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ECHO-Chicago Complex Diabetes Management: Managing Medical and Social Issues
Chicago, IL US
January 17, 2020 to May 8, 2020
PI CME/Quality Improvement Effort
Diabetes is the seventh leading cause of death in the U.S (CDC https://www.cdc.gov/nchs/fastats/diabetes.htm). Rates of both diabetes and prediabetes in Illinois are higher than the national averages. An estimate 13% of the population (1.3M people) has diabetes and an additional 38% (3.6) has prediabetes, with 90-95% of all cases attributed to Type-2 diabetes (T2D). The impact of diabetes is even greater among Black populations. Diabetes prevalence among Black populations is 18.7%, compared to a prevalence of 7.1% among non-Hispanic white populations. The disproportionate burden of diabetes is evident in Chicago. The rates of diabetes-related mortality and diabetes-related hospitalization are 2.0 and 3.0 times higher, respectively, among Black populations as compared to non-Hispanic white populations. Current demand for endocrinologists far exceeds the number of trained specialists. Vigersky et al (2014) identified a gap of 1500 adult endocrinologists and projected the shortage to exceed 2700 by 2025. As a result, patients and providers often experience frustration in getting timely access to specialty care. With many subspecialists limiting the number of uninsured or underinsured patients they treat, access to subspecialty care becomes even more difficult for Medicaid and uninsured patients and their providers. While diabetes care is usually in the province of primary care providers (PCPs), reported barriers among PCPs in diabetes care include limited resources and environmental constraints, limited knowledge and skills in complex diabetes management, frequently changing diabetes recommendations, lack of comfort or familiarity in initiating insulin regimens, and difficulty with patient adherence.
This series will address these known challenges and gaps in care, to help PCPs implement and sustain evidence-based, patient-centered diabetes management practices by providing practical knowledge and skills for managing diabetes patients with medically and socially complex needs.
Diabetes is the seventh leading cause of death in the U.S (CDC https://www.cdc.gov/nchs/fastats/diabetes.htm). Rates of both diabetes and prediabetes in Illinois are higher than the national averages. An estimate 13% of the population (1.3M people) has diabetes and an additional 38% (3.6) has prediabetes, with 90-95% of all cases attributed to Type-2 diabetes (T2D). The impact of diabetes is even greater among Black populations. Diabetes prevalence among Black populations is 18.7%, compared to a prevalence of 7.1% among non-Hispanic white populations. The disproportionate burden of diabetes is evident in Chicago. The rates of diabetes-related mortality and diabetes-related hospitalization are 2.0 and 3.0 times higher, respectively, among Black populations as compared to non-Hispanic white populations. Current demand for endocrinologists far exceeds the number of trained specialists. Vigersky et al (2014) identified a gap of 1500 adult endocrinologists and projected the shortage to exceed 2700 by 2025. As a result, patients and providers often experience frustration in getting timely access to specialty care. With many subspecialists limiting the number of uninsured or underinsured patients they treat, access to subspecialty care becomes even more difficult for Medicaid and uninsured patients and their providers. While diabetes care is usually in the province of primary care providers (PCPs), reported barriers among PCPs in diabetes care include limited resources and environmental constraints, limited knowledge and skills in complex diabetes management, frequently changing diabetes recommendations, lack of comfort or familiarity in initiating insulin regimens, and difficulty with patient adherence.
This series will address these known challenges and gaps in care, to help PCPs implement and sustain evidence-based, patient-centered diabetes management practices by providing practical knowledge and skills for managing diabetes patients with medically and socially complex needs.
Target Audience
This performance/quality improvement initiative is intended for physicians, residents, and fellows in internal or family medicine at the University of Chicago Medicine.
Learning Objectives
The aims for this project:
- To show an increase in prescriptions of FDA approved medications by prescribing providers for better medication management.
- To show a reduction in patients A1c levels as higher A1C levels poses greater risk for developing type 2 diabetes.
University of Chicago Medicine
5841 S Maryland Ave
Chicago, IL
60637
United States
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QIPI Project Physician Lead
Daniel Johnson, MD
Professor of Pediatrics Chief, Section of Academic Pediatrics
Chief, Section of Pediatric Infectious Diseases
Vice Chair, Clinical Services
University of Chicago Medicine
Professor of Pediatrics Chief, Section of Academic Pediatrics
Chief, Section of Pediatric Infectious Diseases
Vice Chair, Clinical Services
University of Chicago Medicine
QI Project Owner
Kanika Mittal, MS
Director of Operations
ECHO-Chicago
Director of Operations
ECHO-Chicago
Disclosure Declarations
As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. This includes any entity producing, marketing, re-selling, or distributing health care goods or services consumed by or used on patients. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months, including financial relationships of a spouse or life partner that could create a conflict of interest. Mechanisms are in place to identify and resolve any potential conflict of interest prior to the start of the activity.
Additionally, The University of Chicago Pritzker School of Medicine requires authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
Physician Credit
The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The University of Chicago Pritzker School of Medicine designates this PI CME activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The University of Chicago Pritzker School of Medicine designates this PI CME activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CME and MOC IV Credit
The national Multi-Specialty MOC Portfolio Approval Program has granted approval to the University of Chicago to award MOC Part IV credit to physicians participating in quality improvement (QI) projects. To qualify for both PI CME credit (AMA PRA Category 1 Credit™) and QI MOC through the ABMS Multi-specialty Portfolio Program, participants must be engaged in a systematic effort of reviewing and improving some aspect(s) of care or care delivery for their patients.
Sustained QI Cycles: Physicians are required to complete not less than 2 intervention cycles and not less than 3 data collection points:
1. Pre-intervention cycle 1
2. Post-intervention cycle 1
3. Post intervention cycle 2
The QI effort must be sustained, involving at least two or more linked cycles of performance review and improvement effort. The post-intervention data and review from one cycle become the baseline data and planning for the next cycle. Starting with a suspected or actual problem with care:
1st QI cycle
Baseline data collection, analysis/review, identify underlying cause(s)
Intervention(s) to address underlying cause(s)
Post-intervention data collection, analysis/review, identify remaining underlying cause(s)
1st QI cycle
Baseline data collection, analysis/review, identify underlying cause(s)
Intervention(s) to address underlying cause(s)
Post-intervention data collection, analysis/review, identify remaining underlying cause(s)
2nd QI cycle
Post-intervention data collection, analysis/review, identify underlying cause(s) (same as above)
Adjustment(s) / second intervention(s) to address underlying cause(s)
Post-adjustment data collection, analysis/review, identify remaining underlying cause(s)
Post-intervention data collection, analysis/review, identify underlying cause(s) (same as above)
Adjustment(s) / second intervention(s) to address underlying cause(s)
Post-adjustment data collection, analysis/review, identify remaining underlying cause(s)
Participants will be directed to attest and claim their 20 AMA PRA Category 1 CreditsTM through the CME website that is created for the project. Physician participation information will then be sent to the appropriate ABMS boards to report the successful completion of an MOC IV project. MOC IV credit will then appear in the diplomate’s specific board profile.
Attestation forms must be submitted by November 30th in order for us to report credit to your ABMS specialty board and have your credit count for that year.
Attestation forms must be submitted by November 30th in order for us to report credit to your ABMS specialty board and have your credit count for that year.
Registration: Closed to the public.
Claiming Credit: Enter the access code to unlock the credit claiming process.
Claiming Credit: Enter the access code to unlock the credit claiming process.
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