scholarly journals The Impact of a Decision Support Tool Linked to an Electronic Medical Record on Glycemic Control in People with Type 2 Diabetes

2013 ◽  
Vol 7 (3) ◽  
pp. 653-659 ◽  
Author(s):  
Waruna Gunathilake ◽  
Sajith Gunawardena ◽  
Ranga Fernando ◽  
George Thomson ◽  
Devaka Fernando
Keyword(s):  
Type 2 Diabetes ◽  
Decision Support ◽  
Glycemic Control ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Decision Support Tool ◽  
Support Tool ◽  
The Impact

scholarly journals Improving Management of People with Type 2 Diabetes Using Digital Tools (Preprint)

2020 ◽  
Author(s):  
Richard Milani
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Usual Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Home Based ◽  
Digital Medicine ◽  
One Year ◽  
The Impact

BACKGROUND Diabetes is present in 10.5% of the U.S. population and accounts for 14.3% of all office-based physician visits made by adults. Despite this established office-based approach, the disease and its adverse outcomes, including glycemic control and clinical events, tend to worsen over time. Available home technology now provides accurate, reliable data that can be transmitted directly to the electronic medical record. OBJECTIVE To evaluate the impact of a virtual, home-based diabetes management program on clinical measures of diabetes control compared to usual care. METHODS We evaluated glycemic control and other diabetes-related measures after one year in 763 patients with type 2 diabetes enrolled into a home-based digital medicine diabetes program and compared them to 794 patients matched for age, sex, race, BMI, A1C, creatinine, eGFR, and insulin use in a usual care group after one year. Digital medicine patients completed questionnaires on-line, received medication management and lifestyle recommendations from a clinical pharmacist or APP and a health coach, and were asked to submit blood glucose readings using a commercially available Bluetooth enabled glucose meter that transmitted data directly to the electronic medical record. RESULTS After one-year, usual care patients demonstrated no significant changes in A1C (7.3±1.7 to 7.3±1.6; P =.41), or in the proportion of patients with A1C ≥ 9.0 (15% to 14%; P = .51). Digital medicine patients demonstrated improvements in A1C (7.3±1.5 to 6.9±1.2; P <.001), the proportion of patients with A1C ≥ 9.0 (14% to 6%; P <.001), diabetes distress (26% to 16%; P <.001), and in hypoglycemic episodes (41.1% to 11.9%; P <.001). CONCLUSIONS A digital diabetes program is associated with significant improvement in glycemic control and other diabetes measures. Utilization of a virtual health intervention using connected devices was widely accepted across a broad range of ethnic diversity, ages, and levels of health literacy.

scholarly journals Impact of an Electronic Medical Record-Based Clinical Decision Support Tool for Dysphagia Screening on Care Quality

Stroke ◽  
2012 ◽  
Vol 43 (12) ◽  
pp. 3399-3401 ◽  
Author(s):  
Kamakshi Lakshminarayan ◽  
Nassir Rostambeigi ◽  
Candace C. Fuller ◽  
James M. Peacock ◽  
Albert W. Tsai
Keyword(s):  
Decision Support ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Care Quality ◽  
Support Tool ◽  
Clinical Decision Support Tool

scholarly journals Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record

10.2196/17785 ◽  
2020 ◽  
Vol 4 (9) ◽  
pp. e17785
Author(s):  
Breanne E Kunstler ◽  
John Furler ◽  
Elizabeth Holmes-Truscott ◽  
Hamish McLachlan ◽  
Douglas Boyle ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Decision Support ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Clinical Decision Support ◽  
Pharmacological Treatment ◽  
Design Method ◽  
Clinical Decision ◽  
Treatment Intensification

Background Managing type 2 diabetes (T2D) requires progressive lifestyle changes and, sometimes, pharmacological treatment intensification. General practitioners (GPs) are integral to this process but can find pharmacological treatment intensification challenging because of the complexity of continually emerging treatment options. Objective This study aimed to use a co-design method to develop and pretest a clinical decision support (CDS) tool prototype (GlycASSIST) embedded within an electronic medical record, which uses evidence-based guidelines to provide GPs and people with T2D with recommendations for setting glycated hemoglobin (HbA1c) targets and intensifying treatment together in real time in consultations. Methods The literature on T2D-related CDS tools informed the initial GlycASSIST design. A two-part co-design method was then used. Initial feedback was sought via interviews and focus groups with clinicians (4 GPs, 5 endocrinologists, and 3 diabetes educators) and 6 people with T2D. Following refinements, 8 GPs participated in mock consultations in which they had access to GlycASSIST. Six people with T2D viewed a similar mock consultation. Participants provided feedback on the functionality of GlycASSIST and its role in supporting shared decision making (SDM) and treatment intensification. Results Clinicians and people with T2D believed that GlycASSIST could support SDM (although this was not always observed in the mock consultations) and individualized treatment intensification. They recommended that GlycASSIST includes less information while maintaining relevance and credibility and using graphs and colors to enhance visual appeal. Maintaining clinical autonomy was important to GPs, as they wanted the capacity to override GlycASSIST’s recommendations when appropriate. Clinicians requested easier screen navigation and greater prescribing guidance and capabilities. Conclusions GlycASSIST was perceived to achieve its purpose of facilitating treatment intensification and was acceptable to people with T2D and GPs. The GlycASSIST prototype is being refined based on these findings to prepare for quantitative evaluation.

scholarly journals Impact of Point-of-Care Decision Support Tool on Laboratory Screening for Comorbidities in Children with Obesity

Children ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. 67
Author(s):  
Tara K. Kaufman ◽  
Natalie Gentile ◽  
Seema Kumar ◽  
Marian Halle ◽  
Brian A. Lynch ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Decision Support ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Point Of Care ◽  
Decision Support Tool ◽  
Support Tool ◽  
Care Decision

Background: Childhood obesity is associated with dyslipidemia, fatty liver disease, and type 2 diabetes. Expert guidelines recommend screening for these conditions in children with obesity. Aims and objectives: The objective of the study was to compare rates of laboratory screening for dyslipidemia, fatty liver disease, and type 2 diabetes in children with obesity prior to and following implementation of a point-of-care decision support tool. Methods: We performed a retrospective record review of children with body mass index (BMI) ≥95th percentile for age and gender (age 7–18 years) undergoing well-child/sports examination visits. Multivariable logistic regression models were used to adjust for patient and provider confounders. Results: There was no increase in the rates of screening following implementation of the point-of-care decision support tool. Tests were more likely to be recommended in children with severe obesity and in females. Conclusions: The implementation of a point-of-care decision support tool was not associated with improvement in screening rates for dyslipidemia, fatty liver disease, and type 2 diabetes for children with obesity. Further strategies are needed to improve rates of screening for obesity-related comorbid conditions in children with obesity.

scholarly journals A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes

2015 ◽  
Vol 17 (3) ◽  
pp. 194-202 ◽  
Author(s):  
F. Javier Ampudia-Blasco ◽  
Pierre Yves Benhamou ◽  
Guillaume Charpentier ◽  
Agostino Consoli ◽  
Michaela Diamant ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Decision Support ◽  
Decision Support Tool ◽  
Glucose Lowering ◽  
Support Tool ◽  
Lowering Therapy ◽  
Glucose Lowering Therapy

scholarly journals Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record (Preprint)

2020 ◽  
Author(s):  
Breanne E Kunstler ◽  
John Furler ◽  
Elizabeth Holmes-Truscott ◽  
Hamish McLachlan ◽  
Douglas Boyle ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Decision Support ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Clinical Decision Support ◽  
Pharmacological Treatment ◽  
Design Method ◽  
Clinical Decision ◽  
Treatment Intensification

BACKGROUND Managing type 2 diabetes (T2D) requires progressive lifestyle changes and, sometimes, pharmacological treatment intensification. General practitioners (GPs) are integral to this process but can find pharmacological treatment intensification challenging because of the complexity of continually emerging treatment options. OBJECTIVE This study aimed to use a co-design method to develop and pretest a clinical decision support (CDS) tool prototype (GlycASSIST) embedded within an electronic medical record, which uses evidence-based guidelines to provide GPs and people with T2D with recommendations for setting glycated hemoglobin (HbA1c) targets and intensifying treatment together in real time in consultations. METHODS The literature on T2D-related CDS tools informed the initial GlycASSIST design. A two-part co-design method was then used. Initial feedback was sought via interviews and focus groups with clinicians (4 GPs, 5 endocrinologists, and 3 diabetes educators) and 6 people with T2D. Following refinements, 8 GPs participated in mock consultations in which they had access to GlycASSIST. Six people with T2D viewed a similar mock consultation. Participants provided feedback on the functionality of GlycASSIST and its role in supporting shared decision making (SDM) and treatment intensification. RESULTS Clinicians and people with T2D believed that GlycASSIST could support SDM (although this was not always observed in the mock consultations) and individualized treatment intensification. They recommended that GlycASSIST includes less information while maintaining relevance and credibility and using graphs and colors to enhance visual appeal. Maintaining clinical autonomy was important to GPs, as they wanted the capacity to override GlycASSIST’s recommendations when appropriate. Clinicians requested easier screen navigation and greater prescribing guidance and capabilities. CONCLUSIONS GlycASSIST was perceived to achieve its purpose of facilitating treatment intensification and was acceptable to people with T2D and GPs. The GlycASSIST prototype is being refined based on these findings to prepare for quantitative evaluation.

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