WHAT DOES OUR DIABETES DATA MEAN AND HOW CAN WE USE IT?

Transcription

1 WHAT DOES OUR DIABETES DATA MEAN AND HOW CAN WE USE IT?

2 PANEL MEMBERS Judith Thompson, PharmD, BCPS, CDE, BC-ADM, CDR, USPHS Alaska Area Diabetes Consultant Nancy Haugen, MSN, CNP, PCMH CCE Great Plains Area Diabetes & Nutrition Consultant Monica Giotta, MS, RD/N, CDE Diabetes Consultant (Contractor) to California Area Don Head Western Tribal Diabetes Project (WTDP) Specialist Northwest Portland Area Indian Health Board Erik Kakuska Project Specialist WTDP Northwest Portland Area Indian Health Board

3 OBJECTIVES OF THIS SESSION 1. Describe the relevance of data for diabetes programs, including both internal and external purposes. 2. Identify resources for working with data within and outside of the Area. 3. Describe how data can help with planning and evaluation.

4 EXAMPLES OF USES FOR YOUR DIABETES DATA Clinical care/quality improvement Grant applications and reporting Selecting an SDPI grant Best Practice Reporting health and other data to the communities you serve Internal reports for your organization To determine staffing needs Program evaluation

5 IHS WEBAUDIT TOOLS INCLUDE: Audit report when finalized, includes all-area and all-ihs percentages Trend Graphs Excel spreadsheets

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8 ADDITIONAL REPORTS/TOOLS FROM AREAS: Intended to assist your program to improve diabetes care through: Evaluating data collection/reporting (to avoid garbage in, garbage out ) Assist you in understanding what each data measure means Assessing your data * such as comparing to your program s past performance, Area performance, National IHS performance, literature, CDC, etc. Structuring processes for improving data measures. == Quality Improvement!

9 ALASKA AREA Judy Thompson

10 ALASKA AREA DIABETES PROGRAM

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12 FACILITY DATA, AREA DATA, IHS DATA Your Facility 2016 Alaska Avg 2015 IHS Avg

13 FACILITY SPECIFIC DATA OVER TIME Foot Exam Eye Exam Nutrition Ed. Other DM Ed.

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16 GREAT PLAINS AREA Nancy Haugen

17 GREAT PLAINS AREA- DATA DRIVEN DECISIONS Diabetes Audit Registry- Clean up Checklist Process Area oversight by registry reports spot checking Outcome= 1% improvement in all area measures for Audit17 Interim IHS Diabetes Audit process- quarterly mandatory for IHS sites Checklist Process Loaded into WebAudit for area reporting Prospective like audit process prior to final audit results Facilitates focused opportunities for improvement Outcome= Many sites perform now at an increased frequency

18 GREAT PLAINS AREA Sponsor Annual Area Diabetes Management System Training Diabetes Data Partnership with Great Plains Tribal Chairman s Health Board GPTEC Diabetes Data Roundtable on April 25-26, 2017 Data Workgroup Diabetes Data Project Use of Checklists

19 CALIFORNIA AREA Monica Giotta

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22 FY 2017 SDPI Community-Directed Grant SUMMARY of RKM and Activities Program: XXX Health Center Time period: January 1, 2017 December 31, 2017 Primary Contact: Jane Smith, RN, CDE Diabetes Best Practice: Foot Exams Target population number/description: 75 AI/AN adults and youth diagnosed with diabetes SDPI Outcomes System (SOS) Entry method: 2017 Interim Web Audit SOS Baseline: 22/75 = 29% Required Key Measure (RKM): Number and percent of individuals in your Target Group who receive a comprehensive foot exam.* *A foot exam includes assessment of sensation and vascular status. Best Practice Activities: 1. By 1/31/17, create a SDPI Target Group and save to a new RPMS SDPI Register. 2. Follow health center policies and procedures that adhere to IHS Standards of Care and Clinical Practice Recommendations for foot care. 3. Use pre-visit planning to identify patients needing an annual foot exam and perform according to protocol. 4. Assign a category of foot risk for each patient and record in EHR with notification of Case Manager.

