HHC In Focus - Chronic Disease Management

Diabetes is a chronic disease that affects nearly 24 million Americans and is the leading cause of kidney failure, adult blindness and lower extremity amputation, and a prime contributor to heart disease and stroke.

HHC has more than 50,000 diabetic patients registered in its electronic database. All HHC clinicians use a standard evidence-based treatment protocol for patients with diabetes. By mining data from an electronic diabetes registry, a web-based tool that uses information from HHC's advanced electronic medical records system to provide a real-time "snapshot" of each diabetic patient's health status, doctors give more targeted, evidence-based treatment and can identify patients who need more support in their self management efforts.

To evaluate the effectiveness of diabetes care and the impact in helping patients keep their disease in good control, HHC measures the number of patients who have been tested for their blood sugar and the percentage of those with healthy blood sugar levels. Cholesterol and blood pressure levels are also closely monitored, since it has been recognized that controlling blood sugar alone is not enough for people with diabetes. Controlling cholesterol levels and blood pressure is crucial to preventing cardiovascular problems, including heart attacks and heart disease, which are high risk conditions for diabetics.

In 2008, HHC diabetic patients achieved better quality outcomes than those achieved at the state or national level in 2007. A total of 20,766 patients monitored achieved healthy Hb A1c levels of less than 7. That represented 45.5% of the monitored patients, and an additional 5,000 more patients who achieved control of their diabetes compared to 2007. HHC had more than 20,000 patients -- more than 40% -- who met the healthy blood pressure goal of 130/80 and nearly 27,000 patients -- almost 55% -- whose cholesterol, as measured by LDL levels, were under 100 mg.