Felicia Hill-Briggs, PhD, ABPP, ADA President, Health Care & Education, is on a journey to change the world and she’s taking the American Diabetes Association with her.
“I have had a relationship with the ADA for 42 years since I was diagnosed with type 1 diabetes at the age of nine,” Dr. Hill-Briggs said during her presidential address Saturday morning at the Scientific Sessions. “In the absence of a pediatric diabetes provider, diabetes education, or diabetes peers, the ADA became my lifeline. Mary Tyler Moore, who was on the cover of the first ADA monthly magazine I ever received, became my role model.”
Dr. Hill-Briggs is determined to keep the ADA as current and relevant in today’s era of health care transformation as it was to her in the 1970s. She said her goal is to operationalize the ADA’s mission of preventing and curing diabetes and improving the lives of all people affected by the disease. That means attacking diabetes in concert with other stakeholders, working at the population level, developing new health and therapeutic modalities, and ensuring that people with diabetes get the right care at the right time and place.
“Diabetes is as an exemplar of the need for health care transformation,” she said. “Diabetes is the leading cost in direct and indirect spending in chronic health care in the United States. Disparities of care continue to exist. People of specific racial/ethnic or low-income groups receive lower levels of care and lower quality of care, leading to avoidable complications.”
The ADA model aligns public and private stakeholders with the rest of the diabetes ecosystem to tackle diabetes at the population level. A series of Population Health Programming Initiatives are turning the Association’s mission into practical success.
The National Diabetes Prevention Program (DPP) was launched in 2016 in collaboration with the Centers for Disease Control and Prevention, the American Medical Association, and the Ad Council. The Risk Test campaign, a recently launched initiative to get 20 million Americans tested for diabetes, has a goal of identifying 2.5 million individuals with diabetes or prediabetes and connecting them with the nearest DPP.
“We will engage you in this campaign,” promised Dr. Hill-Briggs, Professor of Medicine, Physical Medicine and Rehabilitation, and Acute and Chronic Care at the Johns Hopkins University and Senior Director of Population Health Research and Development for Johns Hopkins HealthCare, LLC.
Meanwhile, the DPP is being scaled up to better serve specific underserved populations in Arizona, California, Kansas, Oklahoma, and Texas. Targets include Hispanic/Latino residents, Medicare recipients, and men.
Another program, Diabetes Inside, is a long-term strategy to translate the ADA’s 78 years of science and advocacy expertise into the 21st century. The new strategy links knowing with doing, research with action and change, and innovation with real-world translation. The goal is to catalyze, accelerate, and install health care improvements across health systems using data science, quality improvement training, professional development, patient self-management, and other proven approaches by tailoring intervention programs to the needs and preferences of specific partners and populations.
The strategy works. An early health system partner reduced the indication for insulin therapy, an A1C of 9 percent or higher, by 24 percent over three years. The percentage of the target population exceeding an A1C of 9 percent fell significantly in the program. So did the mean A1C across the entire health system population.
“This type of improvement is not easy to achieve, but it’s possible using systematic approaches,” Dr. Hill-Briggs said. “In economic terms, reducing the mean A1C across the population has the potential to save more than $3 billion over three years.”
The ADA is committed to the Mental Health Provider Education Program, a joint effort with the American Psychological Association. The two associations have created the first continuing education program in diabetes for mental health providers, as well as a diabetes-specific referral registry for mental health providers.
The ADA is also expanding its efforts globally, including programs in the Caribbean and Saudi Arabia, two hot spots for type 2 diabetes. Working with local stakeholders, programs adapt ADA standards of care and population health programs to local needs.
“I hope you are as encouraged as I am,” Dr. Hill-Briggs said. “This is a new era with new opportunities for impact. The support of the ADA is palpable.”