OSDH 1815

Project Overview

In collaboration with the Oklahoma State Department of Health and the Centers for Disease Control and Prevention, 1815 is a 5-year grant providing technical assistance to prevent and manage diabetes, heart disease, and stroke targeting Caddo and Lincoln counties.

The 1815 grant supports programs and activities to improve health outcomes for people diagnosed with diabetes, heart disease, and stroke as well as emphasizing prevention and awareness for those who are not diagnosed. Implementing and evaluating evidence-based strategies to manage diabetes and prevent or delay onset of type 2 diabetes in high-burden populations and communities.

OFMQ Role

  • Improve activities supporting data capture, trending, and reporting for Electronic Clinical Quality Measures (eCQMs) CMS 122 and CMS 165

  • Building registry reports in the EHR for Pre-Diabetes patients for the Diabetes Prevention Program (DPP)

  • Supporting Electronic transitions of care specifically for DPP

  • Providing educational materials and training for staff around program measures and goals

  • Advocating the use of Team-Based Care for Diabetes and Hypertension

  • Practice facilitation and technical assistance

Current Project Successes

  • The creation and distribution of new Hypertension and Diabetes educational materials (protocols, magnets, window clings, posters)

  • Registry reports created in EHRs for Pre-Diabetes patient tracking

  • Diabetes and Hypertension eCQM measure improvements

  • Electronic process established in EHRs for Diabetes Prevention Program (DPP) and electronic referrals

  • Workflow materials assembled and distributed for electronic referrals for DPP

Resources

Partners