High performing primary care practices for patients with diabetes during the pandemic

Published in PLOS ONE, University of Minnesota Medical School researchers explored how high performing primary care practices organized care for patients with diabetes during the first months of the COVID-19 pandemic. They found the better performing practices described using 'proactive' approaches to organize staff who deliver care and manage patient interactions and medical records.

During the pandemic, practices increased the number of virtual patient visits, which produced gaps in monitoring blood sugar and blood pressure. Practices responded by adapting their proactive patient care outreach processes. Where practices had run reports about patients to determine if care was needed and then schedule an appointment for patients, an increase in visits during the pandemic to keep staff and patients safe resulted in clinic staff identifying and comprehensively addressing patient care needs during in-person visits.

We thank the practice leaders for telling us about their clinic management experiences. Fortunately, most of these leading clinics were able to adapt, making best use of both virtual and in-person visits to continue the proactive approach."

Milton Eder, PhD, assistant professor at the U of M Medical School

Between August and December of 2020, researchers conducted interviews with 16 leaders from 11 practices in Minnesota that had top quartile performance measures for diabetes outcomes prior to the pandemic. Most of the challenges experienced by practice staff were mitigated by technical, informational and operational help from the larger organizations of which they were a part. According to the findings, these high performing practices:

• Regularly used patient information to remind patients of the medical care they needed.
• Reorganized their interactions with patients during in-person visits while staff limited physical contact with patients to make sure they received the care they needed to successfully manage their diabetes.

The research team encourages practice leaders and staff to explore incorporating proactive patient care processes into their care delivery processes. Further research is suggested to confirm the relationship between the use of proactive patient care processes and patient outcomes, and to learn how to effectively organize practice resources and the care team to implement proactive patient care processes within primary care..

This study was supported by the National Institute of Diabetes, Digestive, and Kidney Diseases of the National Institutes of Health (R18DK110732). Open access publication of this study was supported by the Department of Family Medicine at the University of Minnesota.