Qutoya Alexander, seated at left, and her father, Jerry Alexander, listen to a presentation on diabetes and healthy living being given by Vanderbilt’s Celby Swanson, left, Leslie Gissim, standing, and BlueCross BlueShield’s Melanie Morton. (photo by Susan Urmy)
Program expanded to help manage pediatric diabetes
A BlueCross BlueShield of Tennessee (BCBST) Centers of Excellence pilot initiative with Vanderbilt's Pediatric Diabetes Clinic has proven so effective its sponsors have decided to continue — and expand — the program.
The pilot combined the skills of the diabetes specialists at the Monroe Carell Jr. Children's Hospital at Vanderbilt with the health management skills of BCBST as part of a broader, evidence-based medicine program at Vanderbilt.
Under the two-year pilot program, children newly diagnosed with type 1 diabetes have been able to come to the Pediatric Diabetes Clinic for classes to learn how to live with their disease.
“The ultimate goal is to empower these children and their families to learn how to make independent decisions about diabetes management while maintaining the best possible blood sugar control,” said William Russell, M.D., director of the Pediatric Diabetes Program.
“We want to help them stay out of hospitals and out of emergency rooms and to grow up to be healthy, independently functioning adults with diabetes.”
Care providers at Children's Hospital's pediatric diabetes program made follow-up phone calls to patients or their doctors, a crucial component of the program.
“We found that patients were more likely to get lab tests done in a timely manner, and that many trips to the emergency room were avoided, when parents could be reassured by phone about which symptoms could be handled at home or by the primary care doctor in the patient's hometown,” said Melanie Morton, R.N., clinical project analyst at BCBST.
And it appears the program did just that. BCBST found a significant return on investment in the pilot evaluation.
“Being part of this pilot has been an honor for our program,” Russell said. “The review provides data that will allow us to make a case to other insurers to follow suit, and it allows us to possibly take disease management for BlueCross BlueShield of Tennessee patients to a more intense level.”
BCBST's Morton said the evidence was strong enough to continue the program past the pilot phase and to make a few improvements.
A patient satisfaction survey will be implemented and the program will be expanded to include all children with diabetes, whereas before it was limited to children with poorly controlled diabetes.
Additionally the system to reimburse for phone call interaction with patients in the first year has been streamlined and the program will be opened up to more young patients.