This article, focusing on sustainability, is part of a larger series surrounding the Centers for Medicare & Medicaid Services’ diabetes self-management program, Everyone with Diabetes Counts (EDC).
“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime,” is the motto TMF, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Texas, Arkansas, Missouri, Oklahoma and Puerto Rico, has used as the basis for its successful sustainability program for diabetes care.
TMF implements a “train the trainer” model of sustainability, inclusive of everything from teaching Diabetes Self-Management Education (DSME) instructors to supporting peer educators with the technical assistance needed to sustain programs beyond TMF’s involvement. TMF staff also provides study sessions for individuals preparing to take the Certified Diabetes Educator (CDE) exam.
“Pharmacies are the backbone of sustainability efforts because they have the greatest ability to complete the communications loop between patients, physicians and educators.”
TMF’s sustainability efforts have been highly successful. Over 95 percent of educators in the QIN-QIO’s first DSME Special Innovation Project reported that they continue to teach patients about diabetes even after the conclusion of their training with the QIN-QIO.
According to Ardis Reed, a health disparities-certified diabetes educator at TMF, Texas has seen a 14 percent increase in the number of CDEs since work began in 2010. This rate will need to continue to increase in order to support the projected one in three Texans that will have diabetes by 2040.
Since establishing TMF’s sustainability program, Reed has targeted pharmacists, recognizing that they are the professionals whom beneficiaries see most often on their health care team.
“Pharmacies are the backbone of sustainability efforts because they have the greatest ability to complete the communications loop between patients, physicians and educators,” Reed said.
By helping local pharmacists connect with appropriate associations and become accredited DSME sites, communities can improve access to diabetes self-management education locations.
“Unlike hospitals, which can be difficult for beneficiaries in rural communities to reach, every town, big or small, has a pharmacy that can be trained to provide easily accessible DSME programs,” Reed said.
Creating this support system for ongoing conversations between providers and patients enables beneficiaries to stay informed about local diabetes classes and resources, and holds all parties accountable for filling patient education and health gaps.
According to guidelines from the Centers for Medicare & Medicaid Services (CMS), all Medicare beneficiaries are allowed 10 hours of self-management education within their first year of diagnosis. However according to a recent Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention, only four percent of those with Medicare coverage are taking advantage of such benefits. By increasing program awareness and certifying more DSME instructors, more patients will be able to utilize first-year benefits and keep up with their diabetes self-management education in the long term.