Community Policy and Systems Change Initiatives
Camden Citywide Diabetes Collaborative
The Camden Citywide Diabetes Coalition is leading the effort to:
- Establish and expand the role of Accountable Care Organizations in New Jersey.
- Implement a citywide Health Information Exchange.
- Increase access to free or low-cost medication for diabetes patients most in need.
Improving Diabetes Care and Outcomes on the South Side of Chicago
The University of Chicago is working in six clinics on the South side of Chicago to implement comprehensive clinic and health system redesign by:
- Integrating Community Health Workers and Care Coordinators into the clinical care team.
- Instituting diabetes group clinic visits.
- Establishing a diabetes registry to track high-risk patients.
- Setting up formal agreements with community partners.
The Diabetes Equity Project
The Diabetes Equity Project in Dallas is transforming the Baylor Health System with the aim of reducing disparities in care for underserved people with diabetes in Dallas County, Texas. Accomplishments include:
- Institutionalizing the Community Health Worker role within the Baylor Health System.
- Implementing a comprehensive diabetes registry (Dia WEB).
- Expanded use of Electronic Medical Records (EMR) to improve communication among team.
Diabetes For Life
The Diabetes for Life (DFL) project has been working to transform health system practices to enhance diabetes management and reduce health disparities in Memphis by:
- Establishing a Quality Improvement Collaborative for diabetes care.
- Implementing patient health status logs.
Reducing Diabetes Disparities in American Indian Communities
The Wind River Indian Reservation in Wyoming has launched efforts to:
- Integrate public health and tribal health care systems.
- Secure Medicaid reimbursement for diabetes outreach worker.
- Implement diabetes self-management classes in casinos, homes, work sites and other venues and obtain insurance coverage for such classes.