This year’s Outstanding Educator in Diabetes Award recipient, Jackie L. Boucher, MS, RDN, serves as President for Children’s HealthLink, an organization dedicated to delivering care to children with congenital heart disease around the world. But her experiences as a diabetes educator and dietitian continue to shape her work.
Boucher talked about the skills and guiding principles she has developed in her career during her award lecture Saturday morning at the Scientific Sessions. She titled the lecture “Connectedness—How Technology and Social Networks are Advancing Diabetes Nutrition Care.”
“Technology has a pivotal role in every aspect of [diabetes] management today. We can’t escape it, even if we want to,” she said.
And the technology pendulum has swung toward the patient, Boucher said. Wearable devices, home monitors, mobile apps, and access to online health care information put more power in patients’ hands.
Health care providers also have more tools at their disposal than ever before, Boucher said, and need to consider one thing above all else when considering adoption of any technology: Will it improve health care delivery and outcomes and remove barriers for the patient?
“No matter how sophisticated a technology is, it’s still a tool,” she said. “It will never be a multidisciplinary team. It will never be a holistic approach. Its value is only realized when experts can employ it strategically.”
Identifying barriers for patients is a necessary and often underrated skill for health care providers, Boucher noted. As a young dietitian fresh out of college, she said she often skipped this step because she was so eager to give patients a dietary prescription.
Identifying and removing barriers results in improved access to the tools and healthy foods patients need. That requires informed curiosity, Boucher said. It’s a lesson she learned during her internship at a Detroit hospital where most of the patients were low-income minorities. She realized that barriers come in many forms and aren’t always easy to see.
“I learned it’s kind of hard to talk to someone about eating healthier when they’re scared they might die tomorrow. Note to self: Survival issues always rank above counting fruits and vegetables,” Boucher said. “I learned that my starting point with any patient had to be one of informed curiosity. How far is the grocery store? What can you afford to buy? I didn’t really know these terms at the time, but I was learning early on about ‘food deserts’ and ‘food insecurity.’”
When Boucher returned to her native Minnesota, she honed her informed curiosity not only in diabetes education but also working in cardiology, oncology, eating disorders, and with Alzheimer’s disease patients.
In 1995, she saw firsthand how technology can benefit patients when she was asked by HealthPartners to oversee the first ADA-recognized education program with a telehealth component. Her team developed a telephone-based program that provided patient information and assistance between clinic visits. Topics included management of weight, heart disease, cholesterol, blood pressure, stress, smoking cessation, and prenatal health. The program demonstrated statistically significant improvements in glycemic control.
From there, she moved on to the Minneapolis Heart Institute Foundation and led its Hearts Beat Back program, a community-wide initiative to prevent heart attacks. She also led a comprehensive effort to reduce the traditional risk factors for coronary heart disease in rural Ulm, Minnesota, where the four food groups are “beer, brats, butter, and cheese,” Boucher said. The program led to improved blood pressure management, and more than 90 percent of residents were aware of the campaign by the end of its first year.
Knowledge is power, especially in diabetes, Boucher said. And opportunities exist for innovators, as diabetes education programs still see low participation rates in the first year after patient diagnosis.
“We have to be strategic in our use of technology. Our decisions should always be patient-centered,” she said. “If we keep the patient at the center and we never stop being diligently curious about identifying barriers and removing them, we will improve the quality of life and outcomes for people with diabetes.”