Ochsner Health: Digital Medicine Diabetes Program

Diabetes affects 10.5% of the U.S. population, with Louisiana experiencing a higher prevalence rate of 14.2%, equating to approximately 500,791 adults. Patients with diabetes face severe complications including heart disease, stroke, amputation, end-stage kidney disease, blindness, and death. These risks increase if the patient’s diabetes is uncontrolled. Depending on patient factors, the American Diabetes Association recommends an A1c goal of less than 7.0% or less than 8.0% for patients with Type 2 diabetes. 

Ochsner Health (Ochsner), a prominent nonprofit, academic, multi-specialty, integrated healthcare system in the region, decided to tackle this challenge through innovative digital health solutions. Ochsner developed and scaled a digital solution for cardiometabolic chronic disease management, Digital Medicine, which has served over 50,000 enrollees to date across all treated conditions. The Digital Medicine program, which launched in 2015 as a hypertensionfocused solution, offers personalized care for managing high blood pressure remotely using a Bluetooth-enabled blood pressure cuff and a specialized Digital Medicine care team. 

Digital Medicine expanded in 2017 to incorporate Type 2 diabetes (T2D) care. To deliver this solution, Digital Medicine built upon the infrastructure already in place and continued to provide care to patients by leveraging patient-entered data through Bluetooth-connected devices (glucometers rather than blood pressure cuffs) and expert care team support. This approach delivered superior clinical outcomes and provided an outstanding patient experience in an integrated model of care. 

The Digital Medicine care team leverages clinical data from the Electronic Health Record EHR (when available), as well as data submitted by the patient as part of the Digital Medicine program, including questionnaire responses and blood sugar readings. They use “live” and digital patient interactions to create a customized intervention plan consisting of health coaching and medication management to achieve disease control. 

Patients participating in Ochsner's Digital Medicine program for diabetes surpass the National Committee for Quality Assurance (NCQA) for control rate, which is 71% (95th Percentile for all Levels of Benefits). They achieve an average of 76% A1c control after being enrolled in the program for 365 days. Current enrollment in Ochsner's Digital Medicine diabetes program has surpassed 5,000 patients, with over 8,000 patients receiving care for diabetes during the program’s duration.