Learn about innovative ways to care for patients with diabetes in underserved areas.
Arshiya Baig, MD, MPH, studies an innovative way to deliver care for people with diabetes through group visits at community health centers.
Q: What are diabetes group visits and how do community health centers fit in the mix?
A: Diabetes group visits are shared medical appointments where people with diabetes come together for an appointment where they receive not only medical care, but also diabetes education. Group visits can include services such as a medical exam, a flu shot, blood work, and prescription refills, as well as group education, goal setting, and other social support activities. All of this happens within one setting.Community health centers play a vital role in providing care to patients with diabetes in medically underserved areas. Our research is trying to understand if implementation of group visits may be effective in improving diabetes outcomes among patients using community health centers.
Q: Is your research yielding any valuable insight that you can share?
A: Patients seem to like this collaborative, team-based approach, and providers tell us that they get to know their patients better because of the opportunity for more interaction. Results from our pilot study also found significant improvements in clinical outcomes such as A1C.From the patient point of view, group visits are an effective use of their time because they don’t have to schedule multiple appointments or make several trips to different locations to receive care. Patients get to spend up to two hours or so with their health care team, which is usually more time than they would get in a 10 to 15 to 20-minute appointment with a healthcare provider every few months.
For staff and providers in community health centers, there are many perceived and actual benefits. One of them is working collaboratively with other people at the health center. In a diabetes group visit, the medical provider can be a physician, a physician assistant, or a nurse practitioner who provides the medical care, but they work in concert with other members of the diabetes health care team who help run the group visits such as a dietitian, certified diabetes educator, pharmacist, behavioral health specialist, medical assistant, or nurse.
Q: What are some of the elements that need to be considered when it comes to implementing and sustaining a model using diabetes group visits?
A: There are probably many. However, based on our experience with the pilot study, we found three key necessary elements.
- Identify a team champion—someone at the community health center who takes charge, brings a team together, and really leads the implementation of the diabetes group visits.
- Enlist leadership support—be it a medical director, the chief medical officer, or the executive director. Providers need to be on board and willing to refer patients to the diabetes group visit program. You also need to have engagement with the front desk staff, medical assistants, receptionists, social workers, behavioral specialists, and certified diabetes educators.
- Allow plenty of time—there is a lot of planning that goes into getting a group visit off the ground. Do all team members who are going to be implementing the program know what their roles and responsibilities are? Is a medical assistant going to be checking in people and doing their vitals? Is a pharmacist going to be on-site? When will the medical exams happen? Will patients be taken into private rooms for their exams? The plan needs to include strategies for identifying and recruiting patients.
Would group visits work in your diabetes care practice?