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Although the
Diabetic Collaborative involves a high degree of
dedication from the Center's healthcare
professionals, Keystone Health Center welcomed the
opportunity to improve the quality of health care
to patients with diabetes. Diabetes is the fifth deadliest disease in the United States. In 1999, diabetes contributed to almost 210,000 deaths. Diabetes is a chronic disease that can affect all organs of the body, leading to adult blindness, kidney failure and non-traumatic amputations, and a major cause of heart disease and stroke. While the cause of diabetes is a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles, there remains no cure. In an effort to improve patient outcomes, the Bureau of Primary Health Care (BPHC), in collaboration with health centers, the National Health Service Corps (NHSC), the Center for Disease Control (CDC), and public and private agencies, has launched an innovative program to aid in the treatment of this potentially devastating disease. This effort, the Diabetic Collaborative, began in January 1999. The goals of the collaborative are to decrease or delay the complications of the disease, decrease the economic burden for patients and the community, and improve access to quality chronic disease care for underserved populations. Keystone Rural Health Center, based in Chambersburg, PA, is one of only four community health centers in Pennsylvania and one of 100 in the nation to participate in the collaborative. "We began implementing the new approach to diabetes treatment in January 2000," Joanne Cochran, co-founder and CEO of Keystone Rural Health Center said. "Although the initiative involves a high degree of dedication and commitment from our staff of healthcare professionals, we welcomed the opportunity to implement the Collaborative because it ultimately improves the quality of health care to our patients with diabetes." In January 2000, Keystone Rural Health Center kicked off a year of training and information sharing to determine how best to improve the care of their patients. As a participating community health center, Keystone aims to increase patient involvement in their health care, increase health center partnerships with local, state, and national institutions, and improve education to both patients and practitioners. David Hoffmann, D.O., family
physician and medical director of Keystone Rural
Health Center's family practice facility, shares
information with patients on how to control
diabetes. Guided at the national level by an Expert Panel comprised of individuals experienced with diabetes, health center operations, process improvement/redesign and evaluation strategies, the Collaboratives are located in one of five geographic clusters designated by the Human Resource Service Administration. A National Director oversees all collaborative operations, logistics, and evaluation. Each of the five lead Cluster Primary Care Associations provide regional project oversight and management within their respective region. Sites selected to participate must identify their team, in collaboration with the Cluster Coordinator, six weeks prior to the start of a collaborative. Teams have six weeks to then complete pre-work activities that prepare them for the National Kickoff or "Learning Session 1". At the Learning Session, the Executive Director and the team from each center meet together with the Collaborative's Expert Panel and faculty for two days of intense training. Skills and information gained from this session are applied by the teams upon return to their centers. This is the first of four didactic Learning Sessions for the teams, two are national and two are regional. In April, Keystone's practitioners received on-site training from Wanda Montalvo, the director of the Collaborative for organizations in the northeast section of the country. In addition to formal training opportunities, a monthly conference call takes place during which Ms. Montalvo confers with Keystone practitioners about their new approach to the treatment of diabetes. "Changing a system doesn't happen overnight," Ms. Montalvo said. "Keystone's new approach is time-intensive and a bit costly in the start-up, but Keystone is a model of what can be achieved." A key to the new systematic approach at Keystone is the use of computer technology to track the results of the program. A registry or database provides a decision-making tool for the practitioner and the patient. Through the reports provided, the impact of the program can be measured on a regular basis. These "rapid tests" of the program provide the feedback needed to make continual improvements. With the reports, practitioners can provide more consistent and timely follow-up with patients and can provide them with individualized care plans that include the data patients need to monitor their own health status. Keystone has found many added bonuses to being part of the Collaborative. "Because Keystone's patient registry is part of a national database, migrant farmworkers who enroll in the program are given a card that allows practitioners at their next work site to access their information," Joanne Cochran said. "The Collaborative is providing migrant farmworkers with a continuity of care they've never received before." Keystone Health Center, a public, non-profit organization, provides high-quality medical, obstetric, gynecological and dental health care and, when needed, social services to all Franklin County residents and the surrounding areas, including the underserved populations. Presently, Keystone operates five primary care sites: Keystone Health Center family practice, Keystone Dental Center, Keystone Women's Care, Keystone Health Center-Path Valley satellite family practice, and the State Migrant Farmworker Administration office. Keystone also operates one year-round migrant and seasonal farmworker site in Berks County and one seasonal farmworker site in Adams County. Services to migrant farmworkers are also provided through outreach workers and contracted providers across the Commonwealth. For more information regarding Keystone Rural Health Center, please visit the website at www.keystonehealth.org. For more information regarding the Bureau of Primary Health Care Health Disparities Collaborative, visit the New England Clinicians Forum website at www.neclinicians.org/ne_collaborative.htm. For more information regarding this news release, please contact Karen Gross at (717) 975-2148, kgross@hersheyphilbin.com, or visit the newsroom at www.hersheyphilbin.com. |
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