Featured Practice: Charis Health Center – Using Shared Decision Making for Better Diabetes Care Management

This week’s featured practice is Charis Health Center, a safety net primary care provider that is using shared decision making to collaborate with patients. This interactive approach to the patient-provider relationship can be beneficial for a number of outcomes, and at Charis, it has been an especially helpful ethos and strategy that has aided diabetic patients in improving disease management and A1c control.  

Charis is located in Mount Juliet, Tennessee, and provides affordable healthcare to the uninsured. They operate with a small staff and cadre of dedicated volunteers. Since their founding in 2007, Charis has been providing holistic care to meet the physical, emotional, and spiritual needs of every patient.

Diabetes is a complex chronic condition that requires daily self-management. Charis patients faced a number of barriers to controlling their A1c levels, including challenges to filling prescriptions. Additionally, Charis providers were not regularly considering care gap reports, resulting in the care teams not always being aware of patients who needed or missed testing. With the help of TCPI, Charis integrated patient education and shared decision making throughout the entire patient visits. Beginning with scheduling, the patient is asked if they have any specific wishes or beliefs they would like to guide their care. Patients are provided thorough and easy to understand information about any treatment approach and care recommendations, including the need, rationale, and costs. The patient and care team will work together to determine the best course of action, and patients are able to request different providers or approaches if they are at any time unhappy with their care. 

For diabetes care specifically, Charis established a pre- and post-visit check in protocol to discuss management status and needs. Moreover, they’ve increased access to necessary medications through a prescription assistance program to reduce barriers regarding costs. The practice now consistently generates reports on patients’ A1c levels so all providers are better informed of patients who have diabetes or are at risk.

Charis has successfully reduced the number of diabetes patients with high A1c levels from 33% to 5% over a two year period. Feedback obtained through patient surveys and informal comments indicate patients have consistently positive experiences and appreciate the availability of self-management tools like care logs. 

You can read Charis’ full story here. For more information about the what shared decision making is, what problems it can help address, and how to get started, tune into SHARE the Knowledge, Part 1 of our Best Practices Podcast series.

The views expressed in this story are those of the authors and do not necessarily represent the official views of Charis Health Center. Additionally, this work was funded by the U.S. Department of Health and Human Services – Centers for Medicare and Medicaid Services’ Transforming Clinical Practice Initiative, under grant number 1CMS331549-03-00. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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