The New Health Dialogue

Whether you're swashbuckling in pre-revolutionary France or tackling diabetes, teamwork and accountability always produce the best results.

Dr. Bruce Siegel of the Robert Wood Johnson Foundation highlights a "local laboratory" of health care reform in The Users' Guide to the Health Reform Galaxy. He explains how a “three pronged attack” to improve diabetic care in Minnesota produced hard, measurable results. In just five years, the number of people receiving optimal diabetic care in Minnesota nearly tripled and by the end of next year 10,000 more Minnesotans with diabetes will be working with their doctors to meet these optimal care goals. And the docs that do a good job? They will be rewarded.

Like the Musketeers, these three organizations found that teamwork was the best way to make strides in diabetic care, improving care while also lowering costs.

1. Minnesota Community Measurement and the HealthScores Project

The RWJF grantee collects performance data from 300 clinics and Minnesota health plans.

2. Institute for Clinical Systems Improvement

Created by the HealthPartners Medical Group, Mayo Clinic and Park Nicollet Health Services, the institute helps spread and implement best clinical practices.

3. Buyer’s Health Care Action Group

Twelve members of the Buyer’s Group joined the “Champions of Change” mission to reward medical groups and clinics that provide what is considered “optimal” diabetes care. Physicians and medical groups are graded on five different dimensions -- blood pressure, cholesterol and blood sugar, tobacco use, and, when appropriate, aspirin use.

Once HealthScores starting publishing performance data, doctors and medical clinics began to take notice. They asked for best practice information, started tracking patients to see if they were receiving all of the appropriate care and passed off more responsibility and oversight to nurses. Improvement in care, of course, leads to fewer complications and lower costs. As we’ve written before, when diabetics' health deteriorates, the expenses add up fast-in lost work, hospitalizations, amputations, kidney disease, loss of sight, etc. So really, it’s a win-win.

Patients also jumped in to claim responsibility for their own health. They asked for an easy-to-use website with relevant and helpful information. D5 lists the five patient goals for living well with diabetes -- the benchmarks that patients need to need to sustain to reduce their risk of heart attack or stroke. They can also find out how different clinics are measuring up.

As Dr. Siegel concludes, sure, we could “dismiss this as another example of ‘Minnesota care’ -- where all the clinics are strong, the doctors good-looking and the scores are above average,” but rather, we should view this as a harbinger of things to come in the health care world. And it only gets easier if we have new payment systems and quality incentives.