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Northern Michigan Diabetes Initiative: Provider Education Program

An Evidence-Based Practice

Description

The Provider Education Program of the Northern Michigan Diabetes Initiative (NMDI) consists of two main components: the Educational Outreach Visit program and the web-based iDose application. The Educational Outreach Visit program educates providers on diabetes management through a curriculum based on ADA guidelines and developed by endocrinologist Dr. Jill Vollbrecht. Dr. Vollbrecht reviews the curriculum with primary care providers to increase their knowledge of diabetes management and improve glycemic and lipid control among patients with diabetes.

iDose, also developed by Dr. Vollbrecht, is an online resource for healthcare providers managing diabetes in their patients. Providers are prompted to enter relevant patient information and the tool calculates individualized insulin doses, thereby eliminating the need for manual calculation using two complex formulas.

Goal / Mission

The overall goal is to reduce the prevalence of diabetes and improve the care of people with diabetes by improving provider education.

Impact

The results indicate that a half-day site visit with an experienced diabetologist can lead to sustained, improved glycemic and lipid control in previously-uncontrolled diabetic patients. The online iDose tool provides an easy way for healthcare providers to calculate insulin dosage.

Results / Accomplishments

The head endocrinologist, Dr. Jill Vollbrecht, reviewed the Educational Outreach curriculum with each of nine primary care providers (PCP) during a site visit. Nine months following the site visit, statistically significant reductions in median LDL and urine microalbumin: creatinine were demonstrated in previously-uncontrolled patients. A trend toward improvement in median A1c was noted. Eighteen months after the visit, the effect was sustained. Total diabetic education referrals from the participants increased 23% following the site visit. The number of diabetic patients referred to endocrinology for diabetic management remained stable at 4% of the total diabetic population of the participants.

Participant satisfaction was assessed using pre- and post-visit surveys; participants rated their knowledge of and confidence in managing diabetes using a scale of 1 (least) to 4 (most). Participants reported a subjective average increase in knowledge of treating diabetes of 25%, and an average increase in confidence in treating diabetes of 30%. The results indicate that a half-day site visit with an experienced diabetologist can lead to sustained, improved glycemic and lipid control in previously-uncontrolled diabetic patients.

The online insulin dose calculation tool, iDose, averages over 500 views each month and is used by healthcare professionals in over twenty states.

About this Promising Practice

Organization(s)
Northern Michigan Diabetes Initiative
Primary Contact
Christi Nowak
Munson Medical Center
1105 Sixth St.
Traverse City, MI 49684
(231) 935-9256
cnowak@mhc.net
Topics
Health / Diabetes
Organization(s)
Northern Michigan Diabetes Initiative
Geographic Type
Rural
Location
Michigan
For more details
http://www.nmdiabetes.org
Additional Audience
Healthcare Providers

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.
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