Using data and community partnerships to improve the lives of patients with diabetesFebruary 12, 2016
Susan Spratt, MD, has a passion for caring for patients with diabetes. She is an assistant professor in both the Department of Medicine and the Department of Community and Family Medicine and also a member of the Durham Diabetes Coalition, an effort to partner with community programs to improve the care of patients with diabetes through community interventions. “It is important to understand how environment and socio-economic aspects impact health,” she says. “Poverty, being underinsured or having no insurance, living in a food desert – these all make it much more difficult to prevent complications and death from diabetes.”
Here, in her own words, are some reflections from Dr. Spratt on what shaped – and shapes – her career.
As a physician/professor at Duke, how do you spend your days?
I am an endocrinologist and the Director of Diabetes Service for Duke Health. That means I spend about 25 percent of my time seeing patients in the Duke clinics, which includes spending time supervising medical students and fellows, and another 20 percent of my time serving as the Director of Diabetes. Then I also spend about 20 percent of my time working in the community with the Durham Diabetes Coalition. On top of that I am currently heavily involved in the EPIC/MaestroCare project, and spend about 45 percent of my time on that. If those numbers don’t add up to 100 percent, that’s probably an accurate picture!
How did you get involved with the Durham Diabetes Coalition?
Rob Califf, Michelle Lyn, and Fred Johnson were the ones who got me involved. Community and Family Medicine had created a group that met every two weeks to discuss how we could partner for better diabetes care. We did small pilots to look at things such as whether co-pays improve attendance at clinics, and whether electronic consults work. Then we had the opportunity with Rob Califf to apply for a grant funded by Bristol Myer Squibb, and we put together a proposal to use geospatial data to help us identify particular patients and neighborhoods at high risk for diabetes complications for interventions. That turned into the Durham Diabetes Coalition. The mission of the DDC was to translate known medical solutions into real world pathways.
What does the Durham Diabetes Coalition do?
The Durham Diabetes Coalition and the Southeastern Diabetes Initiative is a project whose mission is to reduce death and disability from diabetes. We use geospatial and secondary medical data analysis to identify patients and neighborhoods at high risk for costly complications. We offered patients at highest risk home visits with a nurse practitioner, social worker, and dietician. Those at medium or lower risk, we offered telephone coaching and awareness of community events. We partner with community efforts to increase awareness of the prevention and management of type 2 diabetes.
What is the best part of working with the Durham Diabetes Coalition?
I am particularly proud of our work with CAARE and the food pantry that we started with them. We were seeing huge amounts of food insecurity in Durham. A patient would show us her kitchen and there would be no food in the house, or there would be cupcakes or some other food that was not appropriate because that was what was at hand at the local food pantry. We worked with CAARE to set up a food pantry that offers only healthy food – low sodium, low sugar canned goods, vegetables, etc. When we started, it was only serving about 5 families. Now it serves over 30.
The food pantry complements the support groups and the consults, where we can sit down with patients and look at their log book to see how their blood sugar levels are doing and find out what challenges they are facing with their diabetes.
What is the most challenging part of working with the Durham Diabetes Initiative?
Poverty. We live in a society that does not treat everyone equally. We have lifesaving tools and medicines to manage diabetes, but I can’t affect change if my patients can’t afford those medications. We are looking now at how we might change government policies that will allow us to improve access to medications for those who can’t afford them.
Where does your volunteer spirit come from?
My parents are strong believers in public service. My dad was a congressman from South Carolina for 28 years. I grew up in South Carolina and then Washington DC where I volunteered in hospitals, group homes, nursing homes, and soup kitchens. I continued to volunteer in college and medical school, although I had to stop during residency because my schedule was too busy. Here in Durham I’ve continued to volunteer with groups such as the Junior League of Durham and Orange Counties, and the American Diabetes Association
You mentioned that you are involved with EPIC/MaestroCare. How did that come about?
When they were rolling out EPIC, they were looking for people who were comfortable using the computers and particularly the previous electronic health record. Initally, I helped providers learn and tailor the system for each person’s use. Then I also became a certified Epic Physician Builder I’ve been up to Wisconsin six times to learn about Epic. I enjoy it because it allows me to help people figure out quality assurance and research questions. I guess I just like solving problems, and this is one way to do it!
What do you do to take care of yourself?
I do strength training 2 hours a week at Functional Fitness in Chapel Hill. I take dance classes 3 hours a week with Tito Hernandez at North Carolina Theatre Conservatory. I take singing lessons with Sherry Lee Allen weekly and an acting class with Christine Heneghan weeky.. My husband David is a gastro-enterologist,. We have three children between the ages of 10 and 17 – Lily Jack, and Max. We spend a lot of time following their pursuits, which include chess, basketball, musical theater, and violin.
Our next big family affair will be a trip to New York to see the musical “Hamilton.” We managed to get tickets in the second to last row of the theater, but I don’t care that we are in the back of the theater. I can’t wait, because I’ve listened to the soundtrack hundreds of times.