June 1, 2016

Healthcare Transformation Creates Sweet Spots for Diabetes Educators’ Unique Contributions

I hope you enjoy my May-June 2016 AADE President's letter:

With my goal to familiarize you with the six key strategies and outcomes in AADE’s new 2016-2018 Strategic Plan (read in full at diabeteseducator.org/strategicplan), this letter focuses on the strategy: Develop initiatives that will showcase the unique contributions of diabetes educators to people affected by diabetes in population health management and new models of care. On the opposite page you’ll read the profiles of two more AADE Change Champions who’ve carved out expanded roles, proved the value of diabetes educators and created job opportunities for other diabetes educators. 

The robust transformation in our healthcare system as a whole and within individual healthcare systems over the last decade has been dramatic. All signs indicate that dynamic transformation will continue. As diabetes educators we’ll increasingly have opportunities to integrate our work into this evolution. 

Numerous factors have fueled the transformation including: changes and innovation in healthcare technology, devices and delivery; change of focus to tracking the risk dollars and delivery of cost effective care,  and last, but importantly, legislation.

The Triple Aim, an important framework for this transformation, was developed in 2008 by the Institute for Healthcare Improvement (IHI) to address the appropriate delivery of healthcare services. It presents three interrelated tenets:  1) improve the patient experience, 2) improve population health, and 3) reduce per person cost.1 Next, The Health Information Technology for Economic and Clinical Health Act (HITECH), enacted in 2009 and being implemented over time provides financial incentives through Medicaid and Medicare to install and meaningfully use electronic health records (EHRs) with the goal of ensuring their meaningful use to improve quality of care.2,3 Third, Patient Protection and Affordable Care Act (ACA), enacted in 2010 and being put into effect progressively through 2018, has the enormous goal of implementing comprehensive reforms to make healthcare more available and affordable to more Americans.3,4.

The current focus on delivering value-based quality care has given rise to many new terms and concepts, several are used in AADE’s new strategic plan. One is population health, which focuses on the health outcomes of a group of individuals and the distribution of their outcomes across the group. Some experts prefer the term “total population health” which includes the management of a population across many sectors.5

Other terms define new healthcare delivery and payment models of care, including, but not limited to, Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs). A focus on quality of care with the use of care coordination along with engaging the patient to be a partner in their care, are key features of both of these care models.  

Everyone involved in and around healthcare today is working in uncharted and often choppy waters. While stressful, this time of robust transformation holds the potential of being very beneficial for us individually, for our profession and people with, affected by and at risk for diabetes. I encourage you to push the boundaries of your role, create new opportunities, seek out knowledge, obtain new skills and practice at the top of your scope. Jointly we’ll catapult our profession forward and achieve the outcomes in our 2016-2018 strategic plan. 

Happy spring!  

PS: Gain knowledge and build new skills at AADE16, our Annual Meeting in sunny San Diego, from Friday August 12th to Monday August 15th. Check out the program, register at AADE16.org.  


  1.  Whittington, JW, Nolan K, Lewis N, Torres T: Pursuing the Triple Aim: The First 7 Years. The Milbank Quarterly. 2015;93(2)263-300. http://www.milbank.org/uploads/documents/featured-articles/pdf/Milbank_Quarterly_Vol-93_No-_2_Pursuing_the_Triple_Aim_The_First_7_Years.pdf. (Accessed 2/25/16).
  2. Health IT Legislation and Regulations.  https://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations. (Accessed 2/25/16).
  3. Emanuel, E: Reinventing American Health Care. Public Affairs. 2014. (Book)
  4. About the Law (ACA): http://www.hhs.gov/healthcare/about-the-law/index.html. (Accessed 2/25/16).
  5. Kindig DA: What is population health? http://www.improvingpopulationhealth.org/blog/what-is-population-health.html. (Accessed 2/25/16).