First it’s a scarlet D, then O, H, C...

Did you hear that San Antonio Metro Health District has decided to create a surveillance program of the lab results on its residents to identify diabetics who aren’t keeping their indices to government-approved levels? Health officials there are initiating a program to make it mandatory that all laboratories electronically turn over hemoglobin A1c results (along with the people’s names, addresses and dates of birth) to its government agency for a database of diabetics.

Not surprisingly, they’ve bought the same technology sold to Vermont and New York City, Vermedx™ Diabetes Information System (VDIS), the largest diabetes registry service and recently recognized by the National Business Coalition on Health. It can electronically compile whatever labwork a government agency might wish, compare it with targeted numbers and initiate follow-up to both the people and doctors, simultaneously generating population reports for the government agency.

This same company has been lobbying hard to label diabetes “a crisis that is becoming an epidemic,” with journal articles claiming that one-third of people have diabetes and don’t know it, as well as many others with “prediabetes” in need of intervention and that there are major problems from lack of managed care and the inability of health insurers to monitor compliance with indices. The debates among doctors about this program and the conflicts of interest behind the “diabetes epidemic” were covered here, indicating a very different reality from the sales and marketing being given to the public.

Vermedx is already laying the groundwork for monitoring blood pressure, cholesterol, depression, health literacy, etc. and working to lay the plans for national public health surveillance of those with chronic diseases.

As the San Antonio Business Journal reports:

Metro Health steps up its fight against diabetes in San Antonio

The San Antonio Metropolitan Health District (Metro Health) selected Vermont Clinical Decision Support LLC to help the city launch its new diabetes intervention pilot program. The Burlington, Vt.-based company will deploy its patented Vermedx technology to create a city-based registry. Metro Health will also use the data to map the epidemiology of hyperglycemia, monitor the diabetes epidemic and initiate improvements. Vermont Clinical Decision Support CEO Benjamin Littenberg says Metro Health's program could improve the health of diabetes patients while reducing the total cost of care. The technology for the Vermedx Diabetes Information System was developed during the course of a five-year clinical trial funded by the National Institutes of Health...

San Antonio's pilot program is starting in May and will run over the next 18 months. It will involve at least 50,000 active diabetic patients and four major testing labs. Metro Health will present a detailed summary of the pilot program to the Texas Legislature in September 2009. If the pilot program is successful, state lawmakers may consider similar programs in other major Texas metropolitan areas.

Healthcare IT News also covered this development, adding its IT expertise:

Texas city uses IT to monitor "diabetes epidemic"

The San Antonio Metropolitan Health District has established a city-based registry to more closely monitor the south Texas city's "diabetes epidemic" and initiate improvements in care throughout the region. SAMHD officials say they intend to use data from the registry to map the epidemiology of hyperglycemia, keep a closer eye on the growing number of diabetes cases and ultimately improve the medical care of San Antonio's diabetic residents...

The Burlington, Vt.-based company will supply San Antonio with its Vermedx Diabetes Information System, or VDIS, a patented technology developed during the course of a five-year clinical trial funded by the National Institutes of Health. "We are delighted to have the opportunity to participate in a program with such far-reaching implications for improving the health of diabetes patients and reducing the cost of care," said Benjamin Littenberg, MD, CEO of Vermont Clinical Decision Support.

VDIS captures laboratory test results from multiple labs and automatically produces population summary reports and "report cards" at regional, community, provider and practice levels. The system also generates individual patient level health status reports with accompanying guideline-based recommendations for care....

The Texas Legislature initially directed the SAMHD to conduct a pilot program for capturing and analyzing the scope and nature of the diabetic populations as the basis for future interventions to curtail the growth of the epidemic in prevalence and cost. If the pilot proves successful, the Legislature plans to consider a similar program in other major Texas metropolitan areas.

Behind every “epidemic” claimed to need government intervention and oversight, you’ll find a lot more going on than objective measures of health problems.