In 2016 Hamad Medical Corporation (HMC) and the Primary Health Care Corporation (PHCC) joined forces to implement a pilot project known as ‘The SMART Clinic’. Two years later, over 4,500 individuals who were identified as being at high risk of developing Type 2 diabetes have been screened for the disease and those who were diagnosed are receiving treatment.
‘The SMART Clinic’, also known as the ‘Al Wakra Diabetes Pilot’, is thought to be the first initiative of its kind in the world and was established to help Qatar alleviate the diabetes epidemic. It aimed to restructure care pathways and improve the overall quality of care patients received by shifting the focus from treatment to prevention.
“In January 2016, the SMART team began comparing health records of individual patients to track diabetes-related risk factors, such as smoking, family history of diabetes, hypertension, and obesity. Those deemed to be at high risk of developing diabetes, approximately 5,000 individuals, were identified and invited to be screened,” said Professor Abdul-Badi Abou-Samra, Director of the Qatar Metabolic Institute (QMI) and Chairman of Internal Medicine at HMC.
Dr. Samya Al-Abdulla, Senior Consultant Family Physician and Executive Director of Operations at PHCC, led the program on behalf of her organization and said the initiative formalized an existing partnership while giving diabetes care providers a greater ability to deliver safe, high-quality care. She said the initiative demonstrates that primary and secondary care providers can effectively collaborate to improve the overall health of the population.
“A key purpose of this initiative was the early identification of preventable conditions, such as diabetes, as a strategy to maintain the health of the population and reverse the trend of high-cost long-term care required to treat these conditions. It is about ensuring care is provided at the right time, in the right setting,” said Dr. Al-Abdulla.
Dr. Al-Abdulla added; “Of those screened as part of the initial diabetes pilot project, 13 percent were diagnosed with diabetes, 21 percent were diagnosed as pre-diabetic, 80 percent were found to be overweight or obese, and 35 percent had borderline or high cholesterol levels.”
Professor Abou-Samra, who is also Co-Chair of the National Diabetes Strategy and led the pilot program in Al Wakra on behalf of HMC, said screening results were delivered during follow-up appointments with multi-disciplinary teams of physicians, dietitians, and health educators who provided guidance on how to manage the disease. He said patients were then directed to the right care pathway, as set out according to the National Diabetes Strategy.
In 2015, the Ministry of Public Health launched the National Diabetes Strategy, which aims to curb the rise in the incidence of dia¬betes and prevent the disease’s complications. The Strategy included the development of a care pathway, which places the patient within the healthcare system based on their stage of disease, co-morbidities, and the requirement for complex treatment.
Professor Abou-Samra attributes the pilot program’s success, and its lasting benefits, largely to the engagement of frontline staff who he says continue to be excited about the patient-driven focus that has led to overcoming organizational silos. Dr. Al-Abdulla echoed that sentiment.
“The SMART Clinic initiative complies with PHCC’s pledge to take forward the national vision for healthcare development in Qatar by providing excellence in healthcare services for the citizens of Qatar. The SMART health check service, which is a comprehensive risk-based screening and clinical management model for a range of chronic conditions, is available at all PHCC Health Centers. It acts as a gateway into the full range of primary healthcare services on offer at PHCC clinics and supports the population of Qatar in taking steps to maintain or improve their health,” added Dr. Al-Abdulla.
What began as a local outcome of the World Innovation Summit for Health (WISH), a global initiative of Qatar Foundation, has had a lasting impact. According to Dr. Al-Abdulla, today patients in Al Wakra are continuing to benefit from ‘The SMART Clinic’ with realigned resources now permanent features in the diabetes care services provided by both organizations.
Combined, HMC and PHCC provide care every month to over 30,000 patients with diabetes, with approximately 3,000 of those patients receiving specialized, complex care at HMC’s National Diabetes Centers in Al Wakra and Hamad General Hospitals and the Diabetes in Pregnancy Clinic at the Women’s Wellness and Research Center.