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Advanced Comprehensive Diabetes Care (ACDC)

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ACDC is a nurse-administered telehealth intervention for Veterans with poor diabetes control despite standard VA diabetes care. ACDC augments standard VA Home Telehealth services with diabetes self-management support and clinician-guided medication management. Critically, ACDC is specifically designed to use only existing VA staffing and infrastructure, so can be easily implemented in practice. In a randomized trial, ACDC improved hemoglobin A1c by an average of 1% vs. usual care, and by ~2% among engaged Veterans. ACDC’s real-world effectiveness has been confirmed at multiple VA sites. Rigorous qualitative testing shows that ACDC is well-liked and greatly appreciated by Veterans and participating staff.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.

Origin:

December 2013, Durham VA Medical Center

Adoptions:

3 successful, 7 in-progress, 1 unsuccessful

Awards and Recognition:

Diffusion of Excellence Promising Practice, Rural Promising Practice, VHA Shark Tank Winner

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Metrics

  • Mean hemoglobin A1c reduction 1.4% (n=230)
  • Qualitative Veteran and staff feedback is consistently positive
  • Implementation is cost-neutral in the short-term, and is likely to be cost-saving as the benefits of diabetes control accrue

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

Multimedia

Images

Above:

During the 2018 Shark Tank competition, the VA Diffusion of Excellence Initiative selected ACDC as a winner, or Gold Status Practice.