Tuesday, July 1, 2008

Consumer Tools On the Web

Diabetic Health Care Success Variability in Minnesota

More data is becoming available on the web that should be of help in making decisions about health care.

A recent example is reported in the Star-Tribune:

Minnesota clinics vary in quality of diabetes care, report says

June 30, 2008

A new "health report card" has found that diabetics are much more likely to get their disease under control at some Minnesota clinics than others.

The report, by a group called MN Community Measurement, rated more than 300 clinics on their use of widely accepted best practices to treat diabetes and vascular diseases.

It found that on average only 17 percent of diabetics received "optimal" care in 2007, but the success rates ranged from 0 percent to 48 percent at different clinics.

Some of the highest ratings went to Fairview and Allina clinics, while some of the lowest were at clinics run by University of Minnesota physicians and those managed last year by Aspen Medical Group, which has since merged with Allina.

"The data show that where you go for health care matters just as much as what you eat and whether you exercise," said Jim Chase, executive director of MN Community Measurement, a nonprofit group.

Chase noted that some clinics have shown dramatic improvements in the past year. The clinic ratings are posted on the group's website, www.mnhealthcare.org.

The fact that the numbers vary so widely shows that "clinics across the region are not equally successful at helping patients achieve good control of diabetes and vascular disease," the group said in a statement released Monday.

But Mary Koppel, a spokeswoman for the University of Minnesota physicians, said there are other reasons that some clinics have low ratings. Many poor patients have a hard time controlling diabetes because of difficulties with access to care and healthier foods, she said. "It's important to recognize the complexity of the people coming in the door when we're doing these measurements."

What's being measured?

Diabetes patients achieve D5 success when they reach all of the following treatment goals:

1: Hemoglobin A1c (HbA1c) level less than 7%
2: Blood Pressure less than 130/80 mmHg
3: LDL-C less than 100mg/dl
4: Daily aspirin use for patients 41-75
5: Documented as tobacco-free in medical record.

Who's doing it the best?

Fairview Oxboro Clinic
Group: Fairview Health Services, County: Hennepin
600 W 98th St Bloomington MN 55420

Percentage of the clinics patients who achieved D5 = 48%

(566/1174 medical records reviewed)

Average of all clinics = 17%

How are UMP physicians doing?

University of Minnesota Physicians - Phalen Clinic
Group: University of Minnesota Physicians, County: Ramsey
1414 Maryland Avenue East St. Paul MN 55106

University of Minnesota Physicians - Smiley's Clinic
Group: University of Minnesota Physicians, County: Hennepin
2020 East 28th Street Minneapolis MN 5540

University of Minnesota Physicians - Primary Care Center
Group: University of Minnesota Physicians, County: Hennepin
420 Delaware Street SE MMC 88 Minneapolis MN 55455

University of Minnesota Physicians - Medicine 6 Clinic, Endocrine
Group: University of Minnesota Physicians, County: Hennepin
MMC 88 420 Delaware St SE Minneapolis MN 55455

University of Minnesota Physicians - Broadway Family Medicine
Group: University of Minnesota Physicians, County: Hennepin
1020 West Broadway Minneapolis MN 55411

Instead of worrying about becoming a "top 20 medical school," by generating increased NIH funding, perhaps the U ought to start worrying about doing an above average job for patients? Diabetes care would seem to be a good place to start.

We have a superior operation in the area of cystic fibrosis, so the argument about the clientel doesn't seem to wash.

Wouldn't it be nice for a change if just once a University of Minnesota mouthpiece, or better yet the Medical School Dean or the Academic Health Center Provost would say: "Those numbers are simply not acceptable, and we are going to do something about it, starting tomorrow."

As tools become available on the web for potential patients to use in selecting health care options, if the U doesn't become competitive in these areas, the future looks grim.

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