DETROIT - Henry Ford Macomb Hospital, in partnership with the American Medical Association (AMA), is piloting a patient registry that could become a national model for enrolling patients with prediabetes into evidence-based diabetes prevention programs and reducing their risk of developing type 2 diabetes.
Henry Ford Macomb, part of the Henry Ford Health System, is currently evaluating the registry for its effectiveness for screening, testing and referring patients diagnosed with prediabetes to a diabetes prevention program. The hospital developed specific clinical protocols before creating the registry using tools available in its Epic electronic medical record.
"We're delighted to be working in partnership with the American Medical Association on this pilot project," says Henry Ford Macomb President and CEO Barbara Rossmann. "Our team has designed a user-friendly, efficient registry that has the potential to be a valuable tool for addressing the rising prevalence of prediabetes in Michigan and across the country."
According to the latest data from the Centers for Disease Control and Prevention (CDC), more than 84 million Americans are living with prediabetes - 2.6 million in Michigan alone - and nearly 90 percent of them don't know they have it and aren't aware of the long-term risks to their health. Prediabetes is a condition in which the blood glucose, or A1C levels, are higher than normal but not yet high enough to be considered type 2 diabetes. A person with prediabetes is at increased risk for developing type 2 diabetes and other serious, long-term health issues such as heart attack and stroke. However, prediabetes can often be reversed through lifestyle changes like weight loss, healthy eating, and increased physical activity.
"With a staggering number of Americans living with prediabetes and the vast majority unaware they have the condition, we must continue to ensure more patients have access to, and enroll in, proven lifestyle change programs that have been shown to cut in half participants' risk of progressing to type 2 diabetes," said AMA President David O. Barbe, M.D. "Through our partnerships with health systems, such as Henry Ford, we will be able to help even more Americans stave off or delay type 2 diabetes to improve health outcomes."
The AMA approached Henry Ford Macomb, located in Clinton Township, MI about 25 miles northeast of Detroit, to collaborate on the pilot project based on the documentation and reporting system used by its diabetes prevention program partner Henry Ford Macomb Faith Community Nursing Network (FCNN). That system allowed providers to view their patients' progress after enrolling in a diabetes prevention program including attendance in classes, weight loss, and blood pressure and activity levels.
The AMA provided its clinical and technical expertise to help Henry Ford enhance the registry to ensure that the providers who use the system have the tools they need to most effectively identify and screen patients at risk for prediabetes and refer them to proven diabetes prevention programs. The AMA and Henry Ford worked together with Epic to develop and implement additional features into the registry based on evidence-based, best practices and clinical guidelines used for patient screening and referral to DPPs.
The registry being pilot tested by Henry Ford Macomb would be attractive to health systems large and small because of its integration in the electronic medical record, says Gina Aquino, R.N., a clinical quality nurse facilitator at Henry Ford Macomb and co-leader of the registry project.
It would allow providers, hospitals and other health care professionals to compile, view and share a trove of data including:
- Diabetes risk assessment.
- Patient instructions.
- Referrals to a diabetes prevention program and patients' progress.
Six months into the test pilot, the Henry Ford Macomb team has seen a positive trend: the number of patient referrals to a diabetes prevention program is increasing.
"This registry would allow for data sharing among providers, and help providers identify patients at risk of prediabetes and refer them to a CDC-recognized diabetes prevention program close to home," Aquino says. "These lifestyle change programs have shown to be more effective than medication for aiding patients to reduce their risk of developing type 2 diabetes."
Programs recognized by the CDC are based on research led by the National Institutes of Health. This research shows that people with prediabetes who take part in a structured lifestyle change program reduce their risk of developing type 2 diabetes by 58 percent.
Long-term results are equally striking: participants are one-third less likely to develop type 2 diabetes 10 years after completing the program. Additionally, participants lose 5-7 percent of their body weight by eating healthier and engaging in 150 minutes of physical activity every week.
After the test pilot ends in June 2018 the AMA will assess the registry's effectiveness as a potential national model that can be used to help other health systems across the country increase patient participation in evidence-based diabetes prevention programs.
The FCNN is implementing a CDC-recognized diabetes prevention program in Macomb County, MI, in collaboration with the Macomb County Health Department and Greater Detroit Area Health Council. A similar program is also planned for Wayne County, MI.
Under the 16-week program, patients diagnosed to have prediabetes meet with a trained lifestyle coach who offers advice and support for:
- Eating healthy.
- Adding physical activity to their daily routine.
- Dealing with stress.
- Staying motivated and overcoming barriers.