At a Dec. 3 award ceremony in Monterey, the institute honored San Francisco General Hospital (SFGH) for its Improving Diabetes Efforts Across Language and Literacy (IDEALL) project, which ran from 2003 to 2006 and was based at the UCSF Center for Vulnerable Populations at the UCSF-affiliated hospital.

The project enrolled 339 patients with type 2 diabetes, many of whom had limited literacy skills and limited English proficiency. Participants were randomly assigned to one of three groups — automated telephone diabetes self-management, group medical visits or standard care — and were followed for a period of one year.

Patients in the telephone group received weekly automated phone calls in their native language, asking them about their self-care behaviors, such as medication adherence and diet, as well as their psychological and emotional well-being. Patients responded using touch-tone commands, and any response that raised red flags was immediately followed by a call from a nurse care manager who spoke the patient’s primary language.

The telephone system proved superior to group-oriented support and standard care in terms of patient engagement, improved diabetes-related health outcomes, and patient safety, Schillinger and his team found. The technology was also highly cost-effective.