The Joslin Diabetes Center: CCA Members Employee Wellness Showcase

The Joslin Diabetes Center’s Center of Excellence for People with Complex Diabetes

The economic impact of the diabetes pandemic has been estimated at some $245 billion each year by the American Diabetes Association. A significant portion of that cost falls on small businesses and corporations as the result of increasing cost of healthcare insurance, lost work and employee disability.

Diabetes can be managed, as a rule, with proper care (medication and education) and lifestyle modification. But there is mounting evidence that the “usual care” does not work for those employees who are most at risk for disease progression and increased complications leading to disability and high and costly utilization of the healthcare system.  Estimates maintain that this applies to about 25% of adults with diabetes, or about 2% of the adult workforce.NEWM_2013_Supporter_Logo_f

Joslin Diabetes Center, in Boston, MA, has created the Center of Excellence (COE) for People with Complex Diabetes to address the need for an alternate form of care for these patients.  This program builds on Joslin’s long history of innovative clinical programming for individuals needing interventional re-orientation to their diabetes self-management. And it supported by a new, custom-built on-line infrastructure.

The COE program involves an intensive, one-week assessment, treatment and educational program at the Joslin Diabetes Center in Boston. At the end of the week, the patient returns home and is followed for three months of e-clinical support, assessment and adjustment of medications and self-management programs (including the Weight Management on line program), as well as six months of e-coaching, web-based education and group interactions using an on-line chat room monitored by a Joslin educator.

Unlike standard diabetes treatment regimens in which the components are most often isolated and poorly coordinated, the COE follows the JoslinCare model of multidisciplinary, highly integrated care. Each patient is assessed for a full range of diabetes complications (eye, kidney, nerve, etc.) and is seen by a comprehensive team of doctors, nurses, psychologists, nutritionists, and educators who are all part of the Joslin Clinic staff.

At the conclusion of the one-week on-site visit, patients return home to their primary care providers. Joslin clinicians partner with patients’ home physicians throughout the program to maintain communication and ensure that the patient’s individualized plan has a sustained impact on medical care and self-care.

At six months, a virtual clinical assessment is conducted and reported to the patient, the primary care physician and the employer. Based on Joslin’s experience in similar programs, we anticipate that at six months, most patients will have achieved a clinically-meaningful drop in their blood glucose levels, along with weight loss, an increase in exercise frequency and compliance to a suggested diet.

For employers the cost of this program will be more than offset over two years through savings in the direct costs of care for diabetes and its complications and improvements in cost of work loss due to diabetes complications and disability.

Contact: Cathy.carver@joslin.harvard.edu

Twitter: @JoslinDiabetes

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