A $3.45 million grant for ‘individualized’ diabetes care in Camden

Posted: November 17, 2011

A health coalition in Camden won a $3.45 million grant Thursday to strengthen diabetes care in a city where rates far exceed the national average, adding to medical costs and detracting from residents' quality of life.

The grant, from the Bristol-Myers Squibb Foundation, is intended to enhance and deepen a three-year-old, citywide diabetes collaborative, officials said at an evening meeting.

Most of the money will go to two or three primary-care practices, expected to be chosen next month. It will allow them to individualize care by, for example, hiring nurse coordinators to track diabetics, and peer educators to help patients navigate the health-care system.

"We're going to have the resources that people up until now only dreamed of," said Steven Kaufman, a Cooper University Hospital diabetes specialist and staff endocrinologist for the Camden Coalition of Healthcare Providers.

The award, to be spread over five years, is the largest single grant for the coalition, a nonprofit with two dozen employees that was founded several years ago by Jeffrey Brenner, a family physician who sought to improve health care in the city.

For Camden diabetics, the funding will mean access to personalized resources they never had before, said Mark DiFilippo, who managed the coalition's diabetes collaborative until taking on other duties recently.

Their nurse will know if they've been sent to the emergency room with high blood sugar - and might even visit them in the hospital, he said. Their peer educator will connect them with a diabetes education class in their neighborhood. They'll get one-on-one mentoring from an endocrinologist and have access to social workers who can help with medication and housing.

"We're talking about a really individualized, customized model of care," DiFilippo said. "By and large, they should expect to improve their diabetes outcomes."

With this new funding, DiFilippo said, the coalition is trying to lower two major hurdles for primary care in Camden: time and money. There are too few primary-care providers in the city - each of them spread too thin - he said, and they don't have enough financial support to do this specialized work.

"They couldn't hire a nurse care coordinator on their own," DiFilippo said.

In addition to the resources for patients, participating practices will also receive coaching on team-based care to help ease the primary provider's burden. "The whole staff will work as a team," DiFilippo said, adding that the goal is for the primary clinician to focus on patient care while delegating other duties to staff members.

The new grant is one of eight totaling $18.4 million announced by the Bristol-Myers Squibb Foundation to aid populations disproportionately affected by type 2 diabetes. Nearly 13 percent of adults in Camden have diabetes, well above the national average, said Patricia Doykos, director of the foundation.

Minority and poor populations generally are at high risk of developing type 2 diabetes, which has risen dramatically nationwide, in tandem with obesity. Philadelphia's adult diabetes rate is also about 13 percent. Bucks County's, by contrast, is 8 percent.

"For us, focused on disparities," Doykos said, "we saw that Camden clearly has a need."

Other recipients include Duke University Medical Center, which received $6.25 million to launch community interventions for diabetics; and Feeding America, a charity that will use $3.1 million to pilot food-bank partnerships providing diabetes care.

The foundation is separate from the giant pharmaceutical company, although the latter's CEO, Lamberto Andreotti, is the former's chairman. Bristol-Myers Squibb has major facilities around New Jersey, and it markets several diabetes drugs, including Onglyza and Glucophage.

Nationally, medical expenses for people with diabetes are more than two times higher than for those without it. The condition is estimated to cost more than $174 billion annually in the United States.

In Camden, 29 percent of inpatient hospital costs in 2009 were for treating diabetics for various conditions, not necessarily related to diabetes, according to the data nonprofit CamConnect.

Complications of uncontrolled diabetes can be staggering. It is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness, as well as a major cause of heart disease and stroke. And according to the Centers for Disease Control and Prevention, diabetes is the seventh leading cause of death in the United States.

If rates continue to rise along the current trajectory, one in three Americans will have diabetes by 2050, said Ann Albright, a diabetes expert at the CDC. "These are big problems, and we need big solutions for them."

The Camden coalition initiated its diabetes efforts in 2009 with a $2 million, five-year grant from the Merck Co. Foundation. Under that program, projects ranged from a care-management team that visited struggling diabetics, to the creation of three diabetes education classes, one in Spanish.

A major part of the Merck-funded work involved transitioning Camden primary-care practices to patient-centered medical homes, a growing model that involves team-based primary care. Some practices implemented electronic health-record systems funded by the coalition, while others launched open-access scheduling, which made most office appointments available same day.

The goal was for the new technologies to increase efficiency, giving providers more time with patients and reducing no-show rates, which would boost revenue.

The new grant announced Thursday will be directed to practices that may compete for the award. They must already have an electronic health-record system, said DiFilippo, the coalition project manager, or plans to start one. A team of coalition board members will choose practices by the end of December.

The goal extends beyond improving care for Camden diabetics, he said, to reach patients on a broader scale. "Everything we're doing, we believe deeply in," DiFilippo said. "We're hoping to become a model nationwide."

Contact Christina Hernandez Sherwood at christinahsherwood@gmail.com.

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