ArticleJournal of general internal medicine2026
Implementing Advanced Comprehensive Diabetes Care Within the Veterans Affairs Learning Health System.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care : A Pragmatic, Randomized, Effectiveness-Implementation Trial.Annals of internal medicine · 2026Trial
- Advancing the Science and Application of Learning Health Systems in General Medical and Primary Care Practice.Journal of general internal medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
backgroundTelehealth can improve glycemic control for patients with type 2 diabetes (T2D), but programs must be designed in a manner that facilitates real-world uptake and effectiveness within learning health systems (LHS).
objectiveTo highlight how the Veterans Affairs (VA) LHS supports real-world practice change by examining Advanced Comprehensive Diabetes Care (ACDC), a telehealth program for persistently poor T2D control, in the context of the Learning Health System Consolidated Framework (LHS-CF) taxonomy.
designEvaluation of program implementation within an LHS.
participantsN = 1154 real-world ACDC participants
interventionsACDC is a 6-month program that leverages widely available VA telehealth infrastructure to deliver telemonitoring, self-management support, and medication management. MAIN MEASURES: In applying the LHS-CF, we accessed clinical hemoglobin A1c (HbA1c) data, examined ACDC encounter completion, and interviewed participants and staff. KEY
resultsACDC's development benefited from LHS-CF Enabling Conditions, including a workforce prepared to engage in structured learning and quality improvement; well-developed clinical data systems; strong VA investments in innovation; and a collaborative culture. Consequently, ACDC has contributed to multiple LHS-CF-aligned Bodies of Work, including building new evidence to improve T2D outcomes; translation of effective, telehealth-based T2D care into practice; authentic engagement of partners; ongoing analyses of data to support effective care; and development of new approaches to foster innovation and improvement. In practice, ACDC has reduced HbA1c from 9.7% at baseline to 8.0% at 6 months (-1.7%, 95% CI -1.7, -1.6, p < 0.0001), with retention of this benefit at 4 years; the program has been delivered with good fidelity and has been valued by participants and staff.
conclusionsThe conditions created by VA's LHS facilitate the development, testing, and implementation of programs like ACDC, which promote further LHS success. As a result of its intentional development within VA's LHS, ACDC is well-positioned to improve outcomes for Veterans with poorly controlled T2D nationwide.
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Registered trials
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