For people with diabetes, controlling blood sugar, cholesterol and blood pressure is critical to staying healthy. When these goals go unmet, dire consequences can result. Following the same chronic care model as recently presented by Vermont Governor Jim Douglas, a new UVM research project intends to provide measurable proof via blood test results that Vermont's more than 28,000 diabetes patients and their physicians can achieve improved diabetes control.
The new Vermont Diabetes Information System project electronically links participating hospital laboratories, primary care providers and their diabetic patients. Funded by a $2 million grant from the National Institutes of Health, the VDIS now has statewide participation, with 10 hospital-based laboratories and 37 primary care practices with 102 providers across the state and in upstate New York and New Hampshire.
The system's process is simple. Each time an enrolled patient has a diabetes-specific lab test, VDIS generates a report for the physician that contains other pertinent lab information and guideline-based prompts regarding treatment targets. If the lab result is out of range, or if a patient is overdue for a test, the physician and patient are automatically sent a reminder via fax or letter. This "decision support" helps everyone involved focus on setting and meeting goals. Physicians also receive periodic report cards to show how well their practice is meeting targets.
Dr. Charles MacLean, UVM associate professor of medicine, is the VDIS project director. MacLean, a practicing primary care physician, has enrolled primary care practices statewide, from the Northeast Kingdom all the way down to Bennington, and in neighboring New Hampshire and New York.
"By facilitating a partnership between physicians and patients with a system of goal-setting, outcomes will improve," MacLean says. "In addition, we expect VDIS will also function as a helpful tool for busy primary care physicians, and provide cost-savings for the overall health care system."
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