Multifaceted approach to preventing, diagnosing, and monitoring diabetes
The Clalit Research Institute has developed accurate algorithms to identify members at risk for diabetes and patients with diabetes. Current research efforts serve to improve the management and treatment of these patients by incorporating data-driven findings on topics such as adherence and comparative effectiveness into the managing physician’s decision-making process.
Context and Aims
Diabetes is a cause of short and long term morbidity as well as increased mortality for over 300,000 Clalit members. The detection of diabetes is often at later stages of illness progression rather than at onset, given a lack of symptoms. Therefore, screening efforts have been undertaken at Clalit to identify members at-risk for, or at early onset of, diabetes in order to prevent disease progression. The Clalit Research Institute, together with Clalit Health Services, develops data-driven tools and techniques to provide support for prevention and treatment in diabetes care.
A composite diabetes case-finding algorithm was built using diagnoses, lab tests, and anti-diabetic medication purchases from Clalit’s electronic medical record database to create a diabetic registry.
In order to predict which members are at highest risk for developing diabetes within 3-5 years without intervention, we built on the American Diabetes Association criteria for pre-diabetes and created a risk model incorporating additional clinical data.
With the identification of members at-risk based on their clinical profile, an intervention is underway to proactively reach out to patients and encourage follow up with their primary care physicians.
Further, there is monitoring of members with diagnosed diabetes for rates of complications, adherence to medication regimens, and indicators of comparative effectiveness between treatment regimens.
Key Findings and/or Potential Impact
The ability to track individual medical history, together with laboratory data and prescribing practices, has enabled the Clalit Research Institute to collaborate with local physicians, new start-ups, academic institutions, and industry to introduce innovative techniques in diabetic prevention and management policy.
Karpati T, Cohen-Stavi CJ, Leibowitz M, Hoshen M, Feldman BS, Balicer RD. Towards a subsiding diabetes epidemic: trends from a large population-based study in Israel. Population Health Metrics, 2014. 12(1): p. 32.