Recorded live at the ADCES24 annual meeting, we sat down with Senior Manager of the Diabetes Education Program at HealthPartners, Erin L. DaRosa, MBA, RDN, LD, CDCES. Erin discussed how she showcases the value of the DCES specialty in her work and how you can speak the language of key stakeholders in your practice to articulate your value, as well as how to build trust and get a seat at the table.
Recorded live at the ADCES24 annual meeting, we sat down with Senior Manager of the Diabetes Education Program at HealthPartners, Erin L. DaRosa, MBA, RDN, LD, CDCES. Erin discussed how she showcases the value of the DCES specialty in her own work and how you can speak the language of key stakeholders in your practice to articulate your value, as well as how to build trust and get a seat at the table.
Interested in learning even more about highlighting your value? Check out our member-only Showcasing Your Value Toolkit for modules, tips, videos, handouts and more that will help you express your value to administrators, prescribers and people living with diabetes in your community: Showcase Value Toolkit
Learn more about HealthPartners here: HealthPartners – Top-Rated insurance and health care in Minnesota and Wisconsin
View a patient handout mentioned in the episode here: Diabetes Education: How an education visit can help you better understand and manage your diabetes (healthpartnersfiles.com)
Register to view ADCES24 on-demand sessions here: ADCES24 (adcesmeeting.org)
Kirsten Yehl
Hello, and welcome to ADCES's podcast, “The Huddle: Conversations with the Diabetes Care Team”. In each episode, we speak with guests from across the diabetes care space to bring you perspectives, issues, and updates that elevate your role, inform your practice, and ignite your passion. I'm Kirsten Yehl, Director of Research and Development at the Association of Diabetes Care & Education Specialists. We know that the DCES plays such a valuable role in the diabetes care space. But sometimes we may find it can be difficult to articulate that value in practice. I recently got to sit down with Erin DaRosa, Senior Manager of Diabetes Education at HealthPartners Health System in Minneapolis. She joined me live on the floor at this year's annual meeting to talk about how DCESs can showcase their value to stakeholders within their practice settings.
Please note that this episode was recorded at our booth in the exhibit hall, so you may hear some background noise throughout.
Erin, welcome to The Huddle.
Erin DaRosa
Thank you. Good to be here.
Kirsten
We're so happy to have you here, especially it's so exciting here at the conference. It's like there's so many things happening. It always kind of gets me jazzed up to talk about diabetes care and education.
Erin
Yeah, absolutely. And there's so much here to see and so much networking. It's been fun to meet people from across the country.
Kirsten
Absolutely and I think this is actually the first time you and I are talking face to face and started out this conversation which is why I pulled you over here to talk about value of the diabetes care and education specialist which is like always top of my mind because I don't think we talk about it enough but before we jump into that conversation, I just met you.
Erin
Yes.
Kirsten
I would love for maybe our listeners to hear a little bit more about you and how you got into the profession and what your interests are.
Erin
Yes, sure. Yeah, thanks for having me. My name's Erin DaRosa, and I am Senior Manager of Diabetes Education and HealthPartners. And I'm very fortunate to partner with the International Diabetes Center, so I have a lot of support there. We have 30 diabetes care and education specialists in our system, and we support primary care. And my background actually started clinically in type 1 in pediatric setting, so I had a really big passion for that community. And then went back to school for my MBA which was really fun and I got a special, it was an MBA particular to health care. So I was in my cohort with other clinicians and we were all very focused on health care. So through that, I ended up with the position that I have now, which is in this leadership position. And I'm very fortunate to have the support of my organization and they are very good at understanding the value of diabetes care and education specialist. So, my role is just to continue that and make sure that that communication is heard.
Kirsten
Okay, so you said MBA, which I think is very rare.
Erin
Yeah.
Kirsten
I guess when I think of MBA, I think of people that can quantify, see the big picture, can kind of bridge in the health care system from clinical to the business side. I think there is a business side of health care. What drove you to get your MBA?
Erin
I should probably back up and say that my very early career was in pharma. And so I kind of had a little bit of an interest in industry and in sales. And when I got my CDCES, I transitioned from sales more to a clinical role in pharma. So I've always had that kind of combination of interest in business and health care. And so this MBA that I had gotten, probably four or five years ago now was particular to health care. And so it really allowed me to dive into the health care industry and understand our system a little bit. But I will say that after I got my MBA, I think I felt it was even more confusing than when I went in. It's a complicated system for sure.
