Disease-Management Programs Can Improve Quality of Care for the Chronically Ill, Even in a Weak Primary Care System: A Case Study From Germany

Examines how Germany's disease management programs featuring information technology support, designated ambulatory care doctors, focus on self-management, quality assurance, and financial incentives raised quality and satisfaction. Outlines implications

Glu: An Online Type 1 Diabetes Information Community

This research paper examines the online health community Glu (MyGlu.org), a type 1 diabetes social media site. Type 1 diabetes is a chronic medical condition that requires constant and specialized medical attention. Online health communities like Glu, are an important part of maintaining a healthy lifestyle for many of its members. This study discusses the composition of this information community, the motivations of its members, and the benefits members gain through their participation. It describes the major characteristics of the community and focuses on the information needs of type 1 diabetics. It concludes with reflections on how libraries and LIS professionals can better serve the information needs of health communities like Glu and accommodate their needs in the physical space of the library

Assessment of Ubiquitous Healthcare Information Systems Benefits

Health is a fully individualized concern, and is therefore inherently mobile. Thus, Ubiquitous Healthcare Information Systems can enable a much-needed patient-centered care environment. This paper presents a decision support system that makes use of system dynamics methodologies in order to assess the improved health benefits that may be realized within the context of ubiquitous healthcare information systems in support of managing diabetes

Transforming the Workforce to Provide Better Chronic Care: The Role of Nurse Care Managers in Rhode Island

This series explores the evolution of primary care systems to better meet the needs of consumers with complex health conditions. It demonstrates that changes in the workforce are required to empower consumers to better manage their health.The series is a collaboration of the National Academy for State Health Policy and the AARP Public Policy Institute. We recognize that it takes a team of skilled professionals to deliver improved chronic care. In this series, we focus on how registered nurses -- who make up the largest segment of the health care workforce -- are being deployed in ambulatory delivery systems to take on new roles. Future series will focus on other members of the health care team.We selected six initiatives that offer replicable policy strategies to develop, implement, and sustain patient-centered approaches to care. Each case study highlights one of these initiatives and provides policy recommendations and an "on-the-ground" look at the work of its nurses

The Incorporation of Integrative Medicine to Assess and Address Diabetic Patients’ Psychosocial Needs

The purpose of this project was to increase the understanding of the assessment, implementation and referral of Complementary and Alternative Medicine (CAM) in order to meet psychosocial needs and decrease stress among diabetic patients. Using a mixed method design, both qualitative and quantitative research questions were incorporated into a survey distributed using a non-probability sample of healthcare professionals working in family medicine or general medicine practices within the metro area. The study attempted to answer the following questions: Is integrative medicine being conducted by healthcare professionals to address type 1 and type 2 diabetic patients’ psychosocial needs in family medicine and primary care settings? Is IM being assessed, referred and implemented in family medicine and primary care settings? Quantitative data was analyzed using both descriptive and inferential statistical analyses. Qualitative data was interpreted using the content analysis technique. Findings indicated respondents who ask about CAM use during clinic appointments are more likely to implementCAMduring office appointments. Respondents that ask about CAM during office visits were more likely to refer toCAMfor additional care. Next, there was an increased likelihood of putting psychosocial interventions in the treatment plan when respondents assessed for diabetic patients’ psychosocial needs. The respondents who endorsed practicing CAM personally were more likely than those who have not to refer diabetic patients’ toCAMfor additional needs. Findings suggested that implementingCAMis not a standard practice. Findings related to barriers were consistent with previous literature. Respondents endorsed an increase in blood sugars are a result of stress among diabetic patients. These findings emphasize the importance of assessing and addressing psychosocial needs among diabetics in order to decrease the harmful effects of stress

The Incorporation of Integrative Medicine to Assess and Address Diabetic Patients’ Psychosocial Needs

