The move to quality ratings will put more pressure on hospitals to find ways to improve the standard of care while cutting costs.
A decade ago, the American Diabetes Association (ADA) called for hospitals to shift from sliding scale to subcutaneous basal-bolus insulin therapy for non-critically ill patients, but change has been slow in coming. Fear of hypoglycemia and concerns that staff would not be able to keep up with dosing demands of basal-bolus kept hospitals from upgrading to the standard of care.
Glytec, Inc, had previously presented data that show its electronic glycemic management system (eGMS) offers hospitals a way to meet the basal-bolus standard, reducing the number of days patients were out of range. At the recent 77th Scientific Sessions of the ADA, Glytec presented the bottom line: the electronic system not only improves glycemic control, but it also saves time and money.
Data presented came from Kaweah Delta Medical Center in Tulare County, California, where 13.2% of the county has diabetes. The hospital had struggled to convert to basal-bolus insulin, but did so with help from the electronic-guided insulin dosing system, known as Glucommander.
Researchers matched 1039 patients who received usual care in 2015 with 3200 patients treated during the first year after the switch to eGMS (March 2016 to March 2017). According to the results:
Before the hospital started using the Glytec system, basal-bolus insulin was only used 5% of the time—afterward, the situation was reversed, and basal-bolus was used 96% of the time. Raymie McFarland, vice president of Quality Initiatives at Glytec, said these results are noteworthy given how much the hospital had struggled to make the switch to basal-bolus insulin before engaging Glytec.
While basal-bolus is the standard of care, “It’s difficult to do this for every patient with no endocrinology support,” he said.
The arrival of the Medicare Access and CHIP Reauthorization Act (MACRA), which will bring greater importance to quality ratings, will make it more important than ever for hospitals to find ways to achieve ADA standards without relying on extra manpower. As a practical matter, there aren’t enough endocrinologists to meet demand, due to lagging incomes and a rise in the number of people who need a specialist.
“As the market moves toward value-based reimbursement, we’re there—we’re ready for it,” said Andrew S. Rhinehart, MD, FACP, CDE, BC-ADM, CDTC. Glytec’s system can assist providers with glycemic management at all points on the continuum of care.
Robby Booth, senior vice president of Research and Development, points outs a distinguishing feature: Glucommander can interact with major electronic health record systems, a hurdle that has kept many digital providers from making headway. (Glytec has reported case studies involving integration with EPIC.)
“After 11 years, we’re an overnight success,” Booth said.
Reference
Newsom R, Patty C, Camarena E, Gray T, Sawyer R. Safely Eliminating Sliding Scale thorugh a hospital wide conversion to basal/bolus insulin vs implementation of an electronic glycemic management system. Presented at the 77th Scientific Sessions of the American Diabetes Association, San Diego, California. Abstract 133-LB.
Dr Kathy Zackowski Discusses the Importance of Rehabilitation Research and Trials in MS
April 26th 2024Kathy Zackowski, PhD, National MS Society, expresses the inherent value of quality rehabilitation trials for broadening clinical understandings of multiple sclerosis (MS) and bettering patient outcomes.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
Read More