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. 2018 Jul 31;7(15):e009271. doi: 10.1161/JAHA.118.009271

Table 2.

Solutions for Healthcare Systems and Quality Improvement

Key Solutions for Healthcare Systems and Quality Improvement
Aggregate information for stakeholders Help patients and providers better recognize the spectrum of CVD and cardiometabolic disorders using culturally sensitive, relevant, and tailored approaches
Bring together all interested partners and organizations to develop and champion 1 simple message about diabetes mellitus and prediabetes
Simplify screening, prevention, and diagnosis Create quick assessment tools for screening for diabetes mellitus, health knowledge and behaviors, and family history
Develop simple, succinct algorithms with the PCP as primary target, based on comprehensive guidelines for treatment/management of clusters of cardiometabolic health diseases (diabetes mellitus, blood pressure, lipids)
Within algorithms, elevate the role of team‐based care, defining new models for the “optimal healthcare team” and ensuring inclusion and buy‐in with an emphasis on patient education and engagement
Identify and promulgate systematic, simplified approaches for identification and treatment of patients with diabetes mellitus and lifestyle interventions using the full continuum of care and care transitions (eg, take the Kaiser model to federally qualified health centers with customized approach, emergency department–based episodic care to PCPs’ offices)
Team‐based care approaches Develop a team‐based approach with multidisciplinary providers such as primary healthcare providers, physician specialists, nurses, dietitians, pharmacists, community, health workers, etc
Encourage healthcare systems to drive patients to enroll in evidence‐based, cost‐effective programs (eg, DPP, DSMES, weight loss)
Leverage technology Utilize innovative technology to help care for patients where they are (eg, telemedicine, e‐monitoring, text messaging)
Explore ways to link electronic health records to pharmacy data to better measure medication adherence
Improve communication between electronic health record systems to clinics to ensure coordination of care
Training for healthcare providers Focus on cultural competency training to support healthcare providers and systems to better understand the communities they serve and leverage these insights to deliver care in meaningful ways for the community
Advocacy Advocate for better reimbursement on programs that work (eg, DPP, DSMES)
Continue policy systems and environmental change strategies working with industry (eg, changes to the food supply, control of prescription drug costs)
Engage employers and payers in all aspects of AHA initiative to drive business case for new models of care delivery and management
Science and research Invest in more research on community health interventions, quality improvement, and population health approaches to diabetes mellitus
Create a comprehensive cardiometabolic health guideline that incorporates all risk factors into 1 centralized resource (eg, obesity, hypertension, dyslipidemia, diabetes mellitus) and that focuses on reducing CVD risk
Quality improvement programs Leverage successes from the AHA's Target: BP program to create a similar outpatient recognition and improvement program for diabetes mellitus care
Leverage the AHA's Get With The Guidelines capabilities to support patients with diabetes mellitus and cardiometabolic disorders

AHA indicates the American Heart Association; BP, blood pressure; CVD, cardiovascular disease; DPP, Diabetes Prevention Program; DSMES, Diabetes Self‐Care Management Education and Support; PCP, primary care provider.