Table 1 Types of CDM strategies for diabetes
STRATEGY*DEFINITIONEXAMPLES
Electronic medical recordElectronic system for tracking patient appointments or for tracking specific patients with diabetesNA
Patient remindersTelephone calls or postcards to patients to remind them of upcoming appointments or other aspects of diabetes managementReminders of annual ophthalmology appointments
Clinician remindersPrompts to health care providers to remind them of patient-specific diabetes managementFlag for patients who have not had recent HbA1c measurements recorded
Audit and feedbackA summary of a physician's clinical performance is sent to him or her for self-evaluationEach month the physician receives the average of the most recent HbA1c values of each patient with diabetes
Facilitated relay of patient dataClinical information from patients that is transmitted to the physician via some other route than traditional medical interactionsPatient home glucometer readings are uploaded and e-mailed to the case manager on a weekly basis
Clinician educationIncreasing physicians awareness of current clinical practice guidelines and evidence-based recommendationsConferences, workshops, educational outreach visits from PCN staff
Patient educationIncreasing patient understanding of disease pathophysiology and effective methods of secondary preventionOne-on-one counseling with nursing staff, group diabetes classes
Promotion of self-managementProviding resources for patients to succeed in self-managementGlucometers, meal-tracking charts
Team changesAddition of 1 or more members to the health care teamAdding CDM nurses, dietitians, or pharmacists to the patient care team
Case managementA team member other than the primary care physician assumes primary responsibility for coordinating care of patients with diabetesRegistered nurses track home glucose readings, send patients for bloodwork, and ensure that patients are seeing specialists appropriately
  • CDM–chronic disease management, HbA1c–glycosylated hemoglobin A1c, NA–not applicable, PCN–primary care network.

  • * Strategy categories are taken from Shojania et al.13