Penn Schubert was adrift. Diagnosed with Type 2 Diabetes in December 2004, he was having difficulty coming to grips with what he calls, my new life.
"I was at a loss,"Schubert recalls. "My doctor's a great guy, but he's busy and didn't have time to educate me about the disease."
But, as Schubert wondered what to do next, someone at Optima, his health plan, was already scrutinizing claims data and lab results to identify him as a new diabetes patient, even before his doctor referred him.
Relief came in the person of Kathy Winters, BA, LPN, DE, a diabetes educator/case manager with Optimas LifeCoach program, who offered Schubert some much-needed help.
"First, we met for an overview," Winters says. "Later we addressed exercise, nutrition, foot care and lifestyle changes that could keep his disease under control."
Winters and Schubert spoke weekly on the phone until Winters decided monthly contacts were sufficient.
Schubert joined the YMCA and works out regularly. He watches his diet and stays on top of his blood sugar. Winters keeps track of his hemoglobin A1c levels through a database and checks in when she notices changes.
"I can't imagine doing this without her," Schubert says. "This worked out beyond my wildest expectations."
LifeCoach Diabetes program wins national award from DMAA
Success stories like Penn Schuberts earned Optima's LifeCoach program for Type 2 Diabetes patients the Disease Management Association of America (DMAA) 2005 Excellence Award for Best Provider Engagement Initiative.
Launched in 2003, the LifeCoach program has dual goals of improving lifestyle and food compliance among Type 2 diabetics and with improving diabetes education and oversight among primary care practices who accept Optima health plans.
"We could not have done this without the cooperation of our physician partners and their staffs," says George Heuser, M.D., senior medical director for Optima Health. Their willingness to let our diabetes educators work with their patients made all the difference.
The program engaged 23 physicians at six primary care practices, who offered space and staff support for a certified diabetes educator (CDE) provided by Optima once a week. These CDEs monitored a total of 1,400 voluntary patients with education, lifestyle plans, phone calls at least once a month and programs for patients and staff in medication management, nutrition, exercise and other lifestyle changes required to manage Type 2 Diabetes effectively.
"We had to clear some cultural hurdles," says Dr. Heuser. "Not many doctors welcome outsiders into their practices, especially when they come from a health plan."
But at the end of the two-year pilot, patients compliance and overall health improved and the physicians were unanimous in their desire to continue the program.
As for Penn Schubert, "I'd be crazy not to stay with this," he says. "It's my life were talking about, and I want to stick around a while."
Second DMAA award in two years for Optima Health
In 2004, DMAA cited Optima Health for its Partners in Pregnancy program, which coaches women throughout their pregnancies with a goal of full-term, healthy babies and reduced neo-natal intensive care admissions.
The Disease Management Association of America is a voluntary non-profit peer organization promoting high quality, cost-effective disease management programs and scientific measures of success in disease management.