Minutes
Present: Ed Angeli,
Screening Phase: Brenda will update the screening
tool to include information such as Providers name and criteria for sending
patients for OGTT. Any patient meeting
the first 2 criteria (first degree relative w/ DM or Hx
GDM) will automatically be sent for OGTT.
Patients with 2 or more of the remaining criteria will also be sent for
the test. A one day test of the
screening tool has already been conducted with patients of Gary Spinner and Dr.
Michels. Linda
will be training the CHW’s this week on how to
properly use the Screening tool and next week the CHW’s
will begin utilizing the form with Walk-in Patients. Gary and Dr. Michels
will also continue to use the tool with their scheduled patients and Jennifer
will begin screening all of her patients at the West Haven Health Center.
Lab Queries & CPT
Coding: Ed
has generated a list of patient’s w/ Hx GDM dating
back 5 years. It was discussed during
the meeting that for future queries it would be beneficial to filter out those
patients whose last service date was greater than 1year ago. Ed and Dr. Michels
will also meet with Linda Dixon and Marsha Reyes to ensure that the correct CPT
code is being used to identify pre-diabetics.
In addition because HHC patients are usually sent for a 3hr OGTT, a
separate code needs to be used to identify possible pilot program participants
being sent for a 2hr OGTT.
Provider Education: Providers will be educated
on the use of the screening tool and appropriate coding in January (date has
not yet been set for the inservice). Jennifer will be sending out a memo to
providers explaining about the Pilot Program, diagnosis criteria and Standards
of Care.
Organizing Prevention
Program Data:
Ed and Dr. Michels will be working on developing a SpreadSheet to keep track of how many patients where
screened, who was sent (and completed) the OGTT and what the results of the
test showed (normal, pre-diabetic or diabetic).
This tracking method will help determine how useful the screening tool
is for identifying patients at risk. It is also extremely important that
patients who are identified as being diabetic are being placed into the
diabetes registry and are receiving follow-up from their providers. Brenda suggested that we keep a separate
folder for patients diagnosed w/ DM.
Linda expressed concern that she has not been receiving lists of
patients with abnormal labs on the days the labs were received. This issue will need to be followed up with
Marsha.
PECS System: Our goal down the road is
that everything (DM, pre-diabetic and asthma patients) be merged into the PECS
system. There is some concern that if information other than that related to
pre-diabetics is entered into the system in the beginning stages, this would in
effect slow down the process. Training
on the PECS system will be held at the Diabetes Collaborative Conference in
January. Ed hopes to eventually set up
a link that would automatically transfer any patient to the diabetes registry,
who after completing the OGTT test, was found to be diabetic. Until a link is available, Linda and Brenda
will keep a separate file of all patients who are identified through the pilot
as being diabetic.
Intervention Stage: Members of the nutrition
department are currently in the process of reviewing materials and developing
lifestyle intervention protocols. The
intervention phase of the program will be implemented after the second learning
session if February, however, Gary stated that patients who are identified as
being eligible for the pilot program will need to be made aware that in the
coming weeks they will be eligible for intervention services. Linda suggested that a Referral Form for the
Pilot Program be developed.
Additional Topics of
Discussion:
Protocol
will need to be set in place to ensure that all patients who are currently
gestational diabetics are being sent for an OGTT at 6 weeks post partum. Ed will be in contact with Sue Ortoleva from the OBGYN department to see if she would be
interested in joining the prevention team.
Brenda
will assist Linda with Chart reviews of people identified as having abnormal
blood sugars to determine whether or not these patients have already been
diagnosed w/ DM
Linda
discussed the need for providers to buy into the idea of using lifestyle change
interventions as opposed to initially using medication w/ pre-DM patients
Jennifer
suggested that the PDSA Cycles that were compiled by those who attended the
first learning session be reviewed by the team, in order to ensure that these
ideas are being implemented along with the example ideas provided by the DPP.
Melinda
suggested that a Learning Session for those members who did not go to
Washington be conducted to ensure that all members are up to date with issues
discussed in D.C.