Solid Innovation in the Fight Against Type 2 Diabetes

By: Christopher W. Miller, Ph.D., NPDP

Congratulations Colorado! Colorado now has the lowest obesity rate in the nation. Isn't that great? Well perhaps, but not when you realize that today's residents of Colorado are on average heavier than the residents of the heaviest state in the union were 50 years ago.

The public health epidemic of Type 2 Diabetes goes right along with this weighty statistic.  America's diabesity problem begins to feel like an evil video game. Help one person manage their diabetes and five others pop up in their place.

Enter the American Pharmacists Association (APhA) Foundation.  The APhA Foundation employed basic new product development process to develop its innovative and successful diabetes intervention program.  APhA started to tackle the diabetes problem seriously with a highly structured innovation strategy collaborating with the medical industry's most important and underutilized healthcare professionals: pharmacists. The fact is that pharmacists are one of the most accessible health care providers available to patients, and yet they are many times relegated to just dispensing medication. What if we could harness these professionals' under-utilized skills, ingenuity and professional enthusiasm to tackle a problem as big as diabetes? So, the new pharmacist collaborative care model was born.

The APhA Foundation and its partners tested their new model of care in the Asheville Project and the Patient Self-Management Program for diabetes with successful results. To assess whether their model would work on a broader scale, APhA initiated the Diabetes Ten-City Challenge with the help of funding from Glaxo-Smith Kline. There were measurable and impressive positive results for improved outcomes.

The three most successful locations in the Ten-City Challenge were Colorado Springs, CO, Cumberland, MD, and Charleston, SC. Each location was visited by ethnographers from Innovation Focus to better understand what made the pharmacist/patient collaboration more successful. The data that Innovation Focus gathered was analyzed and evaluated against quantitative data to identify ten best practice areas that made the difference when the collaborative model was really successful. (See the Innovation Focus case study on the Ten-City Challenge.)

As a result of Innovation Focus’s research and with its web-based LIFEbytes Online™ program, we were able to populate a searchable qualitative database.  This database illustrates with video clips pharmacist, physician and patient perspectives on pharmacist-assisted care of Type 2 diabetics.  Now, all practitioners who want to understand what makes for a successful care model can educate themselves and make informed modifications to what they are doing.  “It [this database] represents the unvarnished truth about what it means to have and to treat diabetes”, reports Ben Bluml, VP R&D, APhA Foundation.

Based on this solid new product development work, APhA Foundation is now scaling the program nationally to underserved populations that need it the most. Funding is being provided by Bristol-Myers Foundation with in-kind support by Walgreen’s, Giant Food Stores, and other national entities.  This next larger scale roll-out is called Project IMPACT: Diabetes. In the first controlled phase, pharmacists in 25 cities will run the program for a year and then each of these cities will use their experience to mentor 5 new-to-the program cities.  Innovation Focus is continuing to work with the program to add qualitative data from the Ten-City Challenge to the searchable database.

The ethnography conducted during these projects put a real, human face on statistics.  The database brings to life how this model of care can work well, and maybe even better, based on the experience and practice of others. The data is available in video clips and documents searchable through words, phrases, demographic data, and patient, pharmacist, doctor roles.  As the Project IMPACT data set grows, it can also be a working tool to guide further research and modeling. If you are doing work in the diabetes arena and would like to know more contact Chris Miller at Innovation Focus.

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