Patient Based Strategy to Reduce Errors in Diabetes Care
Patient Based Strategy to Reduce Errors in Diabetes Care
This project evaluates a HPMG effort to reduce error rates through customized direct feedback
 of diabetes quality of care data to diabetes patients and their physicians. HPMG has
 routinely provided patients with personalized feedback of glucose and cholesterol test
 results since about 1997. This project will implement and evaluate the impact of this
 intervention on diabetes medical error rates and resource use.
The project, Patient-Based Strategy to Reduce Errors in Diabetes Care (referred to as MOVES),
 addresses issues of overuse, under use, or misuse of care for adults with diabetes. This
 combination research and translation project has been developed as a component of the
 Pursuing Perfection initiative of HealthPartners Medical Group, with the close collaboration
 of HPMG leadership. HealthPartners Medical Group is widely regarded as a national leader in
 diabetes care, with dramatic improvements in both glucose control and cholesterol control
 over the past 8 years [Graphs].

 The MOVES study is attempting to activate patients with diabetes to be more involved in their
 care. To help patients do this, HPMG sends patients a customized summary of their care. The
 summary includes a graph of recent glucose and cholesterol test results and specific
 suggestions that may improve care. In many cases, a visit with the patient's personal
 physician is encouraged to assure ongoing progress towards important evidence-based goals in
 diabetes care.

 Physicians also receive a matched communication that indicates areas for potential
 improvement and makes technical suggestions for care based on the Staged Diabetes Management
 © protocols. The project tries to ally expert judgment with the physician's personal
 knowledge of a patient. It is felt that this approach is critical to assessing what the best
 improvement strategy may be in each individual case.

 This inexpensive customized intervention has potential to be widely disseminated and can be
 seamlessly integrated with other interventions to further achievement of clinical goals. The
 results are relevant to patients, clinicians, payers, and policymakers.
Inclusion Criteria:

 -  For physician intervention inclusion criteria included; 1)primary care (general
 internist or family) physician in HealthPartners Medical Group. 2)Provided ongoing
 care to 20 or more adult patients with diabetes.

 -  For patients inclusion criteria included; An established diagnosis of diabetes based
 on either (a) two or more ICD-9 diagnosis codes for diabetes in a 12-month period of
 time, or (b) a filled prescription for a diabetes-specific drug within a 12-month
 period of time.

 In addition, participating patients met all of the following criteria: (a) age less than 75
 years, (b) Charlson comorbidity score of 3 or less, (c) linked to the a primary care
 physician who was participating in the study in two consecutive calendar years, (d) had
 pharmacy coverage at the time of the intervention and for the previous 12-month period, and
 (e) had either HBA1c > 7% or LDL > 130 mg/dl (or LDL > 100 mg/dl if the patient also had
 CHD).

 Exclusion Criteria:

 -  none