Kirsten
Yeah, sometimes it's like just keep it simple, know, keep it in the background. And even just talking to you earlier reminded me and now hearing your background, you're a translator. Right? Like you can translate the work that you do. And maybe we should just dive right into this. Maybe how do you translate the value to the finance people or to that C-suite or even the technology people in your organization? It sounds like that's what you do. I would love to hear.
Erin
Yeah, sure. Yeah, no, I do that. That is probably what I do most. I don't, the one part about my job that I miss is I don't see patients as much. I'm really focused on more of the strategy and supporting the team that I lead. But it is all about that. It is translation. And what I've learned along the way, and part of it is through the MBA, but also some through experience, is just to communicate with the person in the way that they need to be communicated with and trying to understand from their perspective what's important to them. So, as I make my business proposals for new FTE or I want to communicate the value of the diabetes care and education in the system, I'm looking at who I'm working with and my message changes based on that. As an example, if I'm working with the finance, I know that to them they are looking at margins and they are wondering what is the revenue and the expense piece of what we do. And so I'm very fortunate again to have that support, I have a finance partner that I work with and so he will help me understand a little bit more of where we are sitting and how that compares to other clinicians. For example, like a DCES doesn't necessarily make up a large margin, but we do sustain ourselves in our system anyway. And so what I have to then convey to the decision makers is though we don't create a large margin, we're not a profit center, we do bring value in a different way. And that's in our support of in our system, it's primary care for the most part. And so in primary care, we're noticing they're overworked, they're overburdened. A person with diabetes has 15 minutes with them sometimes and there's not a chance for them to get to everything. So when we are working with a patient, we can certainly bring that value in the fact that we can kind of continue the work that the primary care clinician started.
Kirsten
Okay, so I heard two things there that I wanted to dive into. One was: speak their language.
Erin
Yes.
Kirsten
Right, and that was the beginning. So you working with your finance person. So it's amazing that you have a partner that you can talk to. Because you got to learn the language first. Right? Okay, so you find somebody comfortable talking with, learn the language that then hopefully you can expand on. This idea of , okay, margins.
Erin
Yes.
Kirsten
I think this is big. And I'm not sure. Is every system unique in these margins, because I totally agree. I know that 99% of DCESs are in the same position that you're talking about. You don't have the margins, but you're supporting other people who have the margins. And they wouldn't have the margins they do if they weren't working with the DCES. Maybe you can walk us through, like even maybe tell a story, like how do you quantify that?
Erin
Yeah, well, one of the things that in conversations with my finance department that I learned, because he's of course trying to help me make the case for my position as well. And one of the things that I learned in our system anyway, that primary care, they were outperforming 10%. Their margins were up 10% than what they were predicting. And so the way then that I shifted my message was that because their margins are up, it's why we're seeing the referrals. I mean, we get so many referrals. And that obviously shows the value, the demand there from the primary care needing our support. But we have not yet aligned to what they're experiencing. So they're up and they're seeing more patients and they're, of course, making more volume. But we're not aligned with that yet and we're not able to yet support them with that demand, of course. But the other part, I think why we're seeing the demand is because when we go out to the primary care clinician and again, translate a message, it's that we can help support them and kind of shift the burden. And in that conversation, I oftentimes bring in the quintuple aim. And that particular one, it's the clinician experience. And so to alleviate the burden off of the primary care clinician, you could rely on a diabetes care and education specialist to kind of pick up, you know, where you leave off. And again, and be using some of the messaging that's created for us, the ADCES those four critical times to refer, you know, when they're first diagnosed, when there's a transition in care, when there's a complicating factor, or an annual assessment. So I'll communicate that, but then I'll say, basically, any time that you feel like you don't have enough time with a patient, refer to diabetes education. And so that's really helped increase our referrals, that consistent message. And we're just getting a lot of understanding from the primary care clinicians that they need us in that. And we're fortunate to be embedded in the primary care clinic, so they see us there too.
Kirsten
So that's unique, I think. And I want to jump into that in a second too. But one last question before we move on to that, being embedded in the primary care. How much of this, so I love the four critical times, you know that that's really an easy way. I know ADCES has developed this, really easy way to communicate what the diabetes care and education specialist does. Do you use that as a framework to tell people what you do?