23 Portland Area DON HEAD & ERIK KAKUSKA WESTERN TRIBAL DIABETES PROJECT NORTHWEST PORTLAND AREA I NDIAN HEALTH BOARD

24 Portland Area Health Status Report Resolution from the Northwest Portland Area Health Board to receive Audit data, and report back to the Tribes through the HSR Western Tribal Diabetes Project has Audit data for the SPDI programs going back to 2003 or 2004, depending on program The HSR is sent to NPAIHB Delegates, Tribal Health Directors, and Diabetes Coordinators

25 Portland Area Health Status Report - Trends 9000 Patients in the Diabetes Register Charts audited Total active on register

26 Hemoglobin A1c Trends Hemoglobin A1c 100 % 80 % 60 % 40 % 20 % 0 % 2004 (n=3877) 2014 (n=6832) 2015 (n=7534) 2016 (n=6699) 2017 (n=7075) HbA1c missing 11 % 7 % 16 % 7 % 5 % HbA1c 10.0 or higher 13 % 17 % 15 % 17 % 19 % HbA1c % 37 % 33 % 39 % 41 % HbA1c <7 39 % 39 % 37 % 38 % 35 % Average Hemoglobin A1C 2014 (n=6407) 2015 (n=6987) 2016 (n=6239) 2017 (n=6735) Mean HbA1c Standard error % CI upper limit % CI lower limit HbA1c % 30 % 29 % 27 % 25 %

27 Diabetes-Related Education Trends 100 % Diabetes-Related Education 80 % 60 % 40 % 20 % 0 % 2004 (n=3877) 2014 (n=6832) 2015 (n=7534) 2016 (n=6699) 2017 (n=7075) Diet education, any provider 51 % 50 % 51 % 58 % 59 % Diet education, RD only 25 % 18 % 12 % 18 % 17 % Exercise education 41 % 48 % 30 % 60 % 61 % Other diabetes education 51 % 67 % 36 % 67 % 69 % Any of the listed topics 78 % 65 % 83 % 85 %

28 Portland Area Health Status Report - Comparison Active Patients with Diabetes in the 2017 IHS Diabetes Audit Portland Area and All IHS Areas Active register patients not sampled, or diagnosed after 2016 Patients sampled for audit Labels show total numbers of active register patients *The Audit performed in 2017 covers services delivered in 2016

29 Hemoglobin A1c - Comparison 100 % Hemoglobin A1C 80 % 60 % 40 % 20 % 0 % Portland Area All IHS Areas HbA1c < % 33 % HbA1c % 43 % HbA1c % 18 % HbA1c no test or result 5 % 6 %

30 Tobacco Use & Cessation Counseling Tobacco use increases the already elevated risk of cardiovascular and microvascular complications in people with diabetes. Research shows that a brief tobacco dependence treatment intervention delivered by one provider can increase quit rates by as much as 80%. 100 % 80 % 60 % 40 % Tobacco Use Tobacco Cessation Counseling for Current Tobacco Users 100 % 80 % 60 % 40 % 20 % 20 % Portland Area All IHS Areas Current tobacco user 33 % 24 % Not a current tobacco user Tobacco use not documented 0 % 64 % 73 % 2 % 3 % 0 % Portland Area (n=2358 Patients) All IHS Areas (n=29957 Patients) Counseled - Yes 66 % 66 %

31 Health Status Report NPAIHB Website

32 Health Status Report Excel File

33 SUMMARY Do your best to understand your diabetes data Don t be shy about asking Area staff any questions you have Accurate data are very powerful Where are we now? Where do we want to be? Discover ways to tell a story with your data

34 CONTACT INFORMATION Judy Thompson Nancy Haugen Monica Giotta Don Head Erik Kakuska