Physician-tested tools can improve patients' health


Medical practices are trying to keep up with large numbers of patients who have type 2 diabetes and hypertension, and the numbers are expected to continue to grow. Fortunately, free turnkey tools are available for physicians to immediately use in their practices to help prevent and address these conditions in their patients.

Experts from the AMA's Improving Health Outcomes initiative explained how physicians can use these tools during a panel discussion at the 2015 AMA Annual Meeting. These resources are ready to be used today and can help practices improve practice workflow, meet regulatory requirements and earn continuing medical education (CME) credits.

Every year, the number of people who develop prediabetes—the precursor to type 2 diabetes—increases. Prevalence of the condition rose by about 51 percent between 2007 and 2012, according to a December study published in Diabetes Care.


“For patients and physicians, prediabetes should be a wakeup call,” said Namratha Kandula, MD (pictured right),  director of physician and patient engagement for the AMA’s Improving Health Outcomes initiative.

In 2012, the Centers for Disease Control and Prevention (CDC) launched the National Diabetes Prevention Program based on research led by the National Institutes of Health, which showed that individuals at high risk of developing type 2 diabetes who participated in structured lifestyle change programs saw a significant reduction in the incidence of the disease.  

The AMA spent the past year working with the YMCA of the USA and 11 physician practice pilot sites in four states to increase physician screening and testing for prediabetes, and referral of patients with prediabetes to diabetes prevention programs offered by local YMCAs, which use the CDC’s program. Medicare beneficiaries were able to participate in this program at no cost, thanks to an award from the Center for Medicare and Medicaid Innovation.

This work helped inform Prevent Diabetes STAT: Screen, Test, Act – Today, a multi-year AMA and CDC initiative that helps physicians refer patients to diabetes prevention programs in their communities and online. Prevent Diabetes STAT™ includes practical information on how to use an electronic health record (EHR) system to pull information on patients with prediabetes, patient-facing resources and sample telephone scripts and referral forms..

The AMA’s newly launched STEPS Forward website offers an interactive educational module to address preventing type 2 diabetes in your practice—earn CME credit and see how to make these tools work for you.

The number of hypertension-related deaths in the United States increased by 66 percent over the past decade, according to the CDC. To put that in perspective, the number of deaths from all other causes combined increased only 3.5 percent during that period.

“There has never been a more important time to improve blood pressure control,” said Michael Rakotz, MD (pictured left), director of chronic disease prevention for the AMA Improving Health Outcomes initiative.

Through this initiative, the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based blood pressure recommendations and provide practical tools for physician practices. The basis of this research led to a framework called the M.A.P. for achieving optimal hypertension control:

  • Measuring blood pressure accurately every time it’s measured
  • Acting rapidly to address high blood pressure readings
  • Partnering with patients, families and communities to promote self-management of high blood pressure

Get the three checklists (PDF) that make up the M.A.P. framework for use in your practice.

Here are some additional resources to help you improve your practice’s hypertension management:

Another module on the AMA STEPS Forward website also offers CME and shows how to apply the M.A.P. framework to help get your patients’ blood pressures under control.

Table of Contents

  1. Type 2 diabetes
  2. Hypertension