Geisinger sets new standard of care in diabetes management

DANVILLE — From eyes to feet, diabetes patients at Geisinger Health System can look forward to more targeted and complete care with the launch of a new standard for diabetes patients.

The system helps primary caregivers use EPIC electronic health records to ensure patients get the most appropriate, timely care. Tammy Anderer, CRNP, director of best practices for GHS’s 40 community practice sites, and Frederick Bloom, MD, department director for quality and performance improvement, teamed with the Endocrinology Department and others to develop a “diabetes bundle of care.” Comprising diabetic lab targets, specialty consults and immunizations driving “best in class” diabetes care, the program is part of a Geisinger quality initiative to improve care for chronic diseases.

Anderer and Bloom partnered with David Butler, MD, co-director of the Primary Care EPIC Optimization Team, to build decision-support into EPIC. This helps physicians and nurses easily track patients’ care and be alerted when tests should be done, depending on patients’ age, sex and disease. The diabetic bundle includes six new EPIC tools:

• Health maintenance topics, auto assigned to both providers and 36,000 diabetics across the system via MyGeisinger.
•  Diabetic best practices alerts, aligned with six parameters of diabetes management: yearly low-density lipoprotein monitoring, quarterly glycated hemoglobin  monitoring of patients with levels greater than 7.0, six-month monitoring of glycated hemoglobin for levels less than 7.0, annual flu shot, a pneumonia shot and annual microalbumin testing.  
• Diabetic pre-filled referrals for eye and foot exams and routine visits.  
• Diabetic order panels for easy execution of group lab testing and referrals.  
• Diabetic patient report cards for use in the exam room in discussing progress with the patient or for sending a follow up letter to the patient.  
• Diabetic smart sets that allow providers to order labs and follow up care in one easy step, streamlining the process and ensuring consistent monitoring of the diabetic patient.

“These tools automate the process so these practices happen for every patient every time,” Anderer said. “It represents a fundamental change to our strategies for managing chronic disease.”

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