CAPP Physician Group: HENRY FORD MEDICAL GROUP
Project: Auto Manufacturer Care Innovation Collaborative: Diabetes in Active Control PROGRAM

Summary: Faced with rapidly escalating health care costs, leaders at the Big Three auto companies asked Henry Ford Health System and Health Alliance Plan (HAP) to identify ways to decrease costs while maintaining or improving care quality. Leadership at Henry Ford and HAP determined that by tapping into Henry Ford Medical Group and taking advantage of its electronic medical record to carefully monitor patients at more than 25 ambulatory and inpatient sites, both objectives could be achieved. Focusing on the treatment of chronic conditions, several initiatives emerged from the Auto Manufacturer Care Innovation Collaborative including the Diabetes in Active Control program. Seeking to manage the health of its employee population with diabetes, DaimlerChrysler launched the program targeting its World Headquarters employees first. The successful results motivated the automaker to expand the program into one of its assembly plants in early 2007.

DaimlerChrysler (DCX) wanted a workplace program aimed at improving its employee population with diabetes. In 2005, participants were recruited from employees with diabetes working at DCX World Headquarters in Auburn Hills, Michigan. Called Diabetes in Active Control, the intensive management program provides intervention via certified diabetes educators. These “diabetes coaches” facilitate intensive pharmaceutical management of patients who are in poor control of their disease. They also coached patients on self-management and home-monitoring skills in order to improve Glycemic control.

Core components of program are:

• Confidential on-site health screening that includes average blood sugar level, cholesterol, and blood pressure tests
• Confidential depression screening and follow-up treatment
• Six individual coaching sessions with certified diabetes educators from Henry Ford Medical Group that focus on achieving personal health goals and managing medications and diet to control blood glucose levels
• Incentives (participants receive gift certificates)

Pilot patients experienced marked improvements in clinical measures as compared to those in the control group:

• LDL dropped by an average of 14 points
• A1C dropped an average of 1.0%
• 79% reported daily blood sugar testing after intervention (vs. 56% in control group)
• 84% reported being satisfied with the flexibility of their diabetes treatment program

Following the successful roll-out at DCX headquarters, in April 2007 DCX health care executives expanded the program to their Sterling Heights Assembly Plant.

For more information about this project please contact Dr. Bruce Muma, Henry Ford Medical Group at (586) 247-2670.

Integrating Services for Low-Income Seniors Shows Health Care Benefit, by Claire Sowerbutt, Contributing Writer, MedPage Today, December 11, 2007.

INDIANAPOLIS, Dec. 11 -- For low-income seniors, the likelihood of providing the recommended standard of health care services could be enhanced by integrating home-based and institutional services, found researchers here.

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“From High Tech to Soft Touch: The Everett Clinic uses innovative ways to control health care costs,” by Bryan Corliss, Washington CEO, November 26, 2007.

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“CAPP’s 35 MSMGs [multispecialty medical groups] share a common vision as learning organizations dedicated to the improvement of clinical care. Their features include physician leadership and governance; commitment to evidence-based care management processes; well-developed quality improvement systems; team-based care; the use of advance clinical information technology; and the collection, analysis, and distribution of clinical performance information. These features are congruent with the [Institute of Medicine’s] recommendations on key elements needed to redesign delivery systems.”

From Chapter 5, “Developing the Test Bed—Linking Integrated Service Delivery Systems: Council of Accountable Physician Practices,” by Michael A. Mustile, MD. The Learning Healthcare System: Workshop Summary (IOM Roundtable on Evidence-Based Medicine), edited by LeighAnne Olsen, Dara Aisner, and J. Michael McGinnis, National Academies Press, 2007.

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“A shift from the current care model to a more coordinated care model centered on primary care is one potential way to help stave off the healthcare dilemma.”

“It's too expensive to be a primary-care doctor,” by Debra A. Geihsler, president and CEO of Harvard Vanguard Medical Associates & Atrius Health. Boston Globe, July 25, 2007.

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