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APHA Scientific Session and Event Listing

James J. DiResta, DPM, MPH, Department of Surgery, Anna Jaques Hospital, 25 Highland Avenue, Newburyport, MA 01950, 9784652122, james.j.diresta.DMS04@alum.dartmouth.org and Katharine D. Sullivan, OD, Ophthalmic Research Associates (ORA), 863 Turnpike Street, North Andover, MA 01845.

Podiatrists and optometrists are the primary health care providers of foot and eye care in America and are often the first to identify pedal and ocular complications in older Americans with diabetes. An initiative to improve upon the practice behavior of these limited licensed physicians to reduce the complications of lower extremity amputation and blindness is the impetus behind our improvement project.

Our goal is to increase the screening of diabetics for peripheral arterial disease, distal peripheral neuropathy and retinopathy. We will strive to see that this population group has semiannual ABI and monofilament testing by podiatrists along with an annual dilated eye exam by optometrists.

In the present healthcare system we have a variety of self managed and physician managed/coordinated plans and while third party payers have directed their energies to quality performance measures through primary care physicians with incentive programs affecting all providers, many of the early signs and symptoms related to the complications of diabetes are brought first to DPMs and ODs as older patients have traditionally entered those practices on their own.

In the present environment where the large majority of Medicare patients are not in PCP controlled insurance products, the need to establish and implement quality measures for specialists such as DPM and OD providers is lacking. By bringing this initiative forward a new specialist driven approach to the complications of chronic disease management and a benefit compensation system directed toward the specialist provider will serve as a future model for others.

Learning Objectives: