2237-PUB: Diabetes Inside: Regional Collaborative to Improve DM and CVD Care Quality

Abstract

The American Diabetes Association (ADA) and the American Heart Association launched a multi-faceted national partnership in 2018, Know Diabetes by Heart™, to reduce cardiovascular disease (CVD) deaths, heart attacks and strokes in people living with type 2 diabetes. To support this initiative, the ADA’s Diabetes INSIDE® (DI) program formed a mid-Atlantic quality improvement (QI) collaborative of five academic medical centers and a health information exchange (HIE) with partners from primary care, endocrinology, cardiology, nephrology, nursing, pharmacy, health IT, diabetes education, population health and industry. The collaborative’s goal is to accelerate clinical adoption of recent CVD findings using population health analytics, care system redesign, shared learning, provider and patient training, education, and community resources. DI works with each partner to identify, design and monitor quantifiable QI programs to address care quality gaps. The collaborative shared their initial findings and goals at a November 2019 meeting. Three systems identified opportunities to improve low use of SGLT2 inhibitors and GLP-1 agonists in eligible patients (∼12%) or departmental prescribing gaps between primary care and cardiology vs. endocrinology (SGLT2 5% vs. 11%; GLP-1 7.5% vs. 24.6%). Other gaps included coordinating care teams and communication between inpatient and outpatient settings both within and across overlapping health systems, a gap the HIE aims to address. Other systems are implementing DM screening in cardiology clinics or training cardiologists to assume a larger role in managing patients with DM and CVD. A system with a large racial/ethnic minority population is qualitatively evaluating the social, cultural, economic, and literacy factors that facilitate or inhibit optimal care. This regional collaborative across overlapping health systems offers increased opportunity to accelerate improvement of DM and CVD care for all patients and may serve as a model for other regions. Disclosure R.E. Furman: None. F. Hill-Briggs: None. A. Iwamaye: None. C. Knight: None. T. Kouvatsos: None. Y. Lev: None. I. Lorincz: None. W.M. Marella: None. D.J. Rubin: None. M.H. Schutta: Employee; Spouse/Partner; Merck & Co., Inc. D.A. Swavely: None. L. Ward: None. E.C. Furman: None. G. Liptak: Employee; Spouse/Partner; Janssen Pharmaceuticals, Inc. Funding Know Diabetes By Heart™; Boehringer Ingelheim and Eli Lilly and Company Diabetes Alliance; Novo Nordisk; Sanofi; AstraZeneca; Bayer