Evidence-Based Diabetes Management

Leading the Way in Diabetes Care, and in the Discussion of How to Pay for It | Page 2

Published Online: December 16, 2013
An Interview with John L. Brooks III, CEO and President, Joslin Diabetes Center
EBDM: Let’s hear about Joslin’s efforts to work with parts of the country where diabetes and prediabetes are especially acute. Talk about some of your outreach efforts to underserved areas.

Brooks: Even though we are physically located in Boston, we really see ourselves as a national as well as a global resource. In Boston, we have a specific initiative around our Latino population. We recognize the Latino population has diabetes, but it is a different manifestation that needs a different treatment regimen. There are cultural issues, different foods that are eaten, and a different way people in that community think about diabetes. We have a similar program to target the African American population. We understand that in the African American community, diabetes is thought of differently; perhaps there is a little more fatalism. There’s a feeling, “Well, my great-grandmother had it; my father had it; my uncle had it; sugar has been in our family.” Sometimes that is how it is characterized, so that needs special focus. We also have a program for the Asian community.

In Boston, we have developed those programs, and we’ve shown they work. Now, we have opportunities with affiliates across the country, and we are starting to let them access these tools and resources, our educational expertise, and our ability to tailor diabetes for these cultural groups. We think of Boston as a “test kitchen” for new ideas; we prove it, demonstrate it, get the bugs out of it, and through our affiliates and collaborators, we distribute that knowledge and these capabilities. That is now available to payers, providers, community groups, or anyone who wants to leverage our expertise. They don’t have to reinvent the wheel.

EBDM: You had personal experience in dealing with diabetes when you became CEO of Joslin. Since becoming CEO, what about treating with people with diabetes has surprised you?

Brooks: As you mentioned, I am the father of a son who has had type 1 diabetes for 20 years, and that has really been the motivation for what I am doing. What I am not surprised by, but encouraged by, are the number of people with diabetes who are looking to us and other institutions to help them. I am excited about the ability to leverage technology and connectivity— the ability to use mobile apps or cell phones for disease management. If you think about it, we are all connected.

Technology has historically been a little slower to be adopted in health care. Change becomes harder, because we always need to be sensitive to what works for the patients, and the caregivers, and the doctors and the system. So I recognize that change is hard, and people can be a little suspicious of new ideas, such as social media. For example, do doctors really want to have patients e-mail them?

Sometimes we have to walk slowly; we have to encourage people to try something new. That’s why I like to do pilots; it’s a way to say, “Hey let’s try something,” and there’s no harm in failure. If it doesn’t work, we’ll fix it. I’m always optimistic. I think we can leverage all the great things we’re using across the country to make people’s lives better. Our objective in diabetes is: How do we help people with diabetes live well with diabetes? We’re certainly focused on a cure. We have great people at Joslin, and we’re working with people around the globe focusing on a cure. But while we’re doing that, what can we do today? How do we take the burden of managing this disease off patients by levering the power of technology, of cell phones, apps, algorithms?

People with diabetes have a disease—it’s not going away—but we’re not going to let it get in the way of living life to the fullest.