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Advanced Comprehensive Diabetes Care (ACDC)

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ACDC 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=576), and Veterans maintain most of this benefit as much as 3 years after finishing the program.

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

Origin:

December 2013, Durham VA Medical Center

Adoptions:

9 successful, 19 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:

Diffusion of Excellence, Health Services Research & Development, Office of Rural Health

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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)

Statuses

AL: Central Alabama VA Medical Center-Montgomery (Montgomery)
  • Started adoption on 07/2023.
AZ: Bob Stump Department of Veterans Affairs Medical Center (Prescott)
  • Started adoption on 10/2022.
CA: West Los Angeles VA Medical Center (West Los Angeles)
  • Started adoption on 10/2022.
FL: West Palm Beach VA Medical Center (West Palm Beach)
  • Started adoption on 04/2023.
GA: Carl Vinson Veterans' Administration Medical Center (Dublin)
  • Started adoption on 07/2023.
HI: Spark M. Matsunaga Department of Veterans Affairs Medical Center (Honolulu)
  • Started adoption on 06/2023.
IL: Danville VA Medical Center (Danville, Illinois)
  • Started adoption on 07/2023.
IN: Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana)
  • Started adoption on 07/2023.
MA: Edward P. Boland Department of Veterans Affairs Medical Center (Central Western Massachusetts)
  • Started adoption on 07/2023.
ME: Togus VA Medical Center (Togus)
  • Started adoption on 07/2023.
NV: North Las Vegas VA Medical Center (North Las Vegas)
  • Started adoption on 07/2023.
OH: Cincinnati VA Medical Center (Cincinnati, Ohio)
  • Started adoption on 07/2023.
OH: Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio)
  • Started adoption on 10/2022.
OR: Roseburg VA Medical Center (Roseburg)
  • Started adoption on 10/2023.
TX: Thomas E. Creek Department of Veterans Affairs Medical Center (Amarillo)
  • Started adoption on 04/2022.
VA: Hunter Holmes McGuire Hospital (Richmond, Virginia)
  • Started adoption on 10/2021.
WI: Tomah VA Medical Center (Tomah)
  • Started adoption on 07/2023.
WI: William S. Middleton Memorial Veterans' Hospital (Madison)
  • Started adoption on 10/2021.
WV: Louis A. Johnson Veterans' Administration Medical Center (Clarksburg, West Virginia)
  • Started adoption on 10/2023.

VT: White River Junction VA Medical Center (White River Junction)
  • Started adoption on 01/2018, ended on 09/2018.

Multimedia

Images

Above:

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