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Anne Tang M.D., FACP Chief, Bilingual Chinese Module Chief, Pharmacy & Therapeutics

Health Equity: Diabetes Care, Hypertension Control and Cancer Screening in the San Francisco Kaiser Permanente Chinese Clinic Population. Anne Tang M.D., FACP Chief, Bilingual Chinese Module Chief, Pharmacy & Therapeutics Kaiser Permanente San Francisco Medical Center.

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Anne Tang M.D., FACP Chief, Bilingual Chinese Module Chief, Pharmacy & Therapeutics

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  1. Health Equity: Diabetes Care, Hypertension Control and Cancer Screening in the San Francisco Kaiser Permanente Chinese Clinic Population Anne Tang M.D., FACP Chief, Bilingual Chinese Module Chief, Pharmacy & Therapeutics Kaiser Permanente San Francisco Medical Center

  2. Assessment of Health Care Needs of KPSF Chinese Population Patient Survey Results • Bilingual Chinese physicians and staff • Health Education Materials in Chinese • Interpreters • Convenience • Affordable

  3. The KPSF Bilingual Chinese Module (BCM) 15 Board Certified Primary Care Physicians 1 RN Diabetic Health Educator (DHE) 1 Complex Chronic Condition RN Case manager 1 Behavioral Medicine Specialist (BMS) 1 Clinical Health Educator (CHE) 1 Physical Therapist (PT) 15 Medical Assistants 1 Charge/Triage RN, ½ Unit Manager All physicians, staff, and allied professionals are bilingual The Module takes care of >20,000 Chinese patients Mission: To provide affordable, integrated, culturally appropriate high quality care to our Chinese members

  4. The KPSF Bilingual Chinese Module

  5. Chinese Module Diabetes Care

  6. 糖尿病食物金字塔 CHINESE FOOD PYRAMID FOR DIABETIC PATIENTS 脂肪，糖，酒，鹽及醬油 (盡量少用) • 肉類 • (每日二至三份) • 一份=(等於) • 2-3 安士瘦肉、家禽、或魚 • (一副紙牌的尺寸) •  1 湯匙花生醬 •  4 安士(1/2 碗)豆腐 •  1 隻蛋 Butter • 奶類 • (每日二至三份) • 一份=(等於) • 1 杯奶 • 1 杯脫脂及低糖的酸乳酪 • 1 杯加鈣豆奶(無附加糖) 豆奶 加鈣 乳酪 • 水果 • (每日二至四份) • 一份=(等於) • 1 個小的水果 • (如網球的大小) • ½ 個大水果 • ½ 杯果汁 • ¼ 碗乾果 • 蔬菜 • (每日三至五份) • 一份=(等於) • ½ 碗煮熟蔬菜 • 1 碗生蔬菜 • 穀物、豆類及含澱粉質較高的蔬菜 • (每日六至十一份) • 一份=(等於) • 1/3 碗飯、麵、米粉、粉絲 • ½ 碗熟豆、豌豆或粟米 • ½ 碗粥、熟麥片 • 1 片方麵包 • 1 個小饅頭 • 4 片雲吞皮 • 1/3 碗芋頭 • 4-6 小塊無鹽梳打餅乾 1碗=8安士 1杯=8安士 相等於一安士的肉

  7. 糖尿病的併發症 Diabetes Complications • 腎衰竭 • Kidneys(nephropathy) • 眼睛(視網膜病) • Eyes(Retinopathy) • 神經系統(足部問題) • Nerves(Neuropathy) • 血液循環(心臟及血管疾病) • Circulation (stroke, Heart Disease) • 傷口復原較慢 • Ability to heal from wounds • 牙齒(牙周病) • Teeth(Gum disease) • 性健康問題 • Sexual well being

  8. 護理糖尿病的四大要點 CORNERSTONES OF DIABETES CARE 健康的飲食習慣 Healthy Eating 自我監察 Self Monitor 運動 Exercise 藥物 Medications

  9. Chinese Module Hypertension Control

  10. Hypertension Control Program • Culturally competent integrated care by a team of health professionals • Health education in patients’ preferred language • Free drop-in with timely intervention and follow up • Enlisting patient partnership in their care • Chronic condition management program • Outcome data feedback to providers and staff • Community outreach to promote preventive care

  11. Hypertension Education

  12. 健康的外出飲食範例 • EXAMPLES OF EATING OUT IN A HEALTHY WAY

  13. Cancer Screening

  14. Colon Cancer Screening • FIT test packet sent to all patients > age 50 • Colon screening reminder on registration slip • Staff Reminder to do FIT test • Bilingual FIT test instructions • FIT test video in Cantonese/Mandarin • Community outreach

  15. Bilingual Preventive Care Information on Registration Slip

  16. Bilingual Physician Homepage

  17. Health Education Materials in Chinese • [ADVANCE DIRECTIVES] Advance Health Care Directive 醫療護理指示 • [BACK/ JOINTS ] Carpal Tunnel Syndrome - Prevention & Self Care Tip Sheet 腕骨隧道 Chronic Pain 慢性疼痛 Back Problem 如何克服你的背部問題 • [CUTS/BLEEDING ] Cuts 割傷 Nosebleeds 流鼻血 • [DIABETES] Diabetes Self-Care - SC 糖尿病自我護理 What is Type 2 Diabetes - SC 什麼是2型糖尿病 Diabetes Prevention - SC 預防糖尿病 Blood Sugar Control - SC 控制血糖

  18. Key Factors in Health Equity in KPSF Chinese Module Members • Culturally competent integrated care by a team of health professionals • Health education in patients’ preferred language • Timely intervention and follow up • Chronic condition management programs • Outcome data feedback to providers and staff & follow up • Service excellence and easy access • Health promotion in communities • Encourage member participation in preventive health

  19. Asian American & Pacific Islander (AAPI) Members • The AAPI group is the fastest growing group in the United States. Between 1990 and 2000 this population grew by 48%, from 6.9 million to 10.2 million. Currently, 12 million AAPI live in the US • AAPI includes Chinese, Japanese, Korean, Vietnamese, Filipino, South Asian, Pacific Islanders, South East Asian, Indonesian, and Malaysian • In 2025 approximately 50% of the patients with Diabetes 2 will be Asian American &Pacific Islander (AAPI) • AAPI members have marked health disparities that exist for each specific group.

  20. Next Steps • Share effective practices in culturally proficient care with other ethnic groups • Assess specific member needs in other ethnic groups • Implement specific effective practices to address assessed needs • Monitor specific outcomes to determine effectiveness

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