Efficacy Study of Diabetes Group Visits

Much evidence exists that new, more effective methods of delivering care to diabetics are
necessary. In our current system of delivering care, diabetes care is often done in the
context of multiple other issues addressed during a regular office visit. Providers often
lack the time to properly educate patients on diabetes self management topics. This project
hopes to show that group visits can improve clinical outcomes, patient satisfaction,
provider satisfaction, and patient's self management knowledge, while decreasing cost. This
group visit method can make care more patient-centered and team based which is in alignment
with our organization's goal of becoming a true patient centered medical home. If
successful, this could expand to our other family medicine clinic sites and provide a
valuable learning opportunity for the family medicine residents at OHSU.

The investigators will first identify newly diagnosed diabetics (diagnosed within the last
12 months) at the South Waterfront and Gabriel Park family medicine clinics using EPIC. The
investigators will invite those diabetics identified from the South Waterfront clinic to
participate in 6 group visits that will follow a curriculum that the investigators created
based on the National Standards for Diabetes Self Management Education and the ACP Diabetes
Care Guide. This curriculum will address basic pathophysiology of diabetes, the "ABCs to
Better Diabetic Care" as defined by the ACP Diabetes Care Guide, setting goals, nutrition,
exercise, diabetic medications, and complications of diabetes. This intervention group will
be compared to a control cohort identified at the Gabriel Park clinic that will continue to
receive standard diabetes care from their primary physician. The investigators will look at
and compare clinical outcomes (Hemoglobin A1C, blood pressure (BP), and LDL cholesterol
levels), adherence to recommended preventive measures for diabetics (foot exams, eye exams,
yearly microalbumin, and immunizations), patient and provider satisfaction, as well as cost.
Cost data will be collected using EPIC to look at the costs involved in group visits
compared to the cost of delivering diabetic care through the standard individual medical
appointment. The investigators may also use EPIC to look at utilization of specialty
services, emergency room visits, and inpatient admissions and compared utilization across
groups.