Abstract
Diabetes Morning, a program to integrate use of standards of care for patients with diabetes with a clinical visit, was developed and implemented at Harvard Pilgrim Health Care of New England (HPHC/NE). This staff model HMO served members in Rhode Island and south-eastern Massachusetts until the end of 1999. The Diabetes Morning program was developed in response to the assessment of both internal and external need for greater consistency in meeting care standards, including education. The single session was delivered by a multi-disciplinary team (primary care physician, registered nurse, dietitian, pharmacist) with support from clinical and nonclinical departments. Patients with diabetes from a specific physician panel were invited, through a personal invitation from the doctor, for a half-day session to include laboratory and clinical screenings, education, and a follow-up visit. Each of the participating clinicians, including the physician, presented a 10–20-minute instructional segment. The 1-hour educational session focused on topics critical to diabetes self-management. A translation of Diabetes Morning, specifically for Medicare beneficiaries, is currently being delivered in Rhode Island by the Rhode Island Department of Health Diabetes Control Program (DCP). Funding for the program has been granted to the DCP by the Center for Disease Control and Prevention, Centers for Disease Control (CDC). The DCP translation of the Diabetes Morning program, Diabetes Education Assessment and Referral System (DEARS), has been adapted for delivery in the office settings of private practice physicians. Both physician and patient feedback on the advantages of the program has been overwhelmingly positive. Comments have noted the value of DEARS both for the improvement of quality in patient care and for the support of self-management skills.
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