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Agencies team up to reduce diabetes and preterm births in the Delta

Posted on: May 22, 2018

The Medicaid budget is the largest of any state agency in Mississippi, spending more than $6 billion a year. To help reduce costs and improve patient care, the Division of Medicaid has teamed up with Delta Health Alliance and Cerner, a global leader in health care technology, to manage a pilot project aimed at reducing diabetes and preterm births. More than 14% of Mississippi’s population is diabetic, and for every patient who does not progress to diabetes, the program would save $7,900 annually. For every pre-term birth avoided, the program would save $55,000.

The pilot project covers 10 counties in the Delta and combines sophisticated health technology with trained case workers on the ground providing one-on-one patient care.

“By using technology to help identify at-risk patients and determine how to best intervene, we have an opportunity to make a real difference in the Delta. For example, a 5 percent reduction in the preterm birth rate in Mississippi would result in much healthier babies and generate a cost savings of about $49.2 million,” said Shenetta Drone, associate vice president of health information technology for Delta Health Alliance.

Early results of the project are very promising, said Drone. “Pre-diabetes patients in the project have lost weight and have improved their cholesterol and blood glucose, meaning they are improving their chances of not developing diabetes. And we are excited that more than 80 percent of women identified for preterm birth risks by the project have gone to full term.”

Before she was identified by the system, Velma H. was not aware that she was at risk of developing diabetes nor had she ever been informed of the complications associated with the disease. The 53-year-old Indianola resident started working with Camilla Potts, a care coordinator with Delta Health Alliance, and soon came to recognize the seriousness of the situation.

“She took the time to talk to me and explain diabetes and pre-diabetes, even my doctors didn’t explain it to me,” Velma said. “She told me that I needed to know that this could cause heart attacks, it could cause kidney failure, and I paid attention. I want to live.”

Through the pre-diabetes program, Velma learned how to make nutritionally conscious decisions at the grocery store by reading nutritional labels and finding ways to incorporate more fruits and vegetables into her diet. Potts also helped identify ways to exercise without aggravating her back pain, and it has led Velma to be more active in her daily life. To date, Velma has lowered her cholesterol, maintained a normal blood pressure and has noticed that she is breathing better. She has also lost eight pounds, on the way to a goal of 15.

Sophia Y., of Yazoo City, is also an example of improved health care by the pilot project. Sophia knew she was high risk for complications during her pregnancy, like pre-term birth, from her previous bed rest experience with her two older sons. Delta Health Alliance pregnancy coach LaToya Atkins helped Sophia understand the importance of nutrition during pregnancy and Atkins enrolled her in a smoking cessation program.

“When I was introduced to LaToya, she made me feel good,” Sophia said. “I felt important, for someone to come check in on me. I was able to quit smoking and I am breast-feeding for the first time. I was against breast-feeding until she explained to me why it was important.”

Patients in the program are receiving clinical care coordination, help with accessing needed services, grocery store tours, nutrition classes and individual and group education within their communities.

“It’s through improved patient care, patient compliance and disease self-management that we will find better health at lower costs,” Drone said.

Under the project, Cerner technology analyzes clinical data from electronic health records (EHRs) and claims data from the Division of Medicaid to identify patients who might be at risk of either developing diabetes or having a preterm birth. HealtheIntent SM, Cerner’s cloud-based population health platform, helps care providers establish a longitudinal record for individual members of the population and can be utilized by care providers to match members with the right care programs.

EHR data and predictive software are used to aggregate, transform and reconcile near real-time clinical data. In addition to detecting at-risk patients, this process also helps find gaps in clinical care and opportunities for clinical process improvement.

“This initiative’s use of health IT helps verify clinical standards of care are being met. The project gives health care providers new tools to aid with early diagnosis and improved treatment,” said Ryan Hamilton, senior vice president of population health at Cerner.

Intervention data to date show greater patient compliance and improved disease self-management, with increased levels of regular exercise and success in smoking cessation being reported.

Mississippi State Senator Buck Clarke of Hollandale, a major project supporter, agreed. “Nearly 25 percent of Medicaid eligible Mississippians live in the Delta. Using technology to improve the delivery of care is not only benefiting the lives of these patients, it’s in the entire state’s interest,” Clarke said.

About Delta Health Alliance

Delta Health Alliance (DHA), is a non-profit, 501(c)(3) organization that is changing health and wellness outcomes in the Mississippi Delta by improving access to services, promoting healthier lifestyles, improving care coordination between providers, expanding educational opportunities, and increasing regional use of evidence-based models in developing new programs and services. Since 2001, DHA has provided a wide range of programs in the Delta in the areas of health, wellness, family services, and education. To find out more about Delta Health Alliance, go towww.deltahealthalliance.org or follow DHA on Facebook.

About Cerner

Cerner’s health technologies connect people and information systems at more than 27,000 contracted provider facilities worldwide creating smarter and better care for individuals and communities. Recognized globally for innovation, Cerner assists clinicians in making care decisions and assists organizations in managing the health of their populations. The company also offers an integrated clinical and financial system to help manage day-to-day revenue functions, as well as a wide range of services to support clinical, financial and operational needs, focused on people. For more information, visit Cerner.comThe Cerner Blog or connect on FacebookInstagram, LinkedIn, Twitter or The Cerner Podcast. Nasdaq: CERN. Smarter Care. Better Outcomes. Healthier You.

 

Delta Health Alliance Media Contact:

Jobyna France, jfrance@deltahealthalliance.org, (662) 686-3880

 

Cerner Media Contact:

Misti Preston, Public Relations, Misti.Preston@cerner.com, (816) 299-2037