While patient-centered medical homes (PCMHs) can reduce mortality rates and improve outcomes in high-risk diabetes patients, strategic placement of care managers in these organizations can improve those outcomes even more, according to a new study from the Joslin Diabetes Center.
Robert Gabbay, M.D., Ph.D., chief medical officer and senior vice president at the Joslin, and his team studied groups of nurses, nurse practitioners, social workers and medical assistants acting as care managers, comparing different models of care management and how they changed diabetes outcomes in three different practices in southern Pennsylvania with 25 primary-care PCMHs, according to an announcement from the Boston-based organizaton.
Researchers evaluated how well patients did with A1C, blood pressure and cholesterol levels and found that the practices that demonstrated the greatest improvement described more patient-centered care manager duties, better use of electronic medical records (EMRs) for messaging and patient tracking, and stronger integration of the care manager into the care team, Gabbay said in the announcement.
PCMHs that scored lower in patient achievement spent more time on administrative or supervisory duties, researchers found, and the managers in those programs didn't use EMRs.
Furthermore, he said, "practitioners and patients both preferred embedded nurse care managers that were typically a nurse in order to focus wholly on the patient and their medical needs critical for the highest risk patients."
Diabetes rates have doubled worldwide since 1980, escalating to 347 million patients globally and nearly 25 million in the U.S., FierceHealthcare previously reported.