When Debbie Yoro, a licensed social worker and behavioral health specialist at Iora Primary Care in Washington state, began working with Qualis Health, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Idaho and Washington, it was with a shared goal in mind: to bring autonomy to all aspects of their diabetes patients’ lives.
Diabetes self-management education (DSME) classes fit well into Iora’s already patient-focused environment. The health system provides patients with zumba and yoga classes, complimentary lab for blood tests, a library and educational health books and DVDs, and even personalized health coaches.
“The beauty of these classes is that each concludes with goal setting,” Yoro said. “We want patients to be good at managing their health and overall lives, one step at a time.”
Jamie Hunter-Mitchell, Stanford-certified Master Trainer and Quality Improvement Consultant at Qualis Health, saw the dedication from Iora’s team from the start. Debbie, along with other members of the practice staff, including health coaches and physicians, participated in the first workshop along with their patients.
“Right away, we saw staff buy-in for the value of the workshops,” Hunter-Mitchell said. “Even more significant, however, was the added knowledge and accountability we saw from the patient participants once they realized their health coach, physician and social worker were in the room as partners in their health.”
Yoro said, “Whenever you’re working in a group, there’s a sense of partnership. It’s obviously good for patients to hear stories from other patients and feel a sense of inclusion. But hearing about how to self-manage your diabetes while also learning about getting out of the house, exercising, eating right, going to the eye doctor, etc., adds another element of education to the classes.”
Today, six Iora staff members have completed the lay leader training, allowing them to expand the program to an even larger group of patients — nearly 50 thus far across four clinics. Hunter-Mitchell explained that a large reason for the uptick in patient participation was the customized approach taken by Yoro and her team. Iora Health personalizes communication tactics depending on the patient’s unique circumstances — sometimes text or email works best, sometimes a written letter, and sometimes a phone call or home visit.
“We want patients to be good at managing their health and overall lives, one step at a time.”
One patient has even completed the leadership training and held her own classes after being motivated from the fulfillment she received from the program.
“That’s probably one of the biggest success stories you can ask for,” Hunter-Mitchell said. “It’s inspiring to see people blossom into great self-managers and leaders.”
Over the past year, Iora has seen great results from the DSME program, including a collective weight loss of 41 pounds, continual increases in activity levels, and a decrease in insulin levels from two participants. Notably, one 70-year-old male patient decreased his hemoglobin A1c level from 10.7 to 6 percent over the course of five months.
A number of people are participating in Iora’s Patient Ambassador Club, where patients attend events like farmers’ markets or community gatherings. At these events, patient ambassadors can answer other patients’ questions and share their story of health improvement at Iora.
Iora is also expanding its chronic diesease management programs to include sleep care, nutrition, pain and stress management. Washington residents 65 and older can attend free classes offered by Iora.
While this is Iora’s first experience with DSME workshops, with assistance from Qualis Health, the health system is considering pursuing an American Diabetes Association (ADA) or American Association of Diabetes Educators (AADE) recognized or accredited program in the future.