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Alberta’s Caring for Diabetes (ABCD) Project A Chronic Disease Management Initiative

Alberta’s Caring for Diabetes (ABCD) Project A Chronic Disease Management Initiative. Jeffrey Johnson, PhD Canada Research Chair in Diabetes Health Outcomes Professor, Public Health Sciences University of Alberta. Primary Prevention (HAC). 2 o & 3 o Prevention. May 2003.

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Alberta’s Caring for Diabetes (ABCD) Project A Chronic Disease Management Initiative

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  1. Alberta’s Caring for Diabetes (ABCD) ProjectA Chronic Disease Management Initiative Jeffrey Johnson, PhD Canada Research Chair in Diabetes Health Outcomes Professor, Public Health Sciences University of Alberta

  2. Primary Prevention (HAC) 2o & 3o Prevention May 2003 AMFH – Supplies October 2003 Screening FN Off-Reserve (MDSI) ABCD Project Alberta’s Diabetes Strategy 2003-2013

  3. CDM Intervention • Regional • Labs • Lab Linkage • region profiles • MD profiles ADSS Alberta DM Atlas 2007 2009 2011 • patient • enrollment • annual • follow-up Alberta’s Caring for Diabetes (ABCD) Project

  4. ABCD Project • AHW & IHE/ACHORD partnership • $5.2 million from AHW; 2008-2013 • Collaborative CDM initiatives • Working with RHA/PCN • Contribution of funding to support collaborative CDM initiatives • Aim: to improve quality and efficiency of diabetes care in Alberta

  5. Alberta’s Caring for Diabetes (ABCD) Project Key Data Linkages… • ADSS administrative data • Regional Lab data • Lipids • A1C • ACR • PCN/clinic charts (EMR/paper charts) • Patient-reported data (self-report survey) • ABCD Cohort (n=5,000) – 1/3 of non-metro pop’n

  6. ADSS Active Dissemination • Northern Lights Region (Wood Buffalo/Fort McMurray) April • Peace Country TBA • Aspen (Westlock ) June • East Central TBA • DTHR (Red Deer) March • Lethbridge (Chinook) Aug 07 • Palliser Jan, Feb, April 25 • Capital Ongoing • Calgary Ongoing

  7. ABCD and RHA/PCNs… Key Features… • Evidence Based QI Intervention • DOVE Study to Rural health regions • CDA-CPG dissemination/implementation • Enhanced surveillance • Capitalizing on the ADSS • Integrating data sources - Administrative, Laboratory, Clinical, PRO • Performance measurement & benchmarking • Integration with RHA/PCN planning • Developing PCN practices • Concurrent ‘disease management’ programs • Enhanced QI Intervention/Evaluation • Controlled comparisons of new interventions • Collaborative development of interventions

  8. Baseline QISD Measurement ABCD 1-year QISD Measurement 2-year QISD Measurement X X X X X X N= 2 RHAs n=1660 N= 2 RHAs n=1660 N= 2 RHAs n=1660 X X \X \X \X \X DOVE Intervention + A&F Standard CDA - CPG Dissemination DOVE Intervention Enhanced QI Intervention & Evaluation …

  9. DOVE Diabetes Outreach Van Enhancement Study Enhanced QI Intervention & Evaluation … Incidence of MI/Stroke Treatment Quality Improvement Intervention Control No Intervention … a province-wide health services research laboratory!

  10. ABCD - time line… • Jan – June 2008 ADSS Dissemination (RHA/PCN) • March 2008 funding received @ IHE August 2008 Initial staffing Sept - Dec 2008 RHA Laboratory Surveillance QISD development Staffing Spring 2009 Implementation (lab surveillance) - academic detailing - audit & feedback (ADSS Atlas 2009) Annually to 2012

  11. ACHORD/IHE ABCD Project CE&E Steering Committeeb ABCD Management Teama AH&W Regional Integration Groups ABCD - Org Chart … aABCD Management Team would be based at ACHORD offices at the Alberta Diabetes Institute, University of Alberta in Edmonton. bClinical Evidence and Evaluation Steering Committee will be responsible for the overall implementation and evaluation of the ABCD Project

  12. ABCD - challenges … • Coordination of programs • PCN initiated programs • DNPC • Stroke Prevention Strategy • MDSI • Quality indicators…which set…? • Many more, …. • RHAs versus PCNs…? • Professional autonomy…? • Big city specialists…. • Involving AMA/TOPP…? • Regional buy-in … • Local resources • Integration outside “health care” • Sustainability…

  13. Questions… ? jeff.johnson@ualberta.ca www.ACHORD.ca

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