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UPMC like other health systems faces a number of challenges in  providing quality diabetes care.
In 2000, with a diabetes epidemic and escalating costs, UPMC leadership recognized the need to take a systems approach for improvements in diabetes care.
Some of our challenges included
Servicing a large population  across PA
We knew that 30% of our UPMC hospital admissions have a diabetes-related diagnosis
And other problems included poor adherence to guidelines, lack of integrated tech, poor reimbursement leading to lay off of nurse staff during budget cuts and a need to connect with the people in the communities that we served