The authors were also eager to increase their DSMT services and realized that they needed to improve access. An important innovation was that they went beyond traditional models of DSMT delivery as a result of their system redesign; by integrating educators directly into offices, access to DSMT increased. It was demonstrated that DSMT delivered in the office has a positive effect on A1C levels along with PCPs and educators reporting other advantages that included included increased communication on management plans and CDE involvement in medication initiation and adjustments. Patients reported greater comfort with location and easy access to the educator for questions and problem solving. The intent is not to suggest that hospital-based programs be replaced or eliminated but that opportunities to support education and follow up in other settings are investigated.