Erin
What we created in our system is a couple pieces like a little marketing piece that talks about what it is that we do. And we have two, we have a clinician facing one, so it talks about what it is that we can do. We put some links to studies and things that support our work and that's all anything from medication management, diabetes technology. So we kind of bullet point all the things that we can do and then we put the four critical times to refer. So that's a very common message clinician facing. We also developed a piece, patient facing, that talks about what to expect. And for that piece that is kind of also, we say it's patient facing but in a way it's clinician facing because we want the clinician to set us up for success and let the patient know what it is that is gonna happen when they see us. Because I don't think every, when they hear diabetes education, a patient might think we're just gonna teach them a curriculum, and they don't really understand that it's gonna be a very person-centered approach. We're gonna, if the patient, in fact, the first question we ask is what do you wanna talk about today? And so then they usually, sometimes that goes in a medication direction, sometimes that goes in a nutrition direction, but all of that is covered in that patient ed piece so that the person knows what to expect.
Kirsten
That's actually fantastic. Now, is that shareable to anybody?
Erin
Yeah, we do have a link to it. I can certainly share it.
Kirsten
That's awesome. We can actually put it in the resources section. So I do want to jump into you said a couple of really important things. Primary care, 30 people.
Erin
Yeah.
Kirsten
That's pretty big. So it sounds like you're growing.
Erin
We are growing.
Kirsten
And when you walked over here and we started chatting, you were talking about even posting positions and how you do this. So I would love to hear, maybe your evolution, like did you evolve in endocrine and move to primary care? How did you grow to be the program you are and be as sustainable as you are?
Erin
I just feel very, very lucky that I had my predecessors. One of them was Jodi Lavin-Tompkins.
Kirsten
Hi, one of our favorites.
Erin
So she definitely set us up for success. And I think she had that vision early on of really what a DCES is. So, in that regards, we were just kind of ahead of the game. So that was awesome. The thing that I ended up inheriting was, of course, Jodi's team, but our organization merged with another and that also had a whole other, that was the International Diabetes Center.
Kirsten
That's right.
Erin
Yeah. So I was brought in with, along with another to grow this department. But I think in our experience of the value had already been set and so I'm just kind of building upon that. But using those skills that I learned through my MBA and its marketing, its talking the language, communicating the clinician language too because there are unique individuals that want to be communicated with evidence-based information as well. So kind of again translating that message to who you're talking to.
Kirsten
What you're weaving through or what I'm hearing you're weaving through is something that's just so important we don't always think about is to think about what that person in front of you needs to hear first. How are you going to connect with that person? How are you going to build trust? Maybe a person or a department, right?
Erin
Yeah.
Kirsten
How do you build that trust to like open the lines of communication before you even can think about what is the message I want to get to them?
Erin
Right. Yeah. Right. It's kind of finding out who those people are. I will say the other thing that I've learned, I think you hear no, but you hear it in different ways. Sometimes it's a lack of an email or a lack of a communication might be the no. And I've always tried to kind of not let that stop me, but maybe approach things in a different way. And I find myself also looking at the mission of the organization and their values and then trying to get on those committees and work with those people. And that's where we've really kind of established it's going back to basics and having those relationships.
Kirsten
Well, and if you get that seat at the table, work on those committees, you learn how they're communicating and then you can get your message right in. Right.
Erin
Yep.
Kirsten
Oh my gosh, Erin, this has been a wonderful conversation. I could talk forever about this, by the way. But before we leave, I wonder, do you have any final messages you want? If there was like one big thing about talking about the value in the health system, what would you want to leave with our listeners?
Erin
Oh my goodness. I just, I think back to kind of the good old days of when a patient had a lot of time with their physician. And I feel like in some ways we've preserved that with diabetes care and education specialists. And so I try to hold on to that as much as possible, that traditional DSMES, but at the same time with so much innovation happening, not being afraid to try new things and pilot things. It's been kind of what I think has really put us out front. But yeah, it's that communication and going back to basics and making sure you have a seat at the table.
Kirsten
And be fearless.
Erin
And be fearless.
Kirsten
Well, Erin, thank you so much again. I hope we can have a talk like this again sometime.
Erin
Absolutely.
Kirsten
Awesome. Well, enjoy the conference.
Erin
I will. Thank you.
Kirsten
Thank you for listening to this episode of The Huddle. Make sure to download the resources discussed on today's episode. You can find them linked in the show notes. And remember, being an ADCES member gets you access to many resources, education, and networking opportunities. Learn about the many benefits of ADCES membership at adces.org/join. The information on this podcast is for informational purposes only and may not be appropriate or applicable for your individual circumstances. This podcast does not provide medical or professional advice and is not a substitute for consultation with a health care professional. Please consult your health care professional for any medical questions.