Geisinger’s Department of Epidemiology and Health Services Research and the Department of Biostatistics entered into an exciting partnership this year with the PaTH Clinical Data Research Network (CDRN). This network, which includes some of the top academic medical centers and schools of medicine in Pennsylvania and Maryland, as well as the University of Utah and University of Utah Health Care, strives to use patient-empowered research to address the questions and concerns that matter most in the communities that member organizations serve.
“We were brought into the PaTH CDRN because of what we are able to bring to the table,” explains Sharon Larson, PhD, acting chair of the Department of Epidemiology and Health Services Research at Geisinger. “This includes access to well-established electronic health and claims records and our experience with using data in relevant ways through the MyCode initiative.”
PaTH membership provides the infrastructure, rigorous security standards and regulatory support that the six participating organizations need to collaborate and learn from patients’ experiences. Ultimately, this collaboration will help the members achieve greater impact by pooling one another’s resources: electronic health record data, patients and clinicians.
“PaTH has already led to a couple of research grants,” says Dr. Larson, “and is building the mechanism for us to secure additional ones in the future.”
Understanding the barriers to diabetes treatment adherence One of those grants aims to increase the understanding for barriers to treatment adherence among Type 2 diabetics. “About 45 percent of adults with Type 2 diabetes do not achieve glycemic control,” Dr. Larson explains. “A major contributor to this is medication nonadherence. “This affects between 15 and 35 percent of patients who have been on medications for 2 years or less,” she adds.
Through this study, researchers aim to understand the impact of two recently enacted health policies that affect diabetes care on the Healthy People 2020 diabetes objectives:
- Health insurance expansion through the Affordable Care Act (ACA)
- Obesity counseling coverage by private and public health plans through the ACA and Centers for Medicare and Medicaid
Dr. Larson explains that the study is comparing diabetes outcomes in three states — one that adopted Medicaid expansion immediately (Maryland), one that delayed Medicaid expansion until January 2015 (Pennsylvania), and one that has not adopted Medicaid expansion (Utah).
“We’ll be measuring the impact of these policy changes using EHR and claims data across the PaTH CDRN before and after these policies were implemented,” she says. “Specifically, we’ll be evaluating the impact of ACA on the Healthy People 2020 objective for diabetes among patients treated by PaTH CDRN members. We’ll also look at the impact of preventive service coverage by both the ACA and Medicare on obesity screening and counseling in patients with diabetes or at high risk for diabetes.”
The project will also evaluate the effect of the ACA implementation and CMS coverage of obesity counseling on diabetes service use.