State funding helps spur on Avera's gestational diabetes program
Funding from Department of Social Services to focus on serving at-risk American Indian, Medicare populations
Avera Queen of Peace Hospital’s success with slowing gestational diabetes will continue growing, thanks to a recently announced state grant.
A total of $1 million will be directed toward primary and prenatal care through three health care organizations, including $333,000 for Avera’s remote gestational diabetes monitoring project for up to three years, which is led at Avera Queen of Peace in Mitchell. Gov. Kristi Noem announced the funding last week.
Angie McCain, who is the project director of the grant and the director of the Women’s Center at Avera Queen of Peace, said she was thrilled to be involved with expanding the service to two key segments of the population where the risk for gestational diabetes is higher: American Indian women and Medicare enrollees.
The program, which started in August 2016, builds on a three-year federal grant that has brought remote blood sugar monitoring and mobile telehealth visits to patients in South Dakota.
“We were thrilled to be recognized as one of the projects picked for this funding,” McCain said, describing her meetings with state officials. “We visited with them about our grant and our application, and we’ve really had so much success. They were very much interested in the outcomes, with hopes of expanding this with the American Indian population and further into the Medicaid population.”
In the Avera program, pregnant women with potential blood sugar issues visit with an Avera nurse or nutritionist weekly and regularly test their blood sugar, which is then transmitted back to nurses and doctors, where they can monitor progress. Avera uses an app that takes information from a glucometer and stores it digitally, while digital telehealth visits can also occur via smartphone. About 100 women have been involved with the program, and McCain said there’s been about 700 meetings that have taken place, generally digitally.
McCain said the goal is to replicate what’s already been working with the program, which has included patients having reduced time away from work and drive time, fewer births delivered via Cesarean section, increased physician satisfaction and decreased costs and patient stay times, along with healthier babies. For example, McCain said medical staff interventions with potential cases of diabetes have been about 6 to 8 weeks earlier and C-section births have decreased by about 20 percent during the study period so far.
“Whenever you’re able to avoid a surgery, that’s a big plus,” she said.
McCain said that Avera Health has previously tried to serve Native American and Medicare populations, but said that issues like rural connectivity and access to smartphones have been barriers to expanding the program further. The goal is to connect with the Indian Health Service to expand the program.
“We have served some of those populations, but not nearly the number we had hoped to initially,” she said. “But hopefully with this innovation grant, we’ll be able to expand this whole thing.”
The South Dakota Department of Social Services, which put out the request for proposal for the innovation grants, said it was looking for proposals that would help prevent future health issues and would address medical, behavioral and psychosocial factors that can be present during pregnancy or affect potential births. Funding will also go to Native Women’s Health Care in Rapid City, and the Center for Family Medicine in Sioux Falls. In each case, the funding is geared towards helping expecting mothers in the Medicaid program.
“It's incredibly important for expecting moms to get the care they need during their pregnancy,” said Noem in a statement. “We need to find new ways to support access to primary and prenatal care across South Dakota — especially in remote or rural areas. The sooner people get the care they need, the less likely they are to need more intensive interventions or higher cost services later.”
The DSS has said an average of 116,000 South Dakotans rely on Medicaid for their healthcare each month, and 68 percent of those enrolled are children. Half of the children born in South Dakota each year will be on Medicaid during their first year of life.
The federal grant from the Health Resources and Services Administration’s Federal Office of Rural Health Policy that Avera has been using for the last three years has also been extended, McCain said, for another year.
Some of the state funding could go toward making iPhones or iPads available to the at-risk populations, McCain said. She said it’s also possible that Avera would try to find a liaison that could connect with those populations with getting glucometers and do additional education.
“We know we might have to be creative, but there’s a lot of opportunity with this project, and that’s exciting for us,” McCain said.
A start date for the state grant funding has not been announced.