veteran Affairs (VA) Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) program includes education and case-based learning for PCPs by a multidisciplinary specialty team utilizing videoconferencing technology. METHODS: Two PCPs completed a year of SCAN-ECHO diabetes training. These two PCPs set up "diabetes mini-clinics" to treat difficult-to-control high-risk patients with diabetes mellitus from their own panel and from their colleagues in the same community-based outpatient clinic (CBOC). We utilized a retrospective program evaluation by t-test using pre/post glycated hemoglobin (HbA1c) lab values after being seen by the two PCPs. RESULTS: A total of 39 patients, all with HbA1c > 9.0%, were seen in the two PCP mini-clinics over 15 months. The mean HbA1c improved from 10.2 ± 1.4% to 8.4 ± 1.8% (p < 0.001) over the average follow-up period of five months. This was not explained by system-wide changes or improvements. DISCUSSION: Care of veteran patients with poorly controlled diabetes by PCPs who participated in SCAN-ECHO program leads to improvement in glycemic control. This model of health care delivery can be effective in remote or rural areas with limited availability of specialists.
Authors: Brian R Wood; Karin Bauer; Richard Lechtenberg; Susan E Buskin; Lea Bush; Jeff Capizzi; Beth Crutsinger-Perry; Steven J Erly; Timothy W Menza; Jennifer R Reuer; Matthew R Golden; James P Hughes Journal: J Acquir Immune Defic Syndr Date: 2022-08-15 Impact factor: 3.771
Authors: Ryan K McBain; Jessica L Sousa; Adam J Rose; Sangita M Baxi; Laura J Faherty; Caroline Taplin; Andre Chappel; Shira H Fischer Journal: J Gen Intern Med Date: 2019-09-04 Impact factor: 5.128
Authors: Joel C Cantor; Sujoy Chakravarty; Jennifer Farnham; Jose Nova; Sana Ahmad; James H Flory Journal: Med Care Date: 2022-02-22 Impact factor: 3.178