The purpose of this project was to increase the understanding of the assessment, implementation and referral of Complementary and Alternative Medicine (CAM) in order to meet psychosocial needs and decrease stress among diabetic patients. Using a mixed method design, both qualitative and quantitative research questions were incorporated into a survey distributed using a non-probability sample of healthcare professionals working in family medicine or general medicine practices within the metro area. The study attempted to answer the following questions: Is integrative medicine being conducted by healthcare professionals to address type 1 and type 2 diabetic patients’ psychosocial needs in family medicine and primary care settings? Is IM being assessed, referred and implemented in family medicine and primary care settings? Quantitative data was analyzed using both descriptive and inferential statistical analyses. Qualitative data was interpreted using the content analysis technique. Findings indicated respondents who ask about CAM use during clinic appointments are more likely to implement CAM during office appointments. Respondents that ask about CAM during office visits were more likely to refer to CAM for additional care. Next, there was an increased likelihood of putting psychosocial interventions in the treatment plan when respondents assessed for diabetic patients’ psychosocial needs. The respondents who endorsed practicing CAM personally were more likely than those who have not to refer diabetic patients’ to CAM for additional needs. Findings suggested that implementing CAM is not a standard practice. Findings related to barriers were consistent with previous literature. Respondents endorsed an increase in blood sugars are a result of stress among diabetic patients. These findings emphasize the importance of assessing and addressing psychosocial needs among diabetics in order to decrease the harmful effects of stress

Innovative Concept Model Design for Linking Physicians to the System of Patient-Centered Care with Advancing Technologies in the World of Diabetes

This concept paper applies the concepts of complex sociotechnical engineering systems to the care and management of type 2 diabetes. It also includes an innovative design model that integrates the existing ecosystem of care and management of diabetes. This model could potentially improve quality of care, create transparency of information between patient and physician and decrease the overall cost of care of diabetes

The Impact of the Patient-Centered Medical Home on Health Disparities in Adults: A Systematic Review of the Evidence

Introduction: The objective of this study was to review the empirical evidence on Patient-Centered Medical Home (PCMH) impact on health disparities in adults. Methods: We searched PubMed, Scopus, and Google Scholar to identify studies on PCMH/health homes and health disparities published in English between January 1, 2009 and December 31, 2014. Articles met inclusion criteria if they investigated at least one component of PCMH or health homes in vulnerable populations, defined by PROGRESS-PLUS criteria, and reported differences in one of five clinical quality measures. Results: 964 articles were identified through database searching and subsequent snowballing. 60 articles underwent full text screening. Further review eliminated 56 studies. In the final 4 studies, PCMH interventions showed small improvements in health disparities. Discussion: The PCMH has been suggested as a model for improving health disparities. Given rapid implementation in underserved settings, stakeholders should better understand the impact of the PCMH on health disparities

Shared Medical Appointments: An Intervention for Diabetes Management

Abstract Background: Uncontrolled diabetes often develops into complications that are very expensive for both the patient and the healthcare system. Shared Medical Appointments (SMAs) are an evidence-based intervention that has been shown to improve participants’ biophysical outcomes and their ability to manage their disease, which can reduce long-term complications and expense. Project Goal: This project evaluated biophysical outcomes and self-efficacy among a group of primary care patients with uncontrolled diabetes who attended a pilot SMA intervention. Study design and Methods: A pre-test/post-test design utilizing a nonrandomized convenience sample over a 6-month time frame was utilized. Self-efficacy was measured using the Diabetes Empowerment Scale-Short Form (DES-SF). Biophysical measurements included: glycated hemoglobin (HgbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), blood pressure (both systolic and diastolic), weight, and triglycerides. Quantitative data was analyzed using the Wilcoxon-signed rank test to evaluate pre/post effects of the SMA intervention. Results: Descriptive analysis showed a significant reduction in LDL with a median difference of 11.8 mg/dL (p\u3c0.43), and a significant increase in HDL with a median difference of 3.5 mg/dL (p\u3c0.43). HgbA1c, self-efficacy scores, and diastolic blood pressure showed improvements, but were not found to be statistically significant (p\u3c .128, p\u3c .172, p\u3c .610, respectively). There were no changes in weight. Both systolic blood pressure and triglycerides were found to have increased slightly. Conclusion: The intervention showed significant improvements in some measurable outcomes, but not in others. A larger sample size would provide stronger evidence of the impact of the SMA. A homogenous format would also help to determine which components are most effective. Keywords: diabetes, intervention, shared medical appointment, group visit