Rural patients with diabetic foot ulcers currently face 50% higher odds of major (above-ankle) amputation and 40% higher odds of death than their urban counterparts, a health disparity identified by Dr. Meghan Brennan’s team and others. Over 70% of Wisconsin residents live in rural areas, making this a particularly important topic to address in our state.
To reduce or prevent incontinence in older women, we have designed and tested a workshop led by trained leaders to increase skills to control incontinence symptoms through lifestyle changes. “Mind Over Matter: Healthy Bowels, Healthy Bladder” has been shown to improve continence, quality of life, and self-efficacy. The program was tested in a randomized controlled trial and is now being adapted for digital delivery.
To reduce tobacco use, we improved quit line referrals for tobacco users by 20-fold through Quit Connect, a 90-second clinic staff protocol that integrates the electronic health record with the Wisconsin tobacco quit line. This protocol is being implemented in both primary care and specialty care clinics in multiple Wisconsin health systems including Gundersen and UW Health, with a pending grant to implement at Grady Memorial public hospital in Atlanta (83% African American, 40% uninsured).
To prevent the long-term complications of diabetes among children, our program tailored diabetes self-management resources offered to children and their families at two pediatric diabetes centers, meeting the individual needs of over 2,200 Wisconsin children with type 1 diabetes (T1D) and their families. In addition, elements of this program were incorporated into diabetes clinics at Children’s Hospital of Wisconsin in Milwaukee. The study’s methods for engaging youth and families has inspired others like the American Diabetes Association and the Wisconsin Department of Public Health to make use of similar strategies.
To reduce disparities in healthcare quality, we are partnering with the Wisconsin Collaborative for Healthcare Quality and the Collaborative Center for Health Equity to measure and publicly report on disparities in the quality of healthcare in Wisconsin.
In 2019, we will release a statewide report documenting disparities in the quality of care for health systems across Wisconsin by race, ethnicity, and payer.
To find high-risk patients who might benefit from additional health and social services, we have developed and implemented an artificial intelligence system to identify patients in need of enhanced care coordination in partnership with one of our state’s largest health systems (UW Health). We are currently screening over 120,000 patients in Dane County each month using the system.
In the upcoming year, we will extend this system across the southern half of Wisconsin in partnership with one of the state’s largest health plans, screening an additional 166,000 patients each month.
Patient experience is an aspect of health and health care that has received increasing attention in the U.S. For patients and caregivers facing a new diagnosis, or needing to make a health-related decision, other people’s experiences of the same diagnosis, treatments, and impact on the life course have always been valued. With the advent of web-based health information, the influence of patient experience has grown even more rapidly.
Recognizing this gap, researchers at four universities—including UW-Madison—and the Veterans Administration formed a collaboration called the Health Experiences Research Network (HERN) in order to bring an internationally-vetted method of rigorously collecting diverse health experiences to the U.S.
In 2016, they launched www.HealthExperiencesUSA.org with an inaugural module on diverse young adults’ experiences with depression, a disease that can have significant consequences for future social, occupational, and health outcomes.
High blood pressures are the most prevalent and reversible cardiovascular disease risk factors among adults with chronic conditions, who are often vulnerable to gaps between specialty and primary care. Increasing preventive services to address hypertension could prevent more early deaths than any other preventive service. To address these issues, the BP Connect staff protocol was created to connect patients with high blood pressure in a specialty visit back to primary care for timely follow-up.
Approximately 1 in 15 young adults in the United States have high blood pressure, but young adults have the lowest rates of blood pressure control (achieving a blood pressure <140/90 mmHg) compared to other adult age groups, and many young adults have reported having few resources to address their needs for heart health education.
To address these problems, the MyHEART program was developed with young adults and healthcare team members to address a broad range of topics. MyHEART has multiple components, including young adult education and research programs across multiple healthcare systems.
Diabetic eye disease is the leading cause of blindness among working-age adults in Wisconsin, where there are currently over 135,000 adults with diabetes. Early screening and treatment can prevent 90% of blindness, but only half of adults with diabetes get their recommended yearly eye screening.
In response, Dr. Yao Liu created the UW Teleophthalmology Program that enables patients in rural locations to get screened by their primary care providers during regular clinic visits without having to make a second trip or appointment. The images are then sent to UW-Madison, where eye specialists read the images and send reports back to primary care for local follow-up as needed.