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‘Cost is core problem with healthcare’

Seeking records: Debbie Jones, chairwoman of the Bermuda Diabetes Association

A new diabetes centre will offer affordable medication and education under one roof, the Bermuda Diabetes Association said yesterday.

Debbie Jones, the chairwoman, said the organisation was “acutely aware of the urgent need to improve our healthcare offerings and to make diabetes healthcare more accessible and affordable”.

She was speaking after a 2017 report into patients with diabetes highlighted how chronically sick Bermudians fare worse in comparison with British diabetes patients.

Local residents and health IT specialists Sean and Jenny Riddell commissioned the study, which they said “clearly shows Bermudian diabetics are not receiving the effective preventive care they should”.

Ms Jones said “the first and foremost problem is that healthcare is so expensive”.

She added: “To this end we have embarked on an ambitious project of purchasing and renovating a building which when completed will be the Hilton Hill Diabetes Centre.

“It will house our enhanced pharmacy, which provides medicine for those with diabetes at an affordable price, and our diabetes education centre under one roof.”

She added: “Bermuda is a small island and it should be possible to make this island of ours an example of what good affordable accessible healthcare is all about.”

Ms Jones also backed the call for an island-wide electronic medical record system that would enable better monitoring — and risk assessment methods to identify at-risk patients before they got more ill.

She said: “An electronic health record is so important in so many ways.

“Ms Jones added: “In the UK there are guidelines called the Nice guidelines.

“These guidelines dictate what standard care patients should expect to receive and based on what is actually delivered to patients provides the basis for what physicians will be paid.

“Physicians have to fill out records of that visit in order to receive payment. However, that is the NHS and Bermuda is private but there should be some reporting mechanism in place that indicates whether the person with diabetes has received the standard of care.”

Ms Jones said standards of diabetes care were revised each year by organisations such as the American Diabetes Association, Diabetes UK and Diabetes Canada.

She added: “For example if a patient smokes and we know that smoking and diabetes is a ‘double whammy’ that patient should be sent to smoking cessation classes. That referral would be part of the electronic record. Similarly a newly diagnosed patient with type 2 diabetes should be sent for diabetes education and dietary advice. The electronic health record would provide the mechanism for monitoring.”

Ms Jones said an electronic record had been talked about for years but “certain sectors” were reluctant to go ahead with it.

She added: “The Bermuda Diabetes Association tried to introduce a diabetes electronic record years ago and the cost of implementation was given as the reason physicians’ offices were reluctant to do it.

“Legislation could and should alleviate that burden.”

Diabetes educator Sara McKittrick added that the report raised the issue that current structure does not reward GP practices for prevention and education which is grossly undervalued.

“This all becomes very relevant when we look at current healthcare costs being so high while not achieving the desired health outcomes that we could expect when it comes to diabetes management,” she said.

UPDATE: this article has been amended to make clear that Debbie Jones is the chairwoman of the Bermuda Diabetes Association and not the executive director