Better Care for Diabetes: The ‘Diabetes Neighborhood’
Have a heart attack and a medical team rushes to your aid—and rightfully so. Have diabetes—the chronic condition that often underlies disastrous medical events such as heart attacks—and you’re pretty much on your own.
That’s a situation that has long frustrated an Einstein endocrinologist who hopes to change the dynamic.
“It’s been known for nearly two decades that a diagnosis of diabetes can be seen as the equivalent of a heart attack,” said Arthur Chernoff, MD, chair of Endocrinology at Einstein Healthcare Network. “Yet diagnosing diabetes does not bring an ambulance with sirens blaring nor does it bring a swarm of specialists to the patient’s side,” he said.
Dr. Chernoff, along with Einstein’s Chief Medical Officer, Steven Sivak, MD, are leading a task force in the search for more effective ways to respond to diabetes.
The Diabetes Neighborhood, as the group is calling itself, includes physicians, nurses and nurse practitioners, diabetes educators and others invested in the care of diabetes patients. It is striving to develop better engagement with patients and to identify care opportunities through an active collaboration with third-party payers and technology partners.
Almost 30 million children and adults in the United States have diabetes.
The initial focus has been to develop a pilot demonstration of centrally coordinated, proactive diabetes care. The first goal is to “determine and validate measurable parameters of diabetes care,” much in the way that heart attack treatment is measured by the time it takes to get a patient from the hospital door to the placement of a stent in the artery. That “door-to-balloon time”, as it is known, has been greatly reduced in recent years because of intense scrutiny brought to that procedure; Chernoff would like to bring the same scrutiny to diabetes care.
Almost 30 million children and adults in the United States have diabetes. The cost amounts to $245 billion annually, including $176 billion in direct costs and $69 billion in indirect costs such as disability, work loss, premature mortality.
Dr Chernoff explained, “The overarching goal is preventing the preventable. We need to remove the barriers to effective care. We want to improve the knowledge base that our frontline doctors and community have about diabetes. We want to control the blood pressure and the cholesterol. We want our patients to master meaningful lifestyle changes. We must promote and achieve healthier outcomes in our Diabetes Neighborhood.”