The American Diabetes Association in the Era of Health Care Transformation

Abstract

This address was delivered by Felicia Hill-Briggs, PhD, ABPP, President, Health Care & Education of the American Diabetes Association (ADA) at the ADA's 78th Scientific Sessions in Orlando, Fla., on 23 June 2018. Diabetes has become a high-priority condition in the current era of health care transformation due to diabetes and prediabetes prevalence rates, suboptimal diabetes outcomes at the health care system and population levels, and high health care and public health costs attributed to diabetes. Population health is the path forward for the ADA to facilitate diabetes health care and public health improvement nationally. Population health management initiatives underway at the ADA include Diabetes INSIDE for health care systems and a Mental Health Provider Training Program and referral directory. Population health improvement initiatives include the prediabetes Risk Test Campaign, National Diabetes Prevention Program (DPP) dissemination in underserved states and populations, a DPP Express information technology platform, and a social determinants of health scientific review and recommendations. Dr. Hill-Briggs is a professor of medicine; physical medicine and rehabilitation; health, behavior, and society; and acute and chronic care at Johns Hopkins University in Baltimore, Md. She is a core faculty member of the Welch Center for Prevention, Epidemiology & Clinical Research and co-lead of behavioral, social, and systems science for the Johns Hopkins Institute for Clinical and Translational Research. Dr. Hill-Briggs has been elected to the National Academy of Medicine of The National Academies of Science, Engineering, and Medicine and is the 2018 recipient of the Rachmiel Levine Medal for Leadership from the ADA.

FIGURE 1.

Diabetes population health framework. The case for diabetes population health improvement: evidence-based programming for population outcomes in diabetes. Reprinted with permission from Springer Nature (8).

FIGURE 2.

Phases and geographic reach of the ADA’s Diabetes INSIDE program for national impact in diabetes population health management. Phase 1 was engagement of eight single health systems representing diverse geographic, socioeconomic, and racial/ethnic populations. Phase 2 began the transition to a multistakeholder collaborative model. Phase 3 is expansion into rural regions. VA, U.S. Department of Veterans Affairs health care program.

FIGURE 3.

Diabetes INSIDE quality improvement results within an urban safety-net hospital, where the quality improvement initiative focused on improving insulin initiation rates in patients with an A1C >9.0%. Data represent 23,611 patients and 73,849 A1C values over a 3-year period from baseline (2014) to Diabetes INSIDE initiation (2015) and follow-up (through 2017). CL, central line (average); DM, diabetes; LCL, lower control limit; UCL, upper control limit.

FIGURE 4.

Screenshot of the ADA's National DPP online documentation tool, DPP Express. The platform is compliant with HIPAA and HITECH. PA, physical activity.