The telephone system proved superior to group-oriented support and standard care in terms of patient engagement, improved diabetes-related health outcomes, and patient safety, Schillinger and his team found. The technology was also highly cost-effective.
“We are extremely proud of the work done by the innovators of this project,” said Sue Carlisle, PhD, MD, associate dean of the UCSF School of Medicine at SFGH. “This is the kind of approach to patient care that can truly make a difference in the ability not only for public hospitals but for all of our health care systems to provide improved care at lower costs.”
Based on the positive initial outcomes, the automated phone system is being scaled up in collaboration with the San Francisco Health Plan, the city-sponsored local health plan. This second-generation program, SMARTSteps (Self-Management Automated and Real-Time Telephonic Support), is currently being implemented among an additional 500 diabetes patients.
SMARTSteps also includes access to real-time pharmacy claims data and up-to-date clinical registry data. Those tools will enable health plan counselors to support patients in their self-management and to assist them in sticking to—or in some cases intensifying—their medication regimens, Schillinger said.
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