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What Is Diabetes Care Management?

According to the Centers for Disease Control and Prevention (CDC), more than 136 million adults are living with diabetes or prediabetes in the United States. As more people struggle with this disease, the importance of diabetes management becomes increasingly apparent. Unfortunately, successfully navigating diabetes care plans is extremely difficult for both patients and clinicians.

In addition to the overwhelming number of people afflicted with diabetes, various challenges weigh heavy on healthcare providers. Some of the main hurdles include:

  • Communication and monitoring issues
  • Staffing shortages
  • Lack of data to inform concrete decision-making
  • Coordination challenges between all stakeholders
  • High cost of treating chronic illnesses ($1 out of every $4 in U.S. healthcare costs is spent on caring for people with diabetes, according to the CDC)

So, what’s to be done? The chronic care management (CCM) process was designed to help people with chronic illnesses receive the quality care they deserve and take pressure off of overwhelmed healthcare teams. However, conventional CCM approaches possess significant pitfalls regarding implementation and execution. To mitigate these various challenges, comprehensive chronic care management solutions—like TimeDoc Health—combine powerful CCM technology with skilled care coordinators.

To offer greater insight into diabetes care management and the role of CCM solutions, TimeDoc Health created the following guide.

CCM and Optimizing a Diabetes Management Plan

According to the American Diabetes Association guidelines (ADA), CCM includes six core elements to optimize the care of patients with diabetes:

1. Delivery System Design | Proactively treating patients with diabetes has proven to positively impact health outcomes, especially for patients diagnosed with prediabetes. Following a CCM framework, healthcare teams can implement a high-touch care delivery process, including regular remote visits with a patient coordinated using a team-based approach.

2. Self-Management Support | Lack of education is one of the main problems in self-management of diabetes. With an ever evolving list of medications, appointments, and other treatment tasks, the daily routine for a diabetic patient can quickly become overwhelming. Using CCM communication best practices, care teams work with patients to answer questions and provide education related to the patient’s treatment plan. This helps patients better understand the nature of their disease and makes it easier for them to navigate their treatment strategies.

3. Decision Support | A CCM framework encourages the utilization of evidence-based care that aligns with scientific evidence and patient preferences. When treating diabetes this includes facilitating evidence-based insulin use and evaluating quality indicators for patient care. Ultimately, the decision support process enables care teams, and their patients, to make better informed choices when creating and adjusting individual care plans.

4. Clinical Information Systems | CCM encourages providers to utilize information systems, such as patient registries, to gain patient-specific insight. Registry-based learning systems can provide a real-world view of clinical practice, patient outcomes, safety, and comparative effectiveness. All of this information supplements decision making and helps care teams improve and evaluate patient outcomes.

5. Community Resources | By sourcing or developing resources to support healthy lifestyles, care teams can bolster patient education to empower patient self-management. Connecting patients to community-based organizations helps people with diabetes make healthier choices, feel more connected, address social determinants of health, and reduce overall risk.

6. Health Systems | All CCM frameworks, or health systems, should be rooted in a quality-oriented culture, focused on patient outcomes. Collaborative, multidisciplinary teams are best positioned to provide comprehensive care for people with chronic conditions, such as diabetes. The markers of a holistic CCM health system include:

  • Streamlined care team communication
  • Easy access to care and treatment
  • High-level support
  • Regular care and routine follow-ups

CCM has proven time and time again to significantly improve care management for patients with diabetes and other chronic illnesses. Unfortunately, healthcare organizations simply do not have internal staff or resources available to provide all required services. So, how can healthcare providers ensure that the CCM process goes as smoothly as possible for their teams and patients without over extending their staff? That’s where CCM solutions come into play.

How Do You Take Care of a Diabetic Patient Using CCM Technology and Services?

Although many aspects of diabetes care management have improved in recent years, the overall quality of care remains suboptimal. Chronic care management solutions combine the power of a CCM platform and care coordination services as part of our solution to create a stronger management program for people with diabetes and other chronic conditions. Utilizing a CCM solution improves the diabetic care management process by:

  • Equipping providers with better information
  • Simplifying appointment scheduling
  • Lowering patient and facility costs
  • Streamlining the rollout of intensive disease management strategies
  • Tracking patient compliance at a systems level
  • Empowering and educating patients
  • Providing durable medical equipment assistance
  • Assisting with medication reconciliation

Ultimately, a CCM solution helps care teams facilitate sharing information across all involved parties, support seamless care transitions, and monitor a patient’s adherence to treatment plans. With this high-level support, care teams can limit the likelihood of hospitalizations, increase patient satisfaction, and improve health outcomes.

TimeDoc: Better Care Leads to Better Lives

Recognizing the pressure healthcare teams are facing, TimeDoc Health decided to take action. The core goal of CCM solutions like ours is to unburden providers so optimal outcomes are achieved. Our CCM platform and care services support the broad coordination of treatment, extending beyond fundamental disease management to account for comorbidities and social determinants of health. Our solution also includes staff augmentation services to remedy staffing challenges and ensure that patients benefit from regular engagement without straining your existing team.

With TimeDoc Health by your side, it’s finally possible to take a comprehensive approach to treating chronic illnesses. See what our solution can do for you here.