SRF037: Implementation of an integrated electronic referral to local Diabetes Prevention Programs in a family medicine clinic
Karen Scherr, MD, PhD; Matthew Geisz; Amy Ward, MA; Kat Combs, MPH; Siga Vasaitis, MHA; Susan Spratt; Anthony Viera, MD, MPH
Context: The Diabetes Prevention Program (DPP) is an evidence-based treatment that can prevent or delay development of diabetes, but is consistently underutilized. North Carolina has removed cost as a barrier but utilization remains low, at least partially due to the difficulty of the referral process and lack of clinician awareness. Objective: To develop and pilot a new electronic referral to local DPPs and to increase clinician knowledge about DPPs. Study Design: Observational, descriptive study with survey methodology. Setting: Family Medicine clinic within a large academic institution in the Southeastern United States. Population Studied: Clinicians within the family medicine clinic (residents, advanced practice providers, and attending physicians). Intervention: Relationships were established with individuals from multiple organizations, including providers, community organizations, payors, and DPP providers. A survey of family medicine residents (n=14) was used to determine which referral method would most effectively increase referrals. An integrated EHR referral to local DPPs was created, and a self-updating electronic prediabetes registry was developed to help identify patients eligible for a DPP. A clinician education campaign is being designed to inform clinicians about DPPs and the new referral process. A pre/post survey of clinicians will be used to evaluate for changes in clinician knowledge of DPPs and referral practices. Results: Ninety-eight percent of residents in the target clinic indicated an electronic referral would be moderately to extremely effective at increasing referrals to DPPs, compared to 38% and 43% for fax or phone, respectively (the current methods of referral). The prediabetes registry identified 1,753 patients within the target clinic who may benefit from a DPP. Several electronic referrals were placed in an initial pilot phase, and troubleshooting was performed. A more streamlined version of the EHR referral is currently being built and will be pilot tested soon. The clinician education campaign is anticipated to include paper materials, an announcement in the newsletter, and a lecture at a lunchtime seminar. The campaign is expected to increase clinicians’ knowledge of DPPs and their intentions to refer patients to the program. Conclusion: An electronic referral to local DPPs was created but requires additional refinement. A clinician education campaign is being developed to increase utilization of the new referral.