Session ID: 

Team-Based Decision Support in Diabetes: Outcomes and Costs

8:30am - 9:30am Wednesday, February 13
Orlando - Orange County Convention Center


There are 48% of Medicaid patients with diabetes mellitus in poor control. The Commonwealth of Kentucky spends more on diabetes than on the next five chronic diseases combined. This project identified three areas to improve outcomes at lower costs: Shared decision-making (SDM) to increase adherence; reduce providers’ decision complexity; and cost transparency. The SDM process compiled patients’ non-adherence reasons (e.g., “fear of injections”, “cost”). A questionnaire allows for patient and provider to discuss these factors prior to choosing medicines. The project team created a treatment algorithm to compare efficacy and cost of six million combinations of 60 front-line drugs. This solution proposes different regimens (with trade-offs). Results from an initial trial showed a 1.1% drop in HbA1C (from 8.6% to 7.5%) for patients adhering to the program. Through grant funding this initiative is being expanded to multiple locations and includes Medicaid formulary costs in the algorithm.

Learning Objectives: 

  • Describe how shared decision-making tools help patients and providers recognize barriers and support solutions to adherence in diabetes treatment
  • Evaluate customized regimens from a decision support tool within the context of the current literature for clinical decision support and patient engagement
  • Explain the need for a broad interdisciplinary team and each team member’s role in the shared decision-making processes and decision support tools
  • Appraise the unique problems in treating the diabetes mellitus population that can be addressed through clinical and financial decision support at the point of care
  • Create strategies for avoiding clinical inertia through new treatment algorithms


Professor, College of Informatics,
Northern Kentucky University


Chief Quality, Chief Clin Transformation Officer
Physician, CMO, CMIO
Population Health Management Professional