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Joint Department of Veterans Affairs and Department of Defense Collaborative Virtual Diabetes Self-Management Training and Education Program
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Diabetes affects all aspects of an individual's life. Globally diabetes impacts approximately 10% of the adult population while the incidence amongst Veterans receiving care within the VA nears 25%. The American Diabetes Association along with the VA and Military Health System recommends all people with diabetes received Diabetes Self-Management Education and Support at four critical times (1) at diagnosis, (2) annually and/or when not meeting treatment targets, (3) when complicating factors develop, and (4) when transitions in life and care occur.
Diabetes Self Management and Training /Diabetes Self Management Education and Support (DSMT/DSMES) helps people with diabetes learn, integrate, build trust and maintain behaviors as part of their overall treatment program. Providing DSMT/DSMES via multiple platforms including virtual, face to face and telephone improves access to care. The American Diabetes Association has awarded Recognition to this global pilot program for meeting all Diabetes Self-Management Education and Support standards of excellence.
Origin:
December 2019, Cleveland VA Clinic-Superior (Cleveland Superior Avenue), Dayton VA Medical Center
Adoptions:
70 successful, 27 in-progress, 5 unsuccessful
Awards and Recognition:
Diffusion of Excellence Promising Practice
Partners:
Diabetes and Endocrinology, National Center for Health Promotion and Disease Prevention, Nursing, Nutrition and Food Services, Pharmacy Benefits Management Services
Recent Updates
Overview
Problem
Images
Four Key Times for Diabetes Self Management Education and Training
- Presidential Law leading to the VA DHS DSMT DSMES program Presidential Law creating National Clinical Care Commission
- Approved DSMES Handbook Module 1: Diabetes in a Nutshell
- Approved DSMES Handbook Module 2: Monitoring
- Approved DSMES Handbook Module 3: Healthy Coping
- Approved DSMES Handbook Module 4: Taking Medications
- Approved DSMES Handbook Module 5: Healthy Eating
- Approved DSMES Handbook Module 6: Being Active
- Approved DSMES Handbook Module 7: Reducing Risk
- Approved DSMES Handbook Module 8: Problem Solving
- Links to helpful Diabetes resources Organizational Awareness
- National VA Endocrinology and Diabetes Program SharePoint Updated ADA Approved DSME/T Handbook Modules 1-8
Files
Links
Solution
A national curriculum including implementation guide, facilitator guide, pati ... April 2019, a Joint Incentive Fund between VA Subject Matter Experts (SME's) and DOD Subject matter experts was awarded. Teams convened to focus on the creation of a national VA/DOD evidence based, structured, standardized Diabetes Self-Management Education and Support program.
A national curriculum including implementation guide, facilitator guide, patient handouts and class power points have been developed,
The American Diabetes Association recognized the VA and DOD as being a unique population, meeting the defined national standards of excellence.
This program was developed within the Virtual Medical Center, but can be delivered via a multitude of Platforms including VMC, VVC, MHS-video connect, face to face and telephone. See more
Results
Metrics
- Our annual status report for 2022-2023 demonstrated an average A1c lowering of 1.65 for VA and DOD
- Behavioral Goal Attainment was partially achieved for over 90% of patients during the reporting period of 2022-2023.
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
-
September 2022 - March 2025
DSMT/ DSMES Needs assessment Template CPRS and CERNER-GENESIS for Dept of DefenseDSMT/DSMES Group class Templated note CPRS and CERNER which will allow national clinical and behavioral outcome gathering.Continuous Glucose Monitoring (CGM) inclusion in curriculum with focus on competency training for clinicians. -
September 2025
Obtain correct reimbursement. Engage fiscal for VERA and also Third party when indicated. Of note TRICARE requires DSMES from ADA recognized programs for individuals to be issued CGM devices. Proper coding is essential. VERA support for multiprofessional codes G-0108 and G-0109 are still pending. This is a major barrier. -
September 2023 - December 2024
Class PDF's presentations are now 508 compliant. Class handbooks are also 508 compliant. These materials have been posted and are available to all. For those under the umbrella of this national program, an implementation handbook and also a facilitator guide will be issued along with access to CPRS templates or CERNER templates for documentation purposes. A national CPRS database build is currently in phase 2.
Departments
- Diabetes
- Education and training
- Nursing services
- Information technology
- Finance department
- Primary care
- Nutrition, food, and dietary
- Claims
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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TOOLS |
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Files
- Clinic stop code guide for DSMES (VA) Endocrine Approved Diabetes Supplement
Optional Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
|
TOOLS |
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Support Resources
| Resource type | Resource description |
|---|---|
TOOLS |
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Risks and mitigations
| Risk | Mitigation |
|---|---|
| Lack of National Program Office | The Joint VA DOD Diabetes Self-Management Training program remains in the pilot phase due to lack of administrative support. The collateral duties to maintain this program are extensive. |
Contact
Comment
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About
Origin story
Original team
Mary M Julius, RD/N, LD, CDCES
VA/VHA Quality Co-Manager DSMT/DSMES
Jenni Osborne, MPH, MCHES, CDCES
DoD/DHA Quality Co- Project Manager DSMT/DSMES
Brian Burke, MD
VA/VHA Primary Care Physician - Diabetes Field Advisor, VA-DSMES Program Manager
Ret. CAPT. Paul Rockswold, MD
DoD/DHA -Diabetes Field Advisor, Epidemiologists, Statistician
Ellen Kilpatrick, MSEL, BSN, RN, CDCES
Nursing Liaison
Katherine Werner, PharmD, CDCES, VHA-CM
VA/VHA DSME/DSTE Pharmacy Liaison
Jamie Olsen, MS, RDN, CDCES
VA/VHA Dietitian, Education Program Specialist, Incoming DSMT Quality Manager
Jessica Taylor Spurrier, DNP, RN, CDCES
Nursing Liaison
Are there documentation templates for each session? And how are f/u education sessions addressed to evaluate pt's success with goals?
I apologize, for the delay in response. A national template for the DSMT/DSMES needs assessment and class topics has been piloted by Phoenix and Cleveland. It has been approved for a national build at which time a second pilot will be underway. Phase 2 pilot locations are Phoenix, Cleveland, San Antonio, St. Louis and a rural CBOC in Illinois. Following completion of phase 2 CPRS template pilot, the template will be pushed out to everyone under the umbrella of program #006585.
The national Template for the needs assessment plus the class notes has been completed and will be released to all CACS in the nation the first week of April 2024.
links do not work
Links are working. Please e-mail me directly if you wish to begin the facility level adoption of DSMES services.
Following up, our National CPRS needs assessment template plus our national class note templates have been finalized and will be released to CACS nationwide early April 2024
I'm confused. I have a vet who just asked me for this kind of help. Im in CT. Is it available... thanks (i'm a psychologist in ptsd clinic)
Hi Lisa, please reach out to me via TEAMS. I am happy to provide facility mentorship. My tour of duty is m, t, w 0600-1430. Th 0800-1630 and every Saturday 0600-1430. Best time to contact me is before 8:30AM
Please e-mail me at mary.julius@va.gov if you are interested in a facility level adoption.
Hi Lisa, have you attended one of our train the facilitator events yet? If not, please send me an e-mail so we can get your location up and running
Lisa, are you in CLE? Yes, this program is available in CLE. and has been for over a decade. Your CT patients can join a Face to face class on Wednesdays at 8:30 in the nutrition Classroom or they can attend a virtual class on Tuesdays at1PM
Iowa City VA