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SPHERE was launched in January 2007. Using EMTs (first responders), SPHERE targets two massive public health problems: Hypertension and Diabetes. It helps identify new cases of each disease as well as identifies patients whose hypertension or diabetes is out of control. Often times the patient does not know that he or she has any one or both of these problems. The concept is to obtain clinical information and feeding it back to the patient in a useful and consistent fashion. Pilot data indicates that 80% of patients identified with blood pressure >=160 or >=100 already knew they had hypertension. But these patients clearly are not in good blood pressure control and need to see their doctor for better control. Thus of the eligible patients approximately 20% may be new cases. SPHERE encourages EMTs to screen all reasonable patients for diabetes. We know that risk factors for diabetes are overweight, older, and having a first degree relative with diabetes. Currently 20 million Americans have diabetes (85% are type II diabetes). This is 7% of the population. It is estimated that an additional 2% (another 6-7 million) have type II diabetes and do not know it. Does SPHERE work? Information from pilot studies in King County indicates that 65% of patients who receive alert cards follow up with a health care provider. 95% of patients appreciated the firefighters for giving them the alert card. EMS sees almost 10% of the population in any given year. This is a golden opportunity to reach out and help identify and control the major public health diseases of hypertension and diabetes. Furthermore EMS provides services to a disproportionate share of the underinsured population, people who may not have good access to medical screening. |
