Online technology could be used to slow the high growth of diabetes in America
The Palo Alto Medical Foundation and its Research Institute have received a $1.2 million grant to study the management of diabetes patients. The grant is part of an effort to launch a groundbreaking online diabetes management system that promises to cut patients'' health risks.
Traditional patients visit their physician and get advice from their health care team, said Dr. Paul Tang, vice president and chief medical information officer for PAMF. In the study, 400 patients will be split into experimental and control groups. The control group will receive information online to manage their disease.
Instead of just visiting the doctor, patients would log onto a Web site run by the foundation to plot their blood glucose levels in between visits. By entering food intake and exercise logs, diabetics can more clearly ascertain if they are at greater risk for heart disease, stroke or even amputations caused by deterioration of circulatory and nervous systems with elevated glucose levels, said Dr. Tang.
The grant money for the study came from the Agency for Healthcare Research and Quality. The agency was attracted to the study because it has nationwide applications, said Teresa Zayas Caban, senior manager for the HealthCare Information Technology division of the federal agency.
In 2007, the federal agency gave $6 million in grants earmarked for studies that will advance patient-centered health care. The PAMF study falls under the category of "patient-centered" research that the agency supports because it allows diabetics to manage their health better, thus potentially saving lives and millions of dollars. According to the American Diabetes Association, more than 20 million Americans have diabetes, a chronic condition that costs $132 billion annually.
Palo Alto''s pilot study has enrolled 400 people from Alameda, Santa Clara, San Mateo and Contra Costa counties. While one group will use the new online method, a control group will do what they have been doing, logging blood sugar data and food and exercise on paper, which they provide to their physicians.
Caban said the agency is optimistic that the system could improve patients'' lifestyle habits, thus lowering the cost and disability caused by the disease. With the care manager overseeing the cases, doctors will also know whether patients are following the treatment plan. "This is a very innovative project," said Caban, partly because it not only involves the patient and doctor, but pharmacists and nutritionists, and a nurse care manager to oversee the cases. If patients self-monitor, "there''s a lot less damage control" required from providers.
The PAMF''s Research Institute conducts behavioral studies to determine how patients affect the outcome of their treatment. For example, why do asthma sufferers forget to take medication that could alleviate their symptoms? The department would want to gauge whether patients'' results improve with involvement that is more active. In addition, the department determines whether doctors could improve patient health care by changing their behavior. The research department concentrates on reducing medical costs and improving care to patients with chronic illnesses, using unique methods like physician payment plans to motivate higher quality care.
—By Eren Goknar