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Advanced Comprehensive Diabetes Care (ACDC)
Share PrintACDC is a VA Home Telehealth-administered program for Veterans with persistently poor diabetes control despite receiving VA diabetes care. ACDC augments standard Home Telehealth services with additional diabetes self-management support and clinician-guided medication management. Critically, ACDC is specifically designed to use only existing VA staffing and infrastructure, so it can be easily implemented at any VA site. Randomized trial data shows that ACDC improves hemoglobin A1c compared to clinic-based usual care and standard Home Telehealth diabetes services; in real-world practice, ACDC lowers hemoglobin A1c by 1.6% (n=755), and Veterans maintain most of this benefit as much as 3 years after finishing the program.
Origin:
December 2013, Durham VA Medical Center
Adoptions:
21 successful, 12 in-progress, 1 unsuccessful
Awards and Recognition:
Diffusion of Excellence Promising Practice, Rural Promising Practice, VHA Shark Tank Winner, QUERI Rapid Response Project, QUERI Partnered Evaluation Initiative
Partners:
Diabetes and Endocrinology, Diffusion of Excellence, Health Services Research & Development, Office of Connected Care, Office of Rural Health, Quality Enhancement Research Initiative
Recent Updates
Overview
Problem
Solution
ACDC uses only existing VA clinical staffing and infrastructure, and can be fully implemented at any VA ... Via an easy-to-implement collaboration between the VA Home Telehealth program and clinical pharmacy (or other medication managers), ACDC aligns telemonitoring, self-management support, and medication management services around participating Veterans.
ACDC uses only existing VA clinical staffing and infrastructure, and can be fully implemented at any VA site in just a few months without any new hiring or equipment purchases. See more
Results
Metrics
- Mean hemoglobin A1c reduction 1.6% as of the end of FY2023 (n=755)
- 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)
Multimedia
Images
During the 2018 Shark Tank competition, the VA Diffusion of Excellence Initiative selected ACDC as a winner, or Gold Status Practice.
Implementation
Departments
- Pharmacy
- Nursing services
Core Resources
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Support Resources
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PEOPLE |
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Risks and mitigations
| Risk | Mitigation |
|---|---|
| Home Telehealth nurse time availability | Recommend that facility allocate up to 0.5 FTE across one or more Home Telehealth nurse (depending on scale of intervention) |
| Clinical Pharmacy Specialist time availability | Recommend that facility allocate up to 0.25 FTE across one or more Clinical Pharmacy Specialist (depending on scale of intervention) |
| Volume of appropriate Veterans | ACDC is optimal for facilities struggling with diabetes control metrics |
Contact
Comment
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Email vhaduracdc@va.gov with questions about this innovation.
About
Origin story
Original team
Matthew Crowley
Project Leader
Tiff Beaver
Project Coordinator
Summer Anderson
Project Coordinator (DDN QUERI project)
Dr. Malcolm Young approves of this product
I'd like more information for VA Black Hills Health Care System. Can you share the toolkit?