Diabetes Hypertension Classes Engagement

Tri-City tries to call patients two times before the week of classes. Patients will agree to come, but don’t actually show up.

Any other organizations have ideas on how to engage patients to come to the diabetes classes?

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I’m tagging some teams that might have some ideas:
@Santa_Barbara @LA_LGBT @Serve_the_People @Tri_City @Western_Sierra @Native_American @Chapa-De

Hi @Tri_City, @La_Clinica. I am interested if outreaching to patients with care gaps helps re-ingage the patients in their care plans? Sometimes I feel more motivated to take care in myself if someone on my care team seems to be interested in my health (more than just checking a box or gaining a score for QIP).
Thanks, Séamus McChesney, Santa Rosa Community Health

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I wish I had a good answer for this. I know we try to get our providers to push our classes, and I think that helps. If anyone would like to speak with our Diabetes Program manager, I can get you in touch with her, she’s our best resource for this. Email me at bbettencourt@chapa-de.org if you’d like me to help with that connection.

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CommuniCare partnered with the local food bank and provides groceries and fresh veggies to patients who stay for a full diabetes group medical visit. We’ve seen increased attendance since starting the groceries, and we also still do one reminder call.


CMC sends out a text message reminder to patients who have registered. Typically patients bring their spouse/significant other to our diabetes group classes.

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thank you all for the great feed back I appreciate!!!


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That’s a great way! We started a Food Pharmacy here, maybe we can let them know they will receive free Groceries/produce if they attend? Thanks for sharing!

@bcano @caseym @Brandon.Bettencourt @evanp @aalvarez @Trushna-TriCity

Seeing that there’s interest in alternative methods of reaching patients, I wanted to share an upcoming CCI webinar on texting and how to use it to help with outreach, patient scheduling and managing your patient populations between visits:

Texting for Better Health

Join us on Feb. 15 at noon PT as we discuss texting. You will learn:

  • How to use texting in conjunction with patient scheduling.

  • How to use texting to engage and manage a complex patient population between visits.

  • How to use texting as an outreach tool for targeted populations.

This webinar latest installment of our digital health e-learning series. It’s hosted by Raven, CCI’s learning laboratory to discover, pilot, and connect digital health solutions.

DATE: Friday, Feb. 15, 2019

TIME: 12pm PST


Register Now


Ray Pedden
Strategy & Innovation Consultant
Center for Care Innovations

Julie Edgcomb
Ambulatory Services Administrator
Monterey County Health Department

Stephen Gutierrez
Chief Information Officer
Northeast Valley Health Corporation

Adriana Velez
Outpatient Services Manager
Monterey County Health Department