The Provincial Diabetes Program is a Government of Alberta–funded effort, led by Health Cities, aimed at transforming the prevention and management of type 2 diabetes through innovative solutions. The initiative will collaborate with care providers across Alberta to implement tools and care models that support both prevention and ongoing management of type 2 diabetes. Its goal is to validate and scale these solutions within primary care and strengthen the health system’s ability to address diabetes effectively.
The program envisions a future where Albertans can prevent complications from type 2 diabetes through pathways that are:
This initiative focuses on six key areas, working toward improved health outcomes, equitable care, and increased access for Albertans at risk of or living with type 2 diabetes. It does this by supporting effective management for those already diagnosed and helping to prevent or delay the onset of type 2 diabetes for those at risk.
The program is structured across five strategic phases, ensuring real-world input, measurable results, and scalable insights. The timeline reflects our commitment to responsive design, collaborative delivery, and system-wide impact.
Identify key diabetes management challenges or needs and develop novel care pathways.
Goal: Understand gaps in diabetes care, gather insights, and design patient-centered pathways.
Identify innovative solutions to enhance diabetes management by addressing specific needs or gaps.
Goal: Select feasible, effective, and patient-aligned solutions ready for testing.
Test and evaluate new care pathways and technologies with multiple primary care hubs.
Goal: Operationalize promising pathways and solutions in real-world primary care settings.
Scale and validate the program with additional targeted primary care hubs from across Alberta.
Goal: Demonstrate effectiveness and adaptability across diverse care environments.
Analyze findings, create policy recommendations, and disseminate results through reports, publications, and more.
Goal: Generate evidence to inform decision-making, guide practice, and support system-wide adoption.
The Provincial Diabetes Program is a technology-enabled, team-based care initiative designed to prevent and manage Type 2 diabetes across Alberta. Targeting individuals either at risk or already diagnosed, the program leverages virtual tools, innovative care models, and Primary Care Networks (PCNs) to improve access to care, strengthen self-management, and enhance long-term health outcomes. Building on the success of Health Cities’ virtual home health monitoring initiatives, the program develops scalable solutions that align with provincial strategies, support healthier communities, and advance more connected, efficient, and patient-centered care.
View the individual Program initiatives below.
The Alberta Health Virtual Diabetes Project is a technology-enabled, team-based care initiative designed to support the prevention and management of Type 2 diabetes, led by Health Cities in partnership with the Camrose Primary Care Network (PCN). Delivered as part of Alberta’s broader Provincial Diabetes Program, the project brings together virtual health tools and frontline primary care teams to improve access to care, strengthen patient self-management, and support better long-term health outcomes for people living with, or at risk of, diabetes.
The project builds on the proven success of earlier virtual home health monitoring initiatives, using lessons learned to design a scalable, patient-centred model that integrates seamlessly into existing primary care pathways. At the core is a team-based care model that integrates remote health monitoring technology with primary care services. Patients are supported to track key health information from home, enabling care teams to monitor progress, identify issues earlier, and target support to individual needs.
Through this initiative, Albertans will be supported through a virtual diabetes care model that emphasizes accessibility, consistency, and supports people to take an active role in their health.
Learn about the HHM Project
The Alberta Health Virtual Diabetes Project is a technology-enabled, team-based care initiative designed to support the prevention and management of Type 2 diabetes across Alberta. Delivered in partnership with Kalyna Country Primary Care Network (PCN) and Health Cities, the program combines virtual health tools with primary care expertise to improve access to care, support self-management, and enhance overall health outcomes for people living with, or at risk of, diabetes.
The program builds on the success of earlier virtual home health monitoring initiatives, leveraging the CloudDx Home Health Monitoring platform to monitor patient health remotely and enable care teams to provide timely, personalized support.
By integrating virtual monitoring technology with team-based care, the program aims to reduce barriers to care, strengthen patient engagement, and provide actionable insights to improve chronic disease management. The project also contributes to broader provincial efforts to enhance health system efficiency, support healthier communities, and establish a scalable model for virtual diabetes care across Alberta.
The Big Horn PCN HHM & CGM Project is a virtual care initiative focused on improving the management of diabetes through the use of home health monitoring (HHM) and continuous glucose monitoring (CGM) technologies. Delivered as part of Alberta’s broader Provincial Diabetes Program, the project explores how virtual tools can be integrated into primary care to support people living with diabetes in more proactive, connected, and accessible ways.
Led by Big Horn Primary Care Network (PCN) in partnership with Health Cities, the project brings together primary care teams and digital health technologies to test and validate innovative care models for diabetes management. By enabling patients to monitor key health information from home and share it with their care team, the project supports more timely insights, informed clinical decision-making, and stronger continuity of care.
This multi-phase initiative is designed to build the foundational elements needed for longer-term virtual diabetes management within primary care. Early phases focus on learning what works— clinically, operationally, and from a patient experience perspective— to inform future scale and broader adoption across Alberta.
By contributing to the Provincial Diabetes Program, the Big Horn PCN HHM & CGM Project supports a shared provincial effort to improve outcomes for people living with diabetes, reduce barriers to care, and advance sustainable, technology-enabled care models that strengthen communities and the health system overall.
The Big Horn PCN Virtual Primary Care Solution is a virtual care initiative focused on improving access to primary care for people living with diabetes, particularly previously unattached patients who do not have a regular primary care provider. Delivered as part of Alberta’s broader Provincial Diabetes Program, the project explores how virtual primary care models can strengthen continuity of care and support better diabetes management.
Led by Big Horn Primary Care Network (PCN) in partnership with Health Cities, the project uses virtual care technologies to connect patients referred through the Diabetes Program to primary care services. By reducing barriers such as geography, provider availability, and wait times, the initiative aims to improve timely access to care while supporting more coordinated, team-based management of diabetes.
The project is designed as a phased initiative, with early stages focused on testing and validating the effectiveness and scalability of virtual primary care for this patient population. Insights from this work will help inform how virtual primary care can be integrated alongside existing services and expanded to support broader provincial goals.
By contributing to the Provincial Diabetes Program, the Big Horn PCN Virtual Primary Care Solution supports a shared effort to improve health outcomes, enhance access to care, and advance sustainable, technology-enabled care models that better meet the needs of people living with diabetes across Alberta.
Project Overview
The Crowfoot Village Family Practice (CVFP) Diabetes Care Management Project is a team-based initiative designed to improve the delivery of diabetes care through standardized workflows and enhanced appointment preparation. Delivered in partnership with CVFP and Health Cities, the project focuses on creating more coordinated, proactive, and patient-centered care for individuals living with diabetes.
The project is implemented in two phases: Phase 1 establishes a standardized Diabetes Management Care Pathway for the clinical team, clarifying visit planning, follow-up intervals, documentation standards, and care team roles. Phase 2 introduces a digital appointment preparation tool that helps patients and providers organize relevant health information, improving workflow efficiency and ensuring more productive diabetes-related visits.
By combining structured care pathways with digital support tools, the project aims to enhance patient engagement, streamline clinical workflows, and improve both patient and provider experience. This initiative contributes to Alberta’s Provincial Diabetes Program by testing scalable approaches to team-based, technology-enabled diabetes care that can be adapted across primary care settings in the province.
The Palliser PCN Virtual Diabetes Monitoring Project is a technology-enabled initiative designed to improve ongoing monitoring and management for patients living with diabetes. Delivered in partnership with Palliser Primary Care Network (PCN) and Health Cities, the project uses remote monitoring devices and digital tools to help patients track key health metrics from home and share this information with their care teams.
The project will pilot a workflow that allows patients to upload health data, such as blood glucose, blood pressure, and weight, in PDF format directly to their clinic’s EMR portal. The initiative has opened a call for innovation to identify the best software solutions for data capture and integration with patient devices.
By combining virtual monitoring technology with primary care support, the Palliser PCN Virtual Diabetes Monitoring Project aims to enhance patient engagement, improve access to care for those living in rural and remote areas, and provide actionable insights to strengthen chronic disease management. The project contributes to Alberta’s Provincial Diabetes Program by testing scalable virtual care solutions that can improve health outcomes and support healthier communities across the province.
View the Call for Innovation
The Traditional Birthing Centre Remote Digital Health Monitoring Project is a community-led initiative focused on improving maternal and metabolic health outcomes in Indigenous communities. Delivered in partnership with Enoch Cree Nation Sovereign Health’s Traditional Birthing Program, My Normative, and Health Cities, the project pilots a culturally grounded, digitally enabled approach to gestational diabetes care.
This initiative centers Indigenous voices in health innovation by combining remote health monitoring, co-designed tools, and culturally relevant health literacy resources. Using a decentralized population surveillance model, the project captures real-world evidence (RWE) while adhering to OCAP (Ownership, Control, Access, and Possession) principles, ensuring ethical, community-led data stewardship.
By integrating technology with culturally grounded care, the project aims to empower First Nations mothers and families, enhance engagement in gestational diabetes management, and generate insights to inform both healthcare delivery and future research. The proof-of-concept will also create a scalable framework for expanding similar solutions to additional Indigenous communities, supporting broader health system innovation and stronger, healthier communities across Alberta.
Read the Project Announcement
Our team reviews all submissions and inquiries related to the Provincial Diabetes Program. We will follow up with proponents whose proposals show alignment and potential, or where further information is needed.
To contact our team directly, please email projects@healthcities.ca.
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