care diabetes -...
TRANSCRIPT
INDIAN
FAMILY
HEALTH
CLINIC
CARE SERVICES
diabetes
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number of Montanans who have
diabetes?
I N D I A N F A M I L Y H E A L T H C L I N I C
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50,000
I N D I A N F A M I L Y H E A L T H C L I N I C
rate of those with Diabetes in Montana has
0
1
2
3
4
5
6
7
2.8 % in 1990
increased
6.4% in 2013
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The Rate of diabetes in American indians is
2.5 times higher than The general population
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Diabetes complications in Montana Are widespread
• Hospital discharge rates for diabetes has increased (136 per 10,000)
• Diabetes contributed to 45 % of new and existing ERSD • Diabetes contributed to 66% of non-traumatic lower
extremity amputations. • Diabetes Mortality rate was 23 per 100,000 with Montana
Indians being three times higher than non-Indians.
HOPE
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A PLACE OF
HOPE
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CARES A PLACE OF
FROM A TEAM THAT
HOPE
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CARES VITAL
A PLACE OF
FROM A TEAM THAT
PROVIDING SERVICES
HOPE
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CARES VITAL
TREASURED
A PLACE OF
FROM A TEAM THAT
PROVIDING SERVICES
TO A POPULATION
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engage
engage inspire empower I N D I A N F A M I L Y H E A L T H C L I N I C
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engage inspire empower I N D I A N F A M I L Y H E A L T H C L I N I C
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engage inspire empower I N D I A N F A M I L Y H E A L T H C L I N I C
CARE SERVICES
diabetes
INDIAN FAMILY HEALTH CL INIC
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our diabetes CARE team
I N D I A N F A M I L Y H E A L T H C L I N I C
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Ernestine Belcourt Executive Director
Jason Gleason, NP-C Clinic Director/Diabetes Coordinator
Liz Little, RN Chief Nurse
Sandra Corbett, AFAA Fitness Center Director
Barbara Bessette REACH Program Assistant
Josh Wilson REACH Program Manager
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our facility and services
I N D I A N F A M I L Y H E A L T H C L I N I C
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Patient Centered CARE
medical clinic behavioral health clinic
fitness and wellness center administration and support
Comprehensive Primary Care Full Service Lab Pharmacy/Medication Assistance Transportation Services Diabetic Eye Care and Foot Exams CARE Group Diabetes Supplies Diabetes Boot Camp
Addiction Counseling Services Grief Counseling Services Individual and Group Counseling Inpatient Referral Services State Approved Program Cultural Activities
Personalized Fitness Plans Certified Personal Trainers Group Classes for all ages/abilities Nutrition Counseling Weight Loss Programs Community Outreach
Patient Navigator Pharmacy and Diabetes Supply Assistance Community Referrals and Outreach Health and Wellness Fairs Access to Care Station Visionary Leadership
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our tool box
I N D I A N F A M I L Y H E A L T H C L I N I C
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I N D I A N F A M I L Y H E A L T H C L I N I C
Comprehensive Foot Exam Form
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I N D I A N F A M I L Y H E A L T H C L I N I C
Comprehensive Social, Depression and Domestic Violence Screening Form
page 1
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I N D I A N F A M I L Y H E A L T H C L I N I C
Comprehensive Social, Depression and Domestic Violence Screening Form
page 2
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our tool box
I N D I A N F A M I L Y H E A L T H C L I N I C
Diabetes Blog Sugar Log (available online)
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our tool box
I N D I A N F A M I L Y H E A L T H C L I N I C
Electronic Health Record
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our social media
I N D I A N F A M I L Y H E A L T H C L I N I C
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our website www.indianfamilyhealth.org
I N D I A N F A M I L Y H E A L T H C L I N I C
Informative Interactive Empowering
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Informative Interactive Empowering
our website www.indianfamilyhealth.org
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Informative Interactive Empowering
our website www.indianfamilyhealth.org
engage inspire empower I N D I A N F A M I L Y H E A L T H C L I N I C
Informative Interactive Empowering
our website www.indianfamilyhealth.org
engage inspire empower I N D I A N F A M I L Y H E A L T H C L I N I C
Informative Interactive Empowering
our website www.indianfamilyhealth.org
engage inspire empower I N D I A N F A M I L Y H E A L T H C L I N I C
Informative Interactive Empowering
our website www.indianfamilyhealth.org
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Informative Interactive Empowering
our facebook presence
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our group
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our group
I N D I A N F A M I L Y H E A L T H C L I N I C
• Meets Weekly • Interactive • Patient Directed • Field Trips • Lunch • Incentives • Fitness Activities • Hands On
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our results
I N D I A N F A M I L Y H E A L T H C L I N I C
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total patient visits our results
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1000
2000
3000
4000
5000
2011 - 2012 2012 - 2013
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Proof is in the (Sugar Free) Pudding! our results
GPRA MEASURE June 30, 2012 June 30, 2013 Point Change
Good Glycemic Control (A1c <8) 30% 52.0% +22
Controlled BP (<140/90) 35% 53.3% +18.3
LDL Assessed 66% 77% +11
Nephropathy Assessed 34% 64% +30
Retinopathy Assessed 14% 32% +18
Influenza over 65+ 27.4% 23.9% -3.5
Pneumovax over 65+ 37.3% 41.8% +4.5
Childhood Vaccines 0.0% 50% +50
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Proof is in the (Sugar Free) Pudding! our results
GPRA MEASURE June 30, 2012 June 30, 2013 Point Change
Pap Smear Rates (25-64) 40.9% 50.3% +9.4
Mammogram Rates 15.4% 5.5% -9.9
Colorectal Screening Rates 9.0% 13.5% +4.5
Tobacco Cessation Education 12.4% 56.8% +44.4
FAS Prevention 15-44 21% 61% +40
IPV/DV Screen 15-40 7% 51.7% +44.7
Depression Screen 18+ 18.3% 48.3% +30
IHD: Comp CVS Assessment 8.3% 54.5% +46.2
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our future
I N D I A N F A M I L Y H E A L T H C L I N I C
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our future
• EHR Enhancements • Diabetes Boot Camp • Diabetes Coalition • Digital Story Telling • Website Enhancements
TAKE FLIGHT AND SOAR!
INDIAN
FAMILY
HEALTH
CLINIC
CARE SERVICES
diabetes
engage inspire empower