Innovating in the Delivery of Diabetes Care.

Abstract

How do we improve the lives of people with diabetes? Developing new interventions (such as new medications) to manage their glucose control and other risk factors is clearly important. However, we must also strive to deliver existing treatments more effectively, more efficiently and more equitably. Innovative ways of delivering diabetes care could have a profound impact on quality of care and health outcomes for people with diabetes. In fact, improving the delivery of care may lead to greater health impacts than incremental advances in the efficacy of therapy (1). This issue of Canadian Journal of Diabetes focuses on innovative models of care. The majority of diabetes care is delivered in primary care settings; indeed, a recent themed issue of the journal focused on the delivery of primary diabetes care (2). In this issue, Gucciardi et al. (3) explore the integration of specialized diabetes care teams in primary care settings. Through in-depth qualitative interviews with patients, diabetes educators and primary care physicians, they found that situating diabetes education teams within primary care practices was perceived as useful, but clear communication channels and a delineation of provider roles was necessary to facilitate implementation. With the growing prevalence of diabetes, the ability to integrate specialized healthcare providers focused on diabetes within primary care practices could become a useful model to improve quality of and access to care. Incorporating new technologies into clinical care can lead to improved communication, more and better data for decision making and greater patient engagement in self-management. Although e-mail is an integral part of many people’s day-to-day communications, its adoption in the healthcare sector in Canada has been slow, despite the many ways in which it could facilitate patientprovider communication. Popeski et al. (4) found that allied health professionals communicate with diabetes patients via e-mail regularly, but few physicians used it and most were uncertain about its potential to improve clinical care. The authors suggest that policies for the use of e-communications, including appropriate safeguards for privacy and security, could lead to improved efficiency and better access to diabetes care. Care transitions between healthcare sectors or